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Speaker 1: Said, you're listening to a Muma Mia podcast.

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Speaker 2: Mom and Maya acknowledges the traditional owners of land and

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Speaker 2: waters that this podcast is recorded on.

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Speaker 1: I am pregnanty.

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Speaker 2: Welcome to Hello Bump. We're making pregnancy less overwhelming and

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Speaker 2: hopefully more manageable. I'm Grace Ruefrey. I am pregnant for

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Speaker 2: the first time, and I now carry snacks in every

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Speaker 2: bag that I own.

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Speaker 1: I'm Jana Pittman. I'm a former Olympian and now training

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Speaker 1: obstetrician and birth six babies myself. That's a lot of babies,

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Speaker 1: a lot of burgers.

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Speaker 2: Each episode, Yana and I will be holding your hand

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Speaker 2: week by week through the mysterious, perplexing and sometimes very

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Speaker 2: hungry miracle that is pregnancy. Week nine. What size is

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Speaker 2: the baby?

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Speaker 1: Well, it's now like a double malteezer, like you know

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Speaker 1: those ones that are stuck together and you can kindt

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Speaker 1: of get really excited when they're a packet that looks

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Speaker 1: a bit like that too.

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Speaker 2: I have. It could be a piece of sushi which

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Speaker 2: I robicily I can't eat, this.

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Speaker 1: Is true, or a large jelly bean, but it's twenty

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Speaker 1: millimeters or twenty five millimeters or over two centimeters now.

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Speaker 2: And what's happening? What are they grown?

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Speaker 1: Well, babies muscles are starting to develop, which I think

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Speaker 1: is very cute. It's its arms and legs are now bed,

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Speaker 1: so it looks like it's cuddling itself, and they have

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Speaker 1: fingers and toes that are starting to form. They still webbed,

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Speaker 1: so if you think about these sort of fishy, you

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Speaker 1: still bit dinosaur like at this point. And its skin's

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Speaker 1: there starting to develop, so it's very thin layers. You

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Speaker 1: obviously have lots of layers of skin, and it's very

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Speaker 1: transparent at this.

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Speaker 2: Point, and red quite red like it hasn't got the Yeah, exactly,

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Speaker 2: Yeah colors. Is that the same for like every ethnicity

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Speaker 2: as well, Like there's going to be.

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Speaker 1: It's can't tell you red at this point. I mean,

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Speaker 1: I unfortunately have seen a few little ones that have

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Speaker 1: come at this point and they just look all very similar. So, yeah,

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Speaker 1: the melanin hasn't kicked in from a pigmentation perspective in

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Speaker 1: the eyes or the skin for until much later in pregnancy.

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Speaker 2: What's happening to me now in terms of what's happening

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Speaker 2: to our bodies? I do have a question straight off

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Speaker 2: the bat, the weird taste in my mouth.

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Speaker 1: Oh, isn't it? And it's quite metallic. Yeah, that is

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Speaker 1: what most women describe it.

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Speaker 2: I didn't get it.

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Speaker 1: What is it like? What is it?

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Speaker 2: It's like a combination of dry mouth, but then a

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Speaker 2: weird taste like food just doesn't taste the same anymore.

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Speaker 2: Which again, I'm further along than nine weeks that hasn't

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Speaker 2: gone away. And a friend of mine actually said, the

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Speaker 2: first meal you have once the placenta is removed from

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Speaker 2: your body doesn't matter. If it's like the cafeteria sandwich

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Speaker 2: at the hospital, it'll be the nicest tasting food in

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Speaker 2: the entire world.

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Speaker 1: She's one hundred percent correct, because I can confirm that

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Speaker 1: after all of my the cheese toasted the midwife brings

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Speaker 1: are the bomb. She's in ham actually even better, it's

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Speaker 1: so good. So your changes in your taste buds largely

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Speaker 1: come about from estrogen. So again, those pregnancy hormones playing havoc,

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Speaker 1: they often mask some of the more so your normal

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Speaker 1: you know, mask some of the yucky flavors, and in

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Speaker 1: pregnancy they just become more enhanced. I think the science

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Speaker 1: behind it is that you're trying to avoid taking things

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Speaker 1: that you shouldn't, so I guess it's a way it's

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Speaker 1: your own body's surveillance system not to be consuming something

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Speaker 1: that might hurt the baby. It's also a sign of

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Speaker 1: potential nutritional deficiency, so it might be to just check

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Speaker 1: your vitamin D and your vitamin and your eyen elevated enough,

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Speaker 1: and you might even notice it coincides with some of

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Speaker 1: the odd more odd cravings like cabbage or spinach or asparagus,

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Speaker 1: which often indicates a follow that deficiency, So check it out.

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Speaker 1: The other begone in guys is dental health, and I

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Speaker 1: want to talk about this in more depth than another

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Speaker 1: episode because it actually warrants it. But there might be

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Speaker 1: a cavity developing there. So think about all the vomiting

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Speaker 1: and all the acid and everything that's happening around. Now, yeah,

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Speaker 1: it might be that you're actually tasting something yucky that's

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Speaker 1: actually happening to your teeth.

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Speaker 2: And in terms of the vomiting and getting a cavity,

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Speaker 2: one piece of advice that I got was, if you

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Speaker 2: are vomiting a lot, don't brush your teeth every single

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Speaker 2: time afterwards, because you could be stripping more of the

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Speaker 2: enamel away. But to just wash your mouth out with

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Speaker 2: water after you're vomiting each time.

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Speaker 1: Very good idea. And then and obviously book to see

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Speaker 1: a dentists.

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Speaker 2: Yeah, to see a dentists. One of the foods that

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Speaker 2: weirdly that I crave is everything. And I don't know

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Speaker 2: if this is because of the weird taste in the

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Speaker 2: mouth that you're talking about. Is everything else to be

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Speaker 2: really cooked almost to the point of being burnt.

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Speaker 1: Really, yeah, jarcoal sort of sud I don't really or

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Speaker 1: each to look it up and see if someone can

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Speaker 1: let us know what type of diffish and see that

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Speaker 1: there's got to be something to.

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Speaker 2: That, yeah, Or maybe it's more the mouth feel consistency.

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Speaker 1: Like okay, it's not I mean it's good to cook

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Speaker 1: your meat through. I think that's one of the things.

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Speaker 1: You know, there's always questions about what can I and

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Speaker 1: can I not eat in pregnancy and what are the rules,

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Speaker 1: and like, yes, guys, there's guidelines of you know, no

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Speaker 1: raw fish and cheeses are off, and you know, eggs

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Speaker 1: that are cooked have to be cooked through. But maybe

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Speaker 1: that's particularly one of those things. Maybe your body's just

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Speaker 1: actually craving that interesting.

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Speaker 2: And I've spent twelve years as a vegetarian and then pescatarian.

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Speaker 2: And this because I started to feel tired. I've eaten meat.

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Speaker 1: They go, isn't that interesting?

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Speaker 2: Yeah?

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Speaker 1: God, he craved it.

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Speaker 2: Yeah, beefpeak of that episode in Friends. Or it's just like,

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Speaker 2: that's what the baby wants.

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Speaker 1: It's not you.

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Speaker 2: You can blame the baby. Go back now to to you.

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Speaker 1: It depends how you feel environmentally about it too. I'm

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Speaker 1: not a vegetarian. I've flirted with the idea over the years. Fortunately,

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Speaker 1: I just like my meat.

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Speaker 2: But it's just it's the quickest source of protein, and

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Speaker 2: I find that if I don't have protein in each meal,

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Speaker 2: well I'm trying as hard as I can, and that's

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Speaker 2: when I get more or sick because my stomach isn't

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Speaker 2: full enough for long. It's just burnt through it too quickly.

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Speaker 2: So it's trying to find whatever source of protein, which

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Speaker 2: I can talk about later what I did.

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Speaker 1: Once you're able to eat more again, yeah, yeah, And

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Speaker 1: pregnant is the time to give yourself a break in

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Speaker 1: that space you even think about. You know, certain religions

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Speaker 1: that DoD lent, for example, and often Ramadan, and often

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Speaker 1: they're actually allowed to excuse themselves during pregnancy because we

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Speaker 1: know the body demands certain things and it's a little

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Speaker 1: bit more difficult to you know, go without food all

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Speaker 1: day when you're trying to grow grow a small human.

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Speaker 2: And what can we do week nine? What are the

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Speaker 2: things that we should be doing.

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Speaker 1: Well week nine? I think it's quite exciting, is if you're

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Speaker 1: planning to do so we have to do screening. Well, no,

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Speaker 1: that's not true. We don't have to. In fact, in pregnancy,

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Speaker 1: you don't have to do anything. It's your body, your baby,

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Speaker 1: and your decisions around things. But we recommend that you

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Speaker 1: start thinking about doing some early tremesta, so your first

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Speaker 1: tremester screening, so it is the earliest time we can

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Speaker 1: see how this little baby's going in terms of its health.

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Speaker 1: Doesn't have any chromosomal abtormalities, Are there any structural things

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Speaker 1: that we need to let's be honest, make decisions about.

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Speaker 1: And so the NIPT is one of the tests, and

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Speaker 1: the combined try to screening first times screen is the

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Speaker 1: other test. One of them's government funder, the other one, unfortunately,

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Speaker 1: is out of pocket. Nine weeks is the earliest you

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Speaker 1: can have an NIPT test, So that's your noninvasive prenatal testing.

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Speaker 1: It's a blood test, guys, there's nothing more than that.

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Speaker 1: It's just literally prick in the arm. And then they

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Speaker 1: look at certain disabilities like Down syndrome and then PETAO

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Speaker 1: and Edward syndrome, which is basically genetic conditions that you

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Speaker 1: may or may not decide to continue with your pregnancy.

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Speaker 1: Fairly accurate, but again, screening tool not diagnostic. It's a

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Speaker 1: screening tool that gives you a risk ratio of how

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Speaker 1: likely you are to have one of these conditions. The

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Speaker 1: combined message first timesI screen is an ultrasound and a

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Speaker 1: blood test that it actually looks at the nucle thickness

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Speaker 1: of the back of the baby's neck, and we know

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Speaker 1: that a thickened nucle so a thickened portion at the

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Speaker 1: back of the baby's neck has a higher risk of

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Speaker 1: chromosome will abnormalities. There's lots of other soft signs like

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Speaker 1: absent nasal bones and problems with the heart that they

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Speaker 1: can see very early. But the sum of all of

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Speaker 1: that is there two tests that allow us to basically say,

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Speaker 1: are you at risk of a baby with a disability?

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Speaker 1: And so the question is would you do anything about it?

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Speaker 1: Because if you aren't going to do anything about it,

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Speaker 1: then you know, we're less worried about you doing it.

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Speaker 1: Whereas if it's a discussion you had with your family

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Speaker 1: that you would not continue with the pregnancy, then it's

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Speaker 1: essential you have this done before thirteen and a half

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Speaker 1: weeks of pregnancy because.

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Speaker 2: There is that window to have the test. And is

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Speaker 2: that because there's a certain point something closes over and

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Speaker 2: they can't test any further. What's the reason that you

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Speaker 2: have to do it in that window?

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Speaker 1: The NIPT has to be before, sorry, after nine weeks

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Speaker 1: because it's actually would you believe your baby's DNA so

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Speaker 1: fractions of your baby's DNA circulating in the maternal blood,

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Speaker 1: So you need there to be enough fractions or enough

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Speaker 1: and enough of the DNA circulating that they can pick

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Speaker 1: it up accurately. So the negative if you do it

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Speaker 1: at sort of nine weeks and one days, that they

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Speaker 1: send it back and it's not accurate, you need to

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Speaker 1: repeat it. The combined first tremester screen needs to be

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Speaker 1: between eleven weeks and thirteen weeks and six days. The

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Speaker 1: benefit of that blood test is also that it also

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Speaker 1: checks for things like your pre eclampsier risk and your

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Speaker 1: interuterine growth restriction risk. Now that's a bit of a wooh.

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Speaker 1: How do you do that from a blood test? It's

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Speaker 1: a combined algorithm that basically looks at your age, looks

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Speaker 1: at the size of the nukele thickness, some other soft

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Speaker 1: factors on ultrasound, combined with your beta HACG levels, your

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Speaker 1: papa A levels, all extra medical terms I know again,

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Speaker 1: but basically, some very smart people in a laboratory and

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Speaker 1: your sonographer combine all that information and pop out a

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Speaker 1: risk to say, are you at risk of having high

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Speaker 1: blood pressure and problems in your pregnancy? Is your baby

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Speaker 1: going to be small? And does your baby have a

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Speaker 1: disability that then you need to consider discussions about. And

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Speaker 1: so that's when you'll be offered by your doctor a

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Speaker 1: more diagnostic test like an amniocentesis to decide if there

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Speaker 1: really is something wrong with your baby.

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Speaker 2: Do you know the ratio of women who aren't declining

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Speaker 2: those tests? And it's absolutely each to their own. Everyone

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Speaker 2: can make their own decisions, but in twenty twenty five

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Speaker 2: is a lot of people wanting to know that information.

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Speaker 1: I've rarely had someone say no, they may not decide

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Speaker 1: to pay the four hundred and ninety dollars to do

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Speaker 1: their IPT. They might be like, you know what, I'm

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Speaker 1: happy just to have the combined first trimester screen. Now

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Speaker 1: that NIPT is more sensitive, but only for things like

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Speaker 1: down syndrome. It is not an ultrasound. So what we

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Speaker 1: strongly recommend is if you decide to do that, because

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Speaker 1: it tells you the gender as well. And there's some

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Speaker 1: people actually that's a funny one. People are actually choosing

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Speaker 1: not to find out more. It's a total change in

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Speaker 1: that space. But NIPT is the earliest you can find

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Speaker 1: out because they can look at whether it's an XY

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Speaker 1: or AX. You don't have to, of course, but they're

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Speaker 1: only specific for those things. So you've got to remember

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Speaker 1: that even if you had an NIPT, I would still

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Speaker 1: recommend getting an ultrasound because it misses things like trip loidy. Now,

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Speaker 1: I have a very close friend who had this happen.

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Speaker 1: So she had a normal NIPT, completely low risk pregnancy,

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Speaker 1: got to fourteen weeks and had an ultra sunk. She

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Speaker 1: had some spotting, and the baby was found to be

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Speaker 1: morbidly disabled and so not sustainable with life after birth,

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Speaker 1: and so she had to make a very difficult decision

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Speaker 1: to end her pregnancy, but you don't get that alone

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Speaker 1: from the NIPT. It's not diagnostic. It cannot give you

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Speaker 1: all the answers. There's also an extended screen NIPT now

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Speaker 1: which basically looks for a whole lot of chromosome alumn nomalodies.

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Speaker 1: Kind of sounds exciting and cool. There's also a lot

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Speaker 1: of positive tests that are coming back that are false positives.

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Speaker 1: And then it puts you down the pathway of if

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Speaker 1: you have to have a good discussion with your obstecution

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Speaker 1: or you're guiding at that point to decide, well, the

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Speaker 1: risk of an amnios and tesis is miscarriage in one

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Speaker 1: of two hundred risk of a miscarriage is that too much?

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Speaker 2: And amosentsis I only know this because of Gray's anatomy. Yeah,

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Speaker 2: that's where the needle goes into your uterus from like

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Speaker 2: through your stomach. Ye, And those are invasive screenings.

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Speaker 1: Faces screen. That and the CVS, which is basically the

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Speaker 1: two tests that we look at to look for disability

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Speaker 1: because they take actual cells, one from the ambniotic fluid

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Speaker 1: and one from the placental mass.

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Speaker 2: I do have questions on that, but I might talk

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Speaker 2: about that in week twelve when I actually did elect

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Speaker 2: to do NIPT and booked it in so I do

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Speaker 2: have some questions on the data that comes back, but

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Speaker 2: we'll get to that in a couple of weeks. Time

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Speaker 2: talk it. This week, mine is just snack related. It's

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Speaker 2: getting like I mentioned before, Twisti's but I just getting

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Speaker 2: like little snack snackable packets of tiny little things and

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Speaker 2: just having them and also having even though it's going

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Speaker 2: to maybe feel hard depending on what your aversions are.

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Speaker 2: Almonds were really good because they are a small source

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Speaker 2: of protein to hopefully make you if your nausea is

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Speaker 2: tied to hunger, that might push you out a little

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Speaker 2: bit longer in terms of when you need to eat

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Speaker 2: that next meal.

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Speaker 1: And that's perfect. I think having lots of them in

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Speaker 1: your bag too, because you might decide one over the other.

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Speaker 2: You might just hate one one day. I hate so

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Speaker 2: many snacks at one point, I don't know, I'm.

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Speaker 1: Like, that's snacks.

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Speaker 2: I really went back to childhood, like basic, Oh that's gold.

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Speaker 1: Buy an ice drig bottle would be mine because I

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Speaker 1: think you can regulate how much water you're taking in.

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Speaker 1: But also if you like it, it's all pretty and you know,

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Speaker 1: dope meme.

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Speaker 2: We're just yeah, you enjoy.

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Speaker 1: The enjoy the pretty botle, and then you might drinkable.

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Speaker 2: Yeah. There's not a lot of perks at the moment,

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Speaker 2: not much, not at no weeks.

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Speaker 1: It's the worst of the worst.

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Speaker 2: We hope you enjoyed this episode of Hello Bump. We

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Speaker 2: have so many episodes of this series filled with tips

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Speaker 2: and stories from women and experts who've been through it

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Speaker 2: all before.

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Speaker 1: You can go back and listen to everything else Hello

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Speaker 1: Bump related in this podcast.

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Speaker 2: Feed, and while you're there, we'd love if you could

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Speaker 2: give us a flying star rating and maybe leave us

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Speaker 2: a review, or even share this episode with a friend.

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Speaker 1: This episode was produced by Courtney Ammenhauser with audio production

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Speaker 1: by Tom Lyon Next Time.

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Speaker 2: This episode of Hello Bump was made in partnership with

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Speaker 2: Huggies Bye Bye