Promise Community Health Center prenatal care team

Promise Community Health Center prenatal care team
Promise Community Health Center's midwifery care team consists of (standing) certified nurse midwives Belinda Lassen and Pam Hulstein and their support team, clinical assistant/interpreter Ruth Hernandez and registered nurses Erica Robertson and Kari Ney.

Friday, November 17, 2017

Sharing the joy of belly wiggles!

By Pam Hulstein, Ph.D., CNM

Eyes open wide in amazement when a mother-to-be realizes for the first time that she is able to feel for herself how her unborn baby is positioned.

One of the rewarding aspects of my work is when I see a mom-to-be connect with her unborn child beyond fetal movement sensations. The look on her face is priceless as her hands share with her mind’s eye how her baby is positioned.

Pam Hulstein, CNM
Before 34 weeks or so (eight months), moms will be able to describe well where they feel the baby’s wiggles and may describe them as brushes of movement, pokes, bubbles, rolls etc. Babies initially lie with their back opposite moms (transverse), and during the second trimester, I see that many babies begin to assume a head-down (vertex) position with intermittent changes in position.

By 36 weeks (nine months), most babies will be in a head-down position with their back on either the right or left side of mom’s belly with their face toward mom’s spine. In this position, mom feels the kicks, pokes, jabs of the side opposite the baby’s back. The back feels like a smooth curve lying distinctly on one side of the belly as she feels with her hands. Moms can usually feel with their fingertips a rounded bulging in the upper part of her belly, which is typically the baby’s bottom end. Sometimes she will report feeling “kicked” in her ribs by a foot! When she feels gently by her lower belly with her forefingers opposite each other, she can get a “sense” of the baby’s head lying nicely near her symphysis bone. The symphysis is the firm bony area felt at the bottom of the belly.

I encourage moms to develop a good “sense” of how it feels when their baby moves, and
when she is around 34 weeks (eight months), we work to develop the skill of figuring out how her baby is positioned inside her. The movement of a baby growing inside can be almost painful for a few, but at the same time, it provides the incredible indication that life is happening.

As the wiggles change from flutters to kicks, a mom is able to cue into her baby’s movements and eventually how her baby is positioned. Hands-on care, when I put my hands on mom’s hands to learn her baby’s position, is a precious gift given to moms and nurse midwives as we share in the joy of belly wiggles.

Pam Hulstein is a certified nurse midwife at Promise Community Health Center in Sioux Center. To learn more about Promise's midwifery team and prenatal services, visit For more tips and advice on various topics from Promise's midwifery team and baby announcements, visit