New advice for pregnant women on how much a baby moves in pregnancy has been published recently by the Royal College of Obstetricians and Gynaecologists (RCOG).
The patient information Your baby’s movements in pregnancy: information for you, gives advice about what are normal movements for an unborn baby in pregnancy and may also be useful for those who feel their baby’s movements have reduced or changed in pattern.
So what are normal movements for an unborn baby in pregnancy? From about 18-20 weeks most women will first become aware of their baby moving; however for first-time mothers this might not happen until after 20 weeks. For mothers having their next child movements can start as early as 16 weeks.
As the weeks pass and the baby grows the number and type of movements will change. The movements will feel like a kick, flutter, swish or roll. Peak activity times for a baby tend to be during the afternoon and evening. During both day and night, babies have sleep periods that can vary between 20 and 40 minutes, but are rarely longer than 90 minutes. During this time a baby will usually not move.
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 closer to the due date. Often busy mothers do not notice all of these movements; however, women should continue to feel their baby move right until giving birth.
Being aware of the baby’s movements is important because it reassures women that their baby is well. Any reduction or change in movements may be the first sign that the baby is unwell and concerned mothers should contact their midwife or local maternity unit immediately. Women should never go to sleep ignoring a reduction in their baby’s movements. They should not rely on any home kits they may have for listening to their baby’s heartbeat.
Factors which can lead to reduced movements include certain drugs such as strong pain relief or sedatives, alcohol, smoking and in some cases, a baby may move less because they are unwell. Rarely, a baby may have a condition affecting the muscles or nerves that causes very little or no movements.
Women who are unsure should lie down on their left side and focus on their baby’s movements for the next two hours. If there are less than ten separate movements during this time, action should be taken to assess if there are any problems.
If a woman is concerned she should contact her midwife or local maternity unit. If professional advice is sought, the care a woman will receive will depend on the stage of pregnancy. Women less than 24 weeks who have never felt their baby move should contact their midwife, who will check the baby’s heartbeat.
Between 24 and 28 weeks, if a woman is concerned, she should undergo a full antenatal check-up that includes checking the size of the uterus, measuring blood pressure and testing urine for protein.
If a woman is over 28 weeks pregnant she should contact her midwife or local maternity unit immediately. She should not wait until the next day to seek help. A full antenatal check-up should be undertaken, including checking the baby’s heartbeat.
Any investigations usually provide reassurance to women that all is well. It is important to remember that most women who experience one episode of a reduction in the baby’s movements have a straightforward pregnancy and go on to deliver a healthy baby.
If there are any concerns the doctor and midwife will discuss this with the patient and follow-up scans may be arranged. In some circumstances, it may be safer for the woman to deliver her baby as soon as possible.
The full patient information leaflet can be accessed via the RCOG website www.rcog.org.uk
Contributor: Dr Philippa Marsden, Consultant Obstetrician and Chair of the RCOG Patient Information Committee
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