When and why does the baby move?

In order to better understand the "language" of fetal movement, we need to remember some stages of the development of the baby in the womb, scientifically - the stages of embryogenesis.

In a human embryo, the first heartbeats appear on the 21st day of development. Elements of skeletal muscles begin to develop due to early contractile activity. Rhythmic contractile activity of primary muscle fibers is observed even before the nervous system of the embryo begins to take shape.

At the end of the embryonic period (the end of the 8th week of pregnancy) and the beginning of the fetal period (from the 8th week of pregnancy), the fetal nervous system begins to form, which is responsible for motor activity. That is, by this moment there is already muscle tissue, there are nerve fibers that “send” impulses to the muscles, ensuring their contraction.

Motor reflexes caused by excitation of nerve endings were established from the end of the 8th week of pregnancy. The first reflexes in response to irritation of the perioral zone (near the mouth) - the mandibular (buccal) and maxillary (maxillary) branches of the trigeminal nerve occur in the fetus at 7.5 weeks of pregnancy. From the 10th week of pregnancy, reflexes appear, caused by irritation of the skin areas to which the spinal nerves go.

In a word, the baby begins to move in the uterus early enough. True, these movements are not yet coordinated and not conscious, and the relative size of the embryo and the fetal bladder are such that the embryo swims freely in the amniotic fluid and rarely touches the wall of the uterus so that the mother can feel it. However, already from the 10th week of pregnancy, having stumbled upon the wall of the uterus, the baby can change the trajectory of movement. From 9 weeks of pregnancy, the fetus can swallow amniotic fluid, and this is a complex motor process. At 16 weeks of gestation, the fetus begins to move in response to sounds (primarily to the mother's voice, to a change in its intonation). At 17 weeks, the fetus begins to squint. At 18 weeks, she sorts through the umbilical cord with her hands, squeezes and unclenches her fingers, touches her face and even covers her face with her hands at sharp, loud and unpleasant sounds.

In order for the fetal brain to develop and function normally, a lot of stimuli and a sufficient level of their intensity are necessary. The perception of specific sensations has already been formed, and now the baby is learning to respond to them with movement.

In the first trimester

In the first trimester, the child has already formed ideas about comfort. They help the baby navigate what should be the intensity of various stimuli from the outside. The fetus discovers that by moving, he himself can regulate the intensity of stimulation (for example, move away from loud sounds), he becomes the "creator" of his life.

The main task of the fetus is to develop. To do this, he needs food and a lot of incentives. If there is not enough nutrition and oxygen, the fetus begins to move more actively and thereby massage the placenta in order to receive a sufficient portion of blood during uterine contraction, and with it nutrition and oxygen. Or, let's say, the mother lies on her back, thereby squeezing the largest vessels of the body (the inferior vena cava and the site of the aorta bifurcation) with the pregnant uterus. The fetus will immediately respond with violent stirring and force the mother to change the position of the body, therefore, pregnant women are advised to lie only on their side. If the fetus presses the loops of the umbilical cord, it also begins to actively move and changes its position.

How does a mother feel when the baby moves?

By 20–22 weeks, when the spinal cord and brain are formed, fetal movements become regular. At this stage (about 20 weeks), the mother begins to feel and perceive the movements of the fetus. It is known that nulliparous women feel stirring from 20 weeks of pregnancy, and multiparous - from 18 weeks of pregnancy. However, these times may vary.

The first movements are described differently by everyone. They can be similar to the splashing of a fish, the fluttering of a butterfly, or, tritely, to intestinal motility. According to most pregnant women, this is one of the most exciting periods in their lives, and from that moment on, the mother becomes the most accurate and unmistakable "sensor" that registers the condition of her baby. It is from the first shocks that many women begin to perceive the fetus as their child.

At first, the movements of the fetus are rather timid, not coordinated, but gradually they are ordered and acquire a certain meaning and significance. Within half an hour, a 5-month-old fetus can make from 20 to 60 shocks, sometimes more, sometimes less. In general, the pace, rhythm and strength of the movements vary with the time of day.

By 24 weeks of pregnancy, fetal movements resemble those of a newborn. From this age, the baby actively “speaks” with his mother in the language of movements about his anxiety, joy, pleasure and his well-being. In turn, the fetus is very sensitive to changes in the emotional state of the mother. For example, when a mother is worried or happy, the baby may move more actively or, conversely, calm down for a while.

Too violent, painful stirring of the fetus indicates trouble in his condition. Sometimes the movements of the baby cause pain to the mother. In this case, the woman needs to change the position of the body. If for a long time, for several hours, the fetal movements remain painful, the pregnant woman must inform the doctor about this. Most women note some soreness in the hypochondrium in the third trimester of pregnancy - and this is not a deviation from the norm.

So how to properly control and interpret fetal movements?

It is necessary to listen to the movements of the child. A complete cessation of motor activity for 12 hours or more is a very alarming signal.

Starting from the 24th week of pregnancy, the fetus should move an average of 10-15 times per hour, it can sleep for 3 hours and still hardly move. However, if the child is too active for several days or, conversely, for several days his activity has decreased, the pregnant woman should contact her obstetrician. There are situations when you need to constantly monitor the movements of the child. In any case, if you do not feel fetal movements within 12 hours, you need to see a doctor. To independently stimulate the movement of the fetus, you can do some physical exercises, breathing exercises with holding your breath, eat sweets.

Sudden very active fetal movements may be due to the mother's uncomfortable position - a position in which the fetus receives less oxygen, for example, when a woman sits cross-legged or lies on her back. In this case, you need to change the position. If within a few hours the movements remain unusually active, you should consult a doctor. So, sluggish and weak movements or overly active ones also indicate the unfavorable condition of the fetus.

Obstetricians recommend using D. Pearson's "Count to ten" fetal movement test. On a special map, the number of fetal movements is noted daily from 28 weeks of pregnancy. The count of movements starts at 9:00 and ends at 21:00. Start counting the fetal movements at exactly 9 am, write down the time of the 10th movement in the table or on the graph. A small number of movements (less than 10 per day) may indicate fetal oxygen deficiency and is a reason to see a doctor.

If twins develop, it may seem that the movements of the fetus are felt everywhere and they are very intense. Ultrasound can dispel doubts if it is confirmed that two fetuses are developing in the uterus.

The maximum increasing motor activity of the fetus is observed from the 24th to the 32nd week of pregnancy. Then it gradually decreases; this is especially noticeable at the time of childbirth. By the end of the third trimester, the number of movements may decrease somewhat, but their intensity and, one might say, their strength remain the same or increase.

It is also interesting that by the end of pregnancy, the most active movements are felt at the location of the limbs of the fetus. So, if the baby lies head down (this happens in the vast majority of cases), then the movements are clearly felt in the upper sections of the uterus; if the pelvic end is adjacent to the exit from the uterus (breech presentation), the movements are more distinct in the lower sections. Calculation of the frequency of fetal movements for 30 minutes in the morning and evening shows that in healthy pregnant women it increases in the evening.

As already noted, the motor activity of the fetus characterizes its condition.

What does the unusual "behavior" of the baby mean? If there is a deviation from the normal rhythm, frequency and nature of perturbations, listening to heart sounds, ultrasound, CTG are necessary.

What kind of intrauterine suffering are we talking about when we talk about violations of the fetal motor activity? Most often, intrauterine fetal suffering is caused by hypoxia (oxygen starvation). The causes of hypoxia are: complications of pregnancy, various diseases (anemia, cardiovascular diseases, diabetes mellitus, etc.), bleeding, fetal-placental insufficiency, prolapse from the uterine cavity and pressing the fallen loops of the umbilical cord by the fetal head, fetal diseases (Rhesus- conflict, infection of the fetus). Acute oxygen deficiency can be diagnosed by auscultation (listening) to the fetal heart sounds. In chronic intrauterine hypoxia of the fetus, the indicators of cardiotocography (registration of heartbeats using a special apparatus) are more informative. At the time of fetal movement, the heart rate normally increases by 10-15 beats per minute.

In the initial stages of intrauterine hypoxia, restless behavior of the fetus is noted, which consists in increasing and increasing its motor activity. With progressive hypoxia of the fetus, weakening and cessation of its movements occurs.

Concluding our conversation, I would like to remind future mothers: the first movements of the baby are not only an indicator of his condition, but also unique sensations that a woman can experience only in this short, but such a happy period of her life.