Education of fetal movement counting: an effort to increase knowledge and compliance of pregnant women to do self-assessment of fetal wellbeing

Background: Decreased movements of the fetus can indicate decrease supply of oxygen and nutrients to the fetus and increase the risk of fetal compromised, even stillbirth. Providing accurate information on fetal movements will help mother to make right decision when dealing with decreased fetal movements. This study aims to determine the effect of fetal movement counting education on knowledge and compliance of pregnant women in performing fetal movement counting.Method: This pre-experimental study allocated 32 pregnant women at 28-37 weeks gestation to practice daily fetal movement counting for 3 weeks. The intervention was a package of fetal movement counting education and practice for 3 weeks. Knowledge on fetal movement counting was measured 4 times by a validated questionnaire and compliance was measured in the end of intervention. Friedman test was used to analyze the changes of women knowledge on fetal movement counting.Results: The results showed that there was an increase in women knowledge on fetal  movement counting from 52.94% to 86.10% at the end of intervention, by the highest score in the technihue for fetal movement counting (93.67%). Comparison of 4 measurement periods showed significant changes in knowledge (p <0.000), with a tendency of rise in knowledge. The compliance in performing fetal movement counting was high about 96%.Conclusion: Education of fetal movement counting will increases the knowledge regarding fetal movement. Providing appropriate education and continuous follow-up will increase women’s awareness on the importance of fetal movement monitoring and rise up their compliance to do so

Fetal Movement Counting and Maternal Anxiety: A Systematic Literature Review

Perinatal death will decrease maternal quality of life and brought the mother to experience acute grief. Fetal movement count known as a self-screening strategy which may useful to prevent perinatal death and improve pregnancy outcome by increase maternal awareness of decrease fetal activity. On the other hand, this self-screening activity may increase maternal concern, especially maternal anxiety, which the association between these variable are inconsistent. To determine the effect of routine fetal movement counting on maternal anxiety among pregnant women. A comprehensive search was conducted using following database: PubMed, Science Direct and Cochrane Library without any limitation. Evidences about maternal anxiety related to fetal movement were provided by a literature review on the presence of anxiety among women who performing fetal movement count during pregnancy. Five studies were included in this review which consist of four randomized study and one systematic review. All studies were conducted in high income country, which the result may not be generalized in lower-middle income country setting. One RCT (n= 1,013) reported lower worry on fetal movement counting group, one RCT (n= 208) reported significant decrease in state and trait anxiety among counting group, one RCT with small sample (n= 33) found no significant change on state and trait anxiety between control and counting group, one RCT (n= 613) also found no significant change in psychological status among counting group. One systematic review (n=71,458) also reported significant decrease of maternal anxiety among counting group. This review provides sufficient evidence that routine fetal movement counting did not increase maternal anxiety, instead decrease maternal anxiety. Hence, fetal movement counting needs to be introduced to women widely. Further research need to be done in other population, which included lower-middle income country, in order to assess whether fetal movement counting shows positive effect on maternal anxiety in general population