Women's and clinicians perspectives of presentation with reduced fetal movements: a qualitative study.
BACKGROUND
Worldwide maternal perception of fetal movements has been used for many years to evaluate fetal wellbeing. It is intuitively regarded as an expression of fetal well-being as pregnancies in which women consistently report regular fetal movements have very low morbidity and mortality. Conversely, maternal perception of reduced fetal movements is associated with adverse pregnancy outcomes. We sought to gain insight into pregnant women's and clinicians views and experiences of reduced movements.


METHODS
We performed qualitative semi-structured interviews with pregnant women who experienced reduced fetal movements in their current pregnancy and health professionals who provide maternity care. Our aim was to develop a better understanding of events, facilitators and barriers to presentation with reduced fetal movements. Data analysis was conducted using framework analysis principles.


RESULTS
Twenty-one women and 10 clinicians were interviewed. The themes that emerged following the final coding were influences of social network, facilitators and barriers to presentation and the desire for normality.


CONCLUSIONS
This study aids understanding about why women present with reduced movements and how they reach the decision to attend hospital. This should inform professionals' views and practice, such that appreciating and addressing women's concerns may reduce anxiety and make presentation with further reduced movements more likely, which is desirable as this group is at increased risk of adverse outcome. To address problems with information about normal and abnormal fetal movements, high-quality information is needed that is accessible to women and their families.
Division of Nursing Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK. rebecca.smyth@manchester.ac.uk.
R M D
RM
Smyth
Maternal and Fetal Health Research Centre 5th Floor (Research) St Mary's Hospital Central Manchester NHS Foundation Trust, St Mary's Hospital, Manchester, M13 9WL, UK.
W
W
Taylor
Maternal and Fetal Health Research Centre 5th Floor (Research) St Mary's Hospital Central Manchester NHS Foundation Trust, St Mary's Hospital, Manchester, M13 9WL, UK.
A E
AE
Heazell
Division of Nursing Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK.
C
C
Furber
Maternal and Fetal Health Research Centre 5th Floor (Research) St Mary's Hospital Central Manchester NHS Foundation Trust, St Mary's Hospital, Manchester, M13 9WL, UK.
M
M
Whitworth
Division of Nursing Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK.
T
T
Lavender
Clinicians; Interviews; Management; Maternal experience; Qualitative; Reduced fetal movements
Health Care Women Int. 2009 Nov;30(11):971-88
19809901
Aust Fam Physician. 2014 Nov;43(11):782-5
25393464
Fetal Diagn Ther. 1993 May-Jun;8(3):200-2
8240694
Midwifery. 2014 Jan;30(1):e26-33
24246969
Cochrane Database Syst Rev. 2012 Apr 18;(4):CD009148
22513971
Midwifery. 2016 Mar;34:72-8
26867705
Midwifery. 2009 Feb;25(1):14-20
17408822
Cochrane Database Syst Rev. 2015 Oct 15;(10):CD004909
26467769
Acta Obstet Gynecol Scand. 2008;87(3):331-9
18307074
J Obstet Gynaecol. 2010;30(6):578-82
20701506
Acta Obstet Gynecol Scand. 2009;88(12):1345-51
19878088
Acta Obstet Gynecol Scand. 2001 Apr;80(4):321-5
11264606
Gynecol Obstet Fertil. 2005 Nov;33(11):861-9
16243568
J Perinat Med. 2004;32(1):13-24
15008381
BJOG. 2011 Sep;118(10):1229-38
21585644
J Obstet Gynaecol. 2009 Nov;29(8):705-10
19821662
Am J Obstet Gynecol. 2001 Mar;184(4):694-702
11262474
Am J Perinatol. 1996 Nov;13(8):479-82
8989478
Aust N Z J Obstet Gynaecol. 2009 Aug;49(4):358-63
19694688
BMC Pregnancy Childbirth. 2015 Mar 05;15:54
25884544
Acta Obstet Gynecol Scand. 2012 Jan;91(1):28-33
21668416
Tidsskr Nor Laegeforen. 2005 Oct 6;125(19):2631-4
16215607
J Obstet Gynaecol. 2008 Feb;28(2):147-54
18393008