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Is My Baby Okay?: Detecting Fetal Movement
All of my patients worry about their baby’s health, especially as the pregnancy nears term. I advise them to pay attention to their baby’s movement pattern as a sign of a healthy baby. Fetal movement has been shown in numerous medical studies to be a good predictor of the baby’s health when monitored later in pregnancy. I want to stress the “later in pregnancy” aspect of this comment because of the misconceptions propagated in maternity textbooks regarding this point.

You’ll first be able to feel your baby moving somewhere between the 16th and 22nd weeks of pregnancy. For the first several months, the baby’s movement pattern is very erratic and my patients can go days without feeling the baby move. This can be quite unnerving and leads to additional office visits to alleviate their fears. These visits are perfectly fine with us because they present the opportunity to discuss the important role of fetal movement later in pregnancy.

In normal pregnancies, the baby has ample oxygen courtesy of the placenta. If there is a reduction in the amount of oxygen, the baby will reduce its activity level to ration the available oxygen. This will be a warning sign of “fetal stress.”

To identify those rare pregnancies that may show signs of fetal stress, I ask my patients to pay attention to the baby’s movement pattern during the last six weeks of pregnancy. You may perceive fetal movement as a swift sharp kick, a rolling of the baby, or a gentle bumping.

By performing a daily fetal count, we can help detect at-risk pregnancies. There are two methods I use to monitor the baby:

1) two kicks/movements within an hour of each meal;
2) 10 kicks/movements before noon.

If the baby’s movements don’t meet these criteria, I ask my patient to call the office immediately. I hate receiving a phone call at 10:00 pm telling me the baby has not moved in 24 hours. If this happens, I’m quite distraught and upset until I see that patient on the monitor at the hospital. It makes me feel that I’ve failed to make my patient understand that we may be able to detect the rare baby who is in “stress,” and save that baby’s life. During my career, my group has saved a half-dozen babies because of an alert parent!

Some babies have a different movement pattern than I have described. However, they do move frequently. In general, as long as your baby has regular, predictable movements, it is probably okay. You may also know ways to prompt your baby to move. Eating sugary food, drinking a cold drink or playing music are a few examples of the tricks my patients use to check their babies’ movements.

I suggest speaking with your practitioner about his or her suggestions for tracking your baby’s movement during the later stages of your pregnancy. Good luck, and have a healthy pregnancy.

Craig L. Bissinger M.D.