According to Statistics Canada, every year, there are more than 3,000 stillbirths in Canada . The Hunter Medical Research Institute estimates that for each stillbirth, 99 other births narrowly escaped death.
The association between a reduction in fetal movements and stillbirth has been known for a long time. This was formalised from the 1970s onwards in a series of studies that noted the increased incidence of stillbirth and fetal growth restriction in women presenting with reduced fetal movements, which preceded fetal death by several days. Decreased placental perfusion, fetal acidemia and acidosis are recognized as being associated with decreased fetal movements.
Moreover, reduced fetal movements are linked to adverse perinatal outcomes such as:
- birth asphyxia
- developmental disabilities
- emergency deliveries
- umbilical cord complications
- fetal growth restriction
Fetal movements are therefore one of the best indicators of the well being of an unborn child. Maternal monitoring of fetal movements requires no technology and is available to all women. As the 3rd trimester approaches, have an honest discussion with your patients about the significance of fetal movements. Use this occasion to give them the ‘BabyKicks’ flyer.
Also touch on myths that persist within the community and the medical profession.
Myths Surrounding Stillbirth
A daily count of fetal movements within the 3rd trimester can help prevent adverse perinatal outcomes. There is no magic number of fetal movements a pregnant woman should feel. Every baby moves differently, some more than others. What’s important is for each woman to learn what is normal for her baby. To do so, she must pay attention to her baby’s movements.
More and more, pregnant women are busy at work or at home and face many distractions. Unless they take the time to stop and pay attention to their baby’s movements, it can easily happen that a woman will not remember feeling her baby move or that she will have no knowledge of what is normal or not for her baby.
Ask your patient to take a moment, every day, to stop and count her baby’s movements. To take that time and bond with her baby. Counting her baby’s movements will help her learn their movement pattern.
Counting My Baby’s Movements
If your patient perceives that her baby is moving less than usual, or if she notes less than 6 distinct movements within a 2-hour period, ask her to contact you without delay or go to the nearest hospital. Many women who feel reduced fetal movements delay contacting their health care professional or going to the hospital. This lost time could be crucial to intervene and prevent adverse perinatal outcomes.
As a doctor or health care professional, when a patient reports decreased fetal movements, you should complete a thorough evaluation of the maternal and fetal status, including a non-stress test and/or biophysical profile, in accordance with the SOGC Fetal Health Surveillance: Antepartum Consensus Guideline.