You're listening to a Muma Mia podcast. Mama Maya acknowledges the traditional owners of land and waters that this podcast is recorded on.
I am pregnanty.
Welcome to Hello Bump. We're making pregnancy less overwhelming and more manageable. I'm Grace Roubray. I'm pregnant for the first time and I think my child has learned to kick downwards towards my vagina, maybe looking for the exit. Oh my cervix, Let's hope not. It's closed. It's long and close, long and closed.
I'm Ana Pittman, i am a mother of six, I'm training to be an obstetrician, and I'm a former Olympian for Australia.
Each week, Yana and I will be holding your hand, week by week through the mysterious, perplexing and sometimes silly miracle that is pregnancy, all the way from a poppy seed to a pumpkin. Week twenty nine, What animals and fruits are we this week?
Animals and fruits are banana split, which somehow feels smaller though than not a loaf of bread.
Last week, So it has to a bit a half a loaf last week. Yeah, yeah, definitely definitely, or a butter and nut squash.
Yeah, but that's a small wallaby.
Is the Aussie themed animal for this week in animal territory?
I think you have to because you know, how are those apps You can have a choice, you can when you have some of them, you can either have it an animal of fruit. So I think since we're Aussies, we'll go over there with an Aussi.
Animal before we get to melon territory, which is soon a good point, good point.
Babies will really start showing some variation in size now, so some little ones will be around one point one kilos and up to one point four so we're going to see some really big variation. We call that constitutional variation, and that depends on mum and dad and how big they are compared to baby. But it's also going to depend a lot on nutrition, placental function, and lots of other things that can influence your pregnancy now.
And why do things change with your placenta, like blood flow or like things that they're watching out for. Why does that change when we've been checked at the twenty weeks again and we're all good.
Yeah, it's actually a great question and probably really important to bring up now because things do change quite significantly, and a lot of fear sets in in this next couple of weeks because think you might be doing really well, nothing's changing, and all of a sudden, your obstitution says you're a high pregnancy. No one wants to hear that. You're on your Midwiffree pathway, you're planning your home birth, and all of a sudden you're sitting with me.
Not a great play, right, you're great, well, you know what I mean.
But no one sets out on this adventure to need to have a higher risk pregnancy. But things do start changing now. A lot of it is going to be your pre existing pregnancy condition. Do you have any type of blood coagulation issues in terms of a thrompophilia, Do you have diabetes? Do you have hypertension? All of those things before your pregnancy will determine what's going to happen now.
But even the healthiest, slimmest, most what we would say, you know, textbook woman, could run into issues that they weren't expecting. Because we know that diabetes isn't just someone who has a bigger BMI. There can be some genetic predisposition or even underlying type one diabetes that is evolving and it actually shows up in pregnancy, so it's tough. It's tough to know what's going to change. But they're
the things that can affect your baby's growth. Because we know preclampsy you can make small babies, because it can lead to plucent on dysfunction. We know that diabetes can lead to big babies, small babies, and unfortunately babies that don't make it to term. So there are lots of things now, which is why again we like to do to check in. But our podcast obviously isn't for high
risks women. I hope, we hope that people are listening that are in that case, some of this information will be very much led by your obstrition and your obstetric team.
What's happening to me? All that leads us into what's happening with us? Are there any updates that kind of lead into this for the people giving birth to the babies as well? We are totally the importial wise. What's happening to me?
Yeah? Well, and funnily enough, your insulin resistance is becoming worse. So this is why if you have if you have diabetes before pregnancy, you might find that you are starting to have a high insulin requirement. And if you've never had diabetes in your life, you might have just found out you've got gestational diabetes. So that's diabetes caused by the pregnancy because it's a natural state of insulin resistance.
You might find you've been managing beautifully with diet, you're doing everything right that doctor tells you to go for a walk, and you're eating beautifully, and you still get put on insulin at this point, and that is just the way the body changes. Lots of things, lots of hormones and placental lactrogen and things like that will actually change the way your body reacts to insulin. And it's because of the little parasite inside wanting that gluecoast. So
it's a hard place to manage. But again, you'll be really tucked in with a good doctor at this point to make sure that your glucose levels stays as normal as possible.
Yeah, all of those week by week things where it's like eat more nuts this week or eat more vegetables, what should we be eating around this week than if we are able or even if you have gestation like diabetes or not well, I.
Think the thing, the biggest thing at this point in pregnancy is you are feeling full and your baby's pushing up on your stomach, You're getting reflux, all that sort of stuff, So small regular meals is probably key to this. As much protein as you can. Look, women are gonna have a chocolate here and there, so I don't think there's any point in saying no, it's just about moderation.
So it's basically the same as before, but your baby's now growing rapidly, and in fact, the biggest growth is actually in the next couple of weeks, so you'll find you're hungrier, but then you feel full quickly because your stomach smaller. So it's a matter of just trying to fit what you can in what's healthier nutrition as much
as possible. And sometimes I'm a big believer in protein shakes at this point because if you're not tolerating things, just making sure you kick that nutrition in is really important.
I'm still having my protein shake every morning because it just makes me stay full for longer and I feel like I've got a lot more energy to work because if you haven't taken maternity leave, which you might not twenty nine weeks, You've still got to push through an entire day, which feels illegal.
Sure. I actually worked right up until thirty eight weeks and one day, and then I, on my fourth pregnancy, literally walked into the hospital the next day, delivered a baby in the car park by mistake, and then had mine an hour later.
I was like, ok, I was an implantdi to Bertha in the car park.
I just happened to be walking and I could hear the very textbook grunting happening from a car as I was walking in to have my own baby. And then she the head was delivering, so I was like, that's great. It was on my hands and knees, and then I had an aarm, which means they ruptured my waters about an hour and a half later. And I had a very swift labor that time. So it was a busy day.
In four or five hours, I can't right, Yeah, me tippity tappening at my computer. I've got nothing.
But I think let's go quickly that. I don't condone that at all. If I had my time around. I think the sensible and nicest, if you can afford it, with life, is to go off at about thirty four weeks?
Is this normal? Is normal? I've got two? Is this Normal's the chemical of nesting. I've heard a lot about nesting, and I've felt some of it creep in. But it's not about baby items. It's about getting like my life in check, like things like I really should get my tax done early, or I really should like write an admin list of things that I feel like I'm just not going to have capacity to do. But it hasn't. I don't have a nursery. I just have to admit.
Do you have a nursery? But you've got your tax ready? That's good? Yes? I what someone else could do the nursery for you? Yeah? Well sleep with you? People have told me you don't use the nursery for the first Yes.
You're correct, okay, correct, Like I mean most we even say that, and even you know, since campaigns and things say that the best place for a babies in the mum and dad's bedroom at this point in a sidecot or a spot close to the bed. So you're right. What else you're gonna use nursery with other than stinking of that when you're changing nappies? So?
But is that chemical hormone is that a real thing that kicks in the nesting hormone.
Or not that I've ever read, but I would love it if one of our listeners right so he says what that is. There might be some psychologist or psychiatrist that knows that. Again, I'll take it to my boss this week and if there is something that's actually chemically there.
And my second one is the kicking down movement that I've felt. Friends of mine have also explained that that could be lightning crutch.
Sure is well, it can be. I mean lightning crutch does tend to happen more later in pregnancy because as the baby expands in size and the uterus is larger, their feet or their or hopefully their head. We prefer as you get through in gestation is pushing down and actually trapping some of those nerves and the vessels and the size of that baby in the pelvist. So you actually can get quite significant and women have had to be nodding along with us right now, significant sharp pains
down your legs. It can be one side, it can be both sides. It can be in your crutch, it can be in your vagina, it can be in your glitterists all around that area, and it's largely related to a nerve called the pedendal nerve, and there's a couple other nerves in that area as well, obviously that are being compressed by pregnancy. So we want that head to move down really yeah, Like we don't want it to stay there, we want it to come out.
The only thing that I've been told when I was like, how will I know if it's lightning crutch? And I get this dead pan look and they just go, you'll no, no, Okay.
You are correct. I've only had it a coup of times, but you absolutely know. And for some it can literally bowl you over in the street and have to sit down, And it can happen a lot too, particular if you're on your second third or like me, fifth and sixth children, where you just have a little bit of a lax pelvise and there's just more room and more compression with babies.
What can we do this week? What's something on the checklist? Start thinking about?
I think you were going to have a discussion with us around pregnancy classes and things, but I think now is the time. If you haven't booked it, it's really time to start thinking about what you're going to do in that space, because we need to start booking in and not missing out on those activities. Now I know this, and I'm sorry for the people who will be no, Yah, I don't like you anymore. But this is the time to start discussing immunizations in pregnancy. So influenza and DTP
so DTPs are potassis. So we know that hooping cough in non medical terms is unfortunately really prevalent, particularly in Australia at the moment. So I'm sure you've heard lots of people have that barking cough. So it's now a discussion with your medical team around if that's the appropriate thing for you. It's certainly what we recommend for women
is to have that around now. In pregnant we want those antibodies to cross to your baby, so we know those big idm antibodies can cross the center and help your baby in the first few weeks of life. So it's now it's now to start thinking about that discussion.
And they can't be vaccinated against that until there is it six weeks old, so you're kind of building up everything that they need for the first six weeks.
Which is a great actually a great point, because that's also while we want other people to be vaccinated, so your mums and your family and your friends that are going to be coming, if they're open to it, then just to reduce that risk of hooping cough. There's also the RSV. You may have seen that in the news recently that they're now encouraging women, particularly high risk women,
to have the RSV vaccination. So again it's a conversation that we have great pamphlets for these guys, so just go and ask for a pamphlet, have a discussion, and then book in.
The one thing that I did like that I was told about this is that I thought it was new, and it's not that it's new, it's just that it's more publicly available and the RSV vaccine that it has been used in disadvantaged communities for quite a while exactly. Obviously it's such a tricky topic, as you've said, but it's just not a vaccine that's been pushed through quick and well researched.
Yeah, absolutely, that's correct, and we are really glad that it's becoming available because if you do choose to have the vaccine, and we'll talk about herd community heard immunity. In other words, there are people who really can't have it, and it just means we try and reduce that risk of bubbies getting sick.
In my toolkit, I did do an active birth course, and I think I did it maybe at thirty weeks or thirty one weeks, but I did want to bring it up now because I booked it in perfect. So this was like there was an online component which I thought was really good for people who might not be in a capital city, who yes, because they are a lot of the big long weekend ones or night times.
But this was like you did a lot of the pre reading, pre reading and videos I can pop in the show notes as to the one that I did, But then you did a course like a three hour course practical course, and I'm sure we'll get to all the different types of interventions as we go along. But it did make me feel a lot more clarity around
what it is that I want in theory. When people say what's your worth plan, I don't really know what to say because I know that there are so many variables, that's right, And.
I get asked this all the time because obviously I was a dueler first before I went into medicine and then I did a couple of years of Midwiffrey before I became a training obstetrician, and I've obviously had multiple babies come out of my vagina, so a lot of people have asked what your birth plan is, and honestly, Grace, the thing that I say is, you want happy and safe baby and mum. In other words, that's what you're there to do to have a baby on you.
So I love it.
I actually saw one a few weeks ago, as this lady came in with this big white paper and it just said have a baby. Yeah, And I was like, you are amazing, and she had the most incredible birth because there's the expectations were left at the door. But I think I'm going to talk about this several times
over the next few weeks. I know this, but I think the biggest sad thing I'm seeing in social media at the moment is there's a real rift in women's trust in the obstetric and medical team, in midwives and doctors. And I've very, very rarely met someone who goes into this job now in the last twenty years who doesn't absolutely love women and love birth.
We are there.
It's one of the hardest jobs on the planet. But we are there because we love being there and being part of that incredible first moment of life. And so it's been really heartbreaking that women are losing that trust in our system. So if you come in with a really open mind and say, I trust my medical team. I want a happy and safe baby. I know there's going to be some traumatic things that come out of this, because I know birth trauma is huge at the moment.
We're all going to be traumatized from birth. That's not going to be escaped. It's the toughest day of your life, but it'll be the best outcome if you allow yourself to go in with an open heart and know that the people in that room are there for you because they want to be.
I feel really more and I say this having not done it yet, but more okay with pain that's going to come from doing it. The course by they sort of led us through a few things like mantras or visualization or breathing visualization through in the bin for maybe straight away not interesting, nah, but mantras and just pain.
It's like pain with purpose or the more pain that's actually you're in the right position, which means your cervix is opening, and just understanding, understanding that you're on the right path if you're in, and to not fear it. It's just finding tactics to deal with it, that's right. Yeah.
And I always had this little mant with all of my babies, which is every contraction or every surge, because I came from a hypno birthing background, is one step closer to meeting your baby. And you know, we're working together in this space, you know. And I did do a bit of visualization, so whenever a tightening came, it
would be like a wave you're going in. I'd literally imagine myself lying in the sea and we're cresting the top of the wave, and as the surge started to dissipate, then you're cresting off the other side, and then you're sort of laying in the open water. So I mean, again, it'll be different people who are visual visual learners or view with their way they deal with things. And again, just like we talked about it and everything else, some
people are going to find labor really tough. Others are going to breeze through it, and we're just we don't know which one you're going to be so.
Yeah to wait and see. You've got all the data, and I don't know which one applies to me exactly.
And unfortunately it's the little guy in side's fault too, because if that little baby is in an awkward position, it can make a huge difference, like really different labors, back labors, vaginal labors, really depending on what their baby's head is.
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This episode was produced by Courtney Ammenhauser with audio production by Tom Lyon.
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