The care you will get when you report a case of reduced fetal movement depends on the number of weeks pregnant you are.
Less than 24 weeks pregnant
Most women are first aware of their baby moving at 18-20 weeks pregnant although some factors may mean you feel them earlier of later than this. If you have had a baby before, or are pregnant with more than one baby you might notice movements earlier. If you have an anterior placenta (at the front of your womb) you might notice movements later. If you haven’t noticed any movements by 24 weeks you should contact your midwife who will use a Doppler to check the baby’s heartbeat. You may also be referred for an ultrasound scan or to a specialist to assess your baby’s wellbeing.
Between 24 and 28 weeks pregnant
If you have noticed a change in your baby’s movements you should contact your midwife who will be able to check your baby’s heartbeat. Do not be tempted to use a home doppler or app for checking your baby’s heartbeat. It is not just the presence of you baby’s heartbeat that is relevant but also whether there are decelerations, irregularities etc that only a trained person would be able to detect.
You will also have a full antenatal check up that includes checking the size of your uterus, measuring your blood pressure and testing your urine for protein.
If your bump measures smaller than expected then an ultrasound scan may be arranged to check on your baby’s growth and development.
Over 28 weeks
If you notice your baby’s movements have reduced or stopped you should contact your maternity assessment unit immediately. Never go to sleep ignoring a change in movement and do not wait until the next day to seek help.
You will be asked about your baby’s movements and will be given a full antenatal check up including your baby’s heartbeat.
Your baby’s heart rate will be monitored, usually for at least 20 minutes. Your baby’s heart rate would be expected to increase as he or she moves. If this gives adequate reassurance you will usually be able to go home. If you have any more episodes of reduced movement you should return however soon after it is, and however many times it happens.
If your bump is measuring smaller than expected, if you have risk factors associated with stillbirth or if the baby’s heart rate is normal but you still feel your baby’s movements are less than usual an ultrasound scan should be arranged. This should usually be performed within 24 hours of being requested.
These investigations will hopefully provide the reassurance that all is well. Most women who experience one episode of reduced fetal movement go on to have a straightforward pregnancy and deliver a healthy baby. However women who experience multiple episodes of reduced fetal movement are at an increased risk of a poor perinatal outcome, so it is important to report every case of reduced or increased movement.
If the investigations raise any concerns about your baby you may be offered follow up scans or be advised it may be safer to deliver your baby as soon as possible. This would depend on your individual situation and the number of weeks you are in your pregnancy.
For more information on your baby’s movements during pregnancy, please see http://www.kickscount.org.uk/mums/your-babys-movements/