1 00:00:11,149 --> 00:00:13,909 Speaker 1: You're listening to a MoMA Mia podcast. 2 00:00:14,829 --> 00:00:18,349 Speaker 2: Mama Maya acknowledges the traditional owners of land and waters 3 00:00:18,349 --> 00:00:20,069 Speaker 2: that this podcast is recorded on. 4 00:00:21,389 --> 00:00:23,669 Speaker 3: I am pregnant. 5 00:00:27,429 --> 00:00:30,429 Speaker 2: Welcome to Hello Bump. We're making pregnancy less overwhelming and 6 00:00:30,469 --> 00:00:34,069 Speaker 2: more manageable, hopefully. I am Grace Reuvery. I'm pregnant for 7 00:00:34,069 --> 00:00:36,669 Speaker 2: the first time, and I can't walk upstairs slopes or 8 00:00:36,669 --> 00:00:40,629 Speaker 2: speak long sentences without losing my marette without losing my breath. 9 00:00:42,229 --> 00:00:44,469 Speaker 1: Oh, I'm Yanna Pitman. I am a mother of six. 10 00:00:44,469 --> 00:00:46,389 Speaker 3: I had all those babies myself, and now I have 11 00:00:46,429 --> 00:00:48,309 Speaker 3: the privilege of working in a birth unit as a 12 00:00:48,309 --> 00:00:49,109 Speaker 3: training obstitution. 13 00:00:49,989 --> 00:00:52,469 Speaker 2: Each week, Bianna and I will help hold your hand 14 00:00:52,509 --> 00:00:55,789 Speaker 2: week by week through the mysterious, perplexing and sometimes breathless 15 00:00:55,869 --> 00:00:57,149 Speaker 2: miracle that is pregnancy. 16 00:00:58,309 --> 00:00:59,949 Speaker 1: So welcome to week twenty two. 17 00:01:00,389 --> 00:01:02,709 Speaker 2: How big is the baby at week twenty two? 18 00:01:03,629 --> 00:01:06,509 Speaker 1: Babies now about the size of an egg plant. Yeah, 19 00:01:06,549 --> 00:01:07,509 Speaker 1: that's quite big. 20 00:01:07,349 --> 00:01:09,989 Speaker 3: Or a sweet potato, a hair brush, or a defl 21 00:01:10,149 --> 00:01:10,989 Speaker 3: at afl. 22 00:01:10,869 --> 00:01:13,349 Speaker 2: Deflated one, not a full it's a four to one 23 00:01:13,389 --> 00:01:13,869 Speaker 2: full term. 24 00:01:13,949 --> 00:01:17,749 Speaker 3: No, thirty four weeks that I guess twenty eight centimeters. 25 00:01:17,789 --> 00:01:20,229 Speaker 3: Little bubby is now and weighs about four hundred and 26 00:01:20,269 --> 00:01:22,749 Speaker 3: thirty grams, So depending on which hospitals, as you get 27 00:01:22,749 --> 00:01:24,589 Speaker 3: closer to the five hundred grand mark, we're getting closer 28 00:01:24,589 --> 00:01:25,949 Speaker 3: to the time where baby will be viable. 29 00:01:25,949 --> 00:01:26,829 Speaker 1: So only a week away. 30 00:01:26,869 --> 00:01:29,029 Speaker 3: Now, this twenty two week is a really super important 31 00:01:29,029 --> 00:01:32,269 Speaker 3: week medically because if things were starting to happen, if 32 00:01:32,309 --> 00:01:34,389 Speaker 3: you knew you were having getting into pre term label, 33 00:01:34,389 --> 00:01:36,669 Speaker 3: we try very hard and have lots of discussions because 34 00:01:36,709 --> 00:01:39,549 Speaker 3: as of next week you meet the viability age for 35 00:01:39,669 --> 00:01:40,629 Speaker 3: all tertiary hospitals. 36 00:01:40,669 --> 00:01:42,229 Speaker 1: So big hospitals that have a really. 37 00:01:42,029 --> 00:01:46,029 Speaker 2: Good nick use with multiple pregnancies, think, if it's twins 38 00:01:46,069 --> 00:01:48,789 Speaker 2: or true plants, are you starting to look at what 39 00:01:48,909 --> 00:01:50,989 Speaker 2: week you would be looking to get the babies out 40 00:01:51,069 --> 00:01:52,429 Speaker 2: or is it just as long as you can keep 41 00:01:52,469 --> 00:01:52,709 Speaker 2: them in? 42 00:01:52,869 --> 00:01:54,589 Speaker 3: Yeah, great question. I think it depends on what type 43 00:01:54,589 --> 00:01:57,069 Speaker 3: of babies you're having. So there's multiple types of twins. 44 00:01:57,109 --> 00:01:59,909 Speaker 3: I had DCDA twins, so that basically means two percenters 45 00:02:00,189 --> 00:02:02,469 Speaker 3: two separate amniotic secks of the lower risk pregnancy. They 46 00:02:02,509 --> 00:02:04,349 Speaker 3: aim to sort of birth those little ones around thirty 47 00:02:04,349 --> 00:02:05,189 Speaker 3: seven to thirty nine weeks. 48 00:02:05,189 --> 00:02:07,349 Speaker 1: So if it's as long as another other risk factors 49 00:02:07,389 --> 00:02:08,029 Speaker 1: pit prop up. 50 00:02:07,909 --> 00:02:11,109 Speaker 3: Like preclamps Yeah, yeah, MCDA twins, which means there's one 51 00:02:11,109 --> 00:02:14,349 Speaker 3: placenter and two sacks sometimes earlier, and then you save 52 00:02:14,429 --> 00:02:17,589 Speaker 3: you when they have one placenter and they all share 53 00:02:17,629 --> 00:02:20,989 Speaker 3: the same amniotic sacs. So that's your highest risk identical 54 00:02:21,029 --> 00:02:23,909 Speaker 3: twins outside of conjoined twins, because obviously they're twins that 55 00:02:23,949 --> 00:02:26,669 Speaker 3: haven't split completely, so there's variations of different types of twins, 56 00:02:26,669 --> 00:02:29,349 Speaker 3: and they'll be the obstetric team will guide you quite 57 00:02:29,389 --> 00:02:32,109 Speaker 3: closely because things come into play like sometimes they don't 58 00:02:32,109 --> 00:02:34,509 Speaker 3: share the placental flow well enough, or they don't grow equally, 59 00:02:34,629 --> 00:02:36,309 Speaker 3: or sometimes one of them steals all the blood flow 60 00:02:36,309 --> 00:02:38,349 Speaker 3: from the other, which is called twin to twin transfusion. 61 00:02:38,429 --> 00:02:42,229 Speaker 3: So there's lots of complicating things in pregnancy, So definitely 62 00:02:42,269 --> 00:02:44,509 Speaker 3: outside of the scope of this podcast, but it'll be 63 00:02:44,629 --> 00:02:47,789 Speaker 3: really twin pregnancies, even my low risk twin pregnancy will 64 00:02:47,789 --> 00:02:50,869 Speaker 3: be really strongly managed by an obstrition. So that's slightly 65 00:02:50,909 --> 00:02:52,949 Speaker 3: outside the scope of the midwi free grip practice. If 66 00:02:52,949 --> 00:02:54,789 Speaker 3: you end up with doubles, don't get me wrong, the 67 00:02:54,789 --> 00:02:57,469 Speaker 3: midwife is a huge important person and in our obstetric 68 00:02:57,509 --> 00:03:00,469 Speaker 3: department with twins, we have a dedicated MFM midwives to 69 00:03:00,469 --> 00:03:02,189 Speaker 3: make sure the woman doesn't miss out on that wonderful 70 00:03:02,189 --> 00:03:05,029 Speaker 3: midwi free care, which hopefully is in most institutions. But 71 00:03:05,469 --> 00:03:08,709 Speaker 3: they start having lots of frequent ultrasounds, lots of looking 72 00:03:08,709 --> 00:03:10,949 Speaker 3: at the baby's blood flows and and things like that, 73 00:03:10,989 --> 00:03:14,469 Speaker 3: because yes, they are far more they often require preterm birth, 74 00:03:14,589 --> 00:03:16,149 Speaker 3: far more than a single baby or what we call 75 00:03:16,189 --> 00:03:17,269 Speaker 3: a singleton pregnancy. 76 00:03:18,389 --> 00:03:21,669 Speaker 2: And as they are starting to get closer to being viable, 77 00:03:22,229 --> 00:03:23,989 Speaker 2: what have they developed in the past. 78 00:03:23,749 --> 00:03:26,549 Speaker 3: Week, So I think it's a cute one. Well, on 79 00:03:26,549 --> 00:03:28,509 Speaker 3: that note, their lungs is now starting to form those 80 00:03:28,509 --> 00:03:30,749 Speaker 3: little alvole life so those little sacks that will then 81 00:03:30,829 --> 00:03:33,469 Speaker 3: eventually allow oxygen exchange, which is why we're getting close 82 00:03:33,509 --> 00:03:35,909 Speaker 3: to the time where they may survive and may do Okay. 83 00:03:36,269 --> 00:03:39,829 Speaker 3: Brain's now developing the cerebral cortets, so complex thought and 84 00:03:40,389 --> 00:03:42,589 Speaker 3: actions that they will eventually do as starting in that 85 00:03:42,629 --> 00:03:45,029 Speaker 3: process now. And they've even got little retinas in the 86 00:03:45,069 --> 00:03:48,189 Speaker 3: baby's eyes, so yeah, it's amazing. They'll be complete by 87 00:03:48,189 --> 00:03:51,149 Speaker 3: twenty two weeks. And they can now detect light, so 88 00:03:51,189 --> 00:03:53,549 Speaker 3: their eyes remain their eyelids remain fused till about twenty 89 00:03:53,549 --> 00:03:55,789 Speaker 3: six twenty eight weeks. That aren't any color yet, but 90 00:03:55,789 --> 00:03:57,229 Speaker 3: at least they might be able to tell the difference 91 00:03:57,269 --> 00:03:58,109 Speaker 3: between night and day. 92 00:03:58,869 --> 00:04:02,069 Speaker 2: Well, does that affect their sleep at all? They don't 93 00:04:02,069 --> 00:04:03,269 Speaker 2: have any kind of sleep with. 94 00:04:03,309 --> 00:04:06,149 Speaker 3: Not yet the circadian rhythms and stuff come. But that's 95 00:04:06,189 --> 00:04:07,669 Speaker 3: I guess that's what we're going towards. 96 00:04:07,669 --> 00:04:08,189 Speaker 1: Not quite yet. 97 00:04:08,229 --> 00:04:10,229 Speaker 3: A couple more weeks and then they'll have circadian rhythms 98 00:04:10,229 --> 00:04:12,069 Speaker 3: and rem sleep and everything. 99 00:04:11,829 --> 00:04:13,069 Speaker 1: Just like you and I. But yeah, it's a few 100 00:04:13,069 --> 00:04:13,429 Speaker 1: weeks off. 101 00:04:13,469 --> 00:04:15,389 Speaker 3: But at least now their retinas are able to actually 102 00:04:15,949 --> 00:04:20,709 Speaker 3: detect the difference between light and dark inside the uterus. 103 00:04:19,309 --> 00:04:23,269 Speaker 2: What's happening to me? And what's happening to the women? 104 00:04:23,389 --> 00:04:26,109 Speaker 2: What's happening to that? And to me? Tell me what's 105 00:04:26,109 --> 00:04:26,629 Speaker 2: happening to me? 106 00:04:27,389 --> 00:04:30,109 Speaker 3: Constipation is probably at its peak at the moment. You 107 00:04:30,189 --> 00:04:32,829 Speaker 3: might be developing some hemorrhoids. Early hemorrhoids might be starting 108 00:04:32,869 --> 00:04:35,069 Speaker 3: really common in pregnancy. Again, most of them sort of 109 00:04:35,109 --> 00:04:38,149 Speaker 3: go away after birth. It's again increase pressure in the 110 00:04:38,189 --> 00:04:41,509 Speaker 3: rectum so that pregnancy is sitting right there, increased blood flow, 111 00:04:41,949 --> 00:04:45,309 Speaker 3: and with that motility slowing down, you get constipated, you 112 00:04:45,349 --> 00:04:47,109 Speaker 3: push harder, higher chance of hemorrhoids. 113 00:04:47,149 --> 00:04:48,429 Speaker 2: Is this one of the times where you should get 114 00:04:48,429 --> 00:04:50,189 Speaker 2: one of those little stools to put your. 115 00:04:50,149 --> 00:04:55,469 Speaker 1: Proper legs out. Yes, yes, yes, exactly, So go for 116 00:04:55,549 --> 00:04:57,109 Speaker 1: it again. Have you got what I hope? No? 117 00:04:57,349 --> 00:05:00,269 Speaker 2: My pelvic four physio said to get two toilet rolls. 118 00:05:00,589 --> 00:05:02,309 Speaker 2: That's a clever idea if you don't want to buy something, 119 00:05:02,349 --> 00:05:03,629 Speaker 2: so you don't have to buy something new. 120 00:05:03,829 --> 00:05:05,509 Speaker 3: I mean, you're gonna have a baby, it's always having 121 00:05:05,509 --> 00:05:07,389 Speaker 3: a little stool at the end of the baby's going 122 00:05:07,429 --> 00:05:09,109 Speaker 3: to use the toilet train. But I like that just 123 00:05:09,109 --> 00:05:11,389 Speaker 3: a little Yeah I'm doing is literally trying to take 124 00:05:11,429 --> 00:05:13,829 Speaker 3: the pressure off the ground and you know, lift your 125 00:05:13,909 --> 00:05:16,229 Speaker 3: legs up off the so put your feet on toilet. 126 00:05:15,989 --> 00:05:18,749 Speaker 1: Rolls, is what she said. Yeah, I like it. I 127 00:05:18,829 --> 00:05:20,669 Speaker 1: might go and meet your physio. She sounds like is 128 00:05:20,669 --> 00:05:22,949 Speaker 1: it she? Yeah? She excellent? 129 00:05:23,869 --> 00:05:27,269 Speaker 2: Is this normal? Is it normal? Is this normal? Is 130 00:05:27,349 --> 00:05:29,509 Speaker 2: the fact that I am getting out of breath? It's 131 00:05:29,589 --> 00:05:32,949 Speaker 2: just speaking or walking up slopes that I wouldn't even 132 00:05:32,989 --> 00:05:36,749 Speaker 2: call with you anything that requires I've gone back to 133 00:05:36,789 --> 00:05:38,909 Speaker 2: the gym and I've been able to do pilates, but 134 00:05:38,949 --> 00:05:42,029 Speaker 2: I haven't done cardio apart from walking, so I don't 135 00:05:42,029 --> 00:05:43,589 Speaker 2: know how it would go with like a hit class 136 00:05:43,629 --> 00:05:46,189 Speaker 2: at all, because I'm getting out of breath. Why do 137 00:05:46,229 --> 00:05:48,429 Speaker 2: we get out of breath at around twenty two weeks. 138 00:05:48,189 --> 00:05:49,749 Speaker 1: Look nine and nive percent of the time it's normal. 139 00:05:49,869 --> 00:05:53,149 Speaker 3: Okay, Again, your baby's getting hot, bigger, it's pushing up 140 00:05:53,189 --> 00:05:55,789 Speaker 3: and you've got less ability to allow that diaphragm to 141 00:05:55,789 --> 00:05:57,549 Speaker 3: move up and down and take those deep, big breaths. 142 00:05:58,149 --> 00:05:59,989 Speaker 3: You are using more oxygen around your body, so just 143 00:05:59,989 --> 00:06:02,669 Speaker 3: the requirement of the oxygen requirement has gone up. I 144 00:06:02,669 --> 00:06:05,029 Speaker 3: think the thing to consider though, is that breathlessness can 145 00:06:05,109 --> 00:06:07,069 Speaker 3: be one of those red flags just like we've had 146 00:06:07,149 --> 00:06:09,549 Speaker 3: we've talked about before around heart rate going up or 147 00:06:09,549 --> 00:06:13,869 Speaker 3: blood pressure change, you're feeling dizzy. Breathlessness could be could 148 00:06:13,909 --> 00:06:17,829 Speaker 3: be something to do again the risk of a pulmonariabalism 149 00:06:17,909 --> 00:06:20,429 Speaker 3: or a cardiac problem, because if your heart, if you're 150 00:06:20,429 --> 00:06:22,709 Speaker 3: feeling breathless, it means usually you're not quite getting enough 151 00:06:22,749 --> 00:06:26,469 Speaker 3: oxygen around the body. So if it subsequently has breathlessness 152 00:06:26,549 --> 00:06:30,389 Speaker 3: plus chest pain, breathlessness at rest, sitting down, it's time 153 00:06:30,429 --> 00:06:31,909 Speaker 3: to go and see it's doctor. 154 00:06:33,309 --> 00:06:34,869 Speaker 2: One of the things. I've spoken to my mom a 155 00:06:34,869 --> 00:06:36,949 Speaker 2: lot about what happened in her pregnancy, and she's thinking 156 00:06:36,989 --> 00:06:40,109 Speaker 2: back to back in the day and she had something 157 00:06:40,109 --> 00:06:43,829 Speaker 2: that I've not experienced yet. She bled pretty much throughout 158 00:06:43,829 --> 00:06:47,669 Speaker 2: the whole of her pregnancy actually, and then if it 159 00:06:47,669 --> 00:06:50,989 Speaker 2: did stop, it came back at around twenty ish weeks mark. 160 00:06:51,589 --> 00:06:52,509 Speaker 2: What is that a sign of? 161 00:06:52,989 --> 00:06:55,589 Speaker 3: Look, it's really tricky and sometimes we can't work out 162 00:06:55,629 --> 00:06:57,309 Speaker 3: what it is, but it is important to look at that. 163 00:06:57,349 --> 00:06:59,189 Speaker 3: So I think it's a really great discussion for this week. 164 00:06:59,229 --> 00:07:01,709 Speaker 3: Because you've had your morphology hopefully by twenty two weeks, 165 00:07:01,709 --> 00:07:04,389 Speaker 3: we really what I've done before now guys, and look 166 00:07:04,429 --> 00:07:06,749 Speaker 3: for where your placenta is. So sometimes we can get 167 00:07:06,749 --> 00:07:09,469 Speaker 3: what's called a low lying placenta or a placenta previa. 168 00:07:09,549 --> 00:07:10,589 Speaker 1: There's different raids of it. 169 00:07:10,589 --> 00:07:12,909 Speaker 3: So obviously one is just where it's a butting up 170 00:07:12,909 --> 00:07:15,229 Speaker 3: against the cervix and what that basically means. The placenta 171 00:07:15,309 --> 00:07:16,949 Speaker 3: needs to be feeding the baby, so we need it, 172 00:07:16,949 --> 00:07:19,349 Speaker 3: it's essential. But ideally it's up near the fundus, at 173 00:07:19,349 --> 00:07:21,109 Speaker 3: the top of your uterus or on the anterior or 174 00:07:21,149 --> 00:07:23,269 Speaker 3: the posterior walls, so it's somewhere away from where the 175 00:07:23,309 --> 00:07:24,789 Speaker 3: cervix is, and the cervix is obviously the. 176 00:07:24,829 --> 00:07:26,549 Speaker 1: Canal that Levenchy but baby will come out of. 177 00:07:27,029 --> 00:07:29,469 Speaker 3: But unfortunately, in some cases it can actually come really 178 00:07:29,509 --> 00:07:31,949 Speaker 3: close to the cervix. So if it's within twenty millimeters, 179 00:07:31,949 --> 00:07:33,309 Speaker 3: so if you know you're looking atr fingers, it's in 180 00:07:33,429 --> 00:07:36,189 Speaker 3: that sort of period of space, we know there's a 181 00:07:36,269 --> 00:07:38,829 Speaker 3: risk that if that during pregnancy, bleeding may occur, and 182 00:07:38,869 --> 00:07:41,709 Speaker 3: it can be quite significant bleeding, so we monitor you 183 00:07:41,749 --> 00:07:43,589 Speaker 3: more regularly. So if it's just a low lying placenta, 184 00:07:43,709 --> 00:07:45,669 Speaker 3: we then say, look, let's repeat an ultrasound. In the 185 00:07:45,669 --> 00:07:47,829 Speaker 3: third trimester. Most of the time, ninety percent of the 186 00:07:47,829 --> 00:07:49,869 Speaker 3: time that cervix has grown out of the way. It's amazing, 187 00:07:49,869 --> 00:07:52,709 Speaker 3: it's gone. Not even a concern if it's still sitting 188 00:07:52,789 --> 00:07:54,589 Speaker 3: quite close to the cervix, so it's a grade two 189 00:07:54,629 --> 00:07:57,069 Speaker 3: it's sitting like on or just crossing over the cervix. 190 00:07:57,269 --> 00:07:59,829 Speaker 3: Up to a grade four where it's completely covering from 191 00:07:59,829 --> 00:08:02,709 Speaker 3: the front anterior to the back of the cervix posterior, 192 00:08:03,109 --> 00:08:05,229 Speaker 3: that can be quite dangerous because it basically means there's 193 00:08:05,229 --> 00:08:06,909 Speaker 3: no way the baby can come out that placenta is 194 00:08:06,949 --> 00:08:09,629 Speaker 3: crossing right across the exit, and it also means they're 195 00:08:09,629 --> 00:08:11,349 Speaker 3: at much high chance of bleeding. So that's one of 196 00:08:11,389 --> 00:08:14,149 Speaker 3: the big things to know. Where is your placenta. If 197 00:08:14,149 --> 00:08:15,749 Speaker 3: it's low lying, you might be advised to not do 198 00:08:15,829 --> 00:08:18,989 Speaker 3: high impact running for example, or don't or for example, 199 00:08:19,309 --> 00:08:21,269 Speaker 3: reduce intercourse because we don't want to do anything that 200 00:08:21,309 --> 00:08:24,029 Speaker 3: could stimulate or put pressure onto where that placenta is. 201 00:08:24,549 --> 00:08:26,709 Speaker 3: There's also other types of placenta spectrums that you need 202 00:08:26,749 --> 00:08:28,429 Speaker 3: to be aware of. Not for today, but if you 203 00:08:28,789 --> 00:08:30,749 Speaker 3: are someone who has a problem with your placenter, it's 204 00:08:30,749 --> 00:08:32,309 Speaker 3: just really good to get your doctor to explain it 205 00:08:32,389 --> 00:08:34,309 Speaker 3: in thorough detail so that you are aware of what's 206 00:08:34,349 --> 00:08:36,869 Speaker 3: going on. Other things are called bleeding your civix. 207 00:08:36,989 --> 00:08:37,469 Speaker 1: It can bleed. 208 00:08:37,509 --> 00:08:39,389 Speaker 3: It can bleed from contact from intercourse, but I still 209 00:08:39,429 --> 00:08:41,069 Speaker 3: want you to have intercourse as long as your percenta 210 00:08:41,149 --> 00:08:42,549 Speaker 3: is not low lying and you're not having a concern 211 00:08:42,589 --> 00:08:45,829 Speaker 3: is sumportant part of pregnancy. You vagina can bleed because 212 00:08:45,829 --> 00:08:47,789 Speaker 3: it gets dry sometimes and it gets you know, moist 213 00:08:47,869 --> 00:08:48,269 Speaker 3: other times. 214 00:08:48,269 --> 00:08:49,589 Speaker 1: I know probably hate. 215 00:08:49,389 --> 00:08:52,509 Speaker 3: That word, but it's importunately part of the vagina and 216 00:08:52,589 --> 00:08:54,709 Speaker 3: sometimes again back to the placenta, it can lift up 217 00:08:54,709 --> 00:08:56,189 Speaker 3: a little bit on the side. It's more common in 218 00:08:56,229 --> 00:08:57,629 Speaker 3: third semester, but we can get a little bit of 219 00:08:57,629 --> 00:09:00,389 Speaker 3: bleeding from the edge of the placenter called a placenta abruption, 220 00:09:00,469 --> 00:09:02,589 Speaker 3: which is a tiny one and in most cases it 221 00:09:02,629 --> 00:09:05,349 Speaker 3: just sits back down again. It can be a real 222 00:09:05,429 --> 00:09:08,229 Speaker 3: pest bow grace. So some people get this annoying bleeding. 223 00:09:08,269 --> 00:09:10,429 Speaker 3: They don't have a placenta previa, so the placenta nice 224 00:09:10,429 --> 00:09:11,149 Speaker 3: and out of the way. 225 00:09:11,029 --> 00:09:12,869 Speaker 1: And every couple of weeks they do just bleed. 226 00:09:13,509 --> 00:09:15,869 Speaker 3: And these poor women can sometimes be in hospital from 227 00:09:15,869 --> 00:09:18,869 Speaker 3: like twenty five to twenty six weeks till term because 228 00:09:18,909 --> 00:09:20,669 Speaker 3: they bleed. They go home for two or three days, 229 00:09:20,709 --> 00:09:22,629 Speaker 3: they bleed again, they go home for two or three days, 230 00:09:22,629 --> 00:09:25,669 Speaker 3: they bleed again, and they are literally institutionalized for ten 231 00:09:25,709 --> 00:09:28,989 Speaker 3: weeks of pregnancy. The remarkable that they manage to hold 232 00:09:28,989 --> 00:09:31,349 Speaker 3: it together. So I think it's just really important to 233 00:09:31,469 --> 00:09:33,189 Speaker 3: if you do bleed, to try and work out what 234 00:09:33,229 --> 00:09:35,349 Speaker 3: it is. But keep in mind that your doctors are 235 00:09:35,349 --> 00:09:37,149 Speaker 3: probably sometimes standing at the end of your bed going 236 00:09:37,189 --> 00:09:40,389 Speaker 3: I'm really sorry, I have no idea, and often you'll 237 00:09:40,389 --> 00:09:42,149 Speaker 3: get asked, oh can you do an ultrasound to look 238 00:09:42,149 --> 00:09:43,629 Speaker 3: at my placenta, Is it lifting? 239 00:09:43,709 --> 00:09:45,549 Speaker 1: Is it abrupting? Most of the time we can't even 240 00:09:45,589 --> 00:09:47,069 Speaker 1: see it, so it's kind of to proven. 241 00:09:47,069 --> 00:09:50,389 Speaker 3: Otherwise, I'd say more often than not, I can't give 242 00:09:50,389 --> 00:09:52,669 Speaker 3: you a reason, but know that it's common. 243 00:09:53,029 --> 00:09:55,149 Speaker 1: But it's always always a time to go and get help. 244 00:09:55,909 --> 00:09:59,549 Speaker 2: When you talk about the placenta moving. If we for 245 00:09:59,589 --> 00:10:02,069 Speaker 2: a lot of women, the last time they see their 246 00:10:02,069 --> 00:10:04,349 Speaker 2: baby on an ultrasound is that twenty weeks. Can if 247 00:10:04,349 --> 00:10:07,189 Speaker 2: you're low risk, how can you know if the placenta 248 00:10:07,429 --> 00:10:09,269 Speaker 2: has moved? Are there other signs? 249 00:10:10,149 --> 00:10:11,869 Speaker 3: If your percenter is low, that won't be your last 250 00:10:11,949 --> 00:10:15,509 Speaker 3: ultra sound, So it would be strongly against. I mean, 251 00:10:15,509 --> 00:10:17,109 Speaker 3: there's a lot of things we're quite lax with with 252 00:10:17,229 --> 00:10:20,029 Speaker 3: you know, you take our recommendation or you don't that. 253 00:10:20,189 --> 00:10:22,349 Speaker 3: I can't imagine any midwife or doctor or door or 254 00:10:22,469 --> 00:10:25,029 Speaker 3: anyone if you had a low lying percenter a morphology 255 00:10:25,069 --> 00:10:27,949 Speaker 3: that wouldn't say let's repeat it at least between twenty 256 00:10:27,949 --> 00:10:29,749 Speaker 3: eight and thirty four weeks, because we need to know 257 00:10:29,829 --> 00:10:32,029 Speaker 3: ideally the closer to thirty two to thirty four that 258 00:10:32,069 --> 00:10:35,149 Speaker 3: it's moved. It is you have a significant chance of 259 00:10:35,669 --> 00:10:38,269 Speaker 3: a severe postpartum hemorrhage if you don't. 260 00:10:38,589 --> 00:10:40,029 Speaker 2: Is there a chance that if you do have an 261 00:10:40,469 --> 00:10:43,349 Speaker 2: anterior percenter like minds at the front, yep, would it 262 00:10:43,629 --> 00:10:47,589 Speaker 2: move lower or higher? Or if it's an anterior and yeah, 263 00:10:49,949 --> 00:10:52,949 Speaker 2: will it's the other way? No, so because it's not. 264 00:10:52,989 --> 00:10:54,709 Speaker 3: Actually it sounds like the vost is getting a little 265 00:10:54,709 --> 00:10:55,669 Speaker 3: feet and wriggling its way up. 266 00:10:55,869 --> 00:10:56,189 Speaker 1: It doesn't. 267 00:10:56,189 --> 00:10:58,469 Speaker 3: It grows as the muscle and the segment. So you 268 00:10:58,469 --> 00:11:00,909 Speaker 3: actually have what's called your lower segment of your uterus 269 00:11:01,189 --> 00:11:04,069 Speaker 3: in early pregnancy. It's not developed, so there is actually 270 00:11:04,989 --> 00:11:07,909 Speaker 3: an amazing phenomenon where the actual lower segment stretches and 271 00:11:07,909 --> 00:11:09,669 Speaker 3: stretches and stretches are up, and in doing so it 272 00:11:09,749 --> 00:11:11,589 Speaker 3: takes the percenter with it. So the pleasant is not 273 00:11:11,669 --> 00:11:13,869 Speaker 3: physically moving, it's just growing up and away from the 274 00:11:13,909 --> 00:11:16,509 Speaker 3: servix and then it's fine. So if at morphology you 275 00:11:16,549 --> 00:11:19,189 Speaker 3: don't have a low lying placenter, the chances if you're getting. 276 00:11:18,989 --> 00:11:19,989 Speaker 1: One incredibly low. 277 00:11:20,229 --> 00:11:20,549 Speaker 2: Right. 278 00:11:20,949 --> 00:11:23,269 Speaker 3: The other key thing to think about is your cervical length. 279 00:11:23,469 --> 00:11:27,269 Speaker 3: So we talked very early in this series around internal examination. 280 00:11:27,349 --> 00:11:29,869 Speaker 3: So having a trans vaginal which is the probe inside 281 00:11:29,869 --> 00:11:32,309 Speaker 3: the uterus. This is the time we can have a 282 00:11:32,309 --> 00:11:34,429 Speaker 3: look at your cervix and see if it's nice and long. 283 00:11:34,869 --> 00:11:36,869 Speaker 3: If your cervix is super short, in other words, it's 284 00:11:36,909 --> 00:11:40,629 Speaker 3: like only a centimeter long, we would consider at this 285 00:11:40,669 --> 00:11:42,029 Speaker 3: point doing something about it. 286 00:11:42,309 --> 00:11:42,909 Speaker 1: Now not always. 287 00:11:42,909 --> 00:11:44,309 Speaker 3: Some people might say no, thank you, or it might 288 00:11:44,309 --> 00:11:46,309 Speaker 3: be borderline like two centimeters or two point eight, and 289 00:11:46,309 --> 00:11:49,149 Speaker 3: it's just being what we call cervical surveillance, which means 290 00:11:49,189 --> 00:11:51,309 Speaker 3: you have more frequent ultra sounds to check that. But 291 00:11:51,389 --> 00:11:53,109 Speaker 3: ultimately it's what's holding your baby in. 292 00:11:53,349 --> 00:11:54,349 Speaker 1: Once your service. 293 00:11:54,069 --> 00:11:57,269 Speaker 3: Starts to dilate, it's very, very hard to stop labor 294 00:11:57,269 --> 00:11:59,629 Speaker 3: from coming again. I've seen miracles. I thought, there's amazing 295 00:11:59,629 --> 00:12:01,389 Speaker 3: woman with an open service at twenty five weeks. You 296 00:12:01,429 --> 00:12:03,269 Speaker 3: made it to twenty No, it made it to thirty 297 00:12:03,269 --> 00:12:05,909 Speaker 3: four weeks. But it's less common because you know something 298 00:12:05,949 --> 00:12:08,389 Speaker 3: that's the structure is not stable anymore. So if we 299 00:12:08,429 --> 00:12:11,989 Speaker 3: can catch an open cervix or short cervix, I should 300 00:12:11,989 --> 00:12:14,109 Speaker 3: say at twenty weeks, we can usually do something like 301 00:12:14,149 --> 00:12:17,229 Speaker 3: progesterone supplements or even a sicklage. But again that's information 302 00:12:17,309 --> 00:12:19,429 Speaker 3: for your obsoscition to go through with you. But it's 303 00:12:19,429 --> 00:12:21,829 Speaker 3: important when you're saying yay or nay, Do I or 304 00:12:21,829 --> 00:12:24,829 Speaker 3: do I not? Want to have that internal exam It 305 00:12:24,869 --> 00:12:26,669 Speaker 3: would be a reason I'd consider it. 306 00:12:27,149 --> 00:12:29,189 Speaker 2: We've given a lot of advice this episode already, but 307 00:12:29,269 --> 00:12:31,149 Speaker 2: is there anything else that we haven't thought about for 308 00:12:31,669 --> 00:12:33,269 Speaker 2: a checklist this week? For twenty two. 309 00:12:33,149 --> 00:12:36,469 Speaker 3: Weeks monitoring babies movements. Now, let's go into that properly 310 00:12:36,509 --> 00:12:38,149 Speaker 3: next episode, because I think now is the time there's 311 00:12:38,149 --> 00:12:41,149 Speaker 3: patterns will develop, but I think super important to start 312 00:12:41,589 --> 00:12:42,709 Speaker 3: looking and monitoring those. 313 00:12:50,309 --> 00:12:52,469 Speaker 2: My talk itIt for this week is just to stop 314 00:12:52,469 --> 00:12:55,669 Speaker 2: being a hero and if someone love it. If someone 315 00:12:55,749 --> 00:12:59,069 Speaker 2: offers a lift or says, do you want me to 316 00:12:59,469 --> 00:13:03,109 Speaker 2: lift that, Itham, the answer is yes. 317 00:13:03,109 --> 00:13:05,749 Speaker 3: Yeah, perfect take it, including if they want to cook 318 00:13:05,789 --> 00:13:06,669 Speaker 3: your meals and things. 319 00:13:06,669 --> 00:13:08,909 Speaker 2: Yes, oh yes, ay, yes. 320 00:13:08,989 --> 00:13:10,789 Speaker 3: And it also gives them permission to ask you in 321 00:13:10,829 --> 00:13:13,189 Speaker 3: the future. And I think we're so busy not taking 322 00:13:13,229 --> 00:13:15,349 Speaker 3: help because we're want to be heroes, as you perfectly 323 00:13:15,349 --> 00:13:17,589 Speaker 3: said it, but it allows in doing so, them to 324 00:13:17,629 --> 00:13:19,029 Speaker 3: reach back and ask for that when they go through 325 00:13:19,029 --> 00:13:21,069 Speaker 3: prectice in themselves, which makes it a women's club, which 326 00:13:21,069 --> 00:13:22,069 Speaker 3: is exactly what we need. 327 00:13:22,269 --> 00:13:27,949 Speaker 2: Yeah, we hope you enjoyed this episode of Hello Bump. 328 00:13:28,029 --> 00:13:30,869 Speaker 2: We have so many episodes of this series filled with 329 00:13:30,909 --> 00:13:33,989 Speaker 2: tips and stories from women and experts who've been through 330 00:13:34,029 --> 00:13:34,749 Speaker 2: it all before. 331 00:13:35,189 --> 00:13:37,069 Speaker 3: You can go back and listen to everything else Hello 332 00:13:37,069 --> 00:13:38,989 Speaker 3: Bump related in this podcast feed, and. 333 00:13:38,989 --> 00:13:40,749 Speaker 2: While you're there, we'd love if you could give us 334 00:13:40,749 --> 00:13:42,669 Speaker 2: a five star rating and maybe leave us a review, 335 00:13:42,789 --> 00:13:44,749 Speaker 2: or even share this episode with a friend. 336 00:13:45,149 --> 00:13:48,349 Speaker 3: This episode was produced by Courtney Ammenhauser with audio production 337 00:13:48,389 --> 00:13:49,109 Speaker 3: by Tom Lyon. 338 00:13:49,149 --> 00:13:50,949 Speaker 1: We'll catch you next time. Bye. 339 00:13:51,229 --> 00:13:53,549 Speaker 2: This episode of Hello Bump was made in partnership with 340 00:13:53,669 --> 00:13:54,109 Speaker 2: Huggies