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, hopefully.
I am Grace Rubray.
I'm pregnant for the first time and you might be feeling like, am I still pregnant?
I'm done. I've done it six times, so I'm a mother of six. My name's Jana Pittman. I am a former olympian and I'm now training to be an obstetrician and gynecologist.
Each episode will be holding your hand week by week through the mysterious, perplexing, and sometimes long miracle that is pregnancy, all the way from a poppy seed to a pumpkin.
Week thirty eight, What.
Size is our baby? Definitely still a large watermelon.
Yeah exactly, and just getting bigger and bigger and fatter and cuter. A lightweight kettlebell is what I've got.
I think that's that's what it feels like.
Yeah, that's a nice visual too, feeling connection.
Yeah exactly, and you can pick it up in the gymerdation. Yeah, right, this is what's inside me, in my placenta and all my fluid and yea, yeah. So we're about three point one to three point three kilos on average, But again we are thirty eight weeks, which means some babies approaching four kilos now and some are still down around two. So we're very, very varied at this point in pregnancy.
A couple of.
Girls at work told me that you'll have good muscles in your legs at this point because you're essentially carrying around a weighted vest exactly.
I love that.
But it's also when your back starts getting a lot of discomfort, you can get the belly belts and things like that that if you have any sacro which basically means pain in your sacral area in your back and in your pubic bone, that can actually kind of support and almost rigain that muscle strength. So if that is a problem, that's well, you can look online and just get something for the last couple of weeks.
And what are they developing or are they pretty much good?
They're pretty good. They're starting to make that immerconium that baby poo that we were talking about at this point. If they were born, they might still have a bit of vernix, that nice white creamy stuff that helps protect the babies in from the amniotic fluid and the acidity in the uterus. But they're very ready to be born. So I think from a mummy perspective, it's now about how can we get your baby out so we can try starting all those techniques grace around. How can we
bring about labor? Now? There's lots of old live tales like do not drink castor oil. Guys, Like that's this old one that my grandma told me when I was forty weeks pregnant in my third Pregnancy's like, go and drink the yackie oil. It is cast well one other oil. It makes you sick, gives you diarrhea, and does not work. Okay, there's no evidence.
This was in my tool kit, but let's bring it up now. I want to know if these ones are correct. Curb walking dates, raspberry leaf tea, sex, I.
Was ready for that sex, sex a glass.
Actually, a friend on the weekend said she felt so unsexy the whole time that her pregnancy was bookended by, like she had sex and got pregnant and then had sex at the end and nothing in between.
You, Yeah, well, but it's very common.
These are the things that I have read of. Do you know if any of these actually work?
Yeah, so it ras belief tea a little bit of evidence. The strongest evidence actually is intercourse because the prostatecure land and in seement is very similar to what we use if we need to make your cervix soft to do an induction. We also know that a stretch and sweep is effective. So if you don't know what that is, and everyone's like, what is a stretch and sweep, it is basically a vaginal exam, very similar like you would have in labor, and we basically feel for where your cervix is now.
It does two things. It tells us how close to labor are you now. It's not a crystal ball. We can't dictate exactly what it is. But if your servix is soft and a little bit open already, that's a great sign. And so doctors and midwives can do this. Please don't do it yourself. I did do it to myself. Not a great idea, okay, because I knew what I
was doing. Still wasn't a great idea. Get someone who knows what they're doing to do it from a comfort perspective, But what they try to do is actually try to reach inside the cervix a little bit, stretches tiny bit and actually literally release the membranes because obviously the amniotic that has membranes around it from the uterus slightly. So it's thought to sort of stimulate proteins to break down
and hopefully start labor to come on. So that is definitely something that there's good research on to do it one or two times from thirty eight weeks on from this week, not before, not before thirty eight weeks, but from thirty eight weeks onwards, you can do it one, two, even three times a week, and there's good research that it doesn't there's less chance of pronging and needing an induction after forty one weeks?
Is this normal?
Normal?
Is this normal?
Is?
If you are having an elective cesarean and you already know that that's what you're having, what can you be doing at this point to prepare? And I guess does it change things you've had caesareans as well?
Happen? Are you?
Who?
Yes?
But I guess what's the headspace when you're when you're talking to your patients then around knowing the exact date.
They know the birth date well sometimes because babies have a habit of coming before they had booked caesarean dates. So in most cases for an elective cesarian section. Now I remember that the Australian rates of cesarians are at around forty forty two percent, depending if it's public or private hospital. I think it's important to remember that between twenty five and twenty eight percent of labors will actually end up with a cesarean in first time mums, a
bit less in subsequent who's had previous vaginal births. So that's quite a high rate. And I certainly talk to a lot women who bok an elective cesarian section. It might because their baby's a little bit bigger, it might be because they've had a previous bad birth, or often it is that anxiety around well, if I'm gonna have if I've got a twenty five percent chance of caesarian anyway, I'd prefer to planet no my date, organized my childcare,
organize my family, my support system I don't have. There's lots of reasons why women make that decision. Now, if you're only having one baby, it's a great decision guys, because there's the risk of a cesarean section largely is around the subsequent pregnancies. The first one, what we call a virgin abdomen, is very easy, even that very junior registrars are allowed to do the first time cesarean sections
because there's nothing there that's a concern. It's whip baby comes out so back together and it's quite a simple, simple surgery. But scarring and things can cause problems for future pregnancies, as can the scar on the uterus for labor can break apart. So the risk is actually, if you want five or six kids, an elective cesarian is probably not the best choice. But as you know, we do lots of vaginal births after cesarean sections in Australia,
particularly my hospital. We've got lots and lots of ladies having bebacks because we know it is safe with monitoring and the right sort of decisions and spontaneous labor for the subsequent one.
If people are feeling nervous about their sea section, the only thing that I know about it is that it is quite quick from when you're rolled in.
This is true about fifteen minutes. Can you talk us through you.
Mean the baby comes out.
In here, the baby comes out, but then there's being sewn up.
Can you in maybe like a Graz's anatomy version where.
It's not too much, not too hotel.
Of what is actually going to happen to I guess dispel the if people haven't been in an operating room like I have, and it is terrifying.
What are we going to see and what's going to point.
Lots of people. Okay, so it's a busy space, it's very bright lights. You can still have your music, you can still have your support partner like. It can be a very beautiful situation. I've done two maternally assisted cesarians too, which were just gorgeous, where the mum took the baby straight off me like as it helped me birth the baby onto her, which was wonderful.
I think she could lean forward.
Yeah, so basically as soon as yeah, not for everyone, but really beautiful for me. It was one of the most beautiful births I've been in because the mum wasn't appropriate for a vaginal birth and she was very keen to be part of the delivery process, and so as soon as the little one head came through, I basically reached forward and then she was able to sort of assist the birth on to her, and that means baby went director mum to breast and all that kind of stuff.
So there's lots of different ways and means of how they go ahead, but you basically come in at six o'clock in the morning, no food. They have a dual chat with you. I usually or whoever's coming and doing the surgery comes and says hello. Then they will you downstairs or walk you downstairs? You lie down. They pop an epidural in your back most of the time and providing that covers you well enough, you're awake for the
whole thing. You're right. We basically test your tummy. We pop an eye DC so test that you can't feel anything. So it's nice and that's good. Yes, that's good.
You want that, great?
You want that. They pop a little catherin in your bladder. So that's the only thing that a lot of women don't know, but that comes out the next dates because you won't be able to walk around in the afternoon. Dumb question is that through the in through the urethras so basically it just below the glitterists where where you're we from. You pop a little catheter in there, and then the surgery starts and you're right for a first time, Caesar, if you've not had previous scarring or no other surgery
on your own abdomen in the past. I mean, we've had babies come out in three or four minutes, but it's usually about ten and bubbies out and then from there you don't really remember the rest because you're so beautiful, you know, mixed up with your beautiful little human. But it takes about, depending on skill set, between you know, twenty and fifty minutes to close up from there.
What do you do if people get anxious?
Like I sort of said last episode that I worry that I would get panicky, There's.
Lots of things. So we're a team. So in the birth unit, they'll be me and an assistant, So the primary surgeon and an assistant. There'll be an anesthetic doctor and his assistant. There'll be a scrub nurse and nurse holding and giving me the instruments and things, and there'll be also another nurse in the room just to help out. So there is seven or eight people in there, and I think it's something that people don't expect, So it is to be aware of you're all very modestly covered up.
There is a mix of male and female in the room. Often, quite often the birth theme is women these days, because it's a lot of eighty percent of training obstritions in our female And the anesthetic doctor will give you something for those nerves if required, they'll give you something for that nause And that's one thing I do think that people don't know about. It is regularly you get nauseous in
a in a caesarean section. Firstly because the anesthetic medication can make you feel a bit sick, and secondly because sorry guys, but we are rummaging around in your tummy a little bit, so it's a really lovely opportunity to check your ovaries and and and obviously the uterus is being moved around when we're bringing baby out. So please be aware that commonly someone feels a bit anxious and a bit nervous and often gets.
Nauseous, nauseous to the point of vomiting. Regularly, you vomit when half of you is numb.
And it just moves and then we pause. Your whole body vomits up because you're only you're not You're not numb from the like, you're only you don't want to if you grace, if we numbed you to the top of your neck, you wouldn't breathe, darling, So it has to.
Be don't understand medicine. You are you are, you are medicine. I am curiosity.
You're the fund in our relationship. But no so from the you can but you can still high rotate to like vomit into it a bag. Okay, you can move your whole upper body, your whole arms and hands are free of your boobs up work.
The videos of the photos of like, you've got your arms.
Are board, you don't have to No, you've got your arms are on the boards at all. That's only if you're asleep. Okay, yeah, now, and I want to be just one last thing in this space is that some women do decide to have a general anesthetic to go to sleep again. That comes around anxiety. So if you are truly nervous about that space, that is actually an option. You don't have to be awake for the birth of your baby. Most people choose to be, but you don't have to.
If there is a partner who is feeling nervous, could you please share how many birth partners you've seen who have either vomited or passed out?
Oh gosh, I'd say ten percent. Okay, it's quite high, and it's just being aware of which ones are going to do that, and some of the spotted we can spot it, yes, straight away. It's great, and most of
them know. To be honest, most of them know, I mean, but to be honest, in the vast majority of them, even the ones that expect they're going to are so overwhelmed by the love and the tears that come when their baby arrives, and how incredibly impressed with their with their partner they are, that they forget that they're going to be nauseous, so they forget that it's going to be difficult, and they're just so wrapped up in.
The situation, all that anticipation, all that.
Anticipation, and that's why I think you've got to remember there's going to be the positives out of it as well as not all daire.
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