Feeling the baby move brings immense joy to expectant parents during pregnancy. These movements help forge a bond with the unborn baby, help you understand how busy they are even before birth and assure the mother-to-be that all is well. If you feel there is a change, it may be a sign that the baby may be unwell and needs assessment. Continue reading to understand your baby's movement patterns in the womb.
The type of fetal movement you feel depends on the developmental stage and what the baby is doing. Every baby is different, so fetal movements are different. Some are more active, and some babies take their time. The first sensation may be swishing, fluttering movement, rolling or tumbling. Medical professionals refer to these initial movements as "quickening”. As the pregnancy progresses, the movement becomes more pronounced, and you will feel elbowing, jabbing and kicking. Typically, fetal movements are categorised as:
● Weak
● Strong
● Rolling
The baby’s movements are felt for the first time between 18 to 20 weeks of pregnancy. Sometimes, it can be felt early (16 weeks) or late (22 weeks). Even when initially noticed, it's not consistent every day. The movements are subtle turns backwards, which decreases the feeling of movements or sleep or disappears for some time (babies may sleep for close to 40 minutes in intervals) and return. At times, there may be unusual movements that can be repetitive rhythmic hiccups and sudden shaking due to the baby’s startle response. Both are not a cause for concern. Here is a week-week breakup of fetal movement patterns in pregnancy.
● Before week 9, the nerves develop, so all limbs move simultaneously. The embryo bends its back and head.
● In week 9, the baby may stretch and yawn, which can be caught on the ultrasound.
● After 10 weeks of fertilisation, the limbs may start to move separately.
● In week 11, the baby is capable of opening its mouth and sucking its fingers.
● By about 12 weeks, the baby may start ingesting the fluid from the amniotic sac.
● By about 13 weeks, the fetus can move legs and arms vigorously in jabs and kicks.
● Between weeks 14 and 20, the quicking response occurs. This response is the expectant mother's first feeling of the baby’s movement. Depending on how relaxed the abdominal muscles are, it can be felt between 18 and 20 weeks or as early as 14 weeks.
● From 20 to 36 weeks, the baby experiences weak, rolling and strong movements. The baby moves the spine and all the joints, ensuring good joint and bone development. The movement pattern changes from weak to strong over time.
● By about 28 weeks, the baby's startle reflex kicks in. When startled by a sudden movement or a loud noise, the baby draws both legs and arms closer to the chest.
● By the third trimester, the baby demonstrates bicycle-like foot movement, known as stepping. This helps the baby turn upside down and aids in normal delivery. By now, the fetus is large and movements are restricted as there is less space.
The fetal movements vary throughout your pregnancy. The movements are weak initially. The rolling and strong movement increase as the pregnancy progresses. These start to reduce from the 36th week to full term as the baby grows in size and there is a space restriction.
When it comes to the rhythm, your baby has a sleep-activity and time-of-day rhythm. The baby is most active between 9 AM to 2 PM and 7 PM to 4 AM. In the last month of the pregnancy, the baby kicks during light sleep. Sometimes, there is less movement during the fetus’s sleep cycle. Each cycle can be 20 to 40 minutes and go up to 90 minutes. Remember, the fetal activity-rest cycle does not match with the mother’s.
The mother feels fetal movements better when lying on her left side or sitting feet up, concentrating on the baby’s movements. The mother may not notice when she is busy. Factors that prevent from feeling the baby’s movements are:
● Low amniotic fluid levels, which hampers free movement.
● Thick stomach wall due to obesity.
● Anterior placenta (before 28 weeks) increases the thickness of the wall of the uterus.
● First pregnancy and thick abdominal muscles.
● Sedatives or pain relief drugs can make both the baby and the mother sluggish as the sedatives can get into the baby’s circulation, making them move less.
● Smoking and alcohol.
● Some rare nerve or muscle conditions make the baby move less or not move at all.
Normal baby movement in pregnancy was evaluated using kick count, which was done in either of two methods:
● The woman is asked to lie on the left after a meal and count the kicks she feels in about 10 or 15 minutes.
● The woman is asked to lie on her left side or sit to increase blood flow and count ten kicks, tracking the time it takes to reach the number.
It is normal if the count is greater than 10 kicks in a few hours. However, if there is a single instance of reduced fetal movement, it is not a cause for concern in most cases. If there is fetal distress, a sudden increase in fetal activity is seen. However, if there is chronic fetal distress, research indicates a cessation or reduction of movements for up to 12 hours prior to the baby’s heart-stopping, called MAS (movement alarm signal). If death does not happen within 4 days of MAS, there can be changes in heart rate.
● Congenital abnormalities
● Cerebral palsy
● Preterm birth
● Low birth weight
● Intellectual disability
● Hypoglycaemia
● Increased chance of C-section
● Fetal death
● Neonatal death
If you feel decreased fetal movement, get it evaluated. An ultrasound or a cardiotocograph is recommended to assess the movement and check the heart rate.
Feeling the baby move is an assurance of its well-being. If you notice changes or the baby's movement is less than normal, it can be a sign that the baby is unwell. Contact your healthcare provider to ensure the baby is doing well.
A healthy baby moves at least 10 times in a few hours during its period of activity.
Contact your healthcare provider if you notice a reduction in the baby’s movement.
Typically, around 28 weeks of pregnancy.
