As a soon-to-be mother, you’re already doing your best to eat a balanced diet, get plenty of sleep, and avoid stress to ensure the health of your baby. When it comes to the health and well-being of their unborn babies, mothers have two incredibly valuable tools—their instincts and their acquired knowledge of markers of their baby’s well-being.

Although some expectant mothers feel the first flutters of movement as early as 16 to 18 weeks, it’s usually at the third trimester—after 28 weeks gestation—that fetal movement becomes a crucial part of monitoring for fetal health. Because a lack of movement could mean restricted oxygen flow, it’s incredibly important for mothers and their healthcare professionals to monitor fetal movement in the womb. Many birth injury claims are in response to improper fetal monitoring by medical professionals, so here’s what you need to know about what’s normal and what may be cause for concern.

Monitoring Fetal Movement: What’s Normal?

Healthy babies will move about 30 times an hour, on average. Most mothers, however, will not feel all of these movements during the course of a busy day and will generally feel movement the most when sitting still and quiet. Your baby will probably be most active after you eat a meal or something sweet, drink something very cold, or perform physical activity. You may also notice that your baby is most active between 9:00 p.m. and 1:00 a.m., as your blood sugar level declines.

Babies are also very sensitive to even slight changes in the amount of oxygen in their environments, and their movements can dramatically decrease as a result. This makes counting baby kicks very important. At 28 weeks, your obstetrician should help you learn how to monitor fetal movements on a daily basis. This will involve plotting movement on a chart or simply counting all instances of movement with directions to immediately contact your doctor in the event of any abnormalities. This simple method of counting kicks can help to determine whether your baby is healthy and receiving adequate oxygen flow.

Causes of Decreased Fetal Movement—and When You Should Worry

Each baby has their own unique pattern of movement, and a mother will learn this pattern throughout her pregnancy. Babies will naturally develop a pattern of more quiet times where you’ll notice less movement, but there are also some periods of inactivity that could be signs of something very dangerous. Some of the most common reasons for a decrease in detecting fetal movement include:

• When they’re hungry or sleepy. Just like us, babies need their own time for relaxation, so decreased movement during periods of hunger or sleepiness is normal. Your OBGYN will most likely instruct you to lie down on your side, eat or drink something sweet, and see if movement increases within a half an hour—and if not, you should contact them immediately.
• Changes in oxygen supply. Babies are sensitive to even small changes in oxygen supply. That’s why if fetal oxygen supply is constricted, a baby will decrease their movement. This is the most concerning reason for a lack of movement, and it makes monitoring fetal activity critical for the health of your baby.

Conditions in Mothers That Can Affect a Baby’s Movement

It’s not just the baby’s own schedule or needs that dictate how much and how often they move. There are also a number of factors in mothers that affect fetal movement, including:

• Medications with a sedative effect. Of course, virtually anything you ingest has an effect on your baby. Common medications such as sleeping pills, antihistamines, cough medication, and prescription pain medication may affect fetal movement but shouldn’t cause harm if taken per a doctor’s orders. You should always discuss the effects of any medication, over-the-counter or prescribed, with your OBGYN first, who will be able to provide you with information about any potential causes for concern that will allow you to make an informed decision about which medications to take during pregnancy.
• Certain medical conditions. High blood pressure (hypertension) can affect the amount of oxygen your baby receives. If you have hypertension, whether acute or chronic, your obstetrician should work with you to address this issue safely throughout your pregnancy. Other illnesses or conditions can affect blood flow to the baby and should be monitored by a perinatologist or high-risk obstetrician throughout the pregnancy. These include:
• Diabetes with vascular changes
• Heart disease
• Lung disease
• Liver and gastrointestinal diseases
• Certain blood disorders, such as sickle cell or beta-thalassemia
• Collagen vascular diseases
• The amount of fatty tissue the mother carries. Fatty tissue acts as a padding between you and your baby’s movement, so the more fatty tissue present, the less fetal movement you will experience. Still, expectant mothers will learn to identify what is normal for their baby—and their body—and should not hesitate to contact their OBGYN when a lack of movement is concerning.
• Conditions in the placenta. The placenta can also have a pillow-like effect when it is located in front of the mother’s uterus, reducing an expectant mother’s ability to perceive fetal movement as easily. Some issues with the placenta can even put a baby at risk for inadequate oxygen supply. For example, if a portion of the placenta covers the cervix or remains low-lying, your doctor will need to monitor it and pay close attention to the baby’s growth.That’s because placenta health affects not only fetal activity but fetal growth as well. During each visit, your obstetrician will measure the size of your uterus to assess your baby’s growth. If there is a cause for concern, an ultrasound will be performed for closer inspection, or—in the event of an emergency—your doctor should discuss immediately inducing labor or performing a C-section.

If induction does become necessary, electronic fetal monitoring is crucial. During labor, even if not induced, your baby is more vulnerable to being deprived of oxygen. Induction can cause contractions to become too strong and too frequent, which can be more than a baby can tolerate.

A Birth Injury Law Firm by Your Side

No matter how carefully a mother monitors her baby’s movements, her medical team must adequately prepare for and respond to signs of concern. Improper fetal monitoring can have devastating consequences, and families have a right to fight for answers when their lives are impacted by birth injuries that could have been prevented. Contact the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC today for a free, no-obligation consultation with an experienced birth injury law firm to learn more about your rights and legal options.

Reviewed by:
Trish Fletcher, MS, BSN, CRNP, NNP-BC, ALNC
Neonatal Nurse Practitioner | Birth Injury Legal Nurse Consultant

Tricia is a dedicated, focused, Birth Injury Legal Nurse Consultant and Neonatal Nurse Practitioner with more than 25 years of experience. Her strong clinical and critical thinking skills, paired with expertise caring for neonates in a Level III Neonatal Intensive Care Unit (NICU), ensures meticulous medical records review. READ FULL BIO

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