Fetal movements, since biblical times, have been viewed as a reassuring sign of a healthy pregnancy. If the fetus was active, both mother and the health care provider knew that the fetus was at least alive. It was not until the last 15 years that the obstetric community began to place greater emphasis on the importance of the fetal movements. At present, not only an absence of movement, but also a decrease or sudden change in the number or quality of movements should create alarm. This article reviews the growth in the usage of the fetal movement count through a review of the literature. Recommendations on choosing and/or modifying a counting method to fit your clientele also are presented.