Get to know your baby

During pregnancy, routine antenatal check-ups will help you to monitor your baby’s well-being, but as the mother, you are in the best position to get to know your baby before birth.

From around the 24^th week of your pregnancy you will be well aware of your baby’s movements. Movements can be large, such as kicks or changes in position, and small, such as stretching fingers, breathing or hiccups.

Healthy babies vary greatly in how often and how strongly they move and kick. Some mothers feel kicks less obviously than others. If the placenta is at the front of the uterus or you are very overweight, kicks may not be felt as easily.

Babies sleep frequently during the day and normally will not move much during their sleep. Towards the end of pregnancy sleep periods get longer, but even near your due date it is rare that a baby will sleep for more than one hour at a time.

Many pregnant women feel movements best when they are lying down and focussing on their baby’s activity and least when they are standing, walking or are busy with something. The majority of babies are most active in the evening or early morning.

How do I know if my baby’s movements are normal?

There are great variations between pregnancies in how much and how often each baby moves, so there is no set number of movements that you should feel each day. You are unlikely to be asked to fill in a kick chart, as used to be the case, because babies’ patterns of movement can be so different and filling in a chart can make mums unnecessarily anxious.

Instead, become aware of your own baby’s pattern of movement each day. For the most part, the day to day patterns of movement for your baby will be quite similar, with daily rhythms of sleeping and waking. As you to get to know your own baby’s movement patterns you will come to know what is normal activity for your baby, and you can notice any changes.

It is normal for the strength of your baby’s movements to decrease in the last weeks of your pregnancy but you should still feel the same number of movements right up until labour begins.

What should I look out for?

After 28 weeks of pregnancy, you should take action if (compared to normal levels of activity for your baby) you notice:

·         your baby has stopped moving completely

·         a big decrease in your baby’s movements

·         a continuous decrease in movements over several days.

 What if I’m not sure if my baby is moving less or not?

If you are uncertain if your baby is moving less, you should try lying down on your side (preferably on your left, with support under your bump) and focus on your baby’s activity. Try to count up the movements.

If your baby starts to move around then that’s good sign, but keep an eye on movements from now and stop regularly a few times each day so you can focus on the movements and be aware of any changes.

If you are unsure about what is low activity for your baby, then you can count the kicks over a two hour period when you know your baby is usually active (ie when the baby is usually awake). It is rare that a healthy baby kicks less than 10 kicks within a, normally active, two hour period.

What should I do if I think my baby has stopped moving or is moving considerably less than normal?

If you are at all worried that your baby has stopped moving or is moving less than normal, then seek advice immediately. You should also seek advice straight away from your midwife, doctor or midwifery unit if there's a gradual decrease over several days. Don't wait until the next day to seek advice.

Why is a decrease in movements a problem?

Lots of mothers whose babies are born perfectly well and healthy notice a decrease in their baby’s movements at some point in their pregnancy, so a reduction in movements is by no means always a cause for concern.

However a reduction in your baby’s movements can be a sign that something is wrong, for example the placenta may not be providing sufficient nutrients or oxygen. So it is very important to talk to your midwife or doctor quickly if you are at all concerned, so your baby can be checked out.

How will my baby’s wellbeing be checked?

Doctors and midwives should take seriously a mother’s report of a reduction in her baby’s movements. It is particularly important the baby is checked if there are also risk factors associated with an increased risk of stillbirth, including:

·         If you’ve reported a reduction in your baby’s movements before

·         It’s known that your baby is growing slowly or is very small for dates

·         Mothers who are under 20 or over 40

·         Mothers who are obese

·         First pregnancies

·         Mothers with a history of pregnancy complications

·         Mothers who smoke

·         Mothers who have hypertension or diabetes.

Your midwife or doctor will do an initial assessment or refer you to the maternity unit for assessment: 

·         They will check your baby’s heartbeat with a handheld Doppler device (which is a portable ultrasound device).

·         They will check your baby’s size by measuring with a tape measure or doing an ultrasound scan.

·         They may check your blood pressure and urine.

·         They may check your baby’s heart rate pattern with a cardiotachograph (CTG) monitor.

If the CTG is normal but you are still experiencing the reduction in movements, or if any of the additional risk factors apply, then a full ultrasound assessment should be made.

If all the investigations show that everything is normal and you are sent home, but you continue to notice a reduction in movements soon after, or days or weeks later, you should seek advice from your midwife or doctor again straight away.

Sometimes mothers worry they may be ‘bothering’ the health professionals by asking for advice again when they’ve already been checked. However midwives and doctors will know that a mother’s concerns about her baby’s movements are important and you should not delay in asking for further advice.