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 hopefully more manageable.
I'm Grace Rubray.
I'm pregnant for the first time and my clothes definitely don't fit me now.
I'm Aana Pittman. I'm a mother of six, and I'm an obstetric and guyany a registrar, and I'm also a former Olympian for Australia.
Each week, we will be holding your hand week by week through the mysterious, perplexing and sometimes well forever changing miracle that is pregnancy, all the way from a poppy seed.
To a pumpkin.
Week thirty two.
What random objects have you got for me this week? Jana?
A garden gnome. But that's a look at least it's humanoid.
Yeah to a degree. Yeah, that's like you can pick that up, you could cradle that, you.
Could practice yes, being mummy with that for sure.
I got a little kohala joey okay, like a quality.
I had a movie popcorn as well. I'm not sure who came up with that one.
I'm good with that. Scientifically, what are we.
Around one point seven to one point eight kilos if Bubby's doing well, which is around forty two to forty three centimeters in length. But again, huge.
Variation goes and what's happening to them.
So baby's weight has pretty much doubled in the last couple of weeks, so they're going to be growing faster in length and putting on more fat again a little bit late last week. They're going to feel a lot more squished inside, so you'll see a lot more folding and purposeful movements. And what we mean by purposeful movements is they're starting to direct those movements. Whereas before they
were almost reflexes and reactive. Now they're actually deciding to move their arms and stretch and open their fingers and stuck their thumb and things like that on purpose.
So, like, if you can feel sometimes there's like going to erratic movement, is that one that's more they probably haven't thought about that. But if it's a slow one, it's more of a decision.
I don't know, but maybe that also might be what you ate. Whether they're feeling a bit of a sugar ash, but babies definitely move more when they're getting more more food. So it's really interesting if you go and have like a nice b ice cream or something you might actually find or a big drink you might actually find a little bit later, your baby's having a full party in
your belly. Yeah, which I mean used to be one of the Old wives tales when you're worried about baby's movements to actually go and you know, have a diet coke or something like that. Not ideal, like we want to actually see what your baby's doing when they're at rest.
What's happening, what's happening to me, and what's happening to our bodies.
Well, you might notice you are starting to leak a bit more now, so from your breast that is, and the vagina, so you are definitely having an increased discharge. Some people even find they start losing their mucus plug this early. It's okay, it comes back, Okay, it doesn't. It can mean a sign that labor is approaching, but it definitely doesn't mean that. So increase vaginal discharge is common,
it's not always abnormal. It's always worth getting checked if it's odorous if you have a history of an STI in the past, because we again don't want your birth in with an STI which is klymodia or gonorrhea or something like that if it can affect baby and babies our growth. Example, we don't want baby getting climodia in their eyes and things like that, which can have some
pretty serious effects for a baby. So if you have some abnormal discharge itching things like that, it's definitely time to come and have a swab and check what it is.
If you lose your mucus plug, does that mean your cervix is open?
No, No, definitely not. Well, I mean, look, it sits inside the cervix where that mucus is, and it's ultimately it's just it's basically mucus material. There's creating a little plug to stop bacteria going inside. So it's a protective component of your cervix. But now I've seen lots of mucus plugs come out and the cervix remains closed. But it is an indication. So you know, I certainly know with all of my babies that once my mucus plug came out, it was within a week or so that I had my baby.
What's different to the mucus plug, to the amniotic fluid coming out.
A creamy brown, sometimes a little bit bloods tinged. That's normally your mucus plug. Your waters now again will have a little caveat on that at the end. But your waters tend to be clear and they have a very distinct smell. Obviously I'm quite useful because I see smell it every day. But it's very different from urine. It's very different from discharge, and it's just like, oh, that's interesting.
It's quite pregnant. Caveat as I said before, is that as not yet, guys, because babies don't very very rarely make maconium, which is baby poo at this point. But as you're getting closer to two, if your waters break and they are heavily bloodstained or they have maconium which is baby poo, that can be a different way that the amniotic fluid can look and if you have blood now, and I think it's probably a good point to actually for us to quickly touch on it. Women will bleed
in pregnancy. We know that not all women hopefully you don't, but there is definitely women who will experience in aph it can often be things like, you know you have a low lying percent, you're at higher risk of bleeding. You might have problems with your cervix, a higher risk of bleeding, dry vagina, higher risk of bleeding. But it's definitely not something we want you to sit at home with even a small amount of bleeding. You need to give the birth team a call and just say, hey,
this has happened. If it is a very small volume, they may be comfortable with you sitting at home. That's also going to depend where you live, if you live somewhere a long way from a major hospital. Ironically, they're the ones we do want to see because it takes time for us to escalate if there's a problem. But any bleeding more than more than some spotting still is to be seen, and most likely in person.
Is this normal?
Normal?
Is this normal? Is a very dumb question.
Okay, clothes are getting tight if you wear type clothing, for example, tights, and they're high waisted tights, but they're just going to be tighter on your belly.
Now, can you cut off the blood?
So no, that's what I thought you were going to say, But I'm like, I wasn't sure whether you were go well or not. It's more about discomfort, okay around for you, how you're feeling so baby. It's the same with you know, with a seat belt, it's still very safe to wear a seat belt in the car and in fact, even if you have an accident. Now again, guys, another one, if you have a car accident, if you fall on your belly anything, again, it's always a time you have to come for us to do what we call a
four hour CTG. So we just basically wanted to a baby's heart rate for four hours, do a couple of blood tests, and check you're okay and baby's okay. But most of the time babies are very robust inside your belly because you have a lot of amniotic fluid there and it's a big cushion protecting your baby. So no, you can. I don't know any woman that would want to wear tight clothes at thirty two weeks, but if you want.
To go for it, but then ayeh, they're getting their blood from the placenta and everything, so just having stuff sitting.
On your belly is not comfortable.
It's not comfortable, but it's not hurting them, no, not hurting them at all.
Now, the one caveat there is we can and I know I always got. You go the lovely things and I go, here's the scary things and make everyone afraid of having babies. But things like trauma and someone jumping on your belly can cause what's called a placential abruption, so that's where the placenta actually breaks away from the wall. The symptoms that really are evident of that is if
you're you have what we call a woody tummy. So if you touch your stomach and it feels like it's a tonic contraction, so it's tight and it's hard, and it's painful one hundred percent under all circumstances, you go to the hospital. It might also present with with again with vaginal bleeding. So those kind of things are your only wrisk. But tight clothes are not going to do that. But yes, if someone jumps on you, if you bump yourself hard, that's what we're actually worrying about.
Okay, what's something on the checklist.
We are starting to get close to peroneal massage. Okay, Now it may or may not be what you decide to do. And you know there's going to be some single mums listening to this because, as you may or may not know, I was a single mum for two of my kids by choice, and so I had my own fingers and it's a little harder to do so ideally, if your partner is up, it's much better if you can get someone that's not you to do this, largely because it's very hard to reach around your belly. Want
you to consider stretching the peroneal area. So the paranal area is the area between the lower part of your vagina and your ainus, and that's the area that's most likely going to tear a little bit, which is normal guys, but is likely to tear in labor. So there's some
really good research to say that. I mean, there's epinos and all this kind of stuff out there that people buy, but honestly, the research is best for your own fingers and all your partner's fingers to gently stretch from about the thirty four week months, we're getting close, and now the time to do the research, learn how to do it, and then from about thirty four weeks on you start which is basically two fingers with some olive oil or
some lubricant and you roll from nine o'clock to three o'clock. Nine o'clock to three o'clock, just gentle pressure down in that area to stretch up the parent externally, not externally, yep, just on that skin border, on the outside of just where your hymen is, and on the outside of the hymen to where the edge of the skin is.
So it's like working a muscle. It's not the one of like putting it.
No, No, it's definitely the outer skin that's going to stretch up. And for mums who had babies before who were listening, that's where that burning sensation comes from.
So ring fire, the ring a fire and to.
A burn and ring of the vire at a burn burn. So we're trying to reduce that ring of fire. And because there's weeks away, but it's the same thing in birth, we actually don't want you to push so hard that baby's head comes flying out. We want you to stretch up that perineum nice and softly. And that's the same that this paranoral message is doing, is trying to stretch up and elasticize that area.
I will say from the birth course that I did, I'm not as scared of a tear or a cut anymore because I see it as a functional thing.
Correct. Could you explain why they sometimes cut on a diagonal?
Yeah, absolutely, so there are different places like America, for example, a lot of places still cut directly down. We do what's called a right mediolateral, so basically means on the right hand side of her, we do an angled tear to divert any tearing away from the back passage. Now, there are also countries, and you might have not you know, some people listening might have had babies in other countries
before coming here, where they do them routinely. I can assure you there's no hospital in Australia that does a routine episiotomies. The only reason we would do it is if we're worried about you are going to tear third or a fourth degree towards your bottom, or if baby's really distressed and we know you don't need help with a vacuum or anything else, but we're watching, and you're watching little ones heads just not quite coming and we have to basically force that area to open slightly more So,
as you say, it's a functional reason. Ninety percent of the time, though, it is to protect your own bottom. Muscles because third and fourth degree tears. Don't get me wrong, there's lots of ladies that have had them, and they're repaired beautifully in theaters, and most people are okay, but they can be associated with significant concerns with urinary but also bowling continents in the future and flats in continents.
Is it always consent when you're doing a one.
Hundred percent okay? So I have I've actually had a woman and she and I talked about it extensively afterwards who declined an episiotomy and then did have a third degree tair. But again that was her choice. And there is never a time that someone I mean, don't get me wrong. If it does happen, it's reportable. So this is a scenario if you say one hundred percent, I do not want to do this, and I can't say that.
The doctor is not going to argue back and say I strongly recommend this because I really don't want you to tear into your bottom. And it's the hardest decision you make because you're in the moment, you're literally in the burn and ring of fire because your baby's head's on view, but it's just not quite coming well. Enough. But I really want to reassure you that if we're recommending that, it's because we are hundred percent believe it's the right thing. So you know how you're going to
get in birth right. And if there's midwives listening, they're going to be s again nodding here, and we tell women don't yell out, internalize that noise. We want you to push and not go ah. We want you to actually.
Go like that.
But when we're cutting, the appears. It's the one time as partners or anyone in the room where we sell let the lady scream so you don't hear it. So you say, on the next contraction, I want you to scream your head off and we cut and so no one hears it, no one knows it's happened, and she copes with it beautifully. So it's the one time for any birth people listening Orcush's listening that I think works beautifully.
And it's really funny because it's really elderly midwife told me this trick twenty, you know, not that long ago, five or six years ago, and it's worked to treat and so no one ever because if you don't you hear the dad pass out in the corner. So it's just it's such a good little trick. So if you're a birth support partner for someone and they are requiring one, get her to make noise or you make noise.
My friends lying to me when they tell me that there's so much going on they didn't even feel it.
Most people don't. And by the way, guys, we don't do it without anesthetic, just just putting it out there, Okay, So we actually either do a pudendal block or we do just like we put anesthesia into that paraneal tissue before, long before we do that. So you probably actually won't feel it because you shouldn't feel it because I've given you anesthetic before.
Okay.
And the other big thing remember is that a psiotomies are really easy to sew back together. We can get very complicated, even second degree tears, which again are very normal. Most women will have a tear in labor that are really difficult to see. The anatomy. The episiotomy is so easy and so beautiful to repair that if it was me in hindsight, I'd prefer an a pisiotomy than a an early third.
My tool kit is non medical in it. In every way. It's a Facebook group. Okay, my friend recommended it to me.
It's women, and you're grouped together by when your due date is per sis.
It's like a grapevine or something like that.
And it's just so it's a bunch of people in the same time frame.
Es you're around the same time.
Asking dumb questions that's great, and people being like this happened to me, This didn't happen to me. No one is giving medical advice whatsoever. It's all sharing things from when they went on maternity leave to when to apply for your parental leave great, to when should I pack my bag?
What's a good thing to put in my bag? And it's actually been quite.
Good, And I think that's a really good point because there are lots of different groups now there's mums of multiples, there's single mums by choice, There's lots of good support groups out there, and it's just shopping around, having a look until you find your community. Because when your baby's born, in those first four or five weeks, you are home alone a lot, and having that social media is when it can be a really positive You know a lot
of people. It gets a bad rap a lot of the time, yes, but having a community around you makes a huge difference. Yeah.
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