A decrease in cesarean sections and labor inductions among Swedish women by awareness of fetal movements with the...

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatal Health

Background:

• Maternal perception of fetal movements is a common indicator of fetal well-being.
• There is ongoing debate regarding the benefits and risks of encouraging maternal observation of fetal movements, with concerns about increased interventions.
• The Mindfetalness program was developed to enhance women's awareness of fetal movements.

Purpose of the Study:

• To investigate if increased awareness of fetal movements through Mindfetalness impacts rates of cesarean sections and labor induction.
• To evaluate the effect of the Mindfetalness program on perinatal health outcomes.

Main Methods:

• A cluster randomized controlled trial involving 67 maternity clinics.
• Women in the intervention group received a leaflet instructing daily focus on fetal movement characteristics for 15 minutes from 28 weeks gestation.
• Sub-group analysis targeted women born in Sweden giving birth from 32 weeks gestation, applying the intention-to-treat principle.

Main Results:

• The Mindfetalness group (13,029 women) showed lower rates of cesarean sections (18.4% vs. 20.0%) and labor inductions (19.2% vs. 20.3%) compared to the routine care group (13,456 women).
• Fewer babies were born small for gestational age in the Mindfetalness group (8.5% vs. 9.3%).
• Women in the Mindfetalness group contacted healthcare more frequently due to decreased fetal movements (7.8% vs. 4.3%).

Conclusions:

• Implementing Mindfetalness in maternity care is associated with a decrease in cesarean sections and labor inductions.
• The Mindfetalness program contributed to a reduction in the incidence of small-for-gestational-age babies.
• Increased maternal awareness of fetal movements through Mindfetalness appears to improve perinatal health outcomes without negatively impacting intervention rates.