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This is a non-invasive method of monitoring the well-being of the fetus in utero. It has been observed that when something is wrong with the fetus. This is because the baby is conserving needed energy for vital functions in a weakened state.
However, the quality of fetal motions usually changes from small sharp movements to larger, smoother movements as space in the uterus is taken up in late pregnancy. You and your midwife will be checking to see if there is an overall reduction of your baby's NORMAL pattern of movement. In many cases this is a sign that the baby needs to be born soon.
USING THE ASSESSMENT CHART
Counting every move your baby makes is not very practical, so select a time during the day when you can count fetal movements for six consecutive hours. It is best to use the same hours every day. Do not select a time when the baby seems to sleep regularly.
You will begin by counting the first 5 movements in the six hour period. Mark the time you feel the fifth movement in the appropriate time block on your chart. If fewer than 5 movements are felt, note how many you detected in the space below the time slots. Should the baby have periods of constant movement, count one movement for each full minute of activity. Here is an example of how to use the chart:
1. Hours you choose to count movements (you may engage in any normal activity which will still allows awareness of fetal motion). Write in times in 1/2 intervals. This mother started counting at 9 am.
Monday she felt the 5th movement at 11:15 am, so she marks the 11:30 am block on her chart.
On Tuesday she felt the 5th movement at 12:30 am.
Wednesday she did not feel 5 movements in the 6 hour period, she marks the "4" box in Wednesday's space.
On Thursday, she felt 5 movements by 1:30 pm.
2. Notes on special situations or sensations are recorded here.
NOTE: If less than 5 movements are felt in your counting period for any two days in a week, call your midwife immediately.
Example of blank charts to be used for assessments:
ASSESSMENT OF FETAL MOVEMENT
This test goes hand-in-hand with assessment of fetal motion. It has been found that a healthy baby will respond to activity by raising its' heart rate, and lowering it when at rest. (Just as an adult heart will speed up and slow down with activity and rest.)
The test is often used in hospitals before the much more stressful Oxytocin Challenge test. In the hospital, the mother is hooked up to a monitor and asked to indicate when she feels the fetal motion. The heart rate is expected to vary anywhere from 10 to 25 heartbeats per minute and accelerate with movement in a normal, healthy fetus. Lack of such variability has been correlated with high incidence of fetal mortality when observed prenatally. This pattern, when observed during labor, has not been clearly associated with infant outcome, although variability should still be present (but not necessarily associated with movement).
This test can be duplicated at home by simply monitoring the baby with a standard fetascope and being sensitive to when the baby moves. If the baby is not moving (it could be asleep!) palpate until you get a response and continue to listen for heart rate fluctuations. In order to easily assess variability, count the fetal heart rate for consecutive 5 second intervals. Comparing the several numbers that you will come up with will give you a good idea of how the baby is doing and what the range of heart rate is. Multiply each 5 second count by 12 to arrive at the per minute equivalent.
The fetal heart rate is expected to vary at least 15 beats per minute for 15 to 30 seconds twice or more in a 10 minute period or five times or more in a 20 minute period. This frequency reflects fetal health.
MoonDragon's Obgyn Information: Pregnancy - Birth Concerns
This information obtained from Understanding Lab Work in the Childbearing Year by Anne Frye
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