The so-called "self-monitoring" means that the pregnant woman herself and her family members (mainly her husband) personally observe the safety of the fetus to make up for the inadequacies of regular prenatal check-ups. There are mainly two monitoring tasks that can be carried out:
The first one is counting fetal movements. This is something only the pregnant woman can do. Most pregnant women begin to feel fetal movements at around 18-20 weeks of pregnancy. Initially, fetal movements occur about 3-5 times per hour; as the pregnancy progresses, the frequency of fetal movements gradually increases, reaching a peak at 28-32 weeks of pregnancy; after 38 weeks of pregnancy, the number of fetal movements gradually decreases again. The frequency of fetal movements changes between day and night. Usually from 8:00 AM to 12:00 PM, fetal movements are even, then gradually decrease; fetal movements are the least at 2:00 PM to 3:00 PM; and from 8:00 PM to 11:00 PM, fetal movements become frequent. The placenta is an important site for material exchange between the fetus and the mother. The fetus obtains oxygen and nutrients through the placenta while expelling carbon dioxide gas and metabolic products. If placental function weakens and cannot supply enough oxygen and nutrients, the fetus will reduce its activity to conserve oxygen and energy consumption. Therefore, by counting fetal movements, we can understand the fetus's intrauterine condition and evaluate placental function.
The specific method is to choose a fixed and convenient time in the morning, afternoon, and evening each day, count the fetal movements three times, each lasting one hour. Then add up the three counts and multiply by four to get the number of fetal movements in 12 hours. If the self-measurement starts early, the pregnant woman naturally finds a constant value, using this as a standard to monitor the fetus's intrauterine safety. If fetal movement counting begins only in the later stages of pregnancy, generally, fewer than 10 fetal movements in 12 hours indicate fetal hypoxia in utero. Once a reduction in fetal movements is detected, immediate medical examination should be sought. It is crucial to know that although the decline in fetal movements until they disappear indicates serious conditions, the complete cessation of fetal movements followed by the disappearance of fetal heart sounds will not exceed 24-48 hours. If this critical moment is missed, the outcome can be imagined.
The second task is listening to the fetal heartbeat, which is best done by the expectant father. Fetal heart sounds consist of double tones, similar to the "tick-tock" sound of a clock, with clear and crisp sounds, regular rhythm, and a faster rate of 120-160 beats per minute. The location of the fetal heart varies depending on the fetal position. If it's cephalic presentation (head down), listen below or slightly above the right or left side of the pregnant woman's navel. If it's breech presentation (buttocks down), listen above or slightly below the right or left side of the pregnant woman's navel. Family members may not know how to determine the fetal position, but it doesn't matter as long as the pregnant woman remembers what the doctor said during the examination regarding the fetal position and where to listen for the fetal heartbeat. If the fetal heart rate exceeds 160 beats per minute or is less than 120 beats per minute, or if the rhythm is irregular, it could be a sign of fetal distress in utero, and a prompt visit to the hospital is necessary.