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Fetal Movements in late Pregnancy: Categorization, Self-assessment, and Prenatal Attachment in relation to women’s experiences
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet, Institutionen för kvinnors och barns hälsa.
2016 (English)Doctoral thesis, comprehensive summary (Other academic)Text
Abstract [en]

Aim: To explore how pregnant women experience fetal movements in late pregnancy. Specific aims were:  to study women’s experiences during the time prior to receiving news that their unborn baby had died in utero (I), to investigate women’s descriptions of fetal movements (II), investigate the association between the magnitude of fetal movements and level of prenatal attachment (III), and to study women’s experiences using two different self-assessment methods (IV).

Methods: Interviews, questionnaires, and observations were used.

Results: Premonition that something had happened to their unborn baby, based on a lack of fetal movements, was experienced by the participants. The overall theme “something is wrong” describes the women’s insight that the baby’s life was threatened (I). Fetal movements that were sorted into the domain “powerful movements” were perceived in late pregnancy by 96 % of the participants (II). Perceiving frequent fetal movements on at least three occasions per 24 hours was associated with higher scores of prenatal attachment in all the three subscales on PAI-R. The majority (55%) of the 456 participants reported average occasions of frequent fetal movements, 26% several occasions and 18% reported few occasions of frequent fetal movements, during the current gestational week.  (III). Only one of the 40 participants did not find at least one method for monitoring fetal movements suitable. Fifteen of the 39 participants reported a preference for the mindfetalness method and five for the count-to-ten method. The women described the observation of the movements as a safe and reassuring moment for communication with their unborn baby (IV).

Conclusion:  In full-term and uncomplicated pregnancies, women usually perceive fetal movements as powerful. Furthermore, women in late pregnancy who reported frequent fetal movements on several occasions during a 24-hour period seem to have a high level of prenatal attachment. Women who used self-assessment methods for monitoring fetal movements felt calm and relaxed when observing the movements of their babies. They had a high compliance for both self-assessment methods. Women that had experienced a stillbirth in late pregnancy described that they had a premonition before they were told that their baby had died in utero. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2016. , 73 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1171
Keyword [en]
Fetal movements, pregnancy, prenatal attachment, self-assessment, stillbirth
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-22713ISBN: 978-91-554-9446-9OAI: oai:DiVA.org:du-22713DiVA: diva2:953545
Public defence
2016-02-25, Föreläsningssal 6, Högskolegatan 2, Falun, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2016-08-18 Created: 2016-08-18 Last updated: 2016-08-18Bibliographically approved
List of papers
1. Losing contact with one’s unborn baby: mothers’ experiences prior to receiving news that their baby has died in utero
Open this publication in new window or tab >>Losing contact with one’s unborn baby: mothers’ experiences prior to receiving news that their baby has died in utero
2011 (English)In: Omega : Journal of Death and Dying, ISSN 1541-3764, Vol. 62, no 4, 353-367 p.Article in journal (Refereed) Published
Abstract [en]

Background: A change in the pattern of movement of her unborn baby could be indicative that the baby might die.

Aim: To study mothers' experiences during the time prior to receiving news that their baby has died.

Method: Interviews with 26 mothers.

Results: Premonition that something had happened to their baby, a sense based on a lack of movements were experienced. Six categories describe the mother's insight that the baby's life was threatened: not feeling in touch with their baby; worry' feeling something is wrong; not understanding the unbelievable; wanting information; and being certain that their baby had died. The overarching theme "There is something wrong" was formulated.

Conclusion: The mother could not understand the unbelievable: that the baby had died in utero. Implications: Mother's should be cautioned to trust their insights and seek medical advice if they are concerned over the lack of movement from the unborn baby.

Place, publisher, year, edition, pages
Amityville: Baywood, 2011
National Category
Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-5143 (URN)10.2190/OM.62.4.c (DOI)000288504700003 ()
Available from: 2010-12-16 Created: 2010-12-16 Last updated: 2016-08-18Bibliographically approved
2. Development of a tool to evaluate fetal movements in full-term pregnancy
Open this publication in new window or tab >>Development of a tool to evaluate fetal movements in full-term pregnancy
Show others...
2014 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, Vol. 5, no 1, 31-35 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To study women’s description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis.

Methods: Data were collected by distributing questionnaires including an open question: “Please describe your perception of the baby’s movements during this gestational week.” A matrix listed seven categories of movements divided into powerful and non-powerful movements, was used for the content analysis.

Results: 393 (78%) women responded to the open question. The movements were split into two domains: Powerful movements and Non-powerful movements. Altogether, 383 (96%) women perceived fetal movements that were sorted as powerful movement: firm, slow stretchinglarge and side to side. Ten (4%) women described movements exclusively, i.e. movements that did not include any of the movements in the powerful domain. Most women perceived movements that corresponded to more than one type of category, and all movements described by the women could be referred to at least one of the categories in the matrix.

Conclusion: The matrix was useful for identification of the women’s perceptions of fetal movements in full-term pregnancy. Further studies are needed in order to develop the tool and its potential to evaluate the well-being of the fetus before it is to be used in clinical praxis.

Place, publisher, year, edition, pages
Elsevier, 2014
Keyword
Fetal movements; Obstetric; Pregnancy
National Category
Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-13590 (URN)10.1016/j.srhc.2013.11.003 (DOI)000331500300006 ()24472387 (PubMedID)
Projects
Kvinnors upplevelser av fosterrörelser i fullgången graviditet
Available from: 2013-12-31 Created: 2013-12-31 Last updated: 2016-08-18Bibliographically approved
3. Prenatal attachment and its association with foetal movement during pregnancy: a population based survey
Open this publication in new window or tab >>Prenatal attachment and its association with foetal movement during pregnancy: a population based survey
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2016 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24h period among women in the third trimester of pregnancy.

DESIGN: a prospective population-based survey.

SETTING: A county in central Sweden.

PARTICIPANTS: Low risk pregnant women from 34 to 42 weeks gestation, N=456, 299 multiparous and 157 primiparous women.

MEASUREMENTS: The revised version of the Prenatal Attachment Inventory (PAI-R) and assessment of the perception of foetal movements per 24h in the current gestational week.

FINDINGS: A total of 81 per cent of the eligible women completed the questionnaire. The overall sample of women found that the majority (96%) felt their baby move mostly in the evening. More than half of the respondents (55%) stated that they perceived frequent foetal movement on two occasions during a 24h period, while almost a fifth (18%) never or only once reported frequent foetal movement in a 24h period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24h period. Perceiving frequent foetal movements on three or more occasions during a 24h period, was associated with higher scores of prenatal attachment in all the three subscales.

KEY CONCLUSION: Perceiving frequent foetal movements at least during three occasions per 24h periods in late pregnancy was associated with prenatal attachment.

IMPLICATIONS FOR PRACTICE: encouraging women to focus on foetal movements may positively affect prenatal attachment, especially among multiparous women >35 years.

Keyword
Foetal movements; Midwifery; PAI-R; Pregnancy; Prenatal attachment
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-21426 (URN)10.1016/j.wombi.2016.04.005 (DOI)27140328 (PubMedID)
Available from: 2016-05-09 Created: 2016-05-09 Last updated: 2016-08-18Bibliographically approved
4. Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy: a crossover trial
Open this publication in new window or tab >>Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy: a crossover trial
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2014 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, 349Article in journal (Refereed) Published
Abstract [en]

Background: Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women's compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women's experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method.

Methods: Data were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method.

Results: Of the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby.

Conclusions: In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keyword
fetal movements, crossover trial, pregnancy, self-assessment
National Category
Health Sciences
Research subject
Health and Welfare, Mammors erfarenheter och beskrivning av sitt barns rörelser i livmodern
Identifiers
urn:nbn:se:du-16129 (URN)10.1186/1471-2393-14-349 (DOI)000343175500001 ()25288075 (PubMedID)
Available from: 2014-10-07 Created: 2014-10-07 Last updated: 2016-08-18Bibliographically approved

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