Abstract
Background
Presentations for decreased fetal movements comprise a significant proportion of acute
antenatal assessments. Decreased fetal movements are associated with increased likelihood
of adverse pregnancy outcomes including stillbirth. Consensus-based guidelines recommend
pregnant women routinely receive information about fetal movements, but practice is
inconsistent, and the information shared is frequently not evidence-based. There are
also knowledge gaps about the assessment and management of fetal movement concerns.
Women have indicated that they would like more accurate information about what to
expect regarding fetal movements.
Discussion
Historically, fetal movement information has focussed on movement counts. This is
problematic, as the number of fetal movements perceived varies widely between pregnant
women, and no set number of movements has been established as a reliable indicator
of fetal wellbeing. Of late, maternity care providers have also advised women to observe
their baby’s movement pattern, and promptly present if they notice a change. However,
normal fetal movement patterns are rarely defined. Recently, a body of research has
emerged relating to maternal perception of fetal movement features such as strength,
presence of hiccups, and diurnal pattern as indicators of fetal wellbeing in addition
to frequency.
Conclusion
Sharing comprehensive and gestation-appropriate information about fetal movements
may be more satisfying for women, empowering women to identify for themselves when
their baby is doing well, and importantly when additional assessment is needed. We
propose a conversational approach to fetal movement information sharing, focusing
on fetal movement strength, frequency, circadian pattern, and changes with normal
fetal development, tailored to the individual.
Keywords
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Article info
Publication history
Published online: September 22, 2022
Accepted:
September 6,
2022
Received in revised form:
July 20,
2022
Received:
March 25,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
