Week 22: Blocked Up And Out Of Breath?

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Mama Maya acknowledges the traditional owners of land and waters that this podcast is recorded on.

I am pregnant.

Welcome to Hello Bump. We're making pregnancy less overwhelming and more manageable, hopefully. I am Grace Reuvery. I'm pregnant for the first time, and I can't walk upstairs slopes or speak long sentences without losing my marette without losing my breath.

Oh, I'm Yanna Pitman. I am a mother of six.

I had all those babies myself, and now I have the privilege of working in a birth unit as a training obstitution.

Each week, Bianna and I will help hold your hand week by week through the mysterious, perplexing and sometimes breathless miracle that is pregnancy.

So welcome to week twenty two.

How big is the baby at week twenty two?

Babies now about the size of an egg plant. Yeah, that's quite big.

Or a sweet potato, a hair brush, or a defl at afl.

Deflated one, not a full it's a four to one full term.

No, thirty four weeks that I guess twenty eight centimeters. Little bubby is now and weighs about four hundred and thirty grams, So depending on which hospitals, as you get closer to the five hundred grand mark, we're getting closer to the time where baby will be viable.

So only a week away.

Now, this twenty two week is a really super important week medically because if things were starting to happen, if you knew you were having getting into pre term label, we try very hard and have lots of discussions because as of next week you meet the viability age for all tertiary hospitals.

So big hospitals that have a really.

Good nick use with multiple pregnancies, think, if it's twins or true plants, are you starting to look at what week you would be looking to get the babies out or is it just as long as you can keep them in?

Yeah, great question. I think it depends on what type of babies you're having. So there's multiple types of twins. I had DCDA twins, so that basically means two percenters two separate amniotic secks of the lower risk pregnancy. They aim to sort of birth those little ones around thirty seven to thirty nine weeks.

So if it's as long as another other risk factors pit prop up.

Like preclamps Yeah, yeah, MCDA twins, which means there's one placenter and two sacks sometimes earlier, and then you save you when they have one placenter and they all share

And as they are starting to get closer to being viable, what have they developed in the past.

Week, So I think it's a cute one. Well, on that note, their lungs is now starting to form those little alvole life so those little sacks that will then eventually allow oxygen exchange, which is why we're getting close to the time where they may survive and may do Okay. Brain's now developing the cerebral cortets, so complex thought and actions that they will eventually do as starting in that process now. And they've even got little retinas in the

Well, does that affect their sleep at all? They don't have any kind of sleep with.

Not yet the circadian rhythms and stuff come. But that's I guess that's what we're going towards.

Not quite yet.

A couple more weeks and then they'll have circadian rhythms and rem sleep and everything.

Just like you and I. But yeah, it's a few weeks off.

But at least now their retinas are able to actually detect the difference between light and dark inside the uterus.

What's happening to me? And what's happening to the women? What's happening to that? And to me? Tell me what's happening to me?

Constipation is probably at its peak at the moment. You might be developing some hemorrhoids. Early hemorrhoids might be starting really common in pregnancy. Again, most of them sort of go away after birth. It's again increase pressure in the rectum so that pregnancy is sitting right there, increased blood flow, and with that motility slowing down, you get constipated, you push harder, higher chance of hemorrhoids.

Is this one of the times where you should get one of those little stools to put your.

Proper legs out. Yes, yes, yes, exactly, So go for it again. Have you got what I hope? No?

My pelvic four physio said to get two toilet rolls. That's a clever idea if you don't want to buy something, so you don't have to buy something new.

I mean, you're gonna have a baby, it's always having a little stool at the end of the baby's going to use the toilet train. But I like that just a little Yeah I'm doing is literally trying to take the pressure off the ground and you know, lift your legs up off the so put your feet on toilet.

Rolls, is what she said. Yeah, I like it. I might go and meet your physio. She sounds like is it she? Yeah? She excellent?

Is this normal? Is it normal? Is this normal? Is the fact that I am getting out of breath? It's just speaking or walking up slopes that I wouldn't even call with you anything that requires I've gone back to the gym and I've been able to do pilates, but I haven't done cardio apart from walking, so I don't know how it would go with like a hit class at all, because I'm getting out of breath. Why do we get out of breath at around twenty two weeks.

Look nine and nive percent of the time it's normal.

Okay, Again, your baby's getting hot, bigger, it's pushing up and you've got less ability to allow that diaphragm to move up and down and take those deep, big breaths. You are using more oxygen around your body, so just the requirement of the oxygen requirement has gone up. I think the thing to consider though, is that breathlessness can be one of those red flags just like we've had we've talked about before around heart rate going up or

One of the things. I've spoken to my mom a lot about what happened in her pregnancy, and she's thinking back to back in the day and she had something that I've not experienced yet. She bled pretty much throughout the whole of her pregnancy actually, and then if it did stop, it came back at around twenty ish weeks mark. What is that a sign of?

Look, it's really tricky and sometimes we can't work out what it is, but it is important to look at that. So I think it's a really great discussion for this week. Because you've had your morphology hopefully by twenty two weeks, we really what I've done before now guys, and look for where your placenta is. So sometimes we can get what's called a low lying placenta or a placenta previa.

There's different raids of it.

So obviously one is just where it's a butting up against the cervix and what that basically means. The placenta needs to be feeding the baby, so we need it, it's essential. But ideally it's up near the fundus, at the top of your uterus or on the anterior or the posterior walls, so it's somewhere away from where the cervix is, and the cervix is obviously the.

Canal that Levenchy but baby will come out of.

But unfortunately, in some cases it can actually come really close to the cervix. So if it's within twenty millimeters, so if you know you're looking atr fingers, it's in that sort of period of space, we know there's a risk that if that during pregnancy, bleeding may occur, and it can be quite significant bleeding, so we monitor you more regularly. So if it's just a low lying placenta, we then say, look, let's repeat an ultrasound. In the third trimester. Most of the time, ninety percent of the

It can bleed.

It can bleed from contact from intercourse, but I still want you to have intercourse as long as your percenta is not low lying and you're not having a concern is sumportant part of pregnancy. You vagina can bleed because it gets dry sometimes and it gets you know, moist other times.

I know probably hate.

That word, but it's importunately part of the vagina and sometimes again back to the placenta, it can lift up a little bit on the side. It's more common in third semester, but we can get a little bit of bleeding from the edge of the placenter called a placenta abruption, which is a tiny one and in most cases it just sits back down again. It can be a real pest bow grace. So some people get this annoying bleeding. They don't have a placenta previa, so the placenta nice and out of the way.

And every couple of weeks they do just bleed.

And these poor women can sometimes be in hospital from like twenty five to twenty six weeks till term because they bleed. They go home for two or three days, they bleed again, they go home for two or three days, they bleed again, and they are literally institutionalized for ten weeks of pregnancy. The remarkable that they manage to hold it together. So I think it's just really important to if you do bleed, to try and work out what

Is it abrupting? Most of the time we can't even see it, so it's kind of to proven.

Otherwise, I'd say more often than not, I can't give you a reason, but know that it's common.

But it's always always a time to go and get help.

When you talk about the placenta moving. If we for a lot of women, the last time they see their baby on an ultrasound is that twenty weeks. Can if you're low risk, how can you know if the placenta has moved? Are there other signs?

If your percenter is low, that won't be your last ultra sound, So it would be strongly against. I mean, there's a lot of things we're quite lax with with you know, you take our recommendation or you don't that. I can't imagine any midwife or doctor or door or anyone if you had a low lying percenter a morphology that wouldn't say let's repeat it at least between twenty eight and thirty four weeks, because we need to know ideally the closer to thirty two to thirty four that

Is there a chance that if you do have an anterior percenter like minds at the front, yep, would it move lower or higher? Or if it's an anterior and yeah, will it's the other way? No, so because it's not.

Actually it sounds like the vost is getting a little feet and wriggling its way up.

It doesn't.

It grows as the muscle and the segment. So you actually have what's called your lower segment of your uterus in early pregnancy. It's not developed, so there is actually an amazing phenomenon where the actual lower segment stretches and stretches and stretches are up, and in doing so it takes the percenter with it. So the pleasant is not physically moving, it's just growing up and away from the

One incredibly low.

Right.

The other key thing to think about is your cervical length. So we talked very early in this series around internal examination. So having a trans vaginal which is the probe inside the uterus. This is the time we can have a look at your cervix and see if it's nice and long. If your cervix is super short, in other words, it's like only a centimeter long, we would consider at this point doing something about it.

Now not always.

Some people might say no, thank you, or it might be borderline like two centimeters or two point eight, and it's just being what we call cervical surveillance, which means you have more frequent ultra sounds to check that. But ultimately it's what's holding your baby in.

Once your service.

Starts to dilate, it's very, very hard to stop labor from coming again. I've seen miracles. I thought, there's amazing woman with an open service at twenty five weeks. You made it to twenty No, it made it to thirty four weeks. But it's less common because you know something that's the structure is not stable anymore. So if we can catch an open cervix or short cervix, I should say at twenty weeks, we can usually do something like

We've given a lot of advice this episode already, but is there anything else that we haven't thought about for a checklist this week? For twenty two.

Weeks monitoring babies movements. Now, let's go into that properly next episode, because I think now is the time there's patterns will develop, but I think super important to start looking and monitoring those.

My talk itIt for this week is just to stop being a hero and if someone love it. If someone offers a lift or says, do you want me to lift that, Itham, the answer is yes.

Yeah, perfect take it, including if they want to cook your meals and things.

Yes, oh yes, ay, yes.

And it also gives them permission to ask you in the future. And I think we're so busy not taking help because we're want to be heroes, as you perfectly said it, but it allows in doing so, them to reach back and ask for that when they go through prectice in themselves, which makes it a women's club, which is exactly what we need.

Yeah, 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.

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