HELP! Reduced fetal movement and potential induction.

[lbloomf93]

I’ve had a fairly straightforward pregnancy so far which has been low risk however, my third trimester has been a rollercoaster!!!

At 36+3 I became really unwell and attended triage and was told they thought I had a viral infection which was affecting babies movements and patterns and also bringing on sickness and diarrhoea for me which was understandable and to me made sense and I felt reassured all was well.

Fast forward to my 38 week community midwife appointment on Friday 19th Sept we discussed my visit to triage and she asked about babies movements. I explained that babies movement pattern has definitely changed as he used to be active first thing in morning, when I was in the bath and also when I was going to sleep at night. I do still feel his movements however these are more sporadic throughout the day and don’t seem to follow a pattern as such.

She recommended I go back to triage which I did and they monitored me via CTG and also did a scan which showed blood flow and fluid to be within the normal range.

I’m now 38+4 and my concern is that technically I am still experiencing reduced fetal movement by definition as his pattern has changed and hasn’t reverted back to how it was.

I’m due to go back in for CTG monitoring again tomorrow where they will potentially discuss induction as it’s my third visit, but I am really really torn as to what to do. My preference would be spontaneous labour as opposed to induction but feel like I can’t ignore RFM!

Does anybody have any advice or has been in this situation before?!

I was induced for changes in movements. Not going to lie it was a horrible experience and very different from my first natural labour. That said, the baby had two knots in her cord so who knows what would have happened if I’d left her in longer.
I can’t see how you can expect same movements at 38 weeks than 36 though. Surely there’s just less room? I would just be guided by them at the scan though. If you need to be induced and you need the drip my advice would be to get an epidural in before they start the drip.

You should expect the same pattern of movements, even if there's less room. They should still be wiggling and kicking. I was induced at 38+2 for reduced movements, and when she was born (absolutely fine) they saw I had a small placenta. She might have been fine, but she might not have, and at that point I wasn't going to risk it.
The induction was fast and smooth, pain wise felt the same as my first and totally manageable. I didn't even have time to read my trashy mags! Pessary went in at 6pm, taken out at 8pm as I was contracting too much, then went from 2cm to holding her in 40 mins. Job done.

Don’t ignore RFM, go in.

With my first baby I went in for reduced movements at 30 weeks, that picked up that I had preeclampsia. 5 weeks later he was born when he was in distress and I went downhill. So I’m forever thankful for the ctg’s and monitoring. If I had not have gone in that day and started the chain of events I don’t know how much worse it could have been.

I can offer a happy note on RFM though, I went in 5 times with my second baby for reduced movements. By the 5th time at 38 weeks they did start to discuss induction but I already had a csection booked for a week later and she passed the ctg monitoring very quickly. So they said to return immediately if I have another RFM. It turns out she was stuck in one position and couldn’t move. I think her feet were stuck, once born she had positional tallipes which coincides with why she never kicked me. I only ever felt gentle swishing/body movements. So for me it was because she was stuck in a position where she couldn’t kick. She’s 5 months old now.

Sorry that your third trimester has been a rollercoaster. I would be guided by what they advise you tomorrow. Good that they are keeping a close eye on you by the sounds of it.

I did also go in for reduced movements three times by the end and was offered an induction. I actually declined and went in to natural labour 40+4 and all was well. Looking back I am surprised I made the choice not to be induced, but was obviously what felt right for me at the time.

Hey OP I was induced at 40+11 due to having two episodes of reduced movements within a 21 day period. At first I was devastated as I really didn’t want to be induced. It was my first pregnancy and never had any experience of induction but only heard bad things. I spoke to the consultant on duty and asked to have a scan instead the following day as baby was showing well on the monitoring and all obs were fine. He strongly advised against it being my first pregnancy and them “not knowing” how I would labour(?!).

I spoke with my husband and agreed to the induction which started off as a pessary. And around 5hrs later my waters broke. Nothing had progressed by the time another 24 hours had passed so I had to be placed on the hormone drip due to an increased risk of infection.

Honestly speaking, it was the most incredible experience! It was painful at times as they were altering the drip to try and get the right amount of contractions within the timeframe (can’t remember off the top of my head what it needed to be)? But honestly it wasn’t anywhere near as bad as I thought it would be. I used the tens machine and gas & air up to 4cm, and then I found myself to be absolutely shattered (4 day stay in hospital until this point), so I opted for an epidural, had a nap for 2 hours and woke up to them telling me I was 10cm and baby would be here within an hour and he was!

So all I’m saying is, be open minded, it wasn’t as bad as I thought and although I’d heard bad experiences, I really did have a good one. I used breathing techniques I’d picked up from some hypnobirthing videos and managed the pain well with the midwives.

Best of luck x

You have repeated reduced movements which means something is going on. You could be induced to save your baby, the placenta may have stopped working as it should. It could be anything. Understand you may not want to be induced but surely the safety of your baby is more important than your wish to go into labour naturally?? Why would you risk your babies life?

To me, your gut is telling you that this is indeed RFM opposed to changes in the baby's pattern due to decreased room. When mums' believe that to be the case, they openly reject the idea that there is something wrong (and are often right). You don't seem to think this is the case and feel like the baby should be moving differently than they are.

For this reason, I think you should seriously consider induction by 40/40 if your team also recommend it.

I had a number of episodes of reduced movements and then just consistently reduced movements. I was told by the specialist that they shouldn't move less towards the end, it just might feel different.

In the end they decided to induce at 39 weeks and nothing happened at all. None of it worked in the slightest. So in the end I had a c- section. I'm so glad I did as it turned out that the placenta was quite heavily calcified. The midwife speculated that it had started to fail.

I personally know three other women who had poor maternity outcomes around the same time, all around full term. So whilst I didn't get the birth I wanted, I'm very glad I had the one I got and that my baby arrived safely. That's all that really matters.

You might not get spontaneous labour regardless to be honest. I wouldn’t potentially risk your baby’s life to get the preferred birth experience. Labour and giving birth are a means to an end, they are not the reason you got pregnant.

I unfortunately know several women who lost their babies between 38 and 41 weeks due to problems with the placenta leading to still birth. Each of their babies could have been saved if they’d been listened to about reduced movements and delivered rather than waiting it out. Please do not take any risks with reduced movements or changed movements, I wouldn’t want anyone to have to experience this. I’m not saying you’re intentionally taking a risk by the way, but there are some conditions with the placenta that aren’t routinely checked in scans. I do understand how much we hope for spontaneous labour, but baby’s safe delivery has to come first. Wishing you the best for your appointment and I hope you’re holding your baby happily in your arms soon.

I know someone who's baby died at 3 days old after being born at 41 weeks by crash c section. The reduced movements meant something was wrong and by the time she was seen in triage baby had already been starved of oxygen for too long

I can't talk about reduced movements but I was induced at 37+0 for other reasons. I had a spontaneous labour with my first at 38+6 which was a very straightforward water birth in the midwife led unit.
I was told as my first birth was straightforward my body was more likely to respond positively to induction. This is my experience of induction

I was 36+6 when it was decided that it would be better for baby to come out as my physical health couldn't managed pregnancy any longer. There were no induction rooms available so they did a sweep and sent me home for the night. I had been having contractions since 33 weeks due to an irritated uterus and the sweep turned them from sporadically to regular. I went in at 3 and they had me on the monitor for a while to see if I needed the pessetry. They put that in at 8pm and said it could stay in for up to 24h but after 4h it had done it's job so they removed it as I was heading towards hyper stimulation.
My labour was stop start as I had to lie down a lot due to my health. It progressed well whilst I was in my feet. I was moved to the birth centre in the early hours once the paracetamol i had been having wasn't enough. Progress stalled and started going backwards the following morning as I was now unable to stand, again due to my health not the induction. They broke my waters at lunchtime which accelerated my labour and he was born an hour later. He got a bit stuck and was in distress towards the end and was born with the cord around his neck. From an induction point of view it was straightforward birth as my body only needs a couple of nudges to progress labour, it was just my health that added the complications. Had I had the energy to be on my feet for the whole labour like I could with my daughter I wouldn't have needed my waters breaking. It wasn't as idyllic as my daughter's birth but considering there was a question mark over whether I would have the strength to labour at all it went pretty well. It was 20h from start of induction to birth and 6h of active labour.

I had an induction with my first and baby born at 38+3 after many episodes of reduced movement. When he was born he wasn't breathing at first, needed an NG tube and was in NICU for 3 days, he had an infection so idk what would have happened if I'd left it any later. He's 7 now and perfectly fine.

My second was born at 38+4 after spontaneous labour and tbh the spontaneous labour was much less painful - I got to 8cm before going into hospital and it was still hurting less than the induction did at 4cm.

I only needed the prostaglandins with my induction, after putting them in I walked for about an hour around the hospital and they started working straight away. I'd definitely recommend walking a lot/bouncing on birthing ball and keeping moving if you have an induction.

thank you for all of your stories and advice it’s very much appreciated! I’m back this morning for monitoring so I’m going to discuss my
options with the midwives and doctors and will be pushing for intervention of some sort. My issue being that all my tests keep coming back normal and in range so there’s a lot of battling from my side to be taken seriously!

I can’t talk about induction as I never had one but my first born was born due to reduced movement at 39+3. There was absolutely no movement for about 2 hours, I tried poking my bump, eating, drinking cold water etc. and nothing absolutely nothing made him move so I had an emergency c-section done that day. So please please do not take any chances when it comes to reduced movement.

What they can see in test results is pretty limited. However they are aware that repeated reduced fetal movement is more likely to result in stillbirth, listening to your baby’s movements IS part of the testing. Don’t ignore it. What matters is that the baby arrives safely.

How did you get on? My sonographer told me that the scan is just snapshot of that moment, it doesn't tell you what happens before or after and movements are much more important than the scan if the scan looks normal.