I’m no stranger to pregnancy; this is the fourth time I’ve done this. But this pregnancy has been so different to the others, proving beyond a doubt that just as all babies are different, all pregnancies are too. Previously, baby’s movements have never been an issue for me. I felt The Big One flutter at 16 weeks, and those flutters soon turned into kicks, rolls, squirms and jabs. We used to watch her move under my skin almost constantly. Her brother was just the same, perhaps moving even more. I remember being in labour with him, and feeling him kick and squirm in between contractions. I felt The Toddler move very early, around 13 weeks at least. And from then she moved regularly, with strong kicks and definite rolls.
I remember each pregnancy for the way that the babies moved. Each was different, in their own ways. Each was special. Each was amazing.
In the early weeks of this pregnancy I was very very sick. By six weeks gestation I was taking medication so that I could keep up the barest of appearances. I hid away and was unable to face going much further than the school run for weeks and weeks. I was miserable. And yet even in the darkest of moments, I clung to that first flutter. The first kick. The first real sign that all was well with this baby. It came much later than I expected, at around 20 weeks and that was as much a surprise as anything. I wasn’t sure why I wasn’t feeling many kicks or squirms.
Our anomaly scan revealed that my placenta is anterior, and therefore cushioning many of baby’s movements. I was assured that as baby grew, the kicks would be felt a lot lower and that there was nothing to worry about at all.
Later on in the pregnancy we were sent for a growth scan, which revealed that baby was not growing as well as the doctors would have liked. I was told to monitor movements closely and I remember feeling a sense of panic because I wasn’t sure how to monitor movements I couldn’t feel. The best advice I was given was to spend time getting to know my baby’s pattern, and to forget about ‘recommended numbers of movements’ in a set time. What was important was changes to my baby’s pattern.
And so I would sit and think. When did baby move last? Does baby usually move at that time? Is baby moving enough? Has it been too long in between that movement just then and the one before it?
An anterior placenta is no reason not to call the midwife if you believe movements are reduced.
Babies with IUGR may need extra monitoring because they may become distressed or too weak to move, especially in later pregnancy.
IUGR babies are at increased risk of stillbirth.
These facts have been drilled into me with every appointment, every scan, and every session on the CTG monitor.
It is never a waste of anyone’s time to go to the hospital to have a trace performed of baby’s heart rate.
I have dithered. I have stressed. I have prayed, willed and prodded baby into action. I’ve downed icy water, fizzy coke and tart orange juice. I’ve lain on my side, taken a warm bath and played music to my bump. I’ve listened to my baby kick. I’ve seen the heart rate rise in relation to a movement that I have not felt. And I have had periods of no movement at all that have scared me senseless.
I know that some IUGR babies need extra monitoring, and I know that an anterior placenta can cushion movements too. And yet I do not know that all is well when my baby goes quiet. Moments like this are worth recording and keeping forever.
Movements towards the end of pregnancy should not slow down or reduce. If you notice a reduction in what is normal for your baby, Mama Academy advise you to lie on your side for two hours and monitor movement closely. Call your midwife if you are still concerned, or baby does not make more than 10 movements in this time. I know that spending two hours on your side is not always possible, or convenient- but if you are worried, call your midwife straight away. This advice applies to all pregnancies- non IUGR and with posterior placentas. More info here.
At each midwife appointment, you should be asked about baby’s movements; midwives are aware that IUGR babies have links with decreased fetal movements. It helps if you write down when you felt that last movement so that your midwife knows how long the quiet periods are in between movements. If the CTG shows all to be well with baby, and movements are recorded, you must still call your midwife if you notice a reduction in movements later that same day, or the day after. It really does not matter how often you go for monitoring; you will never be told to go home and stop worrying. More info on reduced movements here.
The above advice has been been repeated over and over during this pregnancy and yet I still sit here, just days away from meeting our little poppyseed, and I am still questioning myself. When I last felt baby move, whether or not baby moves enough. Are the reduced movements down to the IUGR, or the placenta, or something else? When baby finally arrives, will it become clear why movements have been so reduced?
Doctors and midwives can only know so much. Scans and CTGs can only give information gathered at that moment in time. A mother’s perception of movements is an additional source of monitoring, but we will never really know what is going on inside. For now, each kick, squirm and roll is so precious, and so welcome. And until baby is here, I will treasure each active moment more than you know.