Learn to count fetal movements and interact with your baby in a friendly way

Author: Zhao Aimei, deputy chief physician of Shandong Liaocheng Dongchangfu District Maternal and Child Health Hospital

Reviewer: Cai Rui, Chief Physician, Dongchangfu District Maternal and Child Health Hospital, Liaocheng City, Shandong Province

Many pregnant mothers often ask our obstetricians, how to count fetal movements? Fetal movements are very important for pregnant mothers in the late pregnancy. Every time during the prenatal checkup, our obstetricians will tell pregnant mothers: Be sure to count fetal movements when you go home. Be sure to count fetal movements when you go home.

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Fetal movement is a very important criterion for evaluating the baby's condition in the mother's womb. The number, speed, strength, etc. of fetal movements all represent the baby's condition. As a pregnant mother, you must learn how to count fetal movements, that is, to "interact" with the baby. This is an important way to self-monitor the baby's condition in the womb.

So what exactly is fetal movement? How to count fetal movements? How to identify abnormal fetal movements? Let's talk about it in detail.

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1. What is fetal movement?

Fetal movement refers to the movement of the fetus in the uterine cavity that impacts the uterine wall. It is the various body activities of the fetus in the uterus, such as kicking, reaching out, turning over, etc.

Pregnant women can feel fetal movement at 16-20 weeks of pregnancy. Usually, primiparas can feel fetal movement at around 18-20 weeks of pregnancy. For multiparas, they can feel fetal movement relatively earlier because they have the experience of having their first child. Fetal movement gradually increases as pregnancy progresses, reaching a peak at 32-34 weeks of pregnancy, and gradually decreases after 38 weeks of pregnancy. Sometimes fetal movement can be seen or touched during abdominal examination.

What does fetal movement feel like? Some pregnant mothers say it feels like their intestines moving, some say it feels like a goldfish blowing bubbles, some say it feels like popcorn popping, and some say it feels like a butterfly flapping its wings... As fetal movement becomes more and more obvious, you can feel the baby punching and kicking in your belly. Pregnant mothers with a low body mass index, that is, thin, will feel more obvious fetal movement.

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From the early to the late pregnancy, the fetal movement felt at different stages is different, and each pregnant mother feels differently. The fetal movement felt in the early pregnancy is relatively weak; in the second trimester, as the gestational age increases, the fetal movement will be significantly stronger; in the third trimester, because the fetus is relatively large, the movement strength will be greater than in the second trimester, which will have a more direct stimulation on the uterine wall, so pregnant mothers will feel the fetal movement relatively more obvious.

2. How do pregnant mothers count fetal movements correctly?

Generally, we should learn to count fetal movements after 28 weeks. I suggest that pregnant mothers count them in three time periods: morning, noon and evening. Count for one hour each time. The time period does not have to be fixed. We generally have to avoid the baby's sleep cycle and count when the baby moves.

After 28 weeks of pregnancy, normal fetal movements are generally ≥3 times per hour or ≥10 times in 2 hours. If the movement is continuous, it is counted as 1 time, and if there is an interval of 3 to 4 minutes, we count it as 2 times. This is a counting method.

Another method is to count one hour each in the morning, noon and evening, add up the number of fetal movements in three hours, and then multiply it by 4. If the number exceeds 30, it generally indicates that the baby is not suffering from hypoxia and is in good condition.

3. How to detect abnormal fetal movement?

If the total number of fetal movements is less than 20 times, or if you find that the fetal movements are different from usual and have decreased significantly, you need to go to the hospital as soon as possible.

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For the safety of the baby, pregnant mothers must learn how to count fetal movements from the second trimester, so that they can understand the baby's situation in the womb in time.

I wish all pregnant mothers friendly "interaction" with their babies and "good luck" during pregnancy!

References:

[1] ACOG “Prenatal Fetal Monitoring Practice Guidelines (2021 Edition)”

[2] Kong Beihua, Martin, Duan Tao (eds.). Obstetrics and Gynecology[M]. 10th edition. Beijing: People's Medical Publishing House, 2024.