Baby movements in pregnancy

This leaflet is to inform you what to expect about your baby’s movements during pregnancy and what to do if you are concerned that your baby has not been moving as much as usual or if you feel that your baby’s movements have changed.

It tells you:

• What are normal movements for an unborn baby.
• What affects how much you feel your baby move.
• What you should do if your baby’s movements are reduced or changed.
• What care you will have if your baby’s movements are reduced or changed.

This information aims to help you ensure you know the importance of monitoring your baby’s movements to help you and your healthcare team make the best decisions about your care. It is not meant to replace advice from a doctor or midwife about you own situation.

What are normal movements?

Most women first become aware of their baby moving between 18 to 20 weeks pregnant. However, if this is your first pregnancy, you may not become aware of movements until you are more than 20 weeks pregnant.

If you have been pregnant before, you may feel movements as early as 16 weeks. Pregnant women can feel their unborn baby’s movements as a kick, flutter, swish or roll. Hiccups do not count as a movement.

As your baby develops, the number and type of movements will change with your baby’s activity pattern.

During both day and night your baby has sleep periods, these mostly last between 20 and 40 minutes, and are rarely longer than 90 minutes. Your baby will usually not move during these sleep periods.

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

Why are movements important?

During your pregnancy, feeling your baby move gives you reassurance of his or her wellbeing, and you learn what is normal for your baby.

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 Kingston Hospital maternity unit immediately so that your baby’s wellbeing can be assessed. Do not wait until your next appointment if you are concerned.

How many movements are enough?

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, an absence or a change in your baby’s movements is what is important.

Should I use a chart to count my baby’s movements?

There is not enough evidence to recommend the routine use of a movement chart.

It is more important for you to be aware of your baby’s individual pattern of movements and recognise a change in your baby’s normal pattern throughout your pregnancy.

You should contact the Day Assessment Unit or Triage immediately, if you feel that your baby’s movements are changed.

What if I am unsure of 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. Have a cold drink and/or something to eat. If you are still not feeling movements, you should take action (see below). Taking time to notice your baby’s movements is an opportunity to notice his/her pattern even before they are born.

What should I do if I feel my baby’s movements are reduced or changed?

The care you will be given will depend on the stage of your pregnancy.

Less than 24 weeks pregnant: Most women first become aware of their baby moving when they are 18 to 20 weeks pregnant. If by 24 weeks you have never felt your baby move, you should contact your midwife or Kingston Hospital Maternity Unit, who will check your baby’s heartbeat. Between 24 weeks and 28 weeks pregnant: You should contact your midwife or Kingston Hospital, who will check your baby’s heartbeat. Over 28 weeks pregnant: You must contact your midwife or Kingston Hospital immediately. You must not wait until the next day to seek help.

You will be asked about your baby’s movements. Your baby’s heart rate will be monitored, usually for at least 20 minutes. This should give you reassurance about your baby’s wellbeing. You should be able to see your baby’s heart rate increase as he or she moves. You will usually be able to go home once you are reassured.

These investigations usually provide reassurance that all is well. Most women who experience one episode of reduction in their baby’s movements have a straightforward pregnancy and go on to deliver a healthy baby.

If there are any concerns about your baby, your doctor and midwife will discuss this with you. Follow- up scans may be arranged. In some circumstances, you may be advised that it would be safer for your baby to be born as soon as possible. This would depend on your individual situation and how far you are in your pregnancy.

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

When you go home you will be advised to keep an eye on your baby’s movements and, should your baby have another episode of reduced movements, you must again contact Kingston Hospital immediately. Never hesitate to contact your midwife or maternity unit for advice no matter how many times this happens.

This information leaflet has been developed in accordance with the RCOG: Your baby’s movements in pregnancy (February 2019). The full guidance can be viewed using the link below:

Your baby’s movements in pregnancy – patient information leaflet | RCOG

Contacts

Kingston Hospital Maternity Unit, Day assessment Unit	0208 934 2358 Mon-Fri: 08.00 – 17.00 Saturday 08.00 – 16.00 Sunday 09.00 – 14.00
Triage	0208 934 2802 (Out of Hours)