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Today in the office, I saw two pregnant patients that were highly concerned about their baby’s movements. Patient A was anxious that her baby wasn’t moving nearly as much as normal, while patient B feared her future gymnast was moving far too much.
What is considered “normal” for a baby’s movement during pregnancy varies widely. It might help to understand which movements are abnormal and when you should call your provider.
Quickening
As a writer, I don’t care too much for most medical terms, but I do make an exception for “quickening,” which is beautiful description of the first time the mother feels her baby moving inside her. Those first movements feel like little tender butterflies randomly fluttering their wings inside your womb (uterus). The quickening can occur anytime between 16-22 weeks of pregnancy. If you had a baby before, you may recognize the sensations earlier with subsequent pregnancies. Once you feel the early flutters, you may not necessarily feel them every day until after about 24 weeks. If you are not feeling the baby move every day by 24 weeks notify your provider.
Movement Counts
I talk to all my expectant moms about the importance of tracking their baby’s movements, or kick counts. After 28 weeks, your baby should move at least 6 times an hour once day. The baby does not need to move 6 times EVERY hour, but he should have one active hour each day. If the baby stops moving, it could be an early sign that he is in distress. The baby may be tangled in the cord or you may have too little amniotic fluid. These complications can be very serious. If you haven’t felt your baby moving normally, then drink some fruit juice and rest on your left side for an hour and pay close attention to his activity. If you do not get 6 distinct movements or kicks over that hour, call your provider right away.
Movement Variety
Every child has their own special personality, sometimes starting in the womb. I will often have patients concerned that their current pregnancy is more or less active than their last. Or, women will say their friend’s baby moves nonstop while their little one only wiggles after dinner. I remind them to count the kicks. Again, if there is one active hour each day, the baby’s movements are fine.
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A mom’s perception of her baby’s movement can depend on a couple of factors – one being the location of the placenta. When the placenta is attached to the front of the uterus, it essentially creates a pillow between her and the baby. This makes it more difficult to feel the movements regularly. It may also be a reason a woman feels the baby moving really early in one pregnancy but not until much later with the next.
A mom’s weight can also affect perception of movement. If you are overweight and have extra padding in the belly, you may not feel the movements as distinctly. I’ve had several patients who were overweight with placentas on the front wall of the uterus who could barely feel any movements throughout pregnancy. (I have a feeling these are the women who show up on those “I Didn’t Know I was Pregnant” shows.) In this situation, I performed weekly heart beat tests (nonstress tests) to confirm everything was happy and healthy with the baby.
Weird Movements
A rhythmic movement that occurs every couple seconds is likely the baby hiccupping. This feeling can sometimes be disconcerting, but it’s actually a normal part of baby’s development and a reassuring sign that baby is healthy.
I will commonly get concerned calls from patients whose babies normally move at night and today are moving in the morning or vice versa. Baby is not on a schedule in the womb. Again, having one active hour a day – or night – is what is important. It doesn’t need to be the same hour each day.
As your pregnancy progresses and baby grows, the little guy may begin to run out of room. The intensity of movements may decrease. He should still be active, but he may not be able to perform his more elaborate ninja moves.
At some point in the third trimester, those precious flutters that once made your eyes misty with maternal bliss turn into painful 3 a.m. beatings that bring tears to your sleep-deprived eyes for an entirely different reason. However, babies can’t move “too much” and there is really nothing you can do to ease painful fetal movements.
Just as each pregnancy is unique, so are the baby’s movements. Try not to compare this pregnancy to previous ones or that of your coworker across the cubicle. Realize that many factors affect your little guy’s activity. Just remember, if he hasn’t met his kick count for the day, you need to call your provider to get things checked out.
by Heather Rupe, DOBoard-certified OB/GYN
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