baby movements during pregnancy

Baby Movements During Pregnancy

What are normal movements for a baby during pregnancy?

Most women first feel their baby moving when they are 18–20 weeks pregnant. However, if this is their first pregnancy, they may not become aware of baby movements until they are more than 20 weeks pregnant. If they have been pregnant before, they may feel movements as early as 16 weeks. Pregnant women feel their unborn baby’s movements as a kick, flutter, swish or roll.

As your baby develops, both the type and number of movements will change with your baby’s activity pattern. Usually, afternoon and evening periods are times of peak activity for the baby. During both day and night, the baby has sleep periods that mostly last between 20 and 40 minutes, and are rarely longer than 90 minutes. Your baby will usually not move during these sleep periods.

The number of movements tends to increase until 32 weeks of pregnancy and then stay about the same, although the type of movement may change as you get nearer to your due date. Often,

if you are busy, you may not notice all of these movements. Importantly, you should continue to feel your baby move right up to the time you go into labor. Your baby should also move during labor.

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Why are my baby movements in pregnancy important?

During your pregnancy, feeling your baby move gives you reassurance of his or her wellbeing. If you notice your baby is moving less than usual or if you have noticed a change in the pattern of movements, it may be the first sign that your baby is unwell and therefore it is essential that you contact your midwife or local maternity unit immediately so that your baby’s well being can be assessed.

How many movements are normal?

There is no specific number of movements which is normal. During your pregnancy, you need to be aware of your baby’s individual pattern of movements. A reduction or a change in your baby’s movements is what is important.

What factors can affect my baby movements?

You are less likely to be aware of your baby’s movements when you are active or busy. If your placenta is at the front of your uterus, it may not be so easy for you to feel your baby’s movements. Your baby lying head down or bottom first will not affect whether you can feel it move. If your baby’s back is lying at the front of your uterus, you may feel fewer movements than if his or her back is lying alongside your own back.

What can cause my baby to move less?

Certain drugs such as strong pain relief or sedatives can get into an unborn baby’s circulation and can make your baby move less. Alcohol and smoking may also affect your baby’s movements. In some cases, a baby may move less because he or she is unwell. Rarely, a baby may have a condition affecting the muscles or nerves that causes him or her to move very little or not at all.

What if I am unsure about my baby’s movements?

If you are unsure whether or not your baby’s movements are reduced, you should lie down on your left side and focus on your baby’s movements for the next two hours. If you do not feel ten or more separate movements during these two hours, you should take action (see below).

What should I do if I feel a reduction or change in my baby’s movements?

It is crucial to seek professional assistance promptly in such situations. Ignoring a decrease in your baby’s movements, especially before going to sleep, is not advisable. It is strongly discouraged to completely rely on home kits for monitoring your baby’s heartbeat. The recommended course of action in response to changes in fetal movements depends on the stage of pregnancy:

  • Less than 24 weeks pregnant: In the initial stages of pregnancy, particularly before reaching 24 weeks, it’s common for women to become aware of their baby’s movements around 18 to 20 weeks. If, by the 24th week, an expectant mother has not felt any movements, it is advisable to contact the midwife. A thorough check of the baby’s heartbeat will be conducted, and if necessary, an ultrasound scan may be arranged. Referral to a specialist fetal medicine center might also be considered to ensure the baby’s overall well-being.
  • Between 24 and 28 weeks pregnant: During this mid-stage of pregnancy, contacting the gynecologist is recommended if there is a perceived reduction or change in the baby’s movements. The gynecologist will conduct a comprehensive antenatal check-up, encompassing various assessments such as measuring the size of the uterus, checking blood pressure, and testing urine for protein. If the uterus measures smaller than expected, an ultrasound scan may be arranged to assess the baby’s growth and development.
  • Over 28 weeks pregnant: If an expectant mother is over 28 weeks pregnant and notices reduced or changed fetal movements, immediate contact with the gynecologist or the hospital is essential. Delays in seeking help are strongly discouraged. A full antenatal check-up will be conducted, including a thorough examination of the baby’s heartbeat. Continuous monitoring of the baby’s heart rate, usually for at least 20 minutes, aims to provide reassurance about the baby’s well-being. Observing the increase in the baby’s heart rate during movement can further reassure the expectant mother. Once reassured, the mother can usually return home. Additionally, an ultrasound scan may be arranged to evaluate the baby’s growth and the amniotic fluid if there are concerns about the pregnancy. This scan is typically performed within 24 hours of being requested.

These investigations conducted in response to perceived changes in fetal movements are designed to provide reassurance about the overall health and well-being of both the mother and the baby. It is noteworthy that the majority of women who experience a single episode of reduced fetal movements go on to have a straightforward pregnancy, delivering a healthy baby.

If there are any lingering concerns about the baby’s well-being, your doctor and midwife will discuss this with you. Follow-up scans may be arranged to monitor the baby’s development closely. In certain circumstances where concerns persist, the medical team might advise that it would be safer for the baby to be born as soon as possible. The decision for early delivery depends on the individual circumstances of the mother and the stage of the pregnancy.

What should I do if I find my baby’s movements are reduced again?

It’s crucial to remain vigilant about fetal movements even after going home following an assessment. Expectant mothers are advised to keep a watchful eye on their baby’s movements, and if there is another episode of reduced movements, immediate contact with the gynecologist is once again necessary. Seeking professional advice promptly is emphasized, regardless of how many times such situations occur. Continuous communication with the gynecologist ensures ongoing monitoring and proactive care to safeguard the health and well-being of both the mother and the developing baby throughout the pregnancy journey.

Author

Dr Sobia Mohyuddin

MCPS, FCPS, MRCOG, Consultant Obstetrics & Gynaecology

Doctor Sobia Mohyuddin is a highly skilled and experienced Obstetrician and Gynecologist, with 25 years of training and experience in renowned, large institutions. She holds the position of Associate Professor and Fellow at the College of Physicians and Surgeons Pakistan. She is also a member of the Royal College of Obstetricians and Gynecologists (UK).