title: Kick-starting action: Canadian women's understanding of fetal movement guidelines.
abstract: OBJECTIVE
  To determine whether obstetrical patients in a large tertiary-care centre receive counselling, are aware of the proper actions in relation to fetal movement (on the basis of discussion with caregivers, educational pamphlet, or access to any information), have an understanding similar to that prescribed in the SOGC guidelines, and seek timely assessment in the event of decreased fetal movement.
  
  
  METHODS
  We surveyed a convenience sample of pregnant women (N = 206) at term between July and October 2011. After collecting demographic and provider information, we assessed patient familiarity with fetal movement counting, including sources, timeliness, counting protocols, and response to decreased fetal movement. We calculated incidence rates, measures of association, and statistical significance by chi-square testing.
  
  
  RESULTS
  The majority of patients (147/206 = 71.4%) relied on their care provider for information, and 44.1% of patients were very familiar with fetal movement counting. A majority, 57.8% (119), received timely information, although 8.1% (27) received information late in pregnancy or not at all. Quite consistently amongst subgroups (low vs. high-risk pregnancy, nullipara vs. multipara, patients of varied providers), one third (34.7%, 70/202) of patients had no knowledge or incorrect knowledge of the SOGC guidelines, 35.1% (71/202) had knowledge of fetal movement counting and what to do, while 30.2% (61/202) who knew how to monitor fetal movements did not know how to respond to decreased movement.
  
  
  CONCLUSIONS
  Timely intervention for decreased fetal movement results in a substantial reduction in the rate of stillbirth. Only one third of our patients were both informed and would have sought further investigation for decreased movement. Reinforcing the significance of fetal movement counting in scholarly publications can remind care providers about the importance of informing all patients about this simple, inexpensive, and successful monitoring protocol.
authors.affiliation: Department of Obstetrics & Gynaecology, University of Toronto, Toronto ON.
authors.forename: Susan
authors.initials: S
authors.lastname: Pakenham
authors.affiliation: Faculty of Science, Queen's University, Kingston ON.
authors.forename: Andrea
authors.initials: A
authors.lastname: Copeland
authors.affiliation: Department of Obstetrics & Gynaecology, University of Toronto, Toronto ON; Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto ON.
authors.forename: Dan
authors.initials: D
authors.lastname: Farine
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D005324:Fetal Movement / Q000502:physiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D050497:Stillbirth