Listening to the Unheard: The Critical Importance of Fetal Movement Awareness
Introduction: The Silent Tragedy of Stillbirth
The anguish of informing a mother that her baby has no heartbeat is an experience that leaves an indelible mark. The piercing cries of a woman receiving such news are unforgettable and underscore the profound tragedy of stillbirth.
Stillbirth affects approximately 1 in 160 pregnancies in the United States. Alarmingly, non-Hispanic Black women experience stillbirth at twice the rate of non-Hispanic White women. CDC
Personal Journey: Navigating Pregnancy with Twins During a Pandemic
During my first pregnancy with twins, distinguishing between their movements was a constant challenge. I used a home Doppler device, however, for piece of mind but was awared of its limitations and the dangers of false reassurance it can provide. I advise against buying a Doppler for expectant mothers, unless you have been properly trained in its use.
In the early months of the COVID-19 pandemic, I found myself in triage due to concerns about fetal movement. Despite the global crisis and overwhelmed healthcare systems, I prioritized my babies' well-being. This experience reinforced a crucial message: never be ashamed to seek medical evaluation when concerned about your baby's movements.
Why Fetal Movement Matters
Fetal movement is one of the few signs a pregnant person can observe directly. It’s a simple but powerful signal that your baby is healthy, active, and getting the oxygen they need. When a baby moves less or stops moving, it can be a warning sign of a problem—one that warrants immediate evaluation.
How to Do a Kick Count the Right Way
If you're in your third trimester (28+ weeks), here’s how to track your baby’s movements effectively:
🧘🏾♀️ Find a calm, quiet space. Sit or lie down on your left side in a dark room. Place both hands on your belly.
🥤 Drink something cold and sweet. A glass of water or a bit of fruit juice can sometimes help wake the baby.
🕒 Focus only on movement. Turn off distractions—TV, phone, and background noise. It helps to do this around the same time each day.
✍🏾 Count until you feel 10 movements. Kicks, flutters, rolls, or jabs all count. Most babies will reach 10 movements within 1–2 hours (often much faster).
If you notice that your baby’s pattern is slower than usual, or if you don’t reach 10 movements within 2 hours, call your provider or go to triage. Do not wait.
Do Not Be Ashamed to Get Checked
Too often, women hesitate to go to the hospital because they’re worried about being seen as overreacting. Please hear this:
👉🏾 You have every right to be cautious.
👉🏾 You do not need permission to protect your baby.
👉🏾 You are not “bothering” anyone.
I say this not just as a health advocate, but as a mother. During my first pregnancy, I was carrying twins. It was incredibly difficult to distinguish between their movements—and I was anxious every day. I’ve also seen firsthand what happens when fetal movement stops.
You will never forget the scream of a woman who is told her baby has no heartbeat.
No one should have to live that moment if it can be prevented.
What Is Antenatal Fetal Surveillance?
If there are signs of decreased fetal movement, or if you’re considered high-risk, your provider might recommend antenatal fetal surveillance. This includes monitoring methods like:
Non-stress tests (NST)
Biophysical profiles (BPP)
Ultrasounds to check fluid and growth
Surveillance usually begins around 32 weeks if there’s an identified risk. In some cases, it may be needed earlier.
Ask your provider:
Am I considered high-risk for stillbirth?
Should I begin antenatal testing?
What changes in movement should I watch for?
What Makes Someone High-Risk?
You may need earlier or more frequent surveillance if you have:
Hypertension or gestational diabetes
Autoimmune disorders or clotting issues
Prior stillbirth
Multiple gestation (twins, triplets)
Reduced fetal growth
Maternal age over 35
Limited access to prenatal care
But here’s the reality: sometimes risk isn’t clear until it’s too late. That’s why fetal movement tracking is essential for everyone.
The Research Gap
The truth is, there’s limited data on the most effective timing and use of fetal surveillance. Many decisions are based on expert consensus rather than rigorous trials. That’s not acceptable—but until we have stronger guidelines, you are your own first line of defense.
We need more research, especially into:
Personalized risk prediction
Effective surveillance for marginalized populations
Stillbirth prevention in healthy pregnancies
Conclusion: Trust Yourself. Take Action. Speak Up.
You are the expert on your body and your baby. If something feels off, go in. If you’re not being heard, ask to speak to someone else. If you need support, bring someone who will advocate for you.
Stillbirth is rare—but not rare enough. And for too many Black and Brown families, it’s far more common than it should be.
Let’s change that—by refusing to ignore warning signs, by demanding better care, and by sharing the truth about what pregnancy can really require.
Understanding the Stark Disparities
The racial disparities in stillbirth rates are a glaring issue. Studies have shown that Black women have a 2.2-fold increased risk of stillbirth compared to White women. Factors contributing to this disparity include differences in healthcare access, quality of care, and underlying chronic conditions. AJOG+1AJOG+1CDC
Moreover, the risk of stillbirth for Black women is higher at earlier gestational ages, with a 2.75-fold disparity at 20–23 weeks, decreasing to 1.57-fold at 39–40 weeks. AJOG+1AJOG+1
Empowerment Through Action
Your concerns are valid, and seeking medical attention is a proactive step toward ensuring your baby's health. Healthcare providers are there to support you, and it's always better to err on the side of caution.
By sharing our stories and raising awareness about fetal movement monitoring, we can work toward reducing stillbirth rates and addressing the disparities that disproportionately affect Black women.
Citations
Centers for Disease Control and Prevention (CDC).
Stillbirth: Data & Statistics.
https://www.cdc.gov/stillbirth/data-research/index.html
Accessed April 2025.MacDorman MF, Kirmeyer S, Wilson E.
Fetal and Perinatal Mortality, United States, 2013.
National Vital Statistics Reports; vol 64 no 8. Hyattsville, MD: National Center for Health Statistics. 2015.Stillbirth Collaborative Research Network Writing Group.
Racial Disparities in Stillbirth Risk Across Gestation in the United States.
American Journal of Obstetrics and Gynecology (AJOG). 2009;201(5):469.e1-469.e8. https://www.ajog.org/article/S0002-9378(09)00701-7/fulltextAmerican College of Obstetricians and Gynecologists (ACOG).
Practice Bulletin No. 229: Intrauterine Growth Restriction.
Obstetrics & Gynecology. 2021;137(6):e75–e90.Count the Kicks Campaign.
https://countthekicks.orgAccessed April 2025.