Pregnant Movements

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By Heather Rupe, DOBoard-certified OB/GYNAugust 26, 2019
Today in the office, I saw two pregnant patients that were highly concerned about their baby’s movements. Patient A was anxious that their baby wasn’t moving nearly as much as normal, while patient B feared their future gymnast was moving far too much.
What is considered “normal” for a baby’s movement during pregnancy varies widely. It might help to understand which movements are abnormal and when you should call your provider.
As a writer, I don’t care too much for most medical terms, but I do make an exception for “quickening,” which is beautiful description of the first time the mother feels their baby moving inside them. Those first movements feel like little tender butterflies randomly fluttering their wings inside your womb (uterus). The quickening can occur anytime between 16-22 weeks of pregnancy. If you had a baby before, you may recognize the sensations earlier with subsequent pregnancies. Once you feel the early flutters, you may not necessarily feel them every day until after about 24 weeks. If you are not feeling the baby move every day by 24 weeks notify your provider.
I talk to all my expectant moms about the importance of tracking their baby’s movements, or kick counts. After 28 weeks, your baby should move at least 10 times in two hours, once a day. The baby does not need to move 10 times EVERY two hours, but they should have a couple of active hours each day. If the baby stops moving, it could be an early sign that he is in distress. The baby may be tangled in the cord or you may have too little amnitoic fluid. These complications can be very serious. If you haven't felt your baby moving normally, then drink some fruit juice and rest on your left side for 2 hours and pay close attention to their activity. If you do not get 10 distinct movements or kicks in that time (or over the two hours) call your provider right away. 
Every child has their own special personality, sometimes starting in the womb. I will often have patients concerned that their current pregnancy is more or less active than their last. Or, women will say their friend’s baby moves nonstop while their little one only wiggles after dinner. I remind them to count the kicks. Again, if there is one active hour each day, the baby’s movements are fine.
A mom’s perception of their baby’s movement can depend on a couple of factors – one being the location of the placenta. When the placenta is attached to the front of the uterus, it essentially creates a pillow between them and the baby. This makes it more difficult to feel the movements regularly. It may also be a reason a woman feels the baby moving really early in one pregnancy but not until much later with the next.
A mom’s weight can also affect perception of movement. If you are overweight and have extra padding in the belly, you may not feel the movements as distinctly. I’ve had several patients who were overweight with placentas on the front wall of the uterus who could barely feel any movements throughout pregnancy. (I have a feeling these are the women who show up on those “I Didn’t Know I was Pregnant” shows.) In this situation, I performed weekly heart beat tests (nonstress tests) to confirm everything was happy and healthy with the baby.
A rhythmic movement that occurs every couple seconds is likely the baby hiccupping. This feeling can sometimes be disconcerting, but it’s actually a normal part of baby’s development and a reassuring sign that baby is healthy.
I will commonly get concerned calls from patients whose babies normally move at night and today are moving in the morning or vice versa. Baby is not on a schedule in the womb. Again, having one active hour a day – or night – is what is important. It doesn’t need to be the same hour each day.
As your pregnancy progresses and baby grows, they may begin to run out of room. The intensity of movements may decrease. The baby should still be active, but they may not be able to perform their more elaborate ninja moves.
At some point in the third trimester, those precious flutters that once made your eyes misty with maternal bliss turn into painful 3 a.m. beatings that bring tears to your sleep-deprived eyes for an entirely different reason. However, babies can’t move “too much” and there is really nothing you can do to ease painful fetal movements.
Just as each pregnancy is unique, so are the baby’s movements. Try not to compare this pregnancy to previous ones or that of your coworker across the cubicle. Realize that many factors affect your baby’s activity. Just remember, if they haven’t met their kick count for the day, you need to call your provider to get things checked out.
Heather Rupe, DO, is a board-certified OB/GYN in private practice in Franklin, TN, and serves as the vice chief of staff at Williamson Medical Center. She is the co-author of The Pregnancy Companion: A Faith-Filled Guide for Your Journey to Motherhood and The Baby Companion: A Faith-Filled Guide for Your Journey through Baby’s First Year.
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Your baby's activity level — the kicks, rolls and wiggles you can feel — will vary throughout your pregnancy. Here's what to expect when it comes to fetal movement.
Feeling your baby kick, twist, wriggle, punch and hiccup is simply one of pregnancy's biggest thrills (and it sure beats heartburn, puffy feet, an aching back and other hallmarks of these nine months). There may be no better proof that a brand-new and impressively energetic life is developing within you.
But fetal movement during pregnancy can also drive a mom-to-be batty with questions and doubts: Is my baby kicking enough? Too much? Does my baby have four legs (because it sure feels that way when the kicking starts)?
Although every baby is different when it comes to fetal movement and there's a wide range of what's normal, it helps to take a peek into your baby's world to understand what's going on in there, and what to expect, when.
From the first few days and weeks of pregnancy (when that rapidly expanding cluster of cells is just a cluster of cells) through the end of the third month (when baby's vocal cords are starting to form), the first trimester is a time of astoundingly fast development. But don't expect to feel any fetal movement just yet (except in the form of the queasiness, fatigue and headaches, that is). Your baby is far too tiny, and buried far too deeply within the protective cushioning of your womb, to make a blip on your belly radar. He or she could dance a jig, and you'd feel neither a stamp nor a hop.
Ah, now we're talking — or at least thumb-sucking, kicking and thrashing. When will you actually feel those early twitterings of life? Here’s what to expect, month by month.
Most women feel the first movement of their active little tenant, known as quickening, between weeks 14 and 26, but generally closer to the average of week 18 to week 22 (though variations are common!). The position of the placenta can play a role: If it’s facing front, also called an anterior placenta, it can muffle the movements and make the wait for those kicks weeks longer.
Fetal Development: Baby’s Bones and Skeletal System
Fetal Development: Baby's Hair, Skin & Nails
9 Things to Know About Your Baby's Kicks in Utero
Fetal Development: Baby’s Bones and Skeletal System
Fetal Development: Baby's Hair, Skin & Nails
9 Things to Know About Your Baby's Kicks in Utero
What do early movements feel like? They’re almost as hard to describe as they are to recognize. Maybe it’ll feel like a flutter (like the “butterflies” you get when you’re nervous) or waves (as though a little fish is swimming in there, which is pretty much what's going on!). It could feel like a twitch, nudge or even the growling of hunger pangs. Or maybe it’ll feel like a bubble bursting or that upside-down, inside out feeling you get on a roller coaster. But no matter what your experience with baby's first movement turns out to be like, it’s bound to put a smile on your face once you figure out what's going on.
Keep in mind that babies are unique, just like the rest of us, and the rhythms and patterns of their activity will vary. Try not to compare your baby's movements with those of others (your best friend's pregnancy is different from yours), or of your own previous children if you have any. And don't stress, either, if your baby seems unusually active; it doesn't mean you'll have a hyper child later on.
During the day, the motion of your own body can lull the fetus to sleep — and you're often focused on so many other things when you're up and about. But you will likely find that baby is more active when:
Some pregnant women (those who are slim, for example, and those for whom this is their second pregnancy) first feel baby's movement around now. But most women won't be aware of or recognize the flits and twitches, which can feel a lot like gas or muscle spasms, for at least another few weeks.
This is the month when most women feel the fetus moving for the first time. And once you're able to feel them, baby's routines will grow increasingly acrobatic and the punches more powerful as those little muscles get stronger and fledgling motor skills develop. Your little gymnast is still small enough to be able to turn somersaults with abandon in your uterus.
Haven’t felt any movement by the middle of the month? Your practitioner may order an ultrasound to take a look at how your baby is doing — it could just be that your due date is off (it happens more often than you might think!). But it's best to get it checked out just to be sure.
Your baby picks up the pace when you're six months pregnant. Leg movements will seem more choreographed, and you may start noticing patterns in the pitter-patter of those little feet (although it's just as likely that the behavior won't be predictable).
From here on out, it’s a bit (to a lot!) more cramped in the womb. You can expect to feel fetal activity every day for the rest of your pregnancy. Here’s what to expect during this final trimester.
To ensure that everything is progressing as expected, your doctor will want you to "count kicks," or fetal movements, starting in week 28 through the end of your pregnancy. Here’s what you’ll want to look out for:
When you're seven months pregnant, your baby still has enough room to toss and turn for a little while longer. Your fetus is getting stronger every day — and those punches, while comforting, can now be downright jolting. 
Kicks and punches are not the only movement you're probably feeling these days. Have you sensed occasional little flutters of faint but rhythmic tics? The baby probably has a harmless and perfectly normal case of the hiccups. (Not having them is just as normal, though.) Know that hiccups don’t cause the same discomfort in babies — in or out of the uterus — as they do in adults. So relax and enjoy!
As your baby packs on the pounds, that formerly spacious apartment called your womb is becoming more like a cramped closet. Acrobatic tumbles are less likely now, but you'll continue to feel wriggling and turning, with a few jabs of elbows and knees thrown in for good measure.
If your little drummer's bongo-playing on your belly starts to be more than you can take, try changing positions: Sit down if you're standing, or lie down on your side; the baby will likely change positions too and find something else to do.
At this point, you may even be able to interact with your baby: Next time you see something protruding — a knee, perhaps, or a foot? — give it a gentle press. If the baby is game, you might see the limb get pulled back, then pushed out at you again.
At nearly full weight and length, your little one is not so little anymore — at least, not relative to those tight quarters. You won't feel those rapid-fire pummeling kicks (there's just no room for that), but larger lurches and bigger movements (as baby turns over, for example) will definitely get your attention. So will the pounding some babies like to inflict on the cervix — maybe they sense where the exit is?
Something else you'll probably feel: baby's foot (or feet) lodging into your ribs, which can sting. A gentle nudge, a shift in your position or a set of pelvic tilts might bring some relief. 
When baby engages — or drops head-first down into the pelvis — before delivery (two to three weeks before if it's your first pregnancy, closer to the due date in later pregnancies), those activity patterns could change again. You'll feel, quite strongly, every turn of your baby's head (it might feel like little sharp electric twinges close to your cervix). Fortunately, those little feet can no longer dig into your ribs.
The last few weeks before delivery vary widely — some babies move a bit less, but don't be surprised if yours keeps up an energetic pace until it's time for your face-to-face introduction. And you should still feel your little one's movements every day, so if there's a noticeable decrease at any point, always check with your practitioner.
While it’s always good to be aware of your baby's punches, kicks and rolls throughout your pregnancy, there may be times when you feel changes in fetal movement, which are in most cases totally normal. Here are a few times you might notice a decrease in fetal activity:
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.
What to Expect When You're Expecting, 5th Edition, Heidi Murkoff and Sharon Mazel.
WhatToExpect.com, Baby's First Kicks, September 2018.
WhatToExpect.com, Changes in Fetal Movement, April 2018.
American College of Obstetricians and Gynecologists, How Your Fetus Grows During Pregnancy, April 2018.
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The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. This educational content is not medical or diagnostic advice. Use of this site is subject to our terms of use and privacy policy. © 2021 Everyday Health, Inc
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