What care should I expect when reporting reduced movements between 24 - 28 weeks?

Between 24 and 28 weeks, movements become more consistent and meaningful, but monitoring tools are still limited so the pathway includes both clinical assessment and selective ultrasound.

1. Immediate triage and a full history

Staff should ask:

  • When movements changed and what that change is

  • Whether baby’s movements have been felt regularly before this

  • Any pain, bleeding, fluid loss or contractions

  • Infection symptoms

  • Previous complications or risk factors

  • Whether this is the first episode or a repeated concern

This conversation should be non-judgemental and supportive.

2. Confirming fetal heartbeat

A midwife or doctor will check the baby’s heartbeat using a handheld Doppler.

This must be done by a medical professional and should not be done using a home doppler.

3. Clinical assessment of movements

Because movements can still vary between 24–28 weeks, staff will assess:

  • Whether the pattern has been consistently established

  • Whether there are any factors suggesting possible fetal compromise

This step guides the next decision.

4. CTG (heart rate monitoring) may be used but it isn’t reliable before 28+ weeks

Most hospitals do not routinely use CTG before 28 weeks because:

  • The fetal nervous system is immature

  • CTGs can appear “non-reassuring” even when everything is normal

However, some units may still perform a short CTG if movements had been very regular before or if there are additional concerns.

A CTG at this stage is:

  • Often brief

  • Interpreted cautiously

  • Not considered diagnostic on its own

5. Ultrasound may be recommended

An ultrasound is more likely to be offered if any of the following apply:

  • Movements have clearly reduced after previously being regular

  • This is a recurrent episode

  • Doppler heart rate is concerning or unclear

  • There are additional risk factors (e.g., high blood pressure, small fundal height, pain, bleeding)

  • Staff have any concerns about growth, fluid levels or placental function

The scan typically includes:

  • Fetal growth

  • Amniotic fluid

  • Umbilical artery Dopplers

  • Placental appearance

Hospitals vary, but ultrasound is more commonly used between 24–28 weeks than before 24 weeks.

6. Clear safety-netting before discharge

The person must be given:

  • Instructions to return immediately if movements reduce again

  • Contact details for triage

  • Written or verbal guidance on when and how to seek help

They must not be told:

  • “Come back only if it happens after 28 weeks”

  • “It’s probably nothing, just wait”

  • “Your placenta is anterior so don’t worry”


These are not appropriate responses.

7. Follow-up

Depending on findings, they might be offered:

  • A repeat scan

  • Consultant review

  • Closer monitoring if risk factors are present

  • Further appointments if reduced movements recur

Why this pathway matters

24–28 weeks is a critical window:
Movements are establishing, fetal wellbeing can be assessed with a combination of tools, and timely action can prevent later complications.