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I am pregnanty.
Welcome to Hello Bump.
We're making pregnancy less overwhelming and more manageable. I'm Grace Rubray, pregnant for the first time, and I've just been fingered by a pelvic four physio rise right.
Oh, so I'm Theannahman. I'm a mother of six and an obsentrician train in training, so I do a lot of that lane, but in a very positive way, hoping to birth your babies.
Each episode will be holding your hand, and the hands, well, your honest hands will make you somewhere else week by week through this mysterious, perplexing and sometimes daunting miracle.
That is pregnancy.
Absolutely so welcome to week twenty one.
What size are we?
Rock melon?
Still abroad?
But that feels a small rock melon to me? It actually seems a little big.
To be honest, knowing what I know about pregnancy, it does seem a little on that a larger size, maybe a small rabbit in terms of and I don't like.
That any better. Just think that's is that our first animal? No our second animal.
Yeah, we had we had a kidy peek before.
What about like a bottle of serracha? Lengthwise, what is a bottle of sacha? It's a type of spice that we probably can't have if you've got heartburn, but it's like a spicy source.
So we now mes a baby's size from its head to its feet. Remember how we talked about for a while they were measuring to its butt. Now it's a full length. So we've jumped significantly to twenty six centimeters three hundred and sixty grand. So yeah, we've got a We've got almost the length of a ruler in there, just curled up. It's all little legs are curled up, and yeah, so it's it's flex it's next flexed, and its head and its knees are all curled up in sides.
It doesn't feel like that, hence the size of a rabbit. But if it went, if you were to get it out and pull his little arm's eye this and stretch, it'll stretch her out. She would be around the twenty six centimeters long.
Do they ever want whilst in utero stretch.
There's no room to do so because the uterus isn't huge. It grows with your baby, so it's not like you're us is like your baby's tiny. It's got this massive cavity to be in. Yeah, so it still it will be stretching out and in and out.
Now, because I've seen those reels where someone goes, oh, this is how long it is, and they put like the average length of the baby, they put the tape measure up to them.
I saw that today they and they just are like, how yeah, they're curled the lovely and what are they growing?
Well, this week's about their bits and pieces.
So the little woman, if she's in you, which is obviously in your case, has now got a fully formed uterress. So we talked about how it's all started around five weeks. It's a long long time ago that she was differentiated into a boy or girl based on genetics, and you know XX and x y and lots of different molecular signals and pathways that change things. But if it's a
little girl, she's now got her useress. And if it's a boy based on the Y chromosome, it still takes a little longer for those testes to descend down outside. That's actually untill about twenty six, twenty eight weeks, quite a while before your baby's gonads are on the outside of his body, but it's still all forming on that inside obviously to allow him to produce in thirty five years.
What's happening to me and what's happening to me?
You might be experiencing heartburn and intergestion even more now, so we've already discussed the myth around.
I have a gavaskin in my mouth. I can see that.
I was wondering for having chewing It was a gavascon. Wow, it's sexy. What about the bloating and the appetite? Has that changed for you as well? Because there's certainly, quite commonly is changes in that space this week.
It's hard to know what's bloating and what's babing at this point.
Yeah.
True, I definitely feel bigger.
Yeah.
Yeah.
The reflux tends a bit worseer now in the bloating because there is more baby taking up that space too, so you can imagine it's pushing all your other bits and pieces aside.
And is gas burping as well.
Again, that's the Sophogel's finkter releasing and relaxing a little bit because of the progesterone. And also if you think about it, particularly when you're sitting down, when you stand up, you might find it relieves a little bit.
But I don't know about you, but when.
The baby, that size of that uterress is now squashing the stomach, so it's actually putting pressure and so you're just getting that acid but it comes back up not much shut normal? Is it normal?
My?
Is this normal? Is it's starting to think about delivery?
Okay?
Yeah?
Because I did go to a pelvic four physio for the first time and when she you know, they have their hands inside you, and she said, let's start teaching you how to push, and with her hands inside me to see how what I was able to measure wise what I was, I guess open more and she said push with what you think pushing would be and my brain just went, I don't get it, and I just didn't understand. And I always thought there would be this
instinctual thing. So maybe if that helps people, if it feels overwhelming, it wasn't instinct No, it's.
More instinctual in the birth room now, and that is also again not for everyone. So we definitely have women where a body just takes over and she just her body just pushes the baby out. So you know, you hear people saying, your baby bree is breathed out, like she just literally went into this amazing zone of you know, berthing, and then the baby.
She just breathed and this baby just delivered.
It does happen, not commonly on your first grace, but it does happen. And you know, people have babies in car parks and at home because it was so unexpected and quick.
So some people do.
But the vast majority of women that I've now been privileged to watch, which is more than a thousand women I've probably watched vaginally birth, take time to learn how to push because for our whole lives we have been told suck in, hold up, and don't let that go. You know, keegels, kegels, kegels pull it. The language, by the way, I think are in c central, including in pregnancy.
But it's having to let all of that go, like you'll be pushing a watermelon out and you need to be okay with opening your boughs because most people do because that's the way the baby's coming out, not up and in.
It's interesting that you say up and in.
That was the only way I was able to lock into how to push out was to first go up and in and then push out. Okay, that's interesting, yeah, because I couldn't. I think I was also trying to push with stomach muscles. Yep, yeah, fair, until it clocked what we were doing. And then we've sort of went in stages of how to engage the muscles. And then she would show me on an ultrasound when I.
Was engaging the muscles.
Okay, to visually see it, and when is the right time to start seeing a pelvic floor physio and is it something that is recommended by obstetricians and midwives to do well?
Look, it's certainly.
We have an amazing women's health physiotherapy team at our hospital. I'm not sure that's the case everywhere, because one of my older hospitals wasn't the case. So I'm a massive believer in it. I had incontinence even as an athlete before pregnancy, and certainly had it afterwards and very much
during pregnancy. So one of the reasons I went and saw women's health visio before it was even advertisers the thing, as you know, a thing to do, was because I could not stand sneezing and pissing myself at work every time.
Found that really uncomfortable. So I went there to try and work out why, and learn about your anatomy, learn about your body, get comfortable with your own vagina because later in pregnancy we'll start talking about things like paranoral massage and stuff to try and help with paranoral trauma and tearing during labor, which, by the way, ladies, sorry because we're all going to close your legs right now, is at common, okay, So, particularly in first pregnancy is
very few people get away with it intact parente, which means no tearing or grazing. This is the time to make a good relationship with your physiotherapist, because I also believe no matter what birth you have, it's fantastic to engage with the physio before and after pregnancy. They help you retrain your pelvic floor, they help you retrain your abdominal muscles, because let's be honest, they're going to separate significantly.
You know, we get a lot of people with diast disrectors afterwards, which is a big gap in the upper start to switch depends on your pregnancy, It depends on your pre existing BMI. It depends how many babies are inside. For me, my first pregnance around the twenty eight week mark, so around where you are now. I noticed in the night work up and it went away and I looked
very much more pregnant the next day. So but you know, I was Onlympic athlete and did a lot of dominant work, so I think I was probably holding it back and that was so tight and strong, which I think is another thing we should probably bring up, and the your physio can guide you on this more than probably an obstetric can. Is that for some women you need to
back off your pelvic floor work. So I was someone who had a really tight pelvic floor from significant amounts of exercise, and that's not ideal for labor.
Everything you need.
You needed to be strong to support the pregnancy, but then you need to be able to turn it off and allow your body to open for birth.
That's fascinating.
So now I'd say twenty weeks is around the time twenty one twenty two weeks where you should be looking at women's health visios and you know, narrowing down one or two that you'd like to see and because it can also even support you with back pain. And they're not just vagina physios, you know, they do lots of other therapy as well. Can help you with your incontinence, can help you with prolapse concerns, talk about birth, can
help you guide you on pushing. I'm not sure I've heard of a physio doing the birth pushing at twenty one twenty two weeks, but maybe that's something she's really passionate about. It's certainly a conversation you need to be happy and as you're getting closer to sort of thirty five and thirty.
Six weeks, yeah, just because of the I don't know if this is going to be my talk, kid, but as it was so nice to figure out what the muscles are.
Yeah, okay, even though it was very daunting.
Well, I'm sure you're not alone, so hopefully it'll inspire someone else to get out and make a phone call.
And book you.
Apart from this, what are some other things we can start to think about this week?
Well, I think it really is starting to consider birth. Like you know, I'm really hoping with every bone in my body that it's not for at least another fifteen weeks. But yeah, starting to approach that space where you know things do change and happen. So I think it's really important to start one a little book where your monitor babies movements. So now is the time to really think, oh yes, I'm feeling it, Oh yes, I'm feeling it regularly.
So that we're going to start harping on about that pretty often in the next couple of episodes, because movement start become very important, but also just planning things that you're going to require and need over the next few months.
My talk kit this week is the pelvic floor exercises, but one that really surprised me was about opening your hip muscles and doing Child's posts, because one of the things that they do is they sort of massage around to see how tight you are in your hips from the inside. And it's the strangest sense, but I was quite tight in my hips, which you just have to start learning how to lose them and let go. And that the physiotomy that it's common for a lot of women that we never fully relax.
You could always be.
Ten percent tensed, and if you're one of those people that's ten percent tens you've got to learn how to let that go.
Absolutely and I think we need to highlight that at this point it's worse for people with chronic pelvic pain and end to eat triosis and stuff like that. So if you have a pre existing pelvic floor condition, it's central to start looking at this early. The flip side of that, not everyone's going to be able to ford together to a physio, that's true, so they are sometimes pricey, deservedly.
So yeah, and so there are really good website like Medibank actually has a page propurely on kegal exercises, So if you want to start looking at what those muscles are and training it, they just basically run you through what to do, which is, you know, like holding your wig and holding in that symptom for three to five seconds and then letting go, and sort of training on how often and frequently you know you should be doing.
Things like that.
So there are good resources out there if you can't afford to guns Efidio.
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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