Mindfetalness to Increase Women's Awareness of Fetal Movements and Pregnancy Outcomes: a Cluster-Randomised Controlled Trial Including 39 865 Women.

ObjectiveTo examine whether a method for raising women's awareness of fetal movements, Mindfetalness, can affect pregnancy outcomes.DesignCluster‐randomised controlled trial.SettingSixty‐seven maternity clinics in Stockholm, Sweden.PopulationWomen with singleton pregnancy with birth from 32 weeks’ gestation.MethodsWomen registered at a clinic randomised to Mindfetalness were assigned to receive a leaflet about Mindfetalness (n = 19 639) in comparison with routine care (n = 20 226). Data were collected from a population‐based register.Main outcome measuresApgar score <7 at 5 minutes after birth, visit to healthcare due to decrease in fetal movements. Other outcomes: Apgar score <4 at 5 minutes after birth, small‐for‐gestational‐age and mode of delivery.ResultsNo difference (1.1 versus 1.1%, relative risk [RR] 1.0; 95% CI 0.8–1.2) was found between the Mindfetalness group and the Routine care group for a 5‐minute Apgar score <7. Women in the Mindfetalness group contacted healthcare more often due to decreased fetal movements (6.6 versus 3.8%, RR 1.72; 95% CI 1.57–1.87). Mindfetalness was associated with a reduction of babies born small‐for‐gestational‐age (RR 0.95, 95% CI 0.90–1.00), babies born after gestational week 41+6 (RR 0.91, 95% CI 0.83–0.98) and caesarean sections (19.0 versus 20.0%, RR 0.95; 95% CI 0.91–0.99).ConclusionsMindfetalness did not reduce the number of babies born with an Apgar score <7. However, Mindfetalness was associated with the health benefits of decreased incidence of caesarean section and fewer children born small‐for‐gestational‐age.Tweetable abstractIntroducing Mindfetalness in maternity care decreased caesarean sections but had no effect on the occurrence of Apgar scores <7.