What fetal movement awareness studies have told us

AFFIRM was a large trial in 33 hospitals in the UK and Ireland, covering more than 400,000 pregnancies. It tested a care package that encouraged pregnant women to report reduced fetal movement promptly, together with a standard plan for how hospitals should respond.

Stillbirth rates were 4.06 per 1,000 births with the package and 4.40 per 1,000 without it. The difference was not statistically significant, although the trial was designed to detect only a large reduction in stillbirth rates (30% or more), and not all hospitals were able to put the full care package in place. Induction of labour and caesarean birth were more common with the package.ⁱ

Other trials have found similar results. My Baby's Movements, in Australia and New Zealand, did not reduce stillbirth.ⁱⁱ Mindfetalness, in Sweden, did not reduce stillbirth but was linked to slightly fewer caesarean births.ⁱⁱⁱ

What these trials tested

These trials tested awareness based on what a pregnant person feels, checked from time to time, based on individual perception of what was normal for their baby. They did not test whether reduced movement matters. Observational studies consistently link reduced movement with stillbirth risk and with babies who are not growing well.

A gradual decline over several days, much of it during sleep, can be hard to notice by feel alone. An open question is whether recording movement objectively, over many hours and against each baby's own pattern, could pick up changes like this. That is one of the questions our research is asking.

What this means now

Current advice has not changed. If you notice your baby's movements have slowed down or changed, contact your maternity unit or healthcare provider straight away. Do not wait until the next day.