How to manage pregnancies complicated by reduced fetal movements

If a baby moves less in the womb or if the pattern of movements change, this may indicate that it is unwell. We want to find out the best way of caring for women and birthing people who experience reduced fetal movements so that we can help to prevent stillbirth.
  • Authors list

    Professor Alexander Heazell, Dexter Hayes, Professor Jo Dumville, Professor Tanya Walsh

    Start date: 2019
    End date: 2022

  • Research centre

  • Research status

    Ongoing projects

Why do we need this research?

Baby movements in the womb – also known as fetal movements or ‘kicks’ – can feel like flutters, kicks, swishes or rolls. Sometimes a baby’s movements may slow down or change, and this could be a sign that the baby is unwell. While most women and birthing people who go into hospital with concerns about their baby’s movements go on to have a healthy child, some babies with reduced movements may not be growing as they should or may be at risk of stillbirth. Getting the right treatment and care as soon as possible is key to saving the lives of these babies.

Women and birthing people are advised to call their midwife or maternity unit immediately if their baby is moving less than usual or if there is a change to the pattern of movements. Despite this, there is no consensus on the best way of caring for people with reduced fetal movements, in part because previous research studies have given varied results. We believe this needs to change.

What’s happening in this project?

Instead of setting up brand new trials to investigate how best to care for women and birthing people with reduced fetal movements, researchers funded by Tommy’s have been combining data from lots of older studies. The team looked at studies that raised awareness of the importance of babies’ movements – for example by providing information to women or to care providers – as well as studies that looked at how women with reduced movements were treated in hospital. While the team found that there may be some benefit to encouraging women to count their baby’s movements, it was hard to draw conclusions as many of the trials measured different outcomes and could not easily be compared.

To combat this, our researchers have been developing something called a ‘core outcome set’ – a list of pregnancy outcomes that should be measured as standard in all future research studies into reduced movements. The team carried out an online survey that asked researchers, clinicians and parents to rate potential outcomes to see which were considered the most important – 128 people completed this survey. Our researchers then held consensus meetings, where the final core outcome sets were agreed.

What difference will this project make?

By developing core outcome sets for studies into reduced fetal movements, we are helping researchers make sure that the most clinically relevant information is collected in any future studies. As well as this, our work to combine data from previous studies will influence national treatment guidelines that advise healthcare teams on how best to care for women and birthing people whose babies are moving less often than usual.