Reduced fetal movements: what to do and what happens at the maternity unit

Babies are individuals. Movements may feel like a kick, flutter, swish or roll. The RCOG explains that activity tends to peak in the afternoon and evening, and that sleep periods usually last 20 to 40 minutes and rarely go beyond 90 minutes. The number of movements rises until around 32 weeks and then levels off, though the type of movement may change as space runs out. You should continue to feel your baby moving right up to the time you go into labour, a point sometimes misunderstood as a decrease in the last weeks.

There is no minimum threshold. Both the NHS and the RCOG stress that a reduction or a change in the pattern matters more than a number. A baby who is usually busy at night and goes quiet, or a baby whose movements feel weaker, needs the same response as one who has stopped completely.

• Fewer movements than usual.

• A different pattern, such as much weaker or slower movements.

• No movements felt at all.

Call your midwife or maternity unit as soon as you notice a change, at any time of day or night. The NHS says do not wait until the next day, even if it is the middle of the night. The RCOG adds that you should never go to sleep ignoring a reduction or change.

Do not rely on a home Doppler, a phone app or having a drink or something sweet to make the baby move. If you cannot reach your unit, go to the nearest A&E or call NHS 111 for help to reach maternity triage.

What happens depends on how far along you are. Under 24 weeks, staff usually listen for the heartbeat and may arrange a scan. Between 24 and 28 weeks, you will have a heartbeat check and a full antenatal examination including blood pressure, urine test and measurement of the womb, with an ultrasound if the womb measures small.

After 28 weeks, you are seen without delay. The midwife will take a movement history, examine you, and monitor the baby's heart rate, usually for at least 20 minutes. An ultrasound scan may check the baby's growth and the amount of amniotic fluid.

Some causes are harmless: a busy day, a position with the placenta at the front cushioning movements, or the baby lying with the back against your spine. Others matter, so the check is worthwhile. Strong pain medicines or sedatives, alcohol and smoking can lower activity. Reduced movements can be a sign that the baby is unwell, for example because of poor placental function, growth problems or infection, and rare muscle or nerve conditions are also possible.

The RCOG says most women who experience one episode of reduced movements have a straightforward pregnancy and a healthy baby. You may be offered extra growth scans or a plan for birth if a concern emerges, and at some units induction may be discussed.

If it happens again, contact your unit again. The RCOG says you should never hesitate, no matter how many times it happens.