7 Months Pregnant Baby Not Moving as Much
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Fetal movement in late pregnancy – a content analysis of women's experiences of how their unborn baby moved less or differently
BMC Pregnancy and Childbirth volume 16, Commodity number:127 (2016) Cite this article
Abstract
Groundwork
Pregnant women sometimes worry about their unborn baby's health, oft due to decreased fetal movements. The aim of this written report was to examine how women, who consulted health care due to decreased fetal movements, draw how the baby had moved less or differently.
Methods
Women were recruited from all 7 delivery wards in Stockholm, Sweden, during one/1 – 31/12 2014. The women completed a questionnaire after it was verified that the pregnancy was feasible. A modified content assay was used to analyse 876 questionnaires with the women's responses to, "Effort to depict how your baby has moved less or had changes in movement".
Results
Four categories and six subcategories were identified: "Frequency" (decreased frequency, absence of kicks and move), "Intensity" (weaker fetal movements, indistinct fetal movements), "Graphic symbol" (changed pattern of movements, slower movements) and "Duration". In improver to the responses categorised in accord with the question, the women also mentioned how they had tried to stimulate the fetus to motion and that they had difficulty in distinguishing fetal movements from contractions. Further, they described worry due to incidents related to changed pattern of fetal movements.
Conclusion
Women reported changes in fetal movement concerning frequency, intensity, character and duration. The challenge from a clinical perspective is to inform significant women well-nigh fetal movements with the goal of minimizing unnecessary consultations whilst at the same fourth dimension diminishing the length of pre-hospital delay if the fetus is at risk of fetal compromise.
Trial registration
Not applicable.
Peer Review reports
Background
It is widely acknowledged that a blueprint of regular movements is associated with fetal wellbeing [1]. Fetal movements can exist divers equally any detached kicking, palpitate, classy or curlicue and are normally outset perceived by the female parent between 18 and twenty weeks of gestation [2]. The frequency of fetal movements reaches a plateau in gestational week 32 and stays at that level until birth [3]. There is commonly a variation in fetal movements with a wide range in the number of movements per hour [4]. The movements are normally absent during sleep and occur regularly throughout the day and nighttime, unremarkably lasting for xx–xl min. The sleep cycles rarely exceed 90 min in the normal and salubrious fetus [5]. Although the movement pattern of the individual fetus is unique, it is full general noesis that decreased fetal motility is associated with adverse issue, including stillbirth [half-dozen].
The character of the movements changes when the pregnancy approaches commitment due to limited space in the uterus, only the frequency and intensity will not normally decrease [three]. In an interview study, 40 term pregnant women with an outcome of a healthy infant described fetal movements during the past week. Almost all experienced fetal movements as "strong and powerful". Half of the women besides described the movements as "large" (involving the whole body of the fetus). Another mutual description was "slow" equally in "deadening motion" and "stretching" or "turning". Some of the women stated that they were surprised how powerfully the fetus moved [7].
Several maternal factors may impair the power to recognize fetal motility [8]. Amniotic fluid volume [9], fetal position [x], having an anterior placenta [10, 11], smoking, being overweight [6] and nulliparity [6, 12] have been reported as such factors. Maternal factors which may enhance the ability to recognize motility are the opportunity to focus on the fetus and the absence of distracting noises [thirteen]. About l % of the pregnant women in a study from Norway were sometimes worried about decreased fetal movements [14]. In a review commodity, it was found that between 4 and 15 percent of pregnant women consult wellness care because of a decrease in fetal movement in the third trimester [i]. The aim of the nowadays written report was to examine how women, who consulted health care due to decreased fetal movements after gestational calendar week 28, depict how the baby had moved less or differently.
Methods
Settings and participants
Women were recruited from all 7 delivery wards in Stockholm, Sweden from 1st January to 31st Dec 2014, and were asked to complete a questionnaire. The inclusion criteria were women in gestational week 28 or more who consulted health care due to concerns over decreased fetal movements, with the power to understand Swedish or English and a normal cardiotocography (CTG). Non responders, inadequate answers, multiple pregnancies, undefined gestational week and unknown personal identity number were exclusion criteria (Fig. 1). In total, 3555 questionnaires were completed during the data collection catamenia. Data collection was in progress while the showtime 1000 questionnaires were analysed. 20-eight women completed two questionnaires and three women filled in three questionnaires; they consulted health intendance more than one time during the data drove period due to concerns over decreased fetal movements. Of the women, 672 (76.7 %) were anile 20–35 years, 582 (66.4 %) had a college or academy level of education and 650 (74.2 %) of the women were born in Sweden (Table 1). All women gave nativity to a live kid.
Flow chart
Data collection
The questionnaire used in the written report was developed from a spider web survey, an interview study [seven, 15] and clinical experience. The questionnaire was face up-to-face validated with 10 women who consulted wellness care due to reduced fetal movements, not included in the written report. The final version of the questionnaire included a total of 22 questions with multiple-choice or open-ended response alternatives (Boosted file 1). This study comprises the women's responses to the asking: "Try to describe how your baby has moved less or had changes in movement". The women were asked to describe their experiences in the space provided but could too, if necessary, proceed on the back of the questionnaire.
Analysis
The women's descriptions (n = 876) of how their unborn baby had moved less or differently were analysed using a modified content assay [xvi]. The material consisted of concise descriptions of movements, which were used without editing. The analysis was performed in three steps. Firstly, all the answers were read and re-read three times to gain a sense of content in the information. Codes were then revealed in accordance with Malterud. Every quotation was read and sorted into codes. In the 2nd phase of the analysis the material was organized. Units, the quotations, with the same code were divided into defined main categories and categories. When advisable the categories were divided into subcategories [17] The quotations could exist placed in more than than one category. Nonetheless, each statement was only placed in one subcategory. During the whole procedure the findings were continually discussed in the inquiry group in order to accomplish agreement. To validate the results, a sample of 50 quotations was randomly selected and re-analysed from the outset of the analysis process. After consensus had been reached some of the quotations were transferred to other subcategories and three quotations were deemed irrelevant and removed. Those carrying out the analysis did not know the gestational week.
Results
Four main categories and 6 subcategories were identified: "Frequency" (decreased frequency, absenteeism of kicks and motility), "Intensity" (weaker fetal movements, indistinct fetal movements), "Character" (changed pattern of movements, slower movements) and "Duration". The number in each category and subcategory as well equally an presentation of the figures for women seeking health care in gestational week 28–32, gestational calendar week 33–36 and during gestational week 37+, are shown in Tabular array two.
Frequency
The most commonly experienced deviation of fetal movements concerned frequency, which was described in 746 (85 %) of the questionnaires. This category was divided into two subcategories; "Decreased frequency" and "Absence of kicks and movement".
Decreased frequency of fetal movement
This subcategory comprises 609 (69 %) statements. These statements referred to movements condign less frequent and indicating to the women a generally decreased liveliness in the fetus. The movements were described with words like, "a few", "seldom", "less frequent", "not as many" and "decreased activity".
"Less frequent during the day"
"From beingness very active and kicking a lot to very few movements during some days"
Absence of kicks and movement
Amidst the answers well-nigh the frequency of fetal movements, 137 (16 %) statements were well-nigh not feeling whatever movement at all.
"I haven't felt any kicking for about 12 hours"
"Have not felt whatever movement during the whole mean solar day"
Intensity
A total of 343 (39 %) responses were perceptions that the movements had contradistinct in intensity. Ii subcategories were formed: "Weaker movements" and "Indistinct movements".
Weaker fetal movements
This subcategory comprised 277 (32 %) statements. Words frequently used were: "Weaker", "Softer", "Less precipitous" and "With less ability".
"From obvious, strong movements and nudging to feathery tickling a few times a day"
"… The movements of the babe felt weaker the few times I have felt my baby"
Indistinct fetal movements
Threescore-half-dozen (viii %) statements fell into this subcategory. Some women were uncertain every bit to whether they felt annihilation at all simply thought they could imagine movements.
"…The only affair I felt was non-specific movements deep inside my tum…"
"Take previously felt credible kicks which can be both felt and seen distinctly. Since yesterday evening only minor occasionally twisting movements"
Character
This category comprised 252 (29 %) statements describing experiences of the fetal movements changing in graphic symbol. The category revealed 2 subcategories: "Inverse design of movements" and "Slower movements".
Changed pattern of movements
This subcategory comprised 141 (xvi %) statements. The women described the fetal movements as having inverse in pattern and decreased in activeness.
"Non the same pattern of movements as before and not agile at the same time"
"The baby has not moved at the times that she had moved earlier, following the design that she had previously. This has been going on for about 2 days. When she has moved, the movements felt weaker the past two days compared to before."
Slower movements
This subcategory included 111 (13 %) statements. When talking about the movements women used words such as: "sluggish", "indolent", "slow and sweeping".
"Calmer more tired movements as if information technology were tired…"
"Slow and smoother movements"
Elapsing
Thirty-eight (four %) were included in this category. Women reported that the periods of movement had get shorter and had been reduced from several kicks in a row to occasional ones. Nevertheless, the frequency of how often the infant had moved had not decreased.
"… the periods when information technology has moved take been shorter"
"No more lively periods."
Differences according to gestational age
Women in gestational weeks 33–36 experienced changes more often than women at term regarding the category Frequency (92 % vs. 81 %), the subcategory Decreased frequency (75 % vs. 67 %), and the category Intensity (42 % vs. 35 %). Compared to women at term, those in gestational weeks 28–32 expressed changes to a bottom extent inside the category Character and the subcategory Slower movements (five % vs. xv %) (Table 2).
Four percentage, 32/876, of the total number of women in this study just stated a change in the character of the movements, not included in any other category. The distribution regarding length of pregnancy was; gestational week 28–32, 1/190 (0.5 %), 33–36, one/263 (0.4 %) and gestational weeks 37+, 30/423 (seven %). In that location were no statistically pregnant differences in the other categories (Not in table).
In addition to the responses categorised in accordance with the question, the women too mentioned how they had tried to stimulate the fetus to move and that they had difficulty in distinguishing fetal movements from contractions. Further, they described worry due to incidents related to changed blueprint of fetal movements.
Stimulation due to less movement
We identified 146 (17 %) statements most trying to provoke motility by triggering the fetus. Most of the women reported that they did this when not having felt movements for a while. When they did not succeed they consulted wellness intendance. The methods used to trigger movements were to pull, nudge or push button on the stomach, stimulate with lite or noise, take a shower or bathroom or to drink cold, sugariness drinks. Others said that they had diverse positions they used to feel the baby more distinctly. Some women described not feeling movements without stimulating the baby.
"No pushes" back when I am pulling on the tummy, no reaction when drinking a drinking glass of lemonade. Otherwise he has been quite active and you have been able to run across my breadbasket moving"
"Even if I touch my tummy, swallow, drink, at that place is not much divergence. He is moving considerably less"
Hard to distinguish fetal movements from contractions
The women stated that the fetal movements ceased or inverse in relation to contractions or that it was hard to distinguish movements from contractions. Some women also described that the movements decreased in relation to contractions, pain in the tummy or the dorsum. We identified 40 statements (5 %) concerning difficulties in distinguishing fetal movements from contractions.
"Non felt whatever movements since the contractions became more intensive"
"It has been more difficult to perceive movements. Difficult to distinguish movements from contractions… previously the movements accept been very distinct"
Worry due to incidents related to inverse pattern of fetal movements
Nosotros identified 25 (3 %) statements about external factors, such as the woman was ill and perceived less fetal movement. Half dozen women stated that they consulted wellness care due to hurting in relation to changed patterns of fetal motion. Two statements referred to the adult female having taken a autumn and wanting to exist reassured that the fetus had not been damaged. Other reasons related to increased worry were: mail service maturity, following an expelled mucus plug, an external cephalic version effort, rupture of the membranes and previous stillbirth in the same gestational week.
"Used to motility a lot during both day and nighttime. Have been ill with fever for three days and then there have been movements four–five times every twenty-four hours"
"Not every bit often as before but I all the same feel him daily. We're extremely worried as we lost our offset child in gestational week 33 in utero so it may exist imagination"
Discussion
Nosotros are not enlightened of any studies that have categorized how women describe the changes they have perceived concerning fetal movements when they seek health intendance due to worry almost their unborn infant.
Women who consulted health care due to decrease fetal movements described changes in frequency, intensity, character and duration of the movements. Nonetheless, all women in this study were reassured after an examination of their unborn baby. In Kingdom of norway, as many equally 51 % of women reported that they were concerned well-nigh decreased fetal movements once or more in pregnancy [fourteen]. In different populations, between four and xv % consulted health intendance facilities because of decreased fetal movements in the tertiary trimester [1]. There are several factors which may impair the ability to recognize fetal movements [viii]. Nonetheless, we have no data apropos amniotic fluid volume, fetal position, placenta position, smoking, overweight and nulliparity among the women participating in this study. These factors may explicate some of the women's perceptions of decreased fetal movements. Also, the plateau in gestational calendar week 32 [3] may be perceived as a decrease. In a study by Sheikh and colleagues (2014), 729 women counted and registered fetal movements for 1 hour three times per day. Eight percent of the significant women in the third trimester, who in the end gave birth to a healthy kid, experienced reduced fetal movements. Further, the researchers establish that among women who consulted health intendance for reduced fetal movements merely later gave birth to a good for you child, more of them were working than those who did not perceive reduced fetal movements [18]. Nosotros do not have data equally to work status among the women participating in our study.
Placental dysfunction is one main reason for decreased fetal movements in late pregnancy [19]. It is thus important for the pregnant women to recognize the blueprint of motion. A change may be a sign of asphyxia due to the redistribution of the circulation which gives priority to the brain over peripheral parts [twenty]. All fetuses in the present study were examined and no symptoms of asphyxia or placental dysfunction were identified at the time when the woman consulted health care. The women'due south worry about their unborn baby'due south health due to decreased fetal movements in this study did not result in a diagnosis or deportment to induce the delivery.
Our results indicate that some women at term seek health care due only to a change in the graphic symbol of the fetal movements. Although these women were asked to depict how their infant had moved less or differently, they did non mention a subtract in frequency in the fetal movements or a change in intensity. Dull, as in tiresome motion, stretching and turning, are descriptions of the character of fetal movements used past women in total term pregnancy, pregnancies that resulted in a salubrious kid [7]. The women in our study who consulted health intendance merely due to a modify in the graphic symbol of the movements and not considering of altered frequency and intensity might not have been enlightened of normal changes in the fetal motility patterns in late pregnancy. The changes they reported as different can be physiological due to limited space in the uterus at term [3]. At that place is no routine in Swedish antenatal health care for giving information near fetal movements only women are recommended to consult health care if they feel decreased fetal movements [21]. However, meaning women ask for information nearly fetal movements in general and for information about the number and blazon of fetal movements they can look, as well as how the movements are supposed to modify over time in pregnancy [22].
At that place were no stillbirths amid the women in this study. Thus, we can just speculate that information technology is possible that women who consult health care due to decreased or changed patterns of fetal movement may exist aware of the importance of detecting fetuses at risk as early as possible. Detection of decreased fetal movements can improve the outcome and reduce delay in consulting health care [23, 24]. Further, the fetuses in this written report who could be at risk were examined and adventure factors such as placental abruptions, growth retardation or malformations [25] may have been detected. The primary reason for consulting health care due to decreased fetal movements is worry about the health of the baby [fourteen]. None of the women in our study consulted health intendance without cause, but their worry was apparently unfounded from a medical perspective in the curt term.
Strengths and limitations
Women in this study had a normal CTG before they completed the questionnaire. Still, aside from no stillbirths amidst the participating women, nosotros have no data regarding the health condition of the babe afterwards birth. This is a major limitation of the study. There is likewise only thin information about the women's' sociodemographic background.
One strength of the study is the big number of participants. Some other strength is that all delivery wards in Stockholm participated in the study. Nevertheless, all women came from the capital metropolis in Sweden where women in mostly are older and well educated compared with women outside the capital. Further, the number of those who declined to participate and their reasons for doing so are non known.
The wording of the request, "Try to describe how your baby has moved less or had changes in motion" might have influenced the responders to use the words "decreased" and "differently" in their descriptions of their experiences. The results may have yielded even more if the initial request had been broader or more open up, for instance, "Try to describe how your infant has moved". However, the context in which the women completed the questionnaire was one of already perceived decreased fetal movements.
Clinical implications
Increased knowledge about the normal changes in the fetal motility patterns in late pregnancy can exist ane way to lessen the number of visits to obstetric clinics from women over concerns that turn out to exist unnecessary from a medical perspective. The claiming from a clinical perspective is to inform and advise significant women nigh fetal movements with the goal of diminishing the length of pre-hospital delay if the fetus is at risk and at the same time reduce worry leading to unnecessary consultation. Reducing the pre-hospital filibuster when the intrauterine environment is a threat to the unborn baby'south life will provide a window of opportunity to salvage a greater number of children from decease or compromised health. Further, fewer visits to obstetric clinics, over business organization that turns out to be unnecessary from a medical perspective, volition have health economical benefits. Earlier giving definitive advice that tin can reduce unnecessary controls at the end of the pregnancy, singled-out differences must be identified regarding how women who lost their child intrauterine or have given birth to a hypoxic or anaemic child, report the changes in character of movements equally only symptoms when they seek treat decreased fetal movements. Hereafter studies are needed.
Conclusions
Women reported changes in fetal movement concerning frequency, intensity, grapheme and duration; they described decreased, absence, weaker, slower and changed pattern of the movements.
References
-
Froen JF. A kick from within--fetal movement counting and the cancelled progress in antenatal care. J Perinat Med. 2004;32(1):13–24. doi:10.1515/JPM.2004.003.
-
Neldam S. Fetal movements as an indicator of fetal wellbeing. Lancet. 1980;1(8180):1222–4.
-
RCOG. Green-summit guideline No.57: reduced fetal movements. London: Majestic College of Obstetricians and Gynaecologists; 2011. http://world wide web.rcog.org.uk/womens-health/clinical-guidance/reduced-fetal-movementsgreen-top-57. Accessed 17 May 2016.
-
Nowlan NC. Biomechanics of foetal movement. Eur Jail cell Mater. 2015;29:1–21. discussion.
-
Patrick J, Campbell Chiliad, Carmichael L, Natale R, Richardson B. Patterns of gross fetal body movements over 24-hour observation intervals during the last 10 weeks of pregnancy. Am J Obstet Gynecol. 1982;142(four):363–71.
-
Holm Tveit JV, Saastad E, Stray-Pedersen B, Bordahl PE, Froen JF. Maternal characteristics and pregnancy outcomes in women presenting with decreased fetal movements in tardily pregnancy. Acta Obstet Gynecol Scand. 2009;88(12):1345–51. doi:10.3109/00016340903348375.
-
Radestad I, Lindgren H. Women's perceptions of fetal movements in full-term pregnancy. Sex Reprod Healthc. 2012;3(3):113–half dozen. doi:10.1016/j.srhc.2012.06.001.
-
Hijazi ZR, Eastward CE. Factors affecting maternal perception of fetal move. Obstet Gynecol Surv. 2009;64(7):489–97. doi:10.1097/OGX.0b013e3181a8237a. quiz 99.
-
Ahn MO, Phelan JP, Smith CV, Jacobs N, Rutherford SE. Antepartum fetal surveillance in the patient with decreased fetal move. Am J Obstet Gynecol. 1987;157(four Pt 1):860–4.
-
Fisher ML. Reduced fetal movements: a inquiry-based project. Br J Midwifery. 1999;seven:733–7.
-
Fried AM. Distribution of the bulk of the normal placenta. Review and classification of 800 cases by ultrasonography. Am J Obstet Gynecol. 1978;132(six):675–lxxx.
-
Mohr Sasson A, Tsur A, Kalter A, Weissmann Brenner A, Gindes Fifty, Weisz B. Reduced fetal movement: factors affecting maternal perception. J Matern Fetal Neonatal Med. 2015:1–4. doi:10.3109/14767058.2015.1047335.
-
Johnson TR. Maternal perception and Doppler detection of fetal movement. Clin Perinatol. 1994;21(4):765–77.
-
Saastad Eastward, Ahlborg T, Froen JF. Low maternal awareness of fetal motion is associated with small for gestational historic period infants. J Midwifery Womens Health. 2008;53(iv):345–52. doi:10.1016/j.jmwh.2008.03.001.
-
Linde A, Pettersson K, Radestad I. Women'south experiences of fetal movements before the confirmation of fetal death--contractions misinterpreted as fetal movement. Birth. 2015;42(two):189–94. doi:10.1111/birt.12151.
-
Malterud Yard. Shared understanding of the qualitative research procedure. Guidelines for the medical researcher. Fam Pract. 1993;10(2):201–6.
-
Malterud Chiliad. Kvalitativa metoder i medicinsk forskning. 3rd ed. Lund: Studentlitteratur; 2014.
-
Sheikh Thousand, Hantoushzadeh S, Shariat M. Maternal perception of decreased fetal movements from maternal and fetal perspectives, a cohort study. BMC Pregnancy Childbirth. 2014;14:286. doi:ten.1186/1471-2393-14-286.
-
Scala C, Bhide A, Familiari A, Pagani G, Khalil A, Papageorghiou A, et al. Number of episodes of reduced fetal motion at term: association with agin perinatal upshot. Am J Obstet Gynecol. 2015. doi:10.1016/j.ajog.2015.07.015.
-
Jensen A, Garnier Y, Berger R. Dynamics of fetal circulatory responses to hypoxia and asphyxia. Eur J Obstet Gynecol Reprod Biol. 1999;84(2):155–72.
-
SFOG. In: Lars-Åke 1000, editor. Mödrahälsovård, Sexuell och Reproduktiv Hälsa. Stockholm: Svensk Förening för Obstetrik och Gynekologi; 2008. p. 52.
-
McArdle A, Flenady V, Toohill J, Gamble J, Creedy D. How pregnant women learn nearly foetal movements: sources and preferences for information. Women Nascence. 2015;28(1):54–9. doi:x.1016/j.wombi.2014.10.002.
-
Froen JF, Arnestad G, Frey One thousand, Vege A, Saugstad OD, Stray-Pedersen B. Hazard factors for sudden intrauterine unexplained decease: epidemiologic characteristics of singleton cases in Oslo, Norway, 1986–1995. Am J Obstet Gynecol. 2001;184(iv):694–702.
-
Grant A, Elbourne D, Valentin L, Alexander S. Routine formal fetal movement counting and take a chance of antepartum late decease in normally formed singletons. Lancet. 1989;2(8659):345–9.
-
Flenady V, Koopmans 50, Middleton P, Froen JF, Smith GC, Gibbons K, et al. Major run a risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011;377(9774):1331–40. doi:10.1016/S0140-6736(10)62233-7.
Funding
The Fiddling Child'southward Foundation, Sophiahemmet Foundation, The Swedish National Baby Foundation and Capo'due south Research Foundation funded this study.
Availability of data and materials
The data will not exist made available in order to protect the participant's identity.
Authors' contributions
AL, KP and IR participated in the design of the study. AL, SG and IR performed the qualitative analyses. SH and EN carried out the first and main part of the analysis. KP contributed to the word of the analysis. AL, SG, KP and IR drafted all versions of the manuscript. AL, SG, KP, SH, EN and IR commented on the draft. All authors read and approved the final manuscript.
Competing interests
The authors declare that they accept no competing interests.
Consent for publication
Not applicable.
Ideals approving and consent to participate
The women gave consent to participate and permission to access supporting data when receiving information about the study. The data will not be made bachelor in order to protect the participant'south identity. The study was canonical by the Regional Upstanding Review Board in Stockholm: DNR: 2013/1077-31/3.
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Linde, A., Georgsson, S., Pettersson, K. et al. Fetal motion in late pregnancy – a content assay of women's experiences of how their unborn babe moved less or differently. BMC Pregnancy Childbirth 16, 127 (2016). https://doi.org/10.1186/s12884-016-0922-z
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DOI : https://doi.org/10.1186/s12884-016-0922-z
Keywords
- Pregnancy
- Fetal movement
- Decreased fetal movements
- Content analysis
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