Baby movements in the womb
You will probably start to feel the movements of your baby in the womb somewhere between 16 and 22 weeks. As the weeks go on you may become aware of a particular pattern of movement that is familiar to you.
Your baby may move more in the evenings when you are resting or before you go to sleep at night. You may also find certain activities such as a bath, putting your feet up and resting on the sofa or eating and drinking seem to cause your baby to move more.
The movements normally become regular by 26 weeks. Recognising these patterns of movement can be very useful during your pregnancy.
If a baby is having problems in the womb they are likely to move less to conserve energy. Noticing when this happens and contacting your hospital immediately can make the difference between life and death.
If there is a definite change in your baby’s movements
If you notice a change or reduction in your baby's movements you should contact your midwife or your maternity unit immediately - do not wait until next day.
If you think there might be a change in your baby’s movements
It is better to be safe than sorry so if you have any doubt, call your maternity ward. Trust your instincts.
Who will I talk to if I report a change in my baby's movements?
Unless you have been given alternative numbers to ring during your pregnancy, the best place to ring is usually the labour ward. The labour ward is not only available for women in labour but also for emergencies during the pregnancy. The ward should be open 24 hours a day and there should always be a midwife there who will be able to discuss with you what you are experiencing and advise you.
What will happen if I go in to hospital?
Once at the hospital they will probably check your health and listen to the baby’s heartbeat. They may attach you to a heart rate monitor which records a trace of the baby’s heartbeat so this can be looked at for any signs of problems. You may also be given a button to push every time you feel the baby move and this can also be seen on the print out of the baby’s heartbeat.
It's quite common that once you lie down, hear the baby’s heartbeat and relax you start to feel the baby kicking a lot. Don’t feel embarrassed about this - midwives see this everyday. It is far better to go and be checked so that any potential problems can be picked up. Read more about what will happen when you report reduced fetal movements here.
Sleeping position in the third trimester
When you reach your third trimester, the advice is to go to sleep on your side. Research has shown that going to sleep on your back is linked to an increased risk of stillbirth. This advice includes daytime napping and night sleeping. Read more about safe sleep positions in pregnancy here.
Leaking fluid / vaginal discharge in pregnancy
If you experience any leaking of fluid from your vagina during your pregnancy you should contact the hospital immediately and go to be monitored. It could be your waters breaking early or a sign of infection of the womb.
Waters breaking early in pregnancy
Waters can break at anytime during pregnancy, not just in the last couple of weeks, and this can lead to premature birth. If you feel a gush or trickle of fluid, or feel damp, it could be a sign that your waters have broken. In these cases put on a clean sanitary towel (not a tampon) and call the labour ward. They may ask you to sniff the pad – as it is common to leak urine in pregnancy - or they may ask you to check the pad again in around 20 minutes to see if it is damp.
Amniotic fluid – the fluid from around the baby – smells different to urine and is usually clear, pinkish or can be green or brown. If you believe it is amniotic fluid it is important to go straight to the hospital to be examined. You may be asked to wear a special panty liner for up to 12 hours to confirm if you are leaking amniotic fluid, and you may need an internal examination (inside the vagina) to look for signs that your cervix is opening or softening for labour.
Infection in pregnancy
You should report any discharge from your vagina which is smelly, and any colour other than white, as it may be a sign of an intrauterine infection. Infections can weaken the bag of membranes around the baby, cause an infection inside the womb or make your waters break.
If you experience an unusual discharge contact your midwife, GP or hospital and ask for a swab to be taken to look for infection.
Diabetes in pregnancy
For women with diabetes in pregnancy, miscarriage, pre-eclampsia, preterm labour, stillbirth and problems with the baby (whilst in the womb, at delivery and after the birth) are sadly more common. This means that good control of your blood sugar levels and regular monitoring are vital.
Whether you had diabetes already, or develop diabetes during pregnancy (known as gestational diabetes), you will need to be closely monitored, and you will need to be aware of how best to care for yourself and your baby during your pregnancy.
What to do in you have diabetes in pregnancy
If you already had type 1 or 2 diabetes before pregnancy you should get good pre-pregnancy counselling and support before stopping contraception and trying for a baby.
If you are pregnant with diabetes you will probably be regularly seen by a consultant and a specialist diabetes midwife. If you are not happy with the care you are receiving talk to the women's health department manager to ask that your condition be correctly monitored. Make sure that you attend all your scheduled appointments and seek help immediately from your GP, midwife or hospital doctors if you are concerned about your glycaemic control or any other factors affecting either your pregnancy or your diabetes.
Monitoring the growth and movements of your baby is more important than in other pregnancies, so make sure you are clear as to who you should contact if you are concerned. Do not wait until next day, you can contact the labour ward to speak to a midwife outside working hours.
If you have any of the risk factors for developing gestational diabetes, including having a BMI of 30 or over, make sure you are tested between weeks 24 and 28, as recommended by NICE.
Pre-eclampsia and stillbirth
Pre-eclampsia is a condition which affects around 10% of all pregnancies in the UK, and untreated, can cause stillbirth. You are most likely to get it in your first pregnancy or a subsequent pregnancy with a new partner. The main symptom is high blood pressure. It is very important that you attend all your antenatal appointments, as pre-eclampsia is one of the pregnancy conditions that your midwife will be looking out for.
If during your pregnancy you are told that your blood pressure has increased since the beginning of the pregnancy ask your midwife how significant the rise is. Your midwife will also be looking for any protein in your urine so always provide a urine sample at every appointment. If you refuse to give a sample the midwife cannot pressure you to give one, but it could mean a vital clue is missed.
What to do if you think you might have pre-eclampsia
Between appointments look out for any of the warning signs of pre-eclampsia, including severe headaches, altered vision such as seeing flashing lights in front of your eyes, and sudden swelling, particularly of your feet, ankles, hands and face.
Some women also experience pain in their upper abdomen, just below the ribs. If you notice any of these signs you should contact your GP, midwife or labour ward for advice. Do not wait until your next scheduled appointment and ensure that you are seen by someone the same day.
Working with your medical team in pregnancy
- It is important that any concerns you have, or things that you notice, are taken seriously. Trust your instincts and report all complications, no matter how insignificant they may seem.
- Try to get to know the team of midwives that are caring for you during your pregnancy. Even if you meet a new midwife at every appointment aim to use every appointment to your best advantage.
- If you have a BMI of 30 or over make sure you get a test for diabetes. It is recommended by NICE and should happen between weeks 24 and 28 of pregnancy. If you are not offered this test ask why.
- Ask about the size of your baby – if it is particularly large or small do you need further scans?
- If your blood pressure is raised do they think it could be the start of pre-eclampsia – do you need more appointments to monitor this?
- Report any unusual symptoms such as headaches, blurred vision (seeing stars), any pains, any aches, nosebleeds, feeling dizzy or faint.
- Itching is particularly important as it can be a sign of obstetric cholestasis, a liver condition in pregnancy. A common symptom of this condition is itching of the hands and soles of the feet, but you should report all itching. A simple blood test can be used to diagnose this.
- If you have a scan or blood test and there seems to be a problem that needs closer monitoring make sure you know as much as you can about the condition they are looking at. If you haven’t been referred to a consultant yet, ask to see whichever consultant specialises in the problems that have been identified. Make sure you know any symptoms to look out for and what to do in the event of experiencing any of them.
- Early in your pregnancy ask your midwife who you should contact if you have any other symptoms or concerns between appointments. Never leave a worrying symptom till your next appointment. Contact your GP, midwife or hospital and ask to be seen.
Finding the causes of stillbirth
Many parents still cannot be told why their baby died. Our researchers are investigating the causes of stillbirth, because without knowing why it's happening we can't find treatments or predict who may be at risk. This animation shows some of our work into finding the causes of stillbirth.