Your Baby's Movements in Pregnancy

First published in Beyond India, August 2016 edition.

Dr Arunaz Kumar

Babies’ movements are usually felt in pregnancy around 18-20 weeks in women who have had babies before and a few weeks later in women in their first pregnancy. Initially the movements may be felt like “light flutters” and later may be perceived as “strong kicks” or “tumbling” movements as the pregnancy advances. Towards the end of the pregnancy, the movements may change again, felt as “softer” and more “quieter” movements, once the baby’s presenting part (which is usually the head) starts to descend in the mother’s pelvis.

Feeling movements not only encourages the bonding of the parents with their unborn child but is also important as it is one of the ways mothers recognize and feel reassured that their babies are well. Evidence suggests that it is a reliable indicator of baby’s well being and occasionally, a significant reduction of movements can be a sign of fetal compromise.

The question then arises is that “Is it important for mothers to keep track of baby’s movements?” If so, “What is the optimal number of baby movements felt in a day?” These are very difficult questions to answer, the reason being that all mums and babies are different! Not all babies will have the same number of movements in a day and mums cannot keep track of all movements, specially, when they are busy! In fact, it would be very onerous and stressful if mums had to count movements all day! Besides, babies have a 90-minute sleep cycle and hence, movements not only occur in the day but also at night!

Just in case you are wondering where this is going, as an obstetrician, I want to leave you with some simple advice for all pregnant mums out there! Most mums have an understanding of the individual pattern of their baby movements. It is important to recognize it, specially after 30-32 weeks of pregnancy! If you are concerned about reduced number of movements felt, you can try to count them over the next couple of hours. If they still do not improve, please alert the midwife of the birth unit where you are booked! You may then be asked to present to the hospital and a fetal heart monitoring can be performed for 30-40 minutes. Alternatively, you may be asked to have an ultrasound examination to check baby’s movements, breathing and amount of amniotic fluid present around the baby.

The midwife or the doctor will also provide you with further advice regarding your follow up and how to monitor baby’s movements after you go home. There may have been a simple explanation that the milder movements that occur later in the pregnancy (once the baby’s head is fixed in the pelvis) may be missed. However, there should still be no decrease in frequency of the movements and hence a decrease in the “number of movements” may be an initial sign of baby’s health being compromised and should be investigated promptly.

For further information please refer to:

https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-your- babys-movements- in-pregnancy.pdf

https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_57.pdf