Fetal Movement Concerns at 19 Weeks: A Doctor's Perspective

Question
Dr. Rappaport,
   I will be 19 weeks pregnant this weekend and thought that I was feeling a lot of movement of the baby last weekend and on Monday.  Over the last four days I have not felt anything to speak of and of course am very worried.  (I have had two previous losses both before 8 weeks).  I have a doppler and used it last night because I was so worried, the heartbeat was slightly harder to find than most days yet it is still 155 as it has been all along.  Should I be worried about this?  I have been worried sick for the last couple of days thinking something is wrong, even the heartbeat does not comfort me.  Should I be feeling the baby every day by now?  I tried to call my doctors office today but they are not open.  Any information you could give me would be very helpful.  Thank you, Heidi

p.s This is my first pregnancy.

Answer
In the first pregnancy, a patient does not usually feel any fetal movement before 22 weeks gestation. There may have been fluttering or feelings of movement before 22 weeks, but that was only gas in the intestines and movement of the organs as the uterus was becoming larger. You should start to feel kicks or summersaults or hiccups starting at 22 weeks. After you start feeling kicking, you should feel movement of some sort, at least 10 times in 10 hours. If not, you should call your doctor and get a non stress test. However, until 22 weeks you do not have anything to worry about.  In subsequent pregnancies, you may feel fetal movement ("quickening") at around 20 weeks gestation. Don't worry. Good Luck with the rest of your pregnancy.