Articles (EN)

Fetal movements: when to expect and how to count

2026-05-27 12:00 Pregnancy
In short: The first movements of the fetus are felt at 18-22 weeks (in primiparous women - closer to the 22nd, in multiparous women - from the 18th). After 28 weeks, it is recommended to count movements daily: normally, at least 10 movements in 2 hours. A decrease in fetal activity is a reason to immediately consult a doctor.

When the fetus begins to move

The fetus begins to move as early as 7-8 weeks, but at this early stage, its movements are too weak for the mother to feel them. From the 16th week, movements become more coordinated - the fetus already knows how to suck the thumb, yawn, hiccup and respond to sounds.
The mother begins to feel the movements of the fetus (movements) at 18-22 weeks. In primiparous women, as a rule, closer to the 20-22nd week: it is more difficult for them to distinguish movements from intestinal peristalsis. In multiparous women, it is earlier, from the 16th-18th week: they are already familiar with this sensation. At first, the movements look like a "butterfly fluttering", a slight "rolling" or gas bubbles.

How the nature of movements changes from week to week

16–20 weeks. The first felt movements are weak, irregular, rather like a "tickling" from the inside. Don't worry if you don't feel anything – every woman has her own threshold of sensitivity.
20–28 weeks. Movements become clearer and more regular. The fetus is active at certain times of the day (often at night – this is normal). You can already clearly distinguish pushes, flips, hiccups (rhythmic twitches).
28–36 weeks. The most active period: the fruit is large, but there is still enough space for it. Movements can be strong and even painful. It is recommended to start counting movements daily.
36–40 weeks. The space in the uterus becomes smaller, and the nature of the movements changes: they may not be so sharp, but no less frequent. It is important to understand: reducing the frequency of movements before childbirth is a myth. Normal activity persists until childbirth. A real decrease in the number of movements is a reason for an urgent visit to the doctor.

How to correctly count fetal movements

The Count to Ten method is the most common and recommended. From the 28th week, count the movements daily in a calm environment (preferably lying down or sitting at the same time of day when the fetus is usually active - often after meals or in the evening):
  1. Remember (write down) the time of the start of the count.
  2. Count any tangible movements: pushes, flips, hiccups.
  3. As soon as you count 10 movements, record the time.
  4. Normal: 10 movements in 2 hours or less. If you count less than 10 movements in 2 hours, immediately contact an obstetrician-gynecologist or go to the hospital.
Other counting methods (Pearson, Cardiff) are also used - the essence is the same: fixing the activity of the fetus at a certain time of the day. The main thing is to do it regularly to understand the individual rhythm of your baby.

What affects the activity of the fetus

Time of day. Most fruits have "sleepy" and "active" periods. Peaks of activity often occur in the late evening and at night, at least in the early morning.
Food and blood sugar levels. The fetus becomes more active 1-2 hours after the mother's meal - the blood glucose level rises.
Noise and light. The fetus reacts to sounds and bright light. Loud music or the flash of a flashlight on the abdomen can provoke movement.
Mother's position. In the lying position (especially on the left side), the fetus is usually more active, as the blood supply to the placenta improves.
Fetal sleep. The fetus has a sleep-wake cycle of 20-40 minutes. During sleep, there are no movements - and this is normal. But if the fetus does not move for longer than 1-2 hours, it is worth counting.
Stress and fatigue of the mother. With severe stress or fatigue of the mother, the fetus may temporarily calm down. However, this should not be a reason to ignore the decrease in activity.

When to see a doctor

Contact your maternity hospital or obstetrician right away if:
You have counted less than 10 movements in 2 hours during the usual active time of the fetus.
The fetus did not move for more than 12 hours.
The movements changed dramatically in character: they became very rare or, on the contrary, unusually violent.
You're worried—even if you can't clearly explain why.
The doctor will conduct a CTG (cardiotocography) - a record of the fetal heartbeat and its motor activity. This is a quick and safe examination that allows you to immediately assess the child's condition.

Myths about fetal movements

"Before childbirth, the fetus calms down." This is a common and dangerous myth. A normal fetus retains motor activity until the beginning of labor. A decrease in movements is always a reason to consult a doctor, regardless of the term.
"If he pushes hard, then he is suffocating." No. Normal active movements are a sign of good fetal condition. An alarming sign is a decrease, not an increase in activity.

Frequently Asked Questions

What to do if the fetus does not move? Should we panic?

No, there is no need to panic – but you need to act. Drink a glass of cold water or eat something sweet, lie on your left side and count the movements for 2 hours. If you did not count 10 movements in 2 hours, call the maternity hospital or the doctor.

From what week should you start counting movements?

The official recommendations of ACOG and NICE suggest that systematic counting should begin at week 28. However, before this period, it is also important to pay attention to the activity of the fetus - any changes that bother you should be discussed with your doctor.

Conclusion

Fetal movements are an important sign of its well-being. From the 28th week, count the movements daily according to the "up to 10" method. A normal fetus is active and retains this activity until delivery. A decrease in movements is always a reason to immediately consult a doctor, and not wait for the next scheduled visit.

Bibliography

  1. ACOG Practice Bulletin No. 229. Antepartum Fetal Surveillance. Obstet Gynecol. 2021. https://pubmed.ncbi.nlm.nih.gov/33370041/
  2. RCOG Green-top Guideline No. 57. Reduced Fetal Movements. RCOG, 2011. https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/reduced-fetal-movements-green-top-guideline-no-57/
  3. Warrander LK, Heazell AE. Identifying placental dysfunction in women with reduced fetal movements can be used to predict patients with adverse pregnancy outcomes. Med Hypotheses. 2011. https://pubmed.ncbi.nlm.nih.gov/21924562/
  4. NICE. Antenatal care. NICE Guideline NG201, 2021. https://www.nice.org.uk/guidance/ng201
  5. Ministry of Health of the Russian Federation. Clinical recommendations: Normal pregnancy. Ministry of Health of the Russian Federation, 2023. https://cr.minzdrav.gov.ru/
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.