Baby's movements in pregnancy: what is typical, and when to call

How movements develop

Most women feel the first movements between about 18 and 24 weeks in a first pregnancy, and often earlier — from around 16 weeks — in a second or later one. Before that the baby is moving, but not strongly enough to be felt.

Early movements feel like flutters, bubbles or wind, and are easy to miss or misread.

Through the second trimester the movements become stronger, more frequent and more recognisable, and a pattern usually emerges — quiet in the morning, active in the evening, or active after meals or after you lie down.

By around 28 weeks, most babies have a settled pattern, and that pattern is the reference point for everything below.

The position of the placenta matters: an anterior placenta cushions movement and many women feel less, later. That is a reason for it being harder to feel, not a reason to worry less about a change.

The thing that actually matters

Babies do not run out of room and slow down at the end. This is the single most damaging myth in pregnancy, it is repeated constantly, and it delays women coming in. Movements should continue right through labour.

The count is less important than the change. A baby who normally moves a great deal and now moves less is the situation that needs assessment, even if the number still sounds fine. A baby who has always moved quietly, and still does, is a different picture.

There is no magic number of movements. Formal counting rules — ten in two hours, and similar — are a structure for paying attention rather than a threshold that guarantees anything.

Movements can also change in character: slower, weaker, or a different kind of movement than usual. That counts as a change.

A hiccup is a movement, and rhythmic regular jerks are usually hiccups. These are normal.

What not to do when you notice a change

Do not drink cold water, eat something sweet, lie down and prod the bump, and then feel reassured. These are the standard suggestions and they cause delay. If a baby moves after cold water, that does not tell you the baby is well; it tells you the baby moved once.

Do not use a home doppler. Hearing a heartbeat is not the same as the baby being well, and false reassurance from a home doppler has been implicated in delayed presentation. Put it away.

Do not wait until morning. Maternity units are staffed overnight and expect these calls, and the assessment is quick and free of charge in most settings.

Do not apologise for coming in, and do not let anyone make you feel you have wasted their time. Most such visits find nothing wrong. Establishing that is the job of the hospital, not of the pregnant woman at home.

Do not wait for a second episode. A single change is enough.

When to see a doctor

Go to the maternity unit the same day — now, not tomorrow — if: movements are reduced, slower, weaker or different from this baby's normal, at any point after around 24 weeks. Call ahead, and call 108 if travel is difficult.

Go immediately for: no movements at all, bleeding, severe or constant abdominal pain, leaking fluid, severe headache with visual changes, sudden swelling of the face and hands, fever, or a fall or blow to the abdomen.

If you have been told your placenta is anterior, or your baby has always been quiet, the same rule applies: report a change from your own baby's pattern.

If you are turned away without an assessment and you remain worried, go back or go elsewhere. Persisting is reasonable and it is sometimes necessary.

This article is general information, not medical advice, and is no substitute for personal medical advice. It has not been reviewed by an obstetrician.

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