FOETAL MOVEMENT

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Foetal movement refers to any perceptible motion your baby makes inside the uterus, from kicks, rolls, stretches, and hiccups to the gentle rhythmic “swishing” many women describe. These movements are controlled by your baby’s developing nervous system, and a consistent pattern of movement is one of the clearest external signs that your baby’s brain, muscles, and placenta are functioning well.

Movement doesn’t start when you first feel it. Ultrasound scans show babies moving from as early as 7–8 weeks of pregnancy. You simply can’t feel it yet because the movements are too small and the uterus is still tucked low behind your pubic bone.

A reduction in movement is one of the most important warning signs in pregnancy, and one of the easiest to act on. Research shows that most women (roughly 70%) who report reduced movement go on to have a healthy outcome. But because reduced movement can, in a minority of cases, signal a problem with the placenta or the baby’s oxygen supply, it should always be checked promptly rather than watched and waited on.

WHEN SHOULD YOU FIRST FEEL YOUR BABY MOVE?

The first sensation of movement is called quickening, and it’s often described as bubbles, flutters, or a goldfish swimming. Timing varies quite a bit from woman to woman:

First pregnancy: Most first-time mothers feel quickening between 18 and 25 weeks, as it takes longer to recognise the sensation and the uterus is often positioned slightly further from the abdominal wall.
Second or later pregnancy: Women who have been pregnant before often notice movement earlier, sometimes from 14 to 20 weeks, because they already know what to expect and often have looser abdominal muscles.

Factors such as an anterior placenta (attached to the front wall of the uterus), higher body weight, or simply a quieter baby can all shift this timing later. This is normal and not, on its own, a cause for concern.

WHAT TO EXPECT

First trimester
Second trimester
Third trimester

From around 28 weeks, movement becomes a genuine wellbeing indicator. Your baby develops a more regular pattern of active and sleep periods, usually lasting 20–40 minutes each. Movements may feel different (less “kicky”, more rolling and stretching) as space becomes tighter, but the frequency should not drop off.

A common myth is that babies “slow down” near the end of pregnancy because there’s less room. This is not true. Movements typically continue at a consistent frequency right up to labour, including during labour itself. What may change is the character of movement (more rolls, fewer sharp kicks), not how often you feel your baby.
Important to understand
There are several factors which can make your baby’s movements harder to feel without anything being wrong:

Placenta position: An anterior placenta can cushion movements, making them feel fainter, especially earlier in pregnancy. An anterior placenta means the organ has attached to the front wall of your uterus, between your baby and your stomach. It is a completely normal position, occurs in about half of all pregnancies, and rarely causes complications.

Baby’s sleep cycles: Babies have genuine rest periods, typically 20–40 minutes, sometimes longer, when they will not be moving.

Being busy or distracted: Movements are often easier to notice when you’re still: lying down or sitting quietly, rather than moving around during the day.

Body position: Many women find movements more noticeable lying on their left side than sitting upright or standing.

Important note

None of these should be used to explain away a genuine, sustained drop in movement. If in any doubt, get checked. Raising any concern as soon as possible is always the right decision.

HOW TO TRACK YOUR BABY’S MOVEMENTS

From around 28 weeks, it’s worth getting to know your baby’s individual pattern. Every baby is different, and there is no single “correct” number of movements per day. What matters is noticing what is normal for your baby, and picking up on any real change from it.

Choose a time your baby is usually active. This is often after a meal, or in the evening. Sit or lie on your left side in a quiet space.
Count each distinct movement. Note each kick, roll, jab, or swish. Hiccups (rhythmic small twitches) don’t count, as they’re involuntary.
Time how long it takes to reach 10 movements. The American College of Obstetricians and Gynecologists suggests most women will feel 10 movements within two hours once they’re paying attention.
Repeat daily. This will help you to build a clear sense of what’s normal for your baby and makes it much easier to notice a genuine change.

You do not need a special app or device to do this well. A notebook, or the paper foetal movement chart used in South African antenatal clinics, works just as well. Your clinic or midwife can give you a chart to keep with your antenatal card, as well as advice on how to use it.

Note

The Maternity Case Record Card is a comprehensive antenatal record book that contains your entire pregnancy history, including antenatal visits, test results, ultrasound scans, and medical complications.
Once your baby is born you will receive a Road-to-Health Booklet which is given to all new parents. This tracks your baby’s immunisations, growth milestones, Vitamin A supplements, and deworming.

South African support

The National Department of Health’s MomConnect service sends free, stage-based pregnancy health messages by SMS or WhatsApp in all 11 official languages, including reminders about monitoring movement. You can self-register by dialling *134*550# free from any cellphone or ask to be signed up at your first antenatal visit at a public clinic.

WHEN SHOULD YOU BE CONCERNED?

Contact your clinic, midwife, or maternity unit immediately if:

You notice a clear reduction in how often your baby is moving, compared to their usual pattern
Movements feel noticeably weaker or different in character and don’t pick up again
You haven’t felt your baby move at all in a period that’s unusual for them
You are past 28 weeks and feel fewer than 10 movements within 2 hours after focusing specifically on counting
You feel a sudden burst of vigorous, frantic movement followed by a marked reduction

At your clinic or hospital, a healthcare provider will typically listen to your baby’s heartbeat, may perform a cardiotocograph (CTG) trace to monitor heart rate patterns, and depending on findings, may recommend an ultrasound to check growth and the amniotic fluid around your baby.

Why it is important that you seek help immediately

Stillbirth rates remain a serious concern in South Africa. Stats SA’s Perinatal Deaths in South Africa, 2016–2020 report recorded 15 908 stillbirths in 2020 alone, more than double the number recorded in 1997.

Southern Africa’s stillbirth rate, while lower than some other African sub-regions, is still many times higher than in high-income countries. Reporting reduced movement promptly is one of the few actions within your control that can make a real difference, so don’t feel you’re overreacting by asking to be checked.

FOETAL MOVEMENT

FOETAL MOVEMENT

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

WHEN SHOULD YOU FIRST FEEL YOUR BABY MOVE?

WHAT TO EXPECT

HOW TO TRACK YOUR BABY’S MOVEMENTS

WHEN SHOULD YOU BE CONCERNED?

FURTHER READING