Counting fetal movement may reveal low fetal activity

Reduced fetal activity may be discovered earlier if pregnant women systematically keep track of the activity pattern of the fetus by counting movements.

"This may help pregnant women to get check-ups faster," says midwife and researcher at Oslo and Akershus University College (HiOA).

Saastad recently wrote a doctoral thesis on fetal movement counting. She has several years of work experience with stillbirths and quality assessments of antenatal and obstetric care.

"Reduced activity in the belly may be a sign of the fetus being in a vulnerable or threatened condition, thus the risk of complications become greater the longer you wait to contact the health services," she points out.

Reassuring pregnant women

There is litte research on the use of fetal movement counting and that is why it has been important to map possible negative effects of this method, for instance unnecessary maternal concern.

Saastad has reviewed the effects of fetal movement counting among 1123 pregnant women at nine Norwegian hospitals from 2007 to 2009.

Half of the participating women were instructed to register the time it took to feel ten movements from the baby, the average time being 10 minutes. The women did the count once every 24 hours from the third trimester.

The remaining participants were going to follow the antenatal care in accordance with Norwegian guidelines where fetal movement counting is not encouraged.

Saastad emphasises that the research showed that fetal movement counting stimulated the pregnant women’s vigilance and sensitivity towards the baby. However, it did not result in an increased amount of consultations at the health services due to concern for reduced fetal activity.

In the study, maternal concern was mapped in different ways. 43 percent of the control group and the group performing movement counting had less than once during the pregnancy been concerned about too few movements. 11 percent went to a check-up at the hospital due to concern for reduced activity.

However, the group of women performing movement counting had lower score on general antenatal-related concerns such as concerns about delivery and their own health. 79 percent of the women said that they would use fetal movement counting during their next pregnancy.

Useful and safe method

The conclusion of the thesis is that fetal movement counting is a useful and safe method, helping women to keep track of the activity pattern of the baby.

However, more research is needed to find out whether fetal movement counting with fixed number limits for reduced activity should be recommended in antenatal care, either as routine for all pregnant women or just for pregnant women with risk pregnancies.

There is a lack of knowledge on what normal fetal activity is.

"We need more research in order to provide pregnant women with better information. The essence of our research in fetal activity is to raise awareness among pregnant women so that they are in a better position to understand how their baby is doing," Saastad concludes.

She believes that the need for more guidelines will be even more important now that the Norwegian health authorities have recommended reducing the number of antenatal check-ups.

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