title: Online information for women and their families regarding reduced fetal movements is of variable quality, readability and accountability.
abstract: OBJECTIVE
  reduced fetal movements (RFM) are experienced by 46-50% of women prior to the diagnosis of stillbirth. Empowering women with evidenced-based information regarding RFM may allow for prompt contact with a health care provider and access to appropriate management. Use of the Internet is growing in popularity as a source of pregnancy information to aid mothers׳ decision-making. This study aimed to identify and examine the available online information for pregnant women regarding RFM.
  
  
  METHODS
  a systematic search was performed using Google, Yahoo and Bing to identify the most popular websites giving information about RFM. The websites were assessed for readability, accountability and content using the Flesh-Kincaid ease of readability score; the Silberg criteria; and by comparison to evidence-based guidelines respectively. Chat forums were assessed using a qualitative thematic analysis.
  
  
  RESULTS
  70 information articles and 63 chat forums were analysed from 77 unique websites. The mean readability score was 65.7 (suitable for the average 13-15 year old) and therefore above the recommended level set for health materials; only 15 (21.4%) websites met all accountability criteria; and 43 (70%) websites contained information that was not in accordance with evidence-based recommendations. Typical questions on forums were 'Is this normal? What should I do?' and responses were 'Better safe than sorry', 'There is no harm in calling'.
  
  
  CONCLUSIONS
  overall, there was wide variation in the quality of information regarding RFM on the Internet. However, the study identified four excellent websites on RFM that may be suitable sources of information for women. Women׳s uncertainty displayed in the chat forums may suggest that clearer, accessible guidance is needed if they experience RFM.
  
  
  CONCLUSIONS
  the Internet can compliment and support current methods of antenatal information provision. However, due to varying levels of quality it is essential that professionals discuss and direct women to useful evidenced-based websites. Care must be taken to ensure consistent advice and management of those presenting with RFM and that women׳s concerns are addressed.
authors: St. Mary׳s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom. Electronic address: kimberley.farrant@cmft.nhs.uk.
authors: Kimberley
authors: K
authors: Farrant
authors: St. Mary׳s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom; Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, United Kingdom.
authors: Alexander E P
authors: AEP
authors: Heazell
mesh_terms: D054626:Consumer Health Information / Q000592:standards*; D003657:Decision Making; D005190:Family; D005260:Female; D005324:Fetal Movement; D014943:Global Health; D006801:Humans; D020407:Internet; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011247:Pregnancy; D011295:Prenatal Care; D015203:Reproducibility of Results; D050497:Stillbirth; D016387:Women's Health
keywords: Evidenced-based practice; Information seeking; Internet; Pregnancy; Reduced fetal movement