Why is my baby not moving? 9 reasons to consider.

Posted by Dr. Yahya MS on January 12, 2020

When ever babies are exposed to adverse condition in the womb, they quickly adapt by reducing energy consumption. Some of the adaptations include redistribution of blood away from relatively non-essential
organs (such as the muscles and kidneys) to a more vital organs (such as the brain and heart). They also reduce breathing movement and general body movement.

Fetal movements are expressions of baby's well being and cessation or even reduction of these movements may signify baby in distress or impending baby's death. It can also be as a result of physiological causes such as fetal sleep.

Mothers commonly perceive a reduction in, or absence of the baby’s movement for some days before a baby’s death. Mothers should always trust their instinct and seek professional medical attention when they are concerned with reduction of their baby’s movement. They should not wait until the next day as it may be too late by then.

When do baby's movement begin?

The first perception of the baby’s movement is called quickening. Passive unstimulated fetal activity commences as early as 7 weeks of pregnancy and becomes more sophisticated and coordinated as the pregnancy advances. These movements are perceived by the mother at 18 to 20 weeks of pregnancy (for first time mothers) and 2 weeks earlier (16 to 18 weeks) for those moms that deliver before. 

The mother is able to perceive about 70% to 80% of gross baby's movements. The baby does make fine body movements such as moving the hands and legs, hand grasping, finger sucking, and tongue protrusion; the mother may not be able to feel such fine body movements.

What are the causes of inability to perceive the baby's movement?

1. Maternal position

Studies have shown that women perceive most fetal movements when lying down, fewer when sitting and much less while standing. This result in women who are busy and not concentrating on the baby’s movement report more decrease movements.

After 28 weeks of gestation if the mother is unsure of the
feeling of baby's movement, she should lie on her left side for 2hrs, the fetal movements may be felt.

2. Fetal sleep

Baby's sleep is a common and benign cause of decrease in baby's movements. Occurs regularly throughout the day and night and usually last for 20-40 minutes and rarely exceed 90 minutes in a healthy baby. 

In a  study that observed late preterm fetuses from uncomplicated pregnancies for 100 minutes, quiet sleep
occurred at least once in 30 percent of babies, but 96 percent of the babies cycled between quiet sleep and active states during the period of observation.

3. Placenta on the front wall of the womb

Before 28 weeks of pregnancy, the baby is small and presence of the placenta on the a front will decrease the mother's perception of baby's movement.

This type of placenta reduces the perception of fetal movements to the extent that such women would be twice as likely to present with decreased or absent baby's movements.

4. Reduced volume amniotic fluid

Decrease in the amniotic fluid is associated with reduction in both amplitude and speed of baby's movement. A study by Sherer et al. assessed the number of fetal movements in relation to amniotic fluid volume. They observed decreased fetal activity with diminished amniotic volumes and suggested that a restricted uterine space might physically limit fetal movements.

5. Early in pregnancy

Before 16 weeks of gestation, the mother may not be able to perceive the baby's movement, even though the baby is moving. In some pregnancies, the fetal movement may not be perceive by the mother under about 20 weeks of gestation.

6. Maternal drug intake

Some drugs taken by the mother can pass to the baby, and cause fetal depresssion, which can be perceive as decrease or absent fetal movement.  Example of these drugs are narcotics and sleeping induced drugs such as diazepam.

Cigarette smoking and alcohol also cause decrease fetal movement and have adverse effect on fetal wellbeing.

7. Poor fetal growth and abnormalities in the baby

Babies that are not growing well for what ever reason, exhibit less movement to conserve energy compared to the normal babies. 

8. Fetal death 

Baby's movement is an indirect indicator of fetal oxygen status, and brain function. with exception of acute complications in pregnancy, sudden cessation of fetal movement is not common. The babies tend to have a prolong period of decrease activity before death ensue.
Absent baby's movement may indicate that the baby is death.

9. Other maternal factors

Maternal factors could influence fetal movements; in different studies maternal smoking, first pregnancy, obesity and exercise in pregnancy were associated with decreased fetal movement.

Conclusion

There can be wide variation from one fetus to another on how often the fetus moves, and it is therefore difficult to specify quantitatively the numerical value of the lowest number of movements that should trigger alarm. The recommendation is when ever the mother is concerned about the movement of her baby should seek urgent medical attention.

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This post is for educational purpose only. It is not meant to replace your professional medical advice.