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EBM Verdict on: Walker KF, Thornton JG. Encouraging awareness of fetal movements is harmful. The Lancet 2018;392:1601–2.
If we cannot withdraw leaflets and campaigns encouraging fetal movement awareness, then, at least, we should follow a policy that specifies the advice by gestation: ‘Don’t worry about reduced or altered movements before 36–37 weeks, because intervention is likely to do more harm than good. Report any movement changes after 36–37 weeks because, if the scan or fetal heart rate are abnormal then, something can be done’.
Although lay people, and even some health professionals, encourage mothers to take note of fetal movement and report any reduction so as to pre-empt and prevent in utero death, a recent large trial of such a policy not only has refuted the possibility of benefit but also has shown harm.
Maternity workers have always been taught that if the baby stops moving completely in the third trimester, it might have died and that mothers who experience stillbirth often report reduced fetal movements. The idea that reduced or altered movements might give warning in time to save the baby is relatively recent. In the 1970s, midwives and doctors started asking mothers to measure how …
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