Addressing Concerns About a Baby Moving Less Than Usual

Whenever you feel like your baby is not moving as much as usual—especially when you're far enough along that you've been feeling regular movement for some time—it is best to call your OB/GYN. There is a good chance that there is nothing wrong, but it is better to take the chance that you may be going in to see your physician over nothing.

In some cases, decreased movement may be an early warning sign of a condition that could lead to stillbirth, so it is absolutely best to err on the side of caution.

If you are sure your baby's movements have become less frequent than usual, such as if you've been monitoring kick counts, call within the next 12 hours and follow the advice your physician gives you.

Monitoring Kick Counts

If you're not sure whether your baby is moving less, try counting your baby's kicks over two hours at a time when your baby is usually active. If she usually starts kicking after you eat, for example, have a snack and then lie down for a few hours while counting the number of times you feel her kick. If you feel fewer than 10 kicks in two hours, call your physician as soon as possible. Explain that you've been charting your baby's kick counts and that your baby kicked less than usual today. If you feel no kicks, call right away—don't wait.

Whenever you're in doubt over whether anything is normal or not during pregnancy, call your physician and let him or her make the determination.

Fetal movement can be irregular when you're still in the second trimester, and there's probably nothing wrong—but if you're worried, call your doctor. It's better to get extra monitoring of a perfectly healthy baby than risk not getting that monitoring when you truly need them. 

How a Doctor Will Assess Decreased Fetal Movement

If your physician feels there is a potential cause for concern based on your observations, he or she will probably ask you to come in for monitoring.

The most common test used in these situations is a non-stress test (NST), which gives your OB-GYN detailed information on your baby's heart rate patterns and a good idea of whether there is any problem with your baby.

If the NST has reassuring results, your physician may perform additional tests or may send you home and tell you to call if your baby doesn't start moving more. If the NST reveals any cause for concern, your physician will probably perform more tests right away, like an ultrasound, in order to determine what needs to be done. You may be admitted to the hospital for observation and/or treatment.

It is also important to note that you shouldn't rely on a fetal heart monitor to tell you your baby is okay. Fetal dopplers and other heart monitors can only tell you that your baby's heart is beating. They can't tell you, for example, whether there is a problem with the placenta or if your baby is in other physiological distress. 

Source

Fretts RC. Decreased Fetal Movement: Diagnosis, Evaluation, and Management. In: UpToDate, Lockwood CJ (Ed), UpToDate, Waltham, MA.

Kick Counts. American Pregnancy Association. http://americanpregnancy.org/while-pregnant/kick-counts/.

Special Tests for Monitoring Fetal Health. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Special-Tests-for-Monitoring-Fetal-Health.