Midwifery assessment of reduced baby movements
NMC OSCE practice station

The task

You are a midwife on a maternity assessment unit. Rebecca Thornton, aged 31, is 36 weeks and 2 days pregnant with her second baby. She has come in because her baby has been moving less than usual since yesterday. Her partner is with her. An obstetric registrar can be reached by phone. Introduce yourself, take a focused history, assess mother and baby, and decide what needs to happen next. Record her observations and your assessment on the chart provided. Say aloud what you are checking and why, and explain the plan to Rebecca.

What this station tests

• Take reduced fetal movements seriously every time; a normal trace does not close the assessment.
• Listen to the fetal heart with a Doppler before applying the CTG.
• Ask about itching: hands and feet itching at night may be intrahepatic cholestasis of pregnancy.
• Escalate to the obstetric team with a clear SBAR for review before discharge.
• Women should contact the unit whenever movements reduce; do not rely on kick-counting numbers.

Sources for the clinical content

• RCOG Green-top Guideline No. 57: Reduced fetal movements
• RCOG Green-top Guideline No. 43: Intrahepatic cholestasis of pregnancy
• NICE NG201: Antenatal care
• NMC: The Code

An original practice scenario with invented patients. Not an exam question.

Practise next

• Breathless older patient with a chest infection
• Worsening abdominal pain after bowel surgery
• Confused patient after a fall with a head injury
• Children's nursing assessment of a child with a high fever
• Midwifery postnatal home visit with a feeding problem