Fetal Movement: Everything You Need to Know!

Today we are talking about all things fetal movement! What does fetal movement feel like? When should you begin counting it? Is there such a thing as too much movement? And what about hiccups!? In addition to today’s episode, be sure to download our Fetal Movement Hand-Out and Tracker, describing all you need to know about how to monitor your baby's health through fetal movement counting, including a hand tracking sheet you can print and use at home!

When does your little one begin moving?

Typically we begin to see fetal movements as early as seven to eight weeks into gestation on an ultrasound, though most people won’t start feeling the movement until about sixteen to twenty weeks of gestation! Your experience of the sensation can depend on a few things. The uterus is far down in the pelvis and quite protected, which is why the movement can be seen before it can be felt. If the placenta is at the front of the uterus, it may also cause the movement to be less obvious to the touch. The number of the pregnancy (first, second, third?) can also make a difference, with people beginning to feel it a little bit sooner in subsequent pregnancies. The first movements may feel more like a flutter or bubbles popping, sometimes described as “quickenings''. It is also important to understand that even though you might not feel fetal movement that often in that 18-24 week period, it doesn't mean that your baby isn't moving.

When should you begin to feel regular, consistent fetal movements? 

Generally speaking at about 28 to 30 weeks of pregnancy, you should start to feel your baby kick, punch, or roll around every day. Often you’ll begin to notice a pattern around the times of day they are most active. Many people will notice increased movement during or after meals as they, and the baby, are getting their extra little sugar hit. You may also feel more movement around bedtime as during the day, your activity and movement lull the baby to sleep, and as you are still the baby often wakes up! But as always, each baby is different, so try to get to know what your baby's fetal movement pattern is, around that 28 to 30 week mark. 

What about fetal movement counting? What is it, when should I start doing it, and how often should I do it? 

Fetal movement counting is a way you can monitor your baby's wellbeing, as a baby that is moving about is a happy baby that’s receiving lots of oxygen! There are a few different approaches to fetal movement counting - one is to choose a time each day to sit down and count your baby’s movements, but this can be time consuming and anxiety provoking if the baby is being particularly quiet or sleeping at the time. Another fine approach is just staying aware of the movement throughout the day. If you do notice your baby’s been quieter than is typical for them, then we would recommend sitting down and doing a formal fetal movement count. 

How to do a formal fetal movement count? 

Sit down in a comfortable position or lie down on your side. Make sure you have some water and a snack close by as it can take up to two hours to count the appropriate number of baby's movements. We recommend you place your hand on your belly and concentrate on feeling for your baby's movement. Each distinct movement is counted as one. So for example, a flurry of activity lasting 5 to 10 seconds would only be counted as one movement, as would be one distinct kick or roll. We expect to feel at least six distinct movements in a two hour window. 

Like we previously said, babies have distinct / sleep-wake cycles, so it may take some time to get those movements if you are attempting to count during their sleepy period. But even in that eventuality, movement should occur within the two hour window.

What happens if I don't feel six movements in two hours?

If you're over 28 weeks pregnant and you do not feel six movements in two hours of concentrated counting, we recommend that you contact your care provider. Decreased fetal movements need to be assessed properly. This may mean different things in different communities, and your care provider can guide you through the next steps. In our community, if someone is experiencing decreased fetal movements in the third trimester, they'll get an assessment which includes a fetal heart rate check, a non-stress test, which is simply having a longer listen to the fetal heart rate, and an assessment of your feeling of movement, seeing if your uterus is contracting. Based on the results, any relevant medical history and associated risk factors, we decide if further tests are necessary.

What about a noticeable increase in fetal movements? 

There's really no such thing as too much fetal movement! Sometimes people experience their babies having a huge flurry of activity and it seems like it couldn't possibly be normal, worried it could be indicative of a seizure. Seizures in babies in utero can be associated with a decreased flow of oxygen and decreased blood flow. There would be a flurry of movement and then almost no movement - the increased amount of activity would not occur repeatedly. If you are worried about an episode of what you think is excessive, fetal movement, and then you feel normal, fetal movement following this, then you can be reassured that this is not a seizure. If there is a huge flurry and then no ongoing fetal movement for a couple hours afterwards, then you should contact your care provider.

What about hiccups!?

Believe it or not, hiccups can start in the womb as early as nine weeks of age! Fetal hiccups are simply a contraction of the fetal diaphragm muscle, the muscle that fits beneath the lungs. It causes a brain cortex response that researchers believe is essential in creating brain connections through the processing of multisensory inputs - in other words, the baby experiencing the hiccup and hearing the hiccup helps to create brain connections that are important for sensory development. If you feel like your baby is not having hiccups, your baby is most likely having hiccups and you're just not feeling them! 

How do you tell the difference between fetal hiccups versus fetal movements? 

There are a few important distinctions. You generally start being aware of fetal hiccups around 24 weeks, a bit later on than fetal movements which begin around 18 to 20 weeks. Hiccups feel like repetitive, jerky movements that can last for a few minutes up to an hour. Fetal movements generally come and go and don’t last for an hour at a time. 

We hope this post was helpful in decoding fetal movements, and in addition to today’s episode, be sure to download our Fetal Movement Hand-Out and Tracker, describing all you need to know about how to monitor your baby's health through fetal movement counting, including a hand tracking sheet you can print and use at home!