Reduced Foetal Movements Late in Pregnancy: What a Mother’s Intuition Knows
Many women say they “just knew something was wrong” long before anyone in the hospital took their concerns seriously. That quiet, insistent sense — often called mother’s intuition — is more than folklore. It’s a powerful combination of body awareness, lived experience, and instinct that can serve as an early warning system when medical care goes astray.
In the context of childbirth and pregnancy, ignoring this intuition has led to tragic and preventable outcomes. When healthcare providers fail to listen, document concerns, or act promptly, the consequences can amount to medical negligence.
What Is Mother’s Intuition?
Mother’s intuition isn’t mystical; it’s a deep, embodied awareness of subtle physical and emotional changes. During pregnancy, labour, and postpartum recovery, women are acutely tuned to what feels normal and what doesn’t.
Studies in maternal health show that many mothers who later suffered poor outcomes — such as undiagnosed haemorrhage, foetal distress, or infection — reported knowing something wasn’t right, sometimes hours or days before complications were identified.
Understanding the Significance of Foetal Movement
For most expectant mothers, one of the earliest signs of connection with their baby is feeling movement — those gentle flutters that later become strong kicks and rolls. By the third trimester, women learn their baby’s unique rhythm. This pattern of movement is one of the most reliable indicators of foetal wellbeing.
When movements suddenly slow down or stop, it can signal that something is wrong — often reflecting compromised oxygen or nutrient supply through the placenta or umbilical cord. Clinically, reduced foetal movements (RFM) are among the earliest warning signs of foetal distress or stillbirth.
Across Australia, maternity guidelines clearly direct that any report of reduced foetal movements, especially in the final weeks of pregnancy, should trigger immediate clinical assessment — not reassurance or delay.
The Mother’s Perspective: Intuition Meets Dismissal
Many women describe an almost primal sense that their baby “feels different.” Sometimes the pattern changes subtly — fewer kicks, slower rolls, or longer gaps between movements. These sensations often appear before any measurable medical change is detected.
Unfortunately, too many women report being dismissed when they raise these concerns. They’re told, “The baby is just running out of room,” or “It’s normal at this stage.” For women who later discover their baby suffered hypoxia or died in utero, these words become haunting.
In numerous coronial investigations and medical negligence claims, mothers recount the same sequence:
They noticed reduced movement.
They reported it to their healthcare provider.
They were reassured instead of investigated.
Hours or days later, tragedy struck.
What Should Happen: The Standard of Care
In NSW and across Australia, maternity care providers are expected to follow the Perinatal Society of Australia and New Zealand (PSANZ) Clinical Practice Guidelines. These guidelines emphasise that any reduction in foetal movement reported by the mother requires immediate assessment — regardless of gestational age or perceived risk level.
That assessment should include:
History and maternal report: A full discussion of when movements were last felt, any changes in strength or pattern, and associated symptoms such as pain, bleeding, or fluid loss.
Foetal heart rate assessment: Using a Doppler or cardiotocography (CTG) trace to assess foetal wellbeing.
Ultrasound: If concerns persist, a scan should be ordered to measure growth, amniotic fluid, and blood flow through the placenta (Doppler studies).
Documentation: Every report and assessment must be clearly recorded.
Failure to take these steps, or dismissing a mother’s report as “normal,” can constitute a breach of duty of care.
How Inaction Can Lead to Catastrophic Outcomes
Reduced foetal movement is a red flag — not a benign variation. When oxygen or nutrient supply drops, the foetus conserves energy by reducing movement. Without timely intervention, this can progress to hypoxia, brain injury, or stillbirth.
Below are common scenarios seen in medical negligence cases involving reduced foetal movement:
1. Placental Insufficiency
A compromised placenta may fail to deliver sufficient oxygen or nutrients. Early detection through monitoring and ultrasound can prompt induction or caesarean delivery — but if ignored, the baby may suffer growth restriction or die in utero.
2. Umbilical Cord Compression or Knotting
A tight or prolapsed cord can intermittently restrict blood flow. Mothers often notice sudden changes in movement. A CTG could reveal late decelerations — a warning to deliver urgently. When these signs are missed, the result can be hypoxic brain injury.
3. Pre-eclampsia or Maternal Hypertension
High blood pressure affects placental perfusion. Mothers frequently report reduced movement days before clinical diagnosis. Early delivery can be life-saving, but failure to listen to the mother’s report can delay treatment fatally.
4. Post-term Pregnancy
Beyond 41 weeks, the placenta naturally begins to deteriorate. Many negligence cases involve post-dates pregnancies where reports of reduced movement were dismissed as “the baby slowing down,” leading to stillbirth shortly after.
Case Example: A Preventable Stillbirth
In one Australian case, a 36-year-old woman in her 39th week of pregnancy reported that her baby’s movements had significantly decreased over the past day. The attending midwife reassured her that this was common in late pregnancy and advised her to wait until her scheduled appointment two days later.
When she arrived at the hospital, no heartbeat could be found. Post-mortem investigations revealed placental insufficiency that likely developed days earlier. Expert evidence confirmed that timely induction or CTG monitoring at the time of her report would have almost certainly saved the baby’s life.
The court found that the failure to act constituted a clear breach of duty and awarded damages for psychiatric injury and loss of expectation of life.
Legal Framework: How Negligence Is Determined
In New South Wales, medical negligence is assessed under the Civil Liability Act 2002 (NSW) and guided by established case law. To succeed in a claim, the mother must prove:
A duty of care existed — between patient and provider (doctor, hospital, midwife).
The duty was breached — by failing to meet the standard of a reasonably competent practitioner.
The breach caused harm — such as stillbirth, hypoxic injury, or psychological trauma.
Breach of Duty
When a mother reports reduced foetal movement and is merely reassured without investigation, that is a clear deviation from national and international obstetric standards. Courts assess what a competent practitioner would have done — and in these cases, the answer is almost always further investigation.
Causation
The challenge often lies in proving that timely action would have prevented the injury. Medical experts assess the likely timing of hypoxia or placental failure. In many cases, evidence shows that the baby was alive and salvageable at the time the mother first reported reduced movement.
Emotional and Psychological Harm
For many parents, the loss of a baby under these circumstances causes enduring trauma. Mothers often replay the conversations in their minds: the phone call, the reassurance, the fatal wait.
Even when the baby survives but with brain injury — for example, hypoxic-ischaemic encephalopathy (HIE) or cerebral palsy — the emotional burden is immense. The sense of “if only they had listened” compounds grief with anger and guilt.
In negligence claims, compensation can cover not just medical and care costs, but also psychiatric injury, counselling, and loss of enjoyment of life.
The Clinical Duty to Listen
Listening is not passive. It’s an active clinical duty. When a woman says her baby isn’t moving as usual, she is reporting a symptom. Under the Australian Charter of Healthcare Rights, patients have the right to be heard and to receive care that respects their knowledge of their own body.
Every clinician knows that documentation matters — but listening matters first.
A midwife who dismisses concern without assessment is not only breaching professional standards but also exposing the hospital to liability.
A doctor who fails to review a patient reporting RFM breaches the continuity of care.
Healthcare is a team effort, and when one link in the chain fails, the consequences ripple across families and generations.
Expert Evidence in RFM Negligence Cases
In litigation involving reduced foetal movements, expert witnesses play a central role. Common specialties include:
Obstetricians – to assess whether care met accepted practice;
Midwifery experts – to evaluate triage, documentation, and escalation;
Neonatologists – to interpret outcomes and causation;
Psychiatrists or psychologists – to quantify emotional harm.
The expert’s role is to determine whether a reasonably competent practitioner, faced with the same presentation, would have acted differently. In virtually all modern cases, the consensus is that reduced foetal movement must not be ignored — making these among the strongest negligence claims in maternity law.
Recurrent Themes in Reported Cases
Across inquiries, coronial findings, and clinical reviews, several themes recur:
Dismissal of Maternal Concern
Staff normalised reports of reduced movement or attributed them to “baby’s position.”Inadequate Assessment
No CTG or ultrasound was performed; monitoring was superficial.Poor Documentation
Records lacked detail about what the mother said, or what actions were taken.Delay in Escalation
Midwives failed to contact obstetric staff, or obstetric review was deferred until routine rounds.Communication Breakdowns
Handover between shifts omitted mention of reduced movements.Systemic Failures
Hospitals lacked clear protocols for RFM or failed to train staff adequately.
Each of these failings compounds the risk of avoidable harm — and together, they paint a picture of systemic negligence rather than isolated error.
The Role of Coronial and Public Inquiries
In recent years, the NSW Health system and counterparts in other states have reviewed numerous cases of stillbirth linked to ignored maternal concerns. The National Stillbirth Action and Implementation Plan (2020–2030) was introduced to reduce preventable stillbirths by 20%, with “listening to women” identified as a critical strategy.
These inquiries have repeatedly confirmed that when women report reduced movements and are not promptly assessed, preventable deaths occur. Hospitals are now required to implement public education campaigns — such as “Count the Kicks” — yet compliance and awareness remain inconsistent.
Legal Remedies and Compensation
If a baby dies or is injured because reduced foetal movements were ignored, parents can pursue a medical negligence claim. The potential damages include:
Pain and suffering for emotional and psychiatric injury;
Loss of expectation of life or dependency damages;
Costs of care for a child with disability;
Loss of income if parents cannot work due to trauma;
Therapeutic and medical expenses.
These claims are not just about money — they are about accountability, acknowledgment, and systemic change.
A Human Rights Dimension
The United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) recognises women’s right to safe, respectful maternity care. When clinicians ignore a woman’s report of reduced foetal movements, they not only breach professional standards but also potentially violate her human rights — the right to bodily integrity, dignity, and informed participation in her care.
Preventing Future Tragedies
The most important lesson from RFM-related negligence is that prevention is straightforward. When mothers are listened to, babies’ lives are saved. Simple steps — such as routine CTG, prompt review, and escalation — can transform outcomes.
Hospitals should:
Train staff in recognising RFM as a medical emergency;
Establish written protocols requiring same-day assessment;
Conduct audits of documentation and response times;
Engage in public education campaigns encouraging women to trust their instincts.
Empowering Mothers: Trust Your Instincts
For mothers reading this who are pregnant or planning to be, the message is clear: you know your baby best.
If your baby’s movement pattern changes:
Do not wait to see if it improves.
Contact your hospital or maternity unit immediately.
Be firm and specific: “My baby is moving less than usual, and I want to be assessed.”
Do not accept reassurance without monitoring.
You are not being “overcautious.” You are being responsible. And if your concerns are ignored, you have the right to escalate your care — and, if harm occurs, to seek legal redress.
Reframing Negligence Through Accountability
At Reframe Legal, we see reduced foetal movement cases as emblematic of a broader problem — the silencing of women’s voices in healthcare. When a mother’s intuition is ignored, it’s not a personal failure; it’s a systemic one. Holding hospitals and clinicians accountable isn’t about blame — it’s about reform. Every successful claim reinforces that listening to mothers saves lives. Every family who speaks up prevents another tragedy. Sadly, women’s concerns are still too often dismissed as anxiety or overreaction. Phrases like “that’s normal,” “trust the process,” or “you’re just tired” can silence critical information that should prompt investigation.
Other common examples include:
Reduced foetal movements reported late in pregnancy but not acted upon;
Abnormal pain or swelling following a C-section dismissed as “healing”;
Concerns about baby’s breathing or feeding difficulties disregarded by midwives or nurses;
Requests for an obstetric review delayed during labour, despite clear signs of distress.
When these warnings go ignored and injury follows — to mother or baby — the issue moves beyond poor communication into the realm of medical negligence.
Beyond the legal implications, the emotional toll of being ignored is profound. Women often describe feeling dismissed, humiliated, or powerless — experiences that can compound trauma even when physical injuries heal. Listening to women’s voices isn’t just a matter of bedside manner; it’s a clinical safety issue. When medical professionals validate and act on a mother’s intuition, they gain vital information that can prevent harm.
