Interpretation of fetal movements and their abnormal patterns
All women interviewed in the ANC considered FMs as a sign of life of the
fetus and a form of communication between fetus and mother.
‘When the baby is kicking, I know it’s continuing in
good health. It’s doing well.’ (Antenatal)
‘When I’m too busy the baby will let me know by kicking me
once very strongly. That’s how it tells me to slow down. Normally the
baby is quiet at night, but when I’m lying on one side for too long the
baby will kick strongly, as if to tell me, or reminds me ‘Hey! Turn the
other side!” (Antenatal)
Half the ANC women perceived FMs as abnormal, or worrisome, if they
become absent. Other women found FMs abnormal if they become weaker or
less frequent than usually.
‘I would be worried if the baby won’t kick when I’m used to
feeling it kick or when I feel that it’s uncomfortable’ (Antenatal)
‘If the baby is not kicking, I will be worried
(…). Because maybe the baby already started to die.’ (Antenatal)
Furthermore, women also perceived FMs and their changes during labor:
‘When my
blood pressure was high [250/120 mmHg], I felt the baby was moving
differently. It moved slower than before that. During labor also it
sometimes stopped moving which worried me.’ (Postpartum)
‘At home it
[FMs] was just fine, but since I arrived, I felt it became less and
less. I already started to drain [losing amniotic fluid] at home but
once I arrived here, I drained more and after that the movements became
even weaker.’ (Postpartum, baby died soon after birth)
All health care providers also considered the presence of FMs as a sign
of health of the fetus and mother. Reported worrying changes included
reduced (n =23, 82,1%), absent (54.6%, n=15) and increased FMs
(46.4%, n=15). (Table 2) Various causes of abnormal FMs were given such
as maternal as well as fetal conditions such as fetal maternal emotions,
activity, hunger, intake of herbal medication, anemia, infection,
hypertension and bleeding, position and sleep state of the baby,
polyhydramnios and oligohydramnios. Pointing to a poster on the wall, an
ANC nurse also indicated that abnormal FMs is one of the danger signs
they look out for.
‘To ask a mother whether her baby moves or not helps us to
decide whether it’s alive or not. They [FMs] may be increased or
decreased which will help us to know whether the baby is healthy or
not.' (Healthcare provider)
‘If it’s absent, the baby died already, if it’s decreased the
baby could be in distress.’ (Healthcare provider)