Table 4 Summary results of CERQual assessments
Finding | Contributing reports | Methodological limitations | Coherence | Adequacy | Relevance | Overall Confidence |
|---|---|---|---|---|---|---|
Analytical theme: How women engage with FMs | ||||||
Women identified perceived factors that impact FMs such as; mother’s position, time of day, and mother’s hunger/eating patterns | 28–30,37 | No or very minor concerns | Minor concerns | Minor concerns | Moderate concerns | Moderate |
Women associated FMs with health; regular, individualised patterns of FMs were viewed as reassuring and altered patterns as a cause for concern | 31–33,34,35 | No or very minor concerns | No or very minor concerns | Minor concerns | Moderate concerns | High |
Informal monitoring of FMs acted as a mechanism of communication between mother and baby | 28–30 | No or very minor concerns | No or very minor concerns | Minor concerns | Minor concerns | High |
Formal engagement with and assessment of FMs can cause worry and anxiety, but was also considered important, providing reassurances that the baby was well | 28,31,35 | Serious concerns | Moderate concerns | Moderate concerns | Minor concerns | Very Low |
When women were experiencing reduced or altered FMs, they adopted a variety of strategies to elicit movement | 30,32-34,37,38 | No or very minor concerns | No or very minor concerns | Moderate concerns | Moderate concerns | Moderate |
Analytical theme: Articulating and describing fetal movements | ||||||
Women’s descriptions and sensations of FMs differed at different gestational ages with changes in FMs noted as pregnancy progressed | 29–30,35–37 | No or very minor concerns | Minor concerns | Minor concerns | Minor concerns | High |
Women’s expectation of the timing of first FMs and the frequency they experienced FMs throughout the day were varied | 29,30,35,37 | Minor concerns | No or very minor concerns | Moderate concerns | Moderate concerns | Low |
Women commonly experienced increased FMs in the evening and before mealtimes | 30,31 | Moderate concerns | No or very minor concerns | Moderate concerns | Minor concerns | Low |
Women associated unusual or changed FMs with changes in frequency or absence of FMs, or changes in the sensation of FMs | 32,33,37 | No or very minor concerns | No or very minor concerns | Moderate concerns | Moderate concerns | Moderate |
Analytical theme: Fetal movements and help/health seeking | ||||||
Women accessed multiple information sources on FMs including; healthcare professionals, antenatal classes, books, the internet, and family and friends | 30,34,35,37,38 | No or very minor concerns | No or very minor concerns | Minor concerns | Minor concerns | High |
There were preferences towards receiving FM information particularly in the format of printed documentation such as a pamphlet or hand-out, although preferences for the types of information were mixed | 34,35,37 | No or very minor concerns | Minor concerns | Minor concerns | Moderate concerns | Moderate |
The internet was a common source of information often ahead of consulting a healthcare professional | 34,35,37,38 | No or very minor concerns | No or very minor concerns | Minor concerns | Moderate concerns | High |
A decrease in FM was generally perceived as a cause for concern that warranted help from a healthcare professional | 30,31,33,35,37,38 | No or very minor concerns | Minor concerns | Moderate concerns | Minor concerns | Moderate |
Reasons for contacting healthcare professionals due to a decrease or change in FMs included; if a defined period of time had passed, if the worry became unmanageable, fear of fetal loss, unsuccessful strategies to stimulate FMs | 33,34,38 | No or very minor concerns | No or very minor concerns | Minor concerns | Minor concerns | High |
Barriers to contacting healthcare professionals were mostly related to doubt or fear of being perceived a particular way, not being listened to, wasting healthcare professionals’ time | 33,35,37,38 | No or very minor concerns | Minor concerns | Moderate concerns | Minor concerns | High |
The advice offered by healthcare professionals to women on monitoring FMs and on what to do if they were concerned about FMs varied | 32–34,37,38 | No or very minor concerns | No or very minor concerns | Moderate concerns | Moderate concerns | Moderate |