Decreased fetal movement is characterized by less than 4 movements counted in one hour. Reduced movement can be especially concerning in women with a history of high blood pressure, diabetes, placental problems, uterine abnormalities or substance use (e.g. alcohol and tobacco).

Fetal movement can start to be felt between weeks 16 and 20 of pregnancy, although some women might only feel movements at around 22 weeks. These movement can be described as vibrations, waves and kicks, and are easily felt after week 28.

If decreased fetal movements are noted, it is important to consult your OB, as decreased movements can be a sign that the baby is not receiving enough oxygen. It is important to identify the underlying cause and initiate prompt treatment as necessary.

What decreased fetal movement can mean

Decreased fetal movements may be a sign that the baby is in distress, due to lack of oxygen or nutrition. If not addressed rapidly, the baby is at risk for health conditions like premature labor, nervous system damage, or epilepsy.

Pregnancies that are well-monitored with all prenatal exams completed are the best way to identify any early abnormalities, which leads to optimal treatment if necessary. If you have any doubts or questions, you are encouraged to consult your OB.

Common causes

Decreased fetal movement may be caused by:

A baby that measures small for their gestational age;
Low amniotic fluid (oligohydramnios);
Fetal growth restriction;
Intrauterine infections or abnormalities in the uterus;
Placental insufficiency;
Fetal-maternal transfusion;
Poorly managed gestational diabetes

Other possible causes of decreased fetal movement include the threat of premature labor or the use of cigarettes, alcohol, sedatives, illicit drugs or corticosteroids.

Fetal sleep cycles can also reduce the baby's movements when they are sleeping. The fetus typically sleeps for 50 to 60 minutes at a time, starting at the 28th week of gestation.

In more serious cases, decreased fetal movement can be a sign of a miscarriage of fetal death.

How to count fetal movements

Fetal movements should be counted during the time of the day that the baby is most active, usually after a meal. You should count movements felt within one hour. The average number of movements is between 4 and 6 movements per hour, however many babies cant move up to 15 or 20 times in an hour.

Another way to count fetal movements is to see how long it takes for the baby to reach 10 fetal movements. If it takes longer than 2 hours to reach 10 movements, you should seek medical attention.

When decreased fetal movement is not concerning

Some women become accustomed to feeling fetal movements, and by the end of pregnancy, it is much easier to ignore them. This may be confused for decreased fetal movements.

Fasting and dehydration can also lead to decreased delta movements, It is very important for pregnant women to take time to eat and hydrate throughout the day.

Nonetheless, if you suspect decreased movements from the baby, you should seek medical attention.

How to stimulate the baby to move

Some ways to stimulate the baby to move include:

Drink cold fluids
Take a walk
Speak to the baby while rubbing your belly
Eat a sweet snack
Lie down with your legs elevated on pillows or on your headboard and try to relax

Each baby has different activity levels, however if the baby does not move with these tips after 2 hours, you should speak to your OB about your concerns. The OB will order testing as necessary to check the baby’s status.