The wonder, and joy of feeling the first little flutters that you are sure is baby moving around is incomparable. It is amazing to have that intimate connection to your baby!

Just as we are all different, when baby movements can be felt will be different for each mother, and for each pregnancy.  Some Moms are so in tune with their body that they can feel the flutters around 14 weeks, and rarely, even earlier.  Other Moms may not notice the movements until 20 weeks or a little later, especially if the placenta is implanted on the front of the uterus. At first they feel like little flutters but as baby grows and gets stronger the flutters are replaced by kicks and punches. Once baby gets even bigger, those movements change to more rolling, nudging movements because there isn't room for baby to punch or kick as much.

Early in pregnancy, there may be days when you may not feel much movement from baby. This is normal.  As pregnancy progresses, baby's movements become more noticeable. Around 28 weeks gestation, babies have settled into a predictable movement pattern. I encourage clients to become familiar with this pattern.  

It is pretty common for baby to move more at night when you are laying down. As pregnancy progresses, it is my opinion that baby has more room when you are laying down compared to when you are standing or sitting so that is why they tend to be more active.  

Baby can be affected by how Mom is feeling. If Mom is dehydrated, or has a cold or other illness, baby's movements may be a little less or subdued. I have worked with mothers who just needed to eat, and then baby was ready to dance a jig. Sometimes Mom is up and busy and doesn't notice movements but when she slows down and focuses on baby, the movements are noticeable.
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Baby's movements can give insight into how baby is doing in utero, so it is important to pay attention to them. Changes in baby's movement pattern might mean something is happening that we need to check on, usually with an ultrasound. Significant changes in baby's movement pattern can indicate baby may need help to prevent a stillbirth, so get to know baby's movement pattern well. 

Torie Bowie was an athlete. She wasn't just any athlete, she won multiple medals including the gold medal at the 2016 Olympics. This was a woman who was incredibly fit. She was found dead at 8 months pregnant due to eclampsia. The takeaway is that even the healthiest of mothers can have health issues that are a direct result of pregnancy, and that maternity care providers must do better for mothers in their care.

It grieves me to learn of stories where normal maternity care should have caught something.  It grieves me to hear of mothers who aren't listened to, whose concerns are dismissed and who do not feel heard and respected. It appalls me that mothers aren't educated about nutrition, appropriate weight gain and normal changes in pregnancy. It scares me that mothers aren't educated about symptoms of concerning health conditions during pregnancy.

In my midwifery practice, I partner with my clients in providing care. I want my clients to understand what is normal and what may be concerning. I want my clients to know what symptoms to watch for that means we need to do some testing, or additional checks. I want my clients to know that I hear them and I take what they say seriously. I want my clients to know I will not dismiss their concerns, observations and complaints. I want my clients to know I care!

It's so hard for me to wrap my mind around how this nation can spend so much money on health care and yet have higher percentages of poor outcomes compared to other countries, including those we consider developing. I don't think more interventions, medications or treatments are going to solve the maternity crisis in America. Listening to women, and trusting them are the things we can do to improve care dramatically and quickly in my opinion. We can't continue doing the same old things and hoping for different results.  We must make big changes, and make them now. Increasing access to midwifery care is a simple, effective way to reduce maternal mortality. I'm proud to be a midwife who is making a difference one birth at a time!
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