Over the past day, I've noticed that my baby's not moving as much as usual. I feel a kick here and there, but I haven't been tracking her movement in charts and I keep wondering if it's just my imagination that she's moving less. I'm worried I'd be making a fuss over nothing if I went in to the doctor. I'm 30 weeks pregnant. How can you tell if you really need to go in or not over a baby that seems to be moving less? --About.com Reader
Whenever you feel like your baby's not moving as much as usual -- especially when you're far enough along that you've been feeling regular movement for some time -- it's best to call your doctor. There is a good chance that there's nothing wrong, but if something did happen to be wrong, time would be of the essence -- and it is better to take the chance that you may be going in to see your doctor over nothing. In some cases, decreased movement may be an early warning sign of a condition that could lead to stillbirth, so it is absolutely best to err on the side of caution.
When to Call Over Decreased Movement
Here's what UpToDate, an online health reference used by doctors and patients, has to say on the issue of when to call over decreased fetal movement (DFM):
"We inform patients that their perception of fetal movement is a significant indicator of fetal well-being and they should pay attention to this activity daily to enable timely detection of DFM. They are instructed to contact their health care provider for further evaluation if they perceive a significant and persistent reduction in fetal movement and never to wait longer than two hours if there is ABSENT fetal movement. If the woman is in doubt about what constitutes DFM, we tell her that it is rare for a healthy baby to have fewer than 10 kicks over two consecutive hours at times when the fetus is usually active, and the mother is lying down and focused upon counting. She is advised to call within 12 hours if she perceives decreased, but not absent, fetal movement."
If you are sure that your baby's movements have become less frequent than usual, such as if you've been monitoring kick counts, call within the next 12 hours and follow the advice your doctor gives you.
If you're not sure if your baby is moving less, try counting your baby's kicks over two hours at a time when your baby is usually active. If she usually starts kicking after you eat, for example, have a snack and then lie down for a few hours while counting the number of times you feel her kick. If you feel less than 10 kicks in two hours, call your doctor as soon as possible. If you feel no kicks, call right away -- don't wait.
Whenever you're not sure whether you need to call your doctor, however, always err on the side of caution and call. It's better to get extra monitoring of a perfectly healthy baby than risk not getting those monitoring tests when you truly need them.
Common Questions About Decreased Fetal Movement
Here are some other common questions people have when they are concerned about their babies' movement patterns in later pregnancy.
I've been monitoring my baby's kicks for weeks. I'm 32 weeks pregnant. He usually kicks between 30 and 50 times in the hour after I eat lunch. Today he only kicked 10 times in an hour. That's still more than 10 kicks in two hours -- do I still need to call my doctor?
Yes, you should still call your doctor any time you think your baby is moving less than usual. Explain that you've been charting your baby's kick counts and that your baby kicked less than usual today. You may or may not need to come in right away for monitoring, but make sure to let your doctor know about your observation so your doctor can determine the appropriate course of action.
What kind of tests do doctors perform when babies aren't moving as much as usual?
If your doctor feels there is potential cause for concern based on your observations, your doctor will probably ask you to come in for monitoring. The most common test used in these situations is a non-stress test (NST), which gives your doctor detailed information on your baby's heart rate patterns and a good idea of whether there is any problem with your baby.
If the NST has reassuring results, your doctor may perform additional tests or may send you home and tell you to call if your baby doesn't start moving more. If the NST reveals any cause for concern, your doctor will probably perform more tests right away in order to determine what needs to be done. You may be admitted to the hospital for observation and/or treatment.
I'm only 21 weeks and I haven't felt movement the past day. I don't really have any idea whether this is normal or not. Should I be concerned?
Whenever you're in doubt over whether anything is normal or not during pregnancy, call your doctor and let him or her make the determination. Fetal movement can be irregular when you're still in the second trimester, and there's probably nothing wrong -- but if you're worried, call your doctor.
My baby is moving less than usual, but the heart rate is strong on my fetal monitor. Should I still be worried?
If your baby is moving less than usual, call your doctor. Don't rely on a fetal heart monitor to tell you your baby is okay. Fetal dopplers and other heart monitors can only tell you that your baby's heart is beating -- they can't tell you, for example, whether there is a problem with the placenta or if your baby is in other physiological distress. You need to call your doctor right away.
Want to learn more? See UpToDate's topic, "Evaluation of decreased fetal movements," for additional in-depth medical information.
Fretts, Ruth C. "Evaluation of decreased fetal movements." UpToDate. Accessed: Dec 2009.