Doctors usually recommend that a woman in a position know how to perform fetal shock counts in the third trimester of pregnancy or earlier if, for example, she has a risk of miscarriage. The fetal shocks reflect the movements of the baby in the womb. Tracking such movements helps the mother distinguish between the normal movements of the baby and determine if there is cause for concern. Counting fetal movements is a counting of any movements that the unborn baby makes, such as sudden jolts, fists, somersaults, twists and turns. However, calculations of fetal movements do not include hiccups. Performing daily fetal movement counts can help doctors respond correctly if necessary and prevent premature birth or other possible serious complications. In addition, to make it easier to determine sleep cycles and wake up your unborn baby, calculating fetal movements is also a great way to communicate with your unborn baby before he is born.
Why does the fetus move?
The movements of the little man in the womb are necessary, they talk about his growth and development. The child begins to move in the first trimester, at about 7 - 8 weeks. By week 10, he has swallowing movements, he can change the trajectory of his movements and touch the walls of the amniotic bubble. But the size of the embryo is still insufficient, it only freely floats in the amniotic fluid, extremely rarely “collides” with the uterine walls, so the woman still does not feel anything.
Starting from 16 weeks, the fetus is already sensitive to sounds, which is manifested by an active motor reaction. From the 18th week, the future baby begins to touch the umbilical cord with his hands, he can squeeze, unclench his fingers, touches the face.
Therefore, the fetus is worried in the mother’s stomach, which in turn worries the woman when exposed to external factors that are unpleasant for the baby:
- strong, unpleasant, loud sounds,
- discomfort in the womb, such as a mother’s hunger,
- stress experienced by the mother (due to the release of adrenaline, blood vessels, including in the placenta, are reduced, blood supply worsens),
- oxygen starvation (due to active movements, the placenta is stimulated, its blood supply increases, which provides the child with additional oxygen).
In addition, if a woman has taken an uncomfortable position when large vessels are squeezed, the child suffers from a lack of oxygen and also becomes active.
Each woman feels the first stirring of the fetus differently at different times. When this happens depends on several factors:
- gestational age
- first or second, etc. pregnancy,
- time of day (usually in the evening or at night),
- mom’s complexion (thin or full),
- Times of Day,
- placenta attachment option,
- individual sensitivity (some senses from 15 to 16 weeks),
- Mom’s behavior (physically active women simply don’t notice movements).
According to statistics, the first fetal movement during the first pregnancy is felt pregnant at 20 weeks. And with repeated gestation, the timing of the movement is reduced to 18 weeks.
But everything is individual, even in an individual woman, the second, third and subsequent pregnancy occurs each time in a new way. If a woman during the second pregnancy began to feel the fetal movement at 19 weeks, then in the third these terms can change (felt earlier or later).
Rate of movement
The rate of fetal movements depends on what period of pregnancy the expectant mother is. The kid is constantly moving, but of course, a woman can not feel all of his movements.
- At a period of 20 to 22 weeks, the fetus commits up to 200 movements per day,
- but by week 27 - 32 he already performs about 600 movements. It is characteristic that with the beginning of the third trimester (32 weeks), the quantity decreases, due to its weight (the fetus is already quite large) and it becomes crowded in the uterus. There are no "large" movements (twists and turns in the uterus) and the baby can only produce "small" arms and legs.
- After the 28th week, the average amount is 8 - 10 per hour. The exception is the periods of sleep of the child, which is 3 to 4 hours - at this time the baby does not make active movements. The expectant mother should remember certain cycles of activity of the child. The highest activity is observed from 7 o’clock in the evening to 4 o’clock in the morning, and a decrease in activity or the so-called state of rest falls on the interval from 4 o’clock in the morning to 9.00.
- By 32 weeks, the fetus takes its final position, as a rule, it is the head to the small pelvis (longitudinal position, head presentation). But the transverse position or pelvic presentation is not excluded. Mom should not despair, to correct such provisions, the doctor will always prescribe the performance of special gymnastics, which contribute to the fetal upheaval and reception of the “correct” position - longitudinal, with the head to the small pelvis.
If the child has taken the “right” position, that is, head down, then the pregnant woman will feel movements in the upper abdomen (the child “hits” with legs). In the case of pelvic presentation, movements will be felt below, in the bosom.
Change in intensity of movements
If the baby in the womb is good and comfortable, and the mother does not experience any external or internal stimuli, then the movements are rhythmic and smooth. Otherwise, the nature of the movements changes dramatically, which should alert the woman and requires consultation of the obstetrician.
As a rule, a woman notes the "increased" activity of the baby when she is calm and resting. And vice versa, many mothers are afraid that during her active work the child does not move at all. A similar phenomenon is easily explained. When a woman is at rest, she carefully listens to her feelings and carefully notes the baby's movements. When she is busy, she has no time to distract from affairs and she simply does not notice that the baby is moving. In order to dispel her doubts (the child is ill, he is dying), the pregnant woman should sit down and relax, watching how he moves.
Doctors often advise pregnant women to take a bed rest position on their left side. It is in this position that the uterine blood supply increases, which is used in the treatment of chronic fetal hypoxia and for its prevention.
Perhaps a change in activity from an uncomfortable or incorrect body position of a woman, for example, lying on her back or sitting with a straight back. When the expectant mother lies on her back, the pregnant uterus strongly compresses the inferior vena cava (one of the main blood vessels).
When this vessel is squeezed, blood flow to the uterus is significantly reduced and the baby begins to experience oxygen deficiency.
In order for Mommy to understand that he is ill, he has rapid and frequent movements. It is quite simple to establish blood circulation and eliminate hypoxia - mom should turn on her side.
Also, the motor activity of the child changes if the mother is in a stuffy or smoky room. Due to a lack of oxygen, the child reacts to the situation with painful and violent tremors. A woman should leave the room and take a walk to restore a comfortable state to herself and the baby.
In addition, fetal tremors change if the mother experiences a feeling of hunger. He suffers from a lack of nutrients and "calms down", moves sluggishly and reluctantly. But as soon as the pregnant woman had a bite, the baby’s joy is expressed in increased activity.
Stirring in pathological conditions
If the child’s motor activity suddenly became violent, prolonged and painful for a woman, this indicates a pathological condition and requires immediate medical attention:
- Threatening premature birth
Stirring becomes frequent and violent due to the increased tone of the uterus.
In this case, the nature of the shocks is radically different. They are rarely felt by a woman, and their strength is insignificant, which is explained by the large volume of the uterus, where the baby rarely touches its walls and the mother does not often feel its movements.
Due to the small amount of amniotic fluid, the baby in the womb becomes cramped, he constantly “beats” in the mother’s stomach, which is characterized by a woman as frequent and painful tremors.
With pathologies such as premature placental abruption, preeclampsia and others, the fetus experiences acute oxygen deficiency and react accordingly.
It develops in the presence of placental insufficiency, anemia, gestosis. Movement is lethargic and rare.
- Diaphragmatic hernia in a pregnant woman
In this case, the mother experiences pain under the sternum when the fetus moves.
- Uterine scar failure
If the woman had a cesarean section in the history, then with scar failure, which can lead to uterine rupture, she feels pain in the scar area when the baby moves.
With inflammation of the bladder, the pregnant woman complains of frequent, painful urination, pain when moving in the lower abdomen.
How are the shocks
Each pregnant woman describes her feelings in her own way, and besides, they change with an increase in gestational age.
- For short periods (20 - 25 weeks), women characterize them as "butterfly flutter" or "fish swimming". Other pregnant women talk about “fluttering” or “vibration of the phone” or “tickling”. Some describe their feelings not so romantically: "gurgling in the stomach, as if the intestines were junking."
- After 27 - 28 weeks, when the fetus has already grown enough, its movements become more clear and specific. The future mother, and even the future father, can feel a kick in the area of the abdomen where the hand is placed. The dissatisfaction of the baby is often expressed by such “kicks” - in the case of the adoption of an uncomfortable posture by the mother or with loud and annoying sounds. But if an unfamiliar hand is attached to the mother’s stomach, the child shrinks in fright and does not want to “kick”.
In order to determine how the fetus feels, it is important to count its movements. How to count fetal movements? For this purpose, several techniques are used:
This method is based on counting movements in 12 hours. It is made from 9am to 9pm. During this test, a woman is required only one condition - to reduce physical activity. All movements are considered, even the most minimal or weak. In the antenatal clinic, the doctor issues a special form or asks you to independently compile a table of fetal movements, where the time of the tenth movement will be noted. Normally, about an hour should pass between the first and tenth movements. And of course, mom should remember that a rest period is also possible, which should last no more than 4 hours. If this time is exceeded, you must urgently contact the obstetrician.
To compile a table, you should take a notebook sheet in a box and lined it as follows. Above is the gestational age. The clock is marked vertically from 9.00 to 21.00, and the horizontal days of the week or date. From nine in the morning you should begin to count the movements. As soon as their number reaches 10, a mark is put in the table at the hour when this happened. Additional information is entered in the table: there were less than 10 movements and how many in total. We continue the counting in the following days, and be sure to enter the data in a table with which we need to come to the doctor's office.
The basis of this method also consists in counting the baby's movements for 12 hours, the only difference is that the woman herself chooses the hour to start the count. Again, a table is compiled where the tenth stirring produced is recorded. The norm is considered when the tenth stirring happened before the 12th hour of the study. Otherwise, see a doctor immediately.
The count of fetal movements begins after dinner from 19.00 to 23.00. This method is based on the fact that in the evening and after eating the fetus increases motor activity. Be sure to record the start time of the account, and the pregnant woman should lie on her left side at this time.
When 10 movements are made by the fetus in an hour or less, the counting stops. But if there were fewer, continue to count the movements. An unfavorable sign is a decrease in movements (less than 10) in 2 hours.
Thus, it becomes clear that each pregnant woman can master the listed methods of counting the baby’s movements. The use of these techniques does not require any equipment or medical supervision.
Auscultation of fetal heart contractions
Listening to the heart rate is carried out directly by the obstetrician using an obstetric stethoscope (wooden tube). Normally, the fetal heart rate is 120 - 160 beats per minute. With a deviation in one direction or another, they talk about oxygen starvation of the baby, which requires instrumental research methods.
CTG is considered to be an affordable, reliable and most accurate method for assessing the condition of the fetus. CTG is performed from 32 weeks of gestation, and with suspicion of intrauterine pathology at an earlier date (from 28 weeks). Using cardiotocography, not only fetal movements are recorded, but also the rhythm of its heart contractions and uterine contractions. The study is carried out as follows: a pregnant woman is laid on a couch, and 2 sensors are mounted on her stomach. One in a well-heard place of the fetal heartbeat (he will record heart rate), and the other nearby (fixes uterine contractions). Cardiotocogram recording is carried out for at least 30 minutes, but it is also possible to increase the study time to 1.5 hours. During the removal of the cardiotocogram, a woman needs to note each movement of the baby and press a special button. Cardiotocogram analysis includes:
- basal heart rate (norm 120 - 160 beats per minute),
- the amplitude of variability (tolerance of deviations up or down) of the basal rhythm (norm 5 - 25 beats per minute),
- decelerations (sudden jumps of the curve down) - normally absent or sporadic, shortened and shallow,
- acceleration (sudden jumps of the curve up) - normally should be at least 2 within 10 minutes of the study.
For a more accurate diagnosis of the condition of the fetus, CTG is performed with functional tests (no load and with the introduction of intravenous oxytocin).
Ultrasound examination allows you to evaluate the size of the fetus, their compliance with the gestational age (with chronic hypoxia there is a lag in size). The doctor also studies the structure of the placenta, the degree of maturity (signs of aging), the amount of amniotic fluid and its type (with oxygen starvation of the baby, these indicators change). With the help of dopplerometry, placental and umbilical vessels, blood flow velocity in them are studied. If blood flow is reduced, they say about fetal hypoxia of the fetus.
During an ultrasound scan for 20 to 30 minutes, the child’s movements, heart rate and muscle tone are evaluated. If the fetus does not feel discomfort, then its limbs are bent - a sign of normal muscle tone. In the case of extended arms and legs, they speak of a reduced tone, which indicates oxygen starvation.
I have my first child, but 4 hours have passed, and I do not feel the fetal movements. What to do?
First of all, you need to calm down. The fetus is not always actively moving, for 3-4 hours no movement is allowed, at this time the baby is sleeping. Try to hold your breath for a short while, the blood will stop flowing to the placenta, to the baby, he will experience slight hypoxia and in response "will be outraged" - will begin to "beat" with arms and legs. If this method does not help, watch the baby for another 30 to 40 minutes. In the absence of even the slightest movements, immediately contact an obstetrician.
What fetal movements should be before childbirth?
On the eve of childbirth, the baby practically stops moving, which is considered normal. The child is preparing for birth, which for him is a very difficult process and requires a lot of strength, and a decrease in the motor activity of the fetus can save energy before childbirth. But there should not be an absolute absence of movements, the baby, although occasionally, performs movements.
I am going to give birth to a third child, the period is still small, 10 weeks. What and when should the movements during the third pregnancy be?
You can’t say for sure how many weeks you will feel moving. Everything is individual here. Normally, with repeated pregnancy, the mother begins to feel fetal movements from 18 weeks. But their earlier start is possible, at 16 weeks. But the nature of the movements can be completely different in contrast to the first two pregnancies and this should not be scared. All children are different, even while still in the mother’s stomach.