What to Know About Decreased Fetal Movement

Feeling fetal movements is one of the most exciting milestones to experience during pregnancy. The connection can help you bond while offering reassurance that your unborn baby is growing inside your womb.

Decreased fetal movements, however, can have the opposite effect. Understandably, it’s a worrying position to find yourself in because in some—but not all—cases, reduced movements can indicate that the fetus is at risk. 

Like most pregnant parents, I studied every ambiguous twinge, pop, and flutter to try to interpret how my baby was progressing, and when I wasn’t satisfied, I called on my care provider. Fortunately, my children were fine, but it didn’t stop me from worrying about decreased fetal movements throughout my pregnancies.

And the experts agree. Reduced fetal movements can be concerning and should always be taken seriously. They weigh in on why monitoring fetal movements is critical for all pregnant people.  

What Do Typical Fetal Movements Feel Like?

Generally, fetal movement is defined as any kick, flutter, swish, or roll that you feel in your womb. This will change in intensity and frequency throughout the pregnancy as the fetus matures.

The activity can relate to a wide range of fetal movements, including bending, hiccuping, and stretching, explains Lilit Baldjyan Sarkissian, RN, MSN, CNM, co-founder of Los Angeles Midwives.

Throughout the day, a healthy fetus will also enjoy sporadic periods of down time, so try not to anticipate constant movement.

Why Fetal Movements Matter

Being aware of fetal movements is said to be the oldest and most basic form of fetal monitoring—and it’s just as important today as it’s always been. This is essential because it can provide insights into their well-being, says Victoria Whelan, MD, a Washington University obstetrician at Barnes-Jewish Hospital in St. Louis. 

“During every prenatal visit from the second trimester on, I ask about fetal movement," she explains. "A reduction in fetal movement is important to pay attention to as it could be signaling something negatively changing within the pregnancy.”

Catherine Caponero, DO, an obstetrician at Cleveland Clinic, agrees, explaining that decreased movements could prompt your provider to run necessary tests that could help you and the fetus. “These tests can help the medical team determine if it is safe to continue the pregnancy or if further intervention is needed,” she says.

When Do You Start Feeling Fetal Movements?

Typically, pregnant people will start to notice their baby’s movements between week 16 and week 20 of their pregnancy. This increases up until week 32. From there, fetal movement is likely to plateau, but not decrease.

The gestational age that patients start to feel movements varies, although it usually should be expected no later than 24 weeks. "Once a patient starts to feel fetal movement, those movements should continue every day,” says Dr. Whelan, adding that the quality but not quantity of movements may change as the pregnancy continues.

Third trimester fetal movement

While movements often start in the second trimester, a regular pattern of movement isn’t always noticeable until the third, explains Dr. Caponero.

“We do not expect regular movements until a fetus is bigger, with regular movement expected around 28 weeks in the pregnancy,” says Dr. Caponero. “However, if a patient was feeling fetal movement prior to 28 weeks and is now not feeling movement, I would want the patient to reach out to their medical team.”

Sarkissian adds it’s a myth that babies move less toward the end of the pregnancy. “They don’t run out of room; they actually just move differently,” she says. “The types of movements may change, they may have more jabs, fewer rolls, but movement is movement and babies should move up to, and even during, labor.”

What Causes Decreased Fetal Movements?

Without further investigation, it’s hard to know whether the fetus is unwell, but there are several reasons for decreased fetal movement. Common and not concerning reasons include:

• The fetus is sleeping. “If it happens in a short span of time (duration of 20-40 minutes), it is likely a fetal sleep cycle,” explains Dr. Whelan.
• A pregnant person’s mobility and exercise pattern. Fetal movement can decrease temporarily after exercise.

More serious causes of reduced fetal movement include: 

• Placental abnormalities or placental insufficiency
• Stillbirth

Low or high amounts of amniotic fluid may also cause decreased fetal movements. With low amounts of amniotic fluid, there may be a concern the bag of water (amniotic sac) ruptured or the placenta isn’t functioning as it should. With high amounts, there is concern for fetal abnormality or poorly controlled diabetes in pregnancy and additional testing may be needed.

In some cases, reduced fetal movements may lead to the induction of labor, Cesarean section, or an admission to the neonatal intensive care unit (NICU).

But while a period of decreased fetal movements can precede difficult outcomes, evidence suggests the majority of pregnant people reporting reduced movements will go on to deliver healthy babies.

On the other hand if your baby suddenly becomes more active, this isn’t a reason to be alarmed. “We are typically not concerned if movements suddenly increase—we love active babies,” says Dr. Caponero.

Ways To Monitor Fetal Movements at Home

The good news is you don’t need medical-grade technology to monitor the fetus's movement at home. One recommended method is kick counting.

“It’s important for women to know about kick counts and this type of assessment as it can be an early indicator something is not right and further evaluation is necessary,” advises Sarkissian.

Pregnant people can opt for the common “count to 10” method. Here’s how to do that:

• Pick a time when the fetus is most active (that’s typically in the evening after meals)
• Sit with your feet up or laying on your side
• Count ever kick, roll, or jab until you get to 10

“She should feel 10 movements within two hours,” says Sarkissian. But keep in mind, counting kicks is only advised in the third trimester (typically 28 weeks). “This is because the central nervous system is not fully intact and the fetal heart is still immature prior to 28 weeks,” explains Sarkissian. “So, prior to 28 weeks gestation, we do and can feel the baby move but don't assign any quantitative value to it.”

Ways to Encourage Fetal Movement

There are some ways to encourage fetal movement at home, but be sure to consult a health care provider first. It's important that anything that doesn't feel right is shared with an OB-GYN or health care professional right away.

Below are some things you can try to encourage your baby to move around:

• Have a glass of juice or a snack – an increase in your blood sugar may also cause a small jump in fetal blood sugar
• Short session of gentle exercise — low-impact exercise or movement can wake your baby if they are sleeping
• Massage or rub your belly – a gentle massage where your feel your baby's head or bottom might stimulate movement
• Make some noise – noise from a television or music player might wake your baby, just don't turn it up too loud

When to Call a Health Care Provider About Decreased Fetal Movement

The time to act is when something deviates from what’s normal to you in a pregnancy. While pregnant people will generally have a good idea about what is normal activity for the fetus throughout the day, often they’re distracted and not paying attention to their movements.

“If you feel there is a difference in fetal movement from what is normal and typical for you and your baby, pause, rest, and actually count,” says Sarkissian. “If you are not getting 10 movements in two hours, please call [your medical provider].”

Keep in mind that counting kicks is only one part of the assessment, as changes in strength and pattern should also be considered.

When I was worried about a reduction or change in my movements, I gave myself time to lie down with a cold drink and focus on my baby’s movement. Sometimes the redirected attention can be all it takes to reassure a worried parent, but of course if you’re not convinced, your health care provider should be informed.

Never Be Afraid To Reach Out to Your Medical Team

Along with worrying about movements, the added pressure of simply misinterpreting movements might steer people away from getting the help they need. Don’t let it.

As someone who can occasionally be a little, shall we say, overly sensitive at times (especially when my babies are concerned), I was acutely aware of anything potentially compromising the health of my baby. Still, it crossed my mind, and perhaps yours too, that a false alarm could be a waste of medical time and resources. However, not once did a midwife or doctor make me feel that I didn’t have a right to investigate my symptoms—or lack of. 

It’s your unborn baby after all and as their parent you need to be confident that your pregnancy is progressing smoothly. If it’s not, the medical experts will intervene as necessary and raising your concerns early could turn out to be a life-saving decision.

Additional reporting by Krissi Danielsson.