Decreased Fetal Movement (Baby Moving Less)

What normal fetal movement is like

Most people first notice movement, called quickening, between 16 and 24 weeks, often as fluttering or bubbling. Movements get stronger and more frequent until about 32 weeks, then stay at roughly the same level until birth. The type of movement changes as space runs out, from sharp kicks to rolls and pushes, but the amount should not fall.

Every baby has its own pattern. Many are most active in the evening and when you lie down. Babies have sleep periods of 20 to 40 minutes, rarely more than 90 minutes, when they do not move.

Why reduced movement matters

A baby who is not getting enough oxygen or nutrients from the placenta conserves energy by moving less. Reduced movement can be an early sign of:

• a poorly functioning placenta and growth restriction
• placental abruption, where the placenta separates early
• low amniotic fluid (oligohydramnios)
• preeclampsia
• infection
• cord problems

Several studies have found that many stillbirths are preceded by a period of reduced movement, which is why acting quickly matters.

Things that make movements harder to feel

These do not explain a change in your baby's usual pattern, but they can make movements feel weaker:

• an anterior placenta (placenta on the front wall of the womb), which cushions kicks
• being busy or distracted
• higher body weight
• the baby's position, such as facing your back
• some medicines that sedate the baby, such as opioids

What to do if your baby is moving less

1. Lie on your left side and focus on movements for up to 2 hours only if you are unsure and your provider has advised this. If you have noticed a clear reduction, call now instead.
2. Call your midwife, obstetrician or labor and delivery unit. These units are open 24 hours.
3. Do not drink cold water, eat sugar or poke your belly to make the baby move and then decide not to call.
4. If movements are reduced again after a normal check, call again every time.

What happens at the hospital

• Questions: your pregnancy history, when you noticed the change, and any risk factors such as high blood pressure, smoking or a small baby.
• Heartbeat check with a handheld Doppler.
• Fetal heart rate monitoring: a CTG or nonstress test, recording the baby's heart rate for at least 20 minutes. A healthy baby's heart rate rises with movements.
• Ultrasound: to check growth, amniotic fluid, placenta and sometimes blood flow in the umbilical cord (Doppler).
• Your checks: blood pressure and urine for protein.

If all is normal, you go home with advice to call again if movements change. If there are concerns, you may have more monitoring, steroids for the baby's lungs if early, or delivery may be recommended.

Kick counts

Some providers suggest a daily kick count from 28 weeks: choose a time when your baby is usually active, lie on your side and count movements. Most babies make 10 movements within 2 hours, often much sooner. Current UK guidance prefers that you learn your own baby's pattern rather than counting to a fixed number. Either way, a change from what is normal for your baby is the key warning sign.

Frequently asked questions

Is it normal for a baby to move less near the end of pregnancy?

No. This is a common myth. Babies do not move less toward the end of pregnancy. Movements may feel different, more rolls and fewer sharp kicks, but the amount should stay the same until birth and during labor. Reduced movement at any stage needs checking.

How long should I wait if my baby is not moving?

Do not wait. If you think your baby's movements have slowed or changed, call your maternity unit right away, day or night. Do not wait until the next day or your next appointment.

What counts as decreased fetal movement?

Any reduction from your baby's normal pattern counts. Some providers use a guide of fewer than 10 movements in 2 hours while resting and paying attention. A complete absence of movement is an emergency.

Can an anterior placenta cause reduced movements?

An anterior placenta can make movements feel weaker, especially before about 28 weeks, but it does not cause a change in your baby's established pattern. Once you know how your baby moves, any reduction should still be reported.

Is my baby okay if I hear the heartbeat on a home Doppler?

Not necessarily. A heartbeat can still be heard when a baby is unwell, and home devices can pick up your own pulse. Professionals use monitoring over at least 20 minutes and ultrasound. Do not use a home device to decide whether to call.