You're listening to a MoMA Mia podcast. Mama Maya acknowledges the traditional owners of land and waters that this podcast is recorded on.
I am pregnant.
I'm Grace Rubray. I'm pregnant for the first time, and just like you, we are officially halfway through. That's so exciting.
I'm out of Pittman. I'm a former Olympian, I'm a mother of six little humans, and I'm now training to be an obstetrician.
Each episode will be holding your hand week by week through the mysterious, perplexing, and sometimes exciting miracle that is pregnancy. Yes, I said exciting, and we'll get to why. Because it is about morphology scan, it is about being halfway through. It is very exciting.
Week twenty, your baby is about the size of a mango.
Now that that feels like I can feel the weight of that. Yeah, big, it is big. I've put it could be a top not hair bun.
And I'm not nice, Okay. An artichoke, I don't even know what an arch choke, but that's.
I only know them as the canned version pizza. Yeah, I don't know what they look like in the wild.
I hear, but for us to be visual sixteen point five centimeters and approaching three hundred grams now, so it's pretty cool.
Yeah, that is hefty. It is hefty, It is afty, it's efty. And what are they developing?
So your little one's head now has some hair on it, no color yet, so the pigmentation is still coming by twenty weeks baby is. If the baby's a female, her ovaries will carry all the eggs she'll ever have. Remember how we talked about the fact you you're carrying your grand babies already. Now they've splitten and they're actually considered all sights and this is the most she'll ever have in her whole life. She has several million eggs at
the moment, which is kind of nuts. And then she'll basically every month you get less and less and less and less. From this point onwards, she's got the highest amount of eggs you'll ever have right now.
That's wild nuts. So when you said about the hair, there is the myth about a hairy baby giving you more brief or more heartburn. Is there any truth to that?
It's again a bit of a old wife tale. But we have done some there's been some good research in this space, I think because of people talking about it all the time, and they think the same sort of hormones that cause think about it. We talked about it with the progesterone and testosterone hormones that cause pregnancy accelerate
hair growth. Can also make the sophageal sphincter, which is basically a muscle around where your stomach becomes your esophagus where your food sits, and then loosen and become weaker, and so you tend to reflux more food out of your tummy. So whether it's directly related alum the sens so some says yes and some says no. Doctor says not sure.
What's happening to me and what is happening to our body?
You're now halfway Obviously you've already highlighted that the uterus now takes up more room and is quite squishy inside your organs. It actually reaches just where your belly button is, So we actually think it's quite funny. This is the time we start measuring your fundel heights. So when you come to see us, you might have had earlier than this, but we like to start it. And that's where we take a tape measure from your pubic bone and measure your belly, and people.
Are like, why are you doing that?
It's very weird. You match twenty weeks, twenty centimeters, twenty one centimeters, twenty two centimeters, so your roughly gestational age of your baby will match the weakes of pregnancy that you are. Will they do that rather than weigh you, we weigh more for BMI, so we weigh more to has she put on too much weight or worse, has she actually not put on enough weight because of hyperremisis or nause'r and vomiting is adequate weight game being You
can also see some conditions. For example, if the woman has a baby that's making too much amniotic fluid, she might have a sudden increase in weight. And unfortunately, things like preaclampsy you can do the same. So it's just a sort of a tool that we use to look at lots of things, weight gain issues in pregnancy, red flags that we might need to look at. The size of that fundus is the thing we look at most
for the baby's growth. So say you're theoretically I mean twenty weeks, we don't worry about it too much.
We just do it.
Almost as a routine. But say you're thirty weeks and your baby's only measuring twenty six weeks, we get a little nervous that the baby might be small. Most of the time, it's just the baby's like in a transverse position or in a position that means it looks smaller because all bits of going sideways instead of up and down. But it's an interesting What will happen is you get a notch sound so we can look more formally at
your baby's size. And obviously if it's big, big, big, and you're measuring forty weeks and you're only thirty weeks, the same thing. We just want to know what's going on inside?
Is this normal? Is it normal? So this week I want to talk about the big twenty week morphology scan. And I'm sure I'm not alone that when I was watching the sonographer do their work, I was staring at their face for any sign of good news bad news. But they any news. But they don't give anything away.
No, they're amazing, are they? They have like the most incredible clown face. You have no idea what's going on.
And there's all these different shapes and then when they switch on the like showing like the blood flow. Yeah, yeah, and you're like, well, that big red thing and the big red and blue thing, is that normal because we have no idea what we're looking at.
Yeah, Well, I'm really lucky I've had I did several weeks in the Elks Sound apartment with some of the best scenographers in the world in the last few weeks, and they taught that they don't want to give away because they're there to do the scans and find anything. And then what you don't realize is after that they send the images to the doctor who sits down and that doctor has strong knowledge about what is normal and what is not. So they're measuring compartments of the brain.
They're looking at the size of the ventricles, they're actually looking at the whole anatomy of the brain. Is is there something there that's unusual? All the bits that should be there present, what could be absent? And so they methodically go through each of the major organ systems and look for anything that could highlight either a structural abnormality.
In other words, sometimes it's sad to say, but sometimes something like an infection in pregnancy early in pregnancy can cause fetal growth restriction, and it can be quite obvious in the features. Sometimes it is a chromosomal abnormality that wasn't put picked up earlier, and there'll be those soft signs. Sometimes it's a genetic condition, like polycystic ovaries. There'll be a little ovaries that covered in little cysts, so they'll pick up all those.
They can picks on the feeder.
Polycystic kidney, sorry, could take.
You for correcting me. Polsistic kidney.
So they look at the kidneys and they could see similar not followicles. Little babies actually see the little cysts that shouldn't be there on the kidneys, so it's tumors even like little babies develop unusual tymbers, brain tumors and hydromas and things that shouldn't be there.
One thing that I did want to bring up, just in case this has happened or if someone is listening before their twenty weeks scan is I was called back, Yes, good point, because well they actually didn't tell me why so, yeah, because it was a receptionist who I am. But then when I started this conversation with a lot of other women, common common Yeah, and it's to do mainly with and this is just the comms of not the doctor, so
I will throw at you in a moment. Is it is done by a snographer, but it is looked at by a doctor who goes, I want another angle exactly, and.
So it's your baby's fault. They've been on the wrong side of the of the ultrasound way and they're basically not cooperating. You might even find during your morphology the doctor gets gets you off and just go for a walk. Your babies positions not right. We can't see what we need to see. We haven't got the fortune, you know, for heart chamber of view. We need to get more.
That's fine, So that's really common. Sometimes it might also be that they do see something that is a little bit unusual that the sonographer didn't quite see, and they want to get more imaging. So don't be alarmed with that. You know, it's obviously not an enormous.
Rip roaring abnormality.
Otherwise they would have seen it straight away. Because that's when I got talked to ultrasound, because it's part of my training is to be solid at ultrasound. It's one of those I need to see this severely severe abnormalities. So the smaller ones will be picked up by the doctors, but the one that the trained obstetric doctors or the MFM specialists who do this even more, they're the ones who are the pretty much the krem little creme of
obstetricians in high risk pregnancies. But at this point you need to see what is grossly abnormal versus what is normal, and then you know you've got your images, but you're not always going to get them. They're still going to be sometimes where things just need a little bit.
Of extra I was laying there and she wouldn't move, and they made me raise my ships like a bridge and wigg a come on, bubba, and then like, I don't know if other people have animals who maybe have taken an interest to a bump, I've always been like, oh, is that my cat? Are they pushing too hard? No, how hard those snographers were pushing to kind of get them into the right recision or even you've just touched me in this recording before, there's a lot of They
can take a lot of pressure, is that correct? Correct?
That's why they're cushioned inside. Like people have car accidents and babies are fine, Like not always you always always, guys, if you have a car acident, even if it's a small bump, need to go and get checked. Or a fall on your bottom, or a fall on your tummy or all of that, you need to go to the to the berth unit and get an assessment. Particularly in our twenty weeks, that means you don't have to go
to your GP. Now it is birth unit, not d It's straight to where you're going to birth your baby. All of those things needs investigating. But yes, you're very robust in there, like very robust toddlers.
Think about it.
You're not yet on your second but I have had two or three children jump on my tummy at the same time.
They're very very safe. Okay, what are some other things that we might need to think about it? Twenty weeks tough discussion.
So twenty weeks mark's viability, not viability for the baby to live. That's twenty three weeks, but it marks the time when Medicare and the government, let's be honest, recognizes that your baby is a baby and not a miscarriage. So I really hope that no one listening to this goes into pre term labor at nineteen weeks and six days, which is literally that custody time as you turn twenty weeks.
But I've already had the privilege of sitting with three women that have had to make that decision where we did. We knew she was going to pass the baby unfortunately and birth her little one. So it is a discussion to think about how what you would do in this case, but also to recognize that now your baby is a baby.
So from this point forward, if you were one of the incredibly horribly unlucky person people to go into labor in the next couple of weeks before your baby was fully formed and able to be resuscitated, that your baby is considered it's our fetal loss. So it's a fetal death from this point onwards.
And what does that mean in terms of how the government seems that, like, what are the steps that you would need to take or that you can take. Is it elective? What the next steps.
Or partially partially not You can elect for the hospital do the burial in the cremation, but it is still something that happens. They get birth certificate, they get a death certificate. There's a bereavement package that can be given to the family for for example, time off work, because I mean, don't get me wrong, I think and this is why I think it's such an arbitrary number. And it's really hard because you get I know that if I had lost a baby at eighteen weeks, to me,
that was a baby. There is no part of it being a miscarriage to me. I mean, we label it medically it's a miscarriage, it's a late miscarriage in the second trimester, but it's not clinically called a baby until that point. So there's a lot more paperwork for the medical team to do. They offer a lot more investigation, so they same baby off, a post mortem and things like that. If you want to know what the cause is,
often it's just pre term labor. But if there's something that happens, like for example, you go fore ultras ount and there's no heartbeat, I think they can give you more information around that space. But the good thing is all of these major hospitals where you would birth your little one, or if you don't and it's a rural hospital,
they can organize it. ADDI tertiary center is to have that counseling and that discussion around what the next steps are so you will be really well supported through this, you and.
Your partner and your family. If that's what you choose. What are some companies or organizations that you know of that can provide supporting If someone's listening and that this does happen to them in the next few weeks, or if they've got a friend that goes through this, is there somewhere we can point them to.
Well, I mean, this one's hard because of the gestation it's happened, But there's Pink Elephants is a really good one and I actually met the founder just recently. Her name is Sophie Smith. She's extraordinary and she runs running for premature babies. So she lost her triplets at her first little one came just after twenty one weeks, lived
for an hour. Her second little boy came and lived for several hours, and the first one lived for several days or actually almost I think it's fifty eight days, she told me. So she has now nineteen years ago. Her triplets will be nineteen this year, and so she's set up an incredible space where women who have premature babies like this can bind together. And she's raised over nine million dollars for premature babies and nic U support.
So pretty impressive woman, isn't she that she's through that loss.
Yeah.
I know it's a touching topic to talk about, guys, but unfortunately everyone listening to this, not all of you are going to go full term. So I think it's really important to have those resources in place and just recognize that it does happen very rarely, but it.
Does for the tool. This week, I don't have anything practical, really or productive. I just said, take yourself out for dinner because you're halfway. Halfway.
I think you celebrate with some apple sparkley, yeah, maake wine, yah.
Some fakey fake something and have to be with your people, booth, your partner and congratulations. Yeah, perfectly said. We hope you enjoyed this episode of Hello Bump. We have so many episodes of this series filled with tips and stories from women and experts who've been through it all before.
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This episode was produced by Courtney Ammenhauser, with audio production by Tom Lyon, we'll catch you next time. Bye.
This episode of Hello Bump was made in partnership with Huggies