I should have seen this one coming! A week or two ago, I posted my thoughts on a recently published study looking at women’s experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy. But I forgot that not everybody would be familiar with the ‘Mindfetalness’ approach that I and the study referred to, so I offer this post in response to the comments I have received asking me to clarify / write more about this…
‘Mindfetalness’ is a term coined by Swedish researcher Ingrid Rådestad. It derives from the concept of ‘mindfulness’ – which Jon Kabat-Zinn describes in Mindfulness for Beginners:
“Mindfulness means paying attention in a particular way; On purpose, in the present moment, and nonjudgmentally.”
Mindfetalness, then, describes how women can apply such a focus and awareness to the well-being of their baby. In an article called ‘Strengthening Mindfetalness‘, Rådestad (2012) wrote that,
“Women who experience reduced fetal movements are at increased risk of adverse pregnancy outcomes . Different methods for systematic measurement of the frequency of fetal movements have been used to predict birth outcomes . A wide variation from one fetus to another in how often the fetus moves makes it difficult to specify quantitatively a single numerical value that should trigger alarm . Researchers have argued that there is no evidence that a specific limit for what is to be viewed as decreased fetal movement is any better than the belief on the part of the mother that a decrease in fetal movement has occurred as concerns to detect a fetal compromise . In addition to awareness of the frequency of fetal movements, the woman’s perceptions of the intensity and duration of the movements can give additional information about the unborn baby’s fitness. The general quality of fetal movements appears to correlate closely with parameters for fetal clinical conditions. In individual cases, observation and analysis of fetal movement fulfilled several prerequisites for serving as a reliable diagnostic tool for predicting fetal condition .
Low maternal awareness of fetal activity is associated with an increased risk of having a small for gestational age infant . Reinforced mindfetalness can be a tool for women in late pregnancy to more carefully follow the movement patterns of their unborn baby, resulting in heightened sensitivity to recognizing a movement pattern that deviates from the normal for their baby. Mindfetalness may be described as an awareness of the fitness of the unborn baby, a mindfulness based focus on fetal movements. The mother-to-be is present in the moment taking note of both frequency and quality of the unborn baby’s movements. Mindfetalness can also be regarded as a sense of contact that the mother has with her unborn baby.”
Rådestad (2012) went on to suggest that mindfetalness could be reinforced if women were encouraged to spend some time each day (a 15-minute period is suggested in her papers, but I have known women who enjoyed it so much that they liked to do this for longer) focusing on how their baby is moving. She stresses the importance of doing this when the baby is awake and active and the woman is relaxed and unstressed, and recommends that the woman lies on her side.
As I was looking for photos to illustrate this post, it really struck me that how a significant percentage of those I found involved women staring directly into a mirror and holding a mobile phone as they were taking the picture of themselves, perhaps for social media sites. This is not intended to be a criticism, but like Rådestad (2012), who is concerned by the trend in which we often turn our attention outward towards social media and the Internet, I have written about my concern – partly derived from reading some of the work of the best social scientists in the birth world – that technology may have had a negative impact on women’s sense of their baby’s well-being:
“It is likely that even women in ancient times may have linked feeling their baby move to a sense of well-being about their baby’s health in utero. There isn’t any evidence that i know of, but it is hard to imagine that fetal movement wouldn’t have been a major feature of conversation during pregnancy, especially in pre-literate societies. as many social scientists (Oakley 1984, Murphy-Lawless 1998, Kitzinger 2005) have discussed, before the relatively recent advent of pregnancy testing, ultrasound and similar technologies, a woman’s experience of physical sensations and symptoms was the main source of information that caregivers could access about pregnancy; which meant that women were an important source of knowledge. It might sound obvious to say, but the pregnancy was hidden away inside the woman. While midwives could feel the baby’s position with their fingers or hands, and listen with their ears, if a midwife really wanted to know how the baby was moving, or what the woman could feel, she had to ask the woman about her experience. These days, the necessity and arguably the value of a woman’s own experience of pregnancy has been vastly reduced by these technologies, which have exposed many aspects of fetal development.” (Wickham in Cooper and Wickham 2013: 33).
Rådestad’s work in this area continues; she and a colleague wrote another really interesting paper (as well as the one mentioned in my related post) which described some of the different kinds of fetal movements: leg, arm and head movements, sideways bending movements, rotation in the uterus, the startle reflex, hand-to-face contact, twitches, jaw movements (e.g. sucking and swallowing) and stretching (Rådestad and Lindgren 2012). This kind of work is so important, for it describes elements of experience that some women just ‘know’, but that will be revelatory to others. If you haven’t read these papers or pondered this, I would encourage you to dig deeper into this fascinating topic.
Cooper T and Wickham S (2013). Evolution of the Theses: monitoring fetal movement to assess fetal well-being. Essentially MIDIRS 4(6): 32=39.
Malm M-C, Rådestad I, Rubertsson C et al. Women’s experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy – a crossover trial. BMC Pregnancy and Childbirth 2014 14:349
Rådestad I (2012). Strengthening mindfetalness. Sexual & Reproductive Healthcare 3(2):59-60.
Rådestad I, Lindgren H (2012). Women’s perceptions of fetal movements in full-term pregnancy. Sexual & Reproductive Healthcare 3(3):113-6.