Reduced movement - confusing hospital advice

[MissTwister]

Yesterday I didn't feel baby move as much as usual (31 weeks) so went to the hospital for monitoring. I was very surprised that 2 MW's there advised that as long as I had 10 movements a day I didn't need to have come in. 10 movements really wouldn't be much for me and I didn't think that was the advice these days. This was a big London hospital. What do others think?

Anyway I was monitored and, of course, baby started moving. However, the HR was high. It started between 165-75 and at one point set an alarm off when it went over 180. A doctor eventually came in and said not to worry but they would keep monitoring for a bit as it needed to come down and he'd come back. Then after 40 or so more minutes the MW just came in and said it was fine to go home. I mentioned that the doctor had said he would come back and relook and she said another doctor had said it was fine - a bit confusing as no other doctor had seen the trace! Looking at the CTG myself the HR had mostly come down to around 155-165 and they said baseline was 160 in notes. There were still big spikes though.

Following a MW appt the other week where she said 155 was on the high side and i might be dehydrated this has left me really unsettled, I'm really not convinced another doctor did say the trace was alright and there's no mention of raised fetal HR in notes. Just says reduced movement that I reported resolved.

Tbh it all seemed a bit disorganised - I waited an hour to be seen and then waited so long inside the whole thing took 4 hours and I kept having to find the MW to find out what was going on - took 15 mins to find someone about alarm!!

What does everyone think? Firstly about movements and then about the HR?

[lexyloub]

You should always go in if your movements are different than what's normal for you whether that be reduced or far more frequent movements. If you feel that applies to you don't be afraid to go back if your movements change at the end of the day it's your child's life at risk. Go back every day if you feel you need too. With regards the Dr seeing the trace without being in the room I think (but not 100% sure) that they can see the results of traces in the nurses station area.

[MissTwister]

This is what I thought but she clearly wasn't going to monitor me unless I'd had less than 10 movements! I just thought that was at odds with other advice

[applecore0317]

They can view the monitor readings in another room, I went in for reduced movements last night and the MW said they can view everything on the monitor from there office as it does a print out there and some monitors show up on screen, so that may be where the doctor saw it.

However if you are not happy ask to be monitored again and put your foot down, you know your baby better than they do.

The HR was fine for me last night but her movements are still muted and getting chunks of quietness which is unlike her, plus she didn't do the usual go nuts on the monitor thing, so I have been referred for a scan to check growth and fluid levels. Am 39+6.

[babypeach]

Hi
If you feel there is a significant change in baby's movements then that is just as if not more important than the 10 movements advice.

It's hard to comment in the baseline as babies do have periods of raised activity and they would have been looking at other features of the trace too but yes for the period they were recording it was at the high end of normal by the sounds of things.

I would def go back and asked to be checked again if you still feel baby's movements are not right and do t be afraid to ask why they are happy with a trace. They should also take into account your observations-eg your heart rate, temperature, breathing rate and urinalysis etc :if you have a raised heart rate baby's often will be too-could be dehydration as your midwife suggested though also lots if ither things such as you having raised temp etc. get them to explain whole picture to help you understand their thinking.

More often than not everything is fine but always go if you're concerned-you are the best judge of baby's normal pattern!

Best wishes x

[MissTwister]

My heart rate and blood pressure were pretty high because I was anxious - can this increase FHR?

They didn't do any other checks - not even urine or temp...

Am seeing MW today so will raise this with her and check HB again

[babypeach]

If a baby's heartrate is persistently high then checking heart rate and temp is sensible as it can sometimes cause high heart rate (although that us unlikely if it is just passing anxiety rather than something medical causing your higher heart rare)

Your midwife will check urine as a routine antenatal check and ask if you have any symptoms of a urine infection- they sometimes do this in hospital as it is part of a full antenatal check.

Breathing rate is something that can indicate an underlying problem with you but again can easily go up if you're stressed.

They should be looking at a whole picture including your general well being, where you are in your pregnancy etc to exclude any other reasons for a trace that is not normal and you are reporting that baby is moving less.

They may well have done this and been satisfied that when they monitored baby everything was normal and just communicated it poorly or not at all to you so that's why if you're still concerned over baby's movements you should go back.
If you do be sure to get them to explain why they think everything is ok and why they don't feel further investigations would help.
If the trace has anything abnormal or if it looks worrying to you make sure they explain why and how they'll investigate. Often it's poor communication that causes unnecessary worry.

Bottom line is better safe than sorry- if you still feel baby is moving less and that movement is decreasing then go back-and don't let anyone make you feel you shouldn't. Any care professional should prefer you to come with that type of concern than sit on it at home

Hope it all goes ok x

[MissTwister]

Thanks for detailed response BabyPeach.

I've had a MW appt today and HR was 155 which is within normal (up to 160) so she wasn't unduly worried.

Urine, BP all fine. Measuring 2 weeks ahead!

She was surprised at the lack of notes from the hospital visit last night but said to just keep monitoring movements and go back again if necessary.

Since I got back I decided to make a note of movements in case I am just underestimating them. I've racked up 15 in last hour which seems decent doesn't it? I guess as baby is now bigger they're just more squirmy than kicky.

I've just got myself so confused over it all and am terrified of missing something that could harm baby. It feels such a responsibility to keep monitoring...

[S2b16]

My midwife also told me about 10 movements a day when I saw her at 28 weeks, I told her I don't seem to have a pattern tho. (now 31+1)
It is old fashioned advice, movements should always be checked out. Glad baby was active for monitoring, typical that.
Sorry no advice on hr. X

[MissTwister]

Even more confusing! How long between movements makes an episode!? 10 minutes, 30 minutes?!

[MissTwister]

I've been counting today and each hour has varied between 7 and 15 movements. One hour there were only three (sleeping?). I assume this is active enough?

[WorldsBiggestGrotbag]

I don't get the 10 movements a day thing, I'm 34 weeks and have been lying on my bed for 20 mins and baby has been moving constantly. Is that one movement? One episode? Who knows. Anyway I think all you can do is be aware of when the movements are different for you. I don't think there's any such thing as enough or too little movement as it depends on the baby and it's pattern. I've never tried it but I think if I counted individual movements id have about 300 a day!

[S2b16]

My baby really doesn't have a pattern, I was considering going to get checked over today but after sitting for a while he has been wriggling about. My app does say when your moving about it rocks baby to sleep so you'll feel them more when resting or trying to sleep. If your feeling baby every hour, I'd say that's active, I don't feel mine every hour, if I eat or drink a freezing drink he's guaranteed to kick but other than that and bed time, I don't feel him much throughout day x

[slithytove]

Check out count the kicks . Com

Sorry in bath can't type

It's what's normal movement for you, not an arbitrary ten a day

Any worry you have. Go in, I can't stress that enough x

[applecore0317]

It's about knowing your baby, so even if they don't have a routine you should no if things aren't quite what they should be.

For me, when having a lazy day at home I can feel her pretty much every hour and her movements are obvious. She is quietest when I sleep (in that she doesn't wake me up and when I wake up during the night she doesn't start wriggling unless I rub my stomach), if I start getting an hour or two in the day where I don't feel her move or her movements are muted then I would be concerned.

[MissTwister]

Applecore that's the bit I find hard 'knowing your baby' I feel like its a judgement and panic that if something was wrong and I've not noticed then I've failed. Its very hard to know normal when they change pattern all the time

[applecore0317]

To be honest twister I would just rather err on the side of caution and if it doesn't feel right then call them. I've been down to the hospital twice now with reduced movements in the last three weeks. Am so used to her being a regular wriggler that as soon as she isn't I feel uneasy. In this case I actually kept an eye on it over the weekend, by yesterday I was getting big chunks where I felt nothing, even with moving my stomach, laying on my side, cold or sweet drink I wasn't getting much more than a very small muted movement, which is why I called the out of hours midwives.

They said they would rather me go down for monitoring ANY time I was worried than not.

[MissTwister]

My one has stopped responding to cold and sweet. They've wised up!

Baby has actually been pretty busy this evening so can go to bed calm. Ish.

I assume everything was okay with your monitoring x

[applecore0317]

Yes, heartbeat fine, but movements were still muted, so have a scan tomorrow to check fluid levels etc. She has moved more today thankfully. Glad yours has been better today x

[MissTwister]

Can inask what you mean by muted movements? Did the CTG pick up on that or is it something you're feeling?

[applecore0317]

So, I was getting some movements but they were a lot softer than normal. I didn't get a print out of the monitoring this time, so couldn't see what they picked up on.

When the doctor came to see me I said that she hadn't reacted much to being on the monitor when she normally does, and he requested that the midwife refer me for a scan to just check all is ok, but said he didn't feel too worried.

Midwife said afterwards that my consultant may want to see me again because of reduced movement... I hope not as was signed back to the midwife at 34 weeks and deemed as now being low risk, so it would suck to get to my due date tomorrow and be referred back.

[MissTwister]

I'm sure the trace was normal if they sent you home - scan is just for reassurance.

I don't think seeing a consultant again means being deemed high risk - I see a consultant and was told it doesn't affect anything such as birth centre if at the end there are no problems.

Hope it all goes well!

[applecore0317]

Thanks, yes I think the scan is just for reassurance, Figures they would have said if there were concerns :), my hospital won't allow birthing unit if you are under consultant led care, have to be referred back to the midwife first, but what will be will be.