WEBVTT - Week 9: To Test Or Not To Test

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<v Speaker 1>Said, you're listening to a Muma Mia podcast.

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<v Speaker 2>Mom and Maya acknowledges the traditional owners of land and

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<v Speaker 2>waters that this podcast is recorded on.

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<v Speaker 1>I am pregnanty.

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<v Speaker 2>Welcome to Hello Bump. We're making pregnancy less overwhelming and

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<v Speaker 2>hopefully more manageable. I'm Grace Ruefrey. I am pregnant for

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<v Speaker 2>the first time, and I now carry snacks in every

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<v Speaker 2>bag that I own.

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<v Speaker 1>I'm Jana Pittman. I'm a former Olympian and now training

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

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<v Speaker 1>a lot of burgers.

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<v Speaker 2>Each episode, Yana and I will be holding your hand

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<v Speaker 2>week by week through the mysterious, perplexing and sometimes very

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<v Speaker 2>hungry miracle that is pregnancy. Week nine. What size is

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<v Speaker 2>the baby?

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<v Speaker 1>Well, it's now like a double malteezer, like you know

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<v Speaker 1>those ones that are stuck together and you can kindt

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<v Speaker 1>of get really excited when they're a packet that looks

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<v Speaker 1>a bit like that too.

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<v Speaker 2>I have. It could be a piece of sushi which

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<v Speaker 2>I robicily I can't eat, this.

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<v Speaker 1>Is true, or a large jelly bean, but it's twenty

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<v Speaker 1>millimeters or twenty five millimeters or over two centimeters now.

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<v Speaker 2>And what's happening? What are they grown?

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<v Speaker 1>Well, babies muscles are starting to develop, which I think

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

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<v Speaker 1>so it looks like it's cuddling itself, and they have

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<v Speaker 1>fingers and toes that are starting to form. They still webbed,

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<v Speaker 1>so if you think about these sort of fishy, you

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<v Speaker 1>still bit dinosaur like at this point. And its skin's

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

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<v Speaker 1>obviously have lots of layers of skin, and it's very

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<v Speaker 1>transparent at this.

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

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<v Speaker 2>Yeah colors. Is that the same for like every ethnicity

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<v Speaker 2>as well, Like there's going to be.

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

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<v Speaker 1>I unfortunately have seen a few little ones that have

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

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<v Speaker 1>the melanin hasn't kicked in from a pigmentation perspective in

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<v Speaker 1>the eyes or the skin for until much later in pregnancy.

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<v Speaker 2>What's happening to me now in terms of what's happening

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<v Speaker 2>to our bodies? I do have a question straight off

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<v Speaker 2>the bat, the weird taste in my mouth.

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

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<v Speaker 1>what most women describe it.

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<v Speaker 2>I didn't get it.

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<v Speaker 1>What is it like? What is it?

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<v Speaker 2>It's like a combination of dry mouth, but then a

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<v Speaker 2>weird taste like food just doesn't taste the same anymore.

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

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<v Speaker 2>gone away. And a friend of mine actually said, the

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<v Speaker 2>first meal you have once the placenta is removed from

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

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<v Speaker 2>at the hospital, it'll be the nicest tasting food in

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<v Speaker 2>the entire world.

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<v Speaker 1>She's one hundred percent correct, because I can confirm that

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<v Speaker 1>after all of my the cheese toasted the midwife brings

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

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<v Speaker 1>so good. So your changes in your taste buds largely

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<v Speaker 1>come about from estrogen. So again, those pregnancy hormones playing havoc,

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<v Speaker 1>they often mask some of the more so your normal

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<v Speaker 1>you know, mask some of the yucky flavors, and in

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<v Speaker 1>pregnancy they just become more enhanced. I think the science

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<v Speaker 1>behind it is that you're trying to avoid taking things

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<v Speaker 1>that you shouldn't, so I guess it's a way it's

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<v Speaker 1>your own body's surveillance system not to be consuming something

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<v Speaker 1>that might hurt the baby. It's also a sign of

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<v Speaker 1>potential nutritional deficiency, so it might be to just check

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<v Speaker 1>your vitamin D and your vitamin and your eyen elevated enough,

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<v Speaker 1>and you might even notice it coincides with some of

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<v Speaker 1>the odd more odd cravings like cabbage or spinach or asparagus,

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<v Speaker 1>which often indicates a follow that deficiency, So check it out.

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<v Speaker 1>The other begone in guys is dental health, and I

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<v Speaker 1>want to talk about this in more depth than another

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<v Speaker 1>episode because it actually warrants it. But there might be

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<v Speaker 1>a cavity developing there. So think about all the vomiting

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

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<v Speaker 1>it might be that you're actually tasting something yucky that's

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<v Speaker 1>actually happening to your teeth.

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<v Speaker 2>And in terms of the vomiting and getting a cavity,

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<v Speaker 2>one piece of advice that I got was, if you

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<v Speaker 2>are vomiting a lot, don't brush your teeth every single

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<v Speaker 2>time afterwards, because you could be stripping more of the

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<v Speaker 2>enamel away. But to just wash your mouth out with

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<v Speaker 2>water after you're vomiting each time.

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<v Speaker 1>Very good idea. And then and obviously book to see

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<v Speaker 1>a dentists.

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<v Speaker 2>Yeah, to see a dentists. One of the foods that

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<v Speaker 2>weirdly that I crave is everything. And I don't know

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<v Speaker 2>if this is because of the weird taste in the

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<v Speaker 2>mouth that you're talking about. Is everything else to be

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<v Speaker 2>really cooked almost to the point of being burnt.

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<v Speaker 1>Really, yeah, jarcoal sort of sud I don't really or

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<v Speaker 1>each to look it up and see if someone can

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<v Speaker 1>let us know what type of diffish and see that

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<v Speaker 1>there's got to be something to.

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

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<v Speaker 1>Like okay, it's not I mean it's good to cook

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<v Speaker 1>your meat through. I think that's one of the things.

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<v Speaker 1>You know, there's always questions about what can I and

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<v Speaker 1>can I not eat in pregnancy and what are the rules,

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<v Speaker 1>and like, yes, guys, there's guidelines of you know, no

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<v Speaker 1>raw fish and cheeses are off, and you know, eggs

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<v Speaker 1>that are cooked have to be cooked through. But maybe

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<v Speaker 1>that's particularly one of those things. Maybe your body's just

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<v Speaker 1>actually craving that interesting.

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

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<v Speaker 2>And this because I started to feel tired. I've eaten meat.

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<v Speaker 1>They go, isn't that interesting?

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<v Speaker 2>Yeah?

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<v Speaker 1>God, he craved it.

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

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<v Speaker 2>that's what the baby wants.

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<v Speaker 1>It's not you.

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<v Speaker 2>You can blame the baby. Go back now to to you.

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<v Speaker 1>It depends how you feel environmentally about it too. I'm

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

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<v Speaker 1>I just like my meat.

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<v Speaker 2>But it's just it's the quickest source of protein, and

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<v Speaker 2>I find that if I don't have protein in each meal,

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<v Speaker 2>well I'm trying as hard as I can, and that's

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<v Speaker 2>when I get more or sick because my stomach isn't

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

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<v Speaker 2>So it's trying to find whatever source of protein, which

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<v Speaker 2>I can talk about later what I did.

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<v Speaker 1>Once you're able to eat more again, yeah, yeah, And

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<v Speaker 1>pregnant is the time to give yourself a break in

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<v Speaker 1>that space you even think about. You know, certain religions

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<v Speaker 1>that DoD lent, for example, and often Ramadan, and often

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<v Speaker 1>they're actually allowed to excuse themselves during pregnancy because we

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<v Speaker 1>know the body demands certain things and it's a little

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<v Speaker 1>bit more difficult to you know, go without food all

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<v Speaker 1>day when you're trying to grow grow a small human.

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<v Speaker 2>And what can we do week nine? What are the

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<v Speaker 2>things that we should be doing.

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

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<v Speaker 1>planning to do so we have to do screening. Well, no,

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

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

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<v Speaker 1>and your decisions around things. But we recommend that you

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<v Speaker 1>start thinking about doing some early tremesta, so your first

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<v Speaker 1>tremester screening, so it is the earliest time we can

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

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<v Speaker 1>Doesn't have any chromosomal abtormalities, Are there any structural things

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

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<v Speaker 1>And so the NIPT is one of the tests, and

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<v Speaker 1>the combined try to screening first times screen is the

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

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<v Speaker 1>is out of pocket. Nine weeks is the earliest you

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

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

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<v Speaker 1>It's just literally prick in the arm. And then they

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<v Speaker 1>look at certain disabilities like Down syndrome and then PETAO

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<v Speaker 1>and Edward syndrome, which is basically genetic conditions that you

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<v Speaker 1>may or may not decide to continue with your pregnancy.

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

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<v Speaker 1>screening tool that gives you a risk ratio of how

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<v Speaker 1>likely you are to have one of these conditions. The

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<v Speaker 1>combined message first timesI screen is an ultrasound and a

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<v Speaker 1>blood test that it actually looks at the nucle thickness

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<v Speaker 1>of the back of the baby's neck, and we know

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<v Speaker 1>that a thickened nucle so a thickened portion at the

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<v Speaker 1>back of the baby's neck has a higher risk of

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<v Speaker 1>chromosome will abnormalities. There's lots of other soft signs like

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<v Speaker 1>absent nasal bones and problems with the heart that they

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<v Speaker 1>can see very early. But the sum of all of

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<v Speaker 1>that is there two tests that allow us to basically say,

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<v Speaker 1>are you at risk of a baby with a disability?

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<v Speaker 1>And so the question is would you do anything about it?

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<v Speaker 1>Because if you aren't going to do anything about it,

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<v Speaker 1>then you know, we're less worried about you doing it.

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<v Speaker 1>Whereas if it's a discussion you had with your family

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<v Speaker 1>that you would not continue with the pregnancy, then it's

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<v Speaker 1>essential you have this done before thirteen and a half

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<v Speaker 1>weeks of pregnancy because.

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<v Speaker 2>There is that window to have the test. And is

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<v Speaker 2>that because there's a certain point something closes over and

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

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<v Speaker 2>have to do it in that window?

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<v Speaker 1>The NIPT has to be before, sorry, after nine weeks

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<v Speaker 1>because it's actually would you believe your baby's DNA so

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<v Speaker 1>fractions of your baby's DNA circulating in the maternal blood,

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<v Speaker 1>So you need there to be enough fractions or enough

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<v Speaker 1>and enough of the DNA circulating that they can pick

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<v Speaker 1>it up accurately. So the negative if you do it

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<v Speaker 1>at sort of nine weeks and one days, that they

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<v Speaker 1>send it back and it's not accurate, you need to

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<v Speaker 1>repeat it. The combined first tremester screen needs to be

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<v Speaker 1>between eleven weeks and thirteen weeks and six days. The

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<v Speaker 1>benefit of that blood test is also that it also

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<v Speaker 1>checks for things like your pre eclampsier risk and your

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<v Speaker 1>interuterine growth restriction risk. Now that's a bit of a wooh.

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<v Speaker 1>How do you do that from a blood test? It's

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<v Speaker 1>a combined algorithm that basically looks at your age, looks

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<v Speaker 1>at the size of the nukele thickness, some other soft

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<v Speaker 1>factors on ultrasound, combined with your beta HACG levels, your

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<v Speaker 1>papa A levels, all extra medical terms I know again,

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<v Speaker 1>but basically, some very smart people in a laboratory and

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<v Speaker 1>your sonographer combine all that information and pop out a

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<v Speaker 1>risk to say, are you at risk of having high

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<v Speaker 1>blood pressure and problems in your pregnancy? Is your baby

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<v Speaker 1>going to be small? And does your baby have a

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<v Speaker 1>disability that then you need to consider discussions about. And

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<v Speaker 1>so that's when you'll be offered by your doctor a

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<v Speaker 1>more diagnostic test like an amniocentesis to decide if there

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<v Speaker 1>really is something wrong with your baby.

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<v Speaker 2>Do you know the ratio of women who aren't declining

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

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<v Speaker 2>can make their own decisions, but in twenty twenty five

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<v Speaker 2>is a lot of people wanting to know that information.

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<v Speaker 1>I've rarely had someone say no, they may not decide

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<v Speaker 1>to pay the four hundred and ninety dollars to do

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

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<v Speaker 1>happy just to have the combined first trimester screen. Now

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<v Speaker 1>that NIPT is more sensitive, but only for things like

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<v Speaker 1>down syndrome. It is not an ultrasound. So what we

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<v Speaker 1>strongly recommend is if you decide to do that, because

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<v Speaker 1>it tells you the gender as well. And there's some

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<v Speaker 1>people actually that's a funny one. People are actually choosing

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<v Speaker 1>not to find out more. It's a total change in

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<v Speaker 1>that space. But NIPT is the earliest you can find

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<v Speaker 1>out because they can look at whether it's an XY

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

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<v Speaker 1>only specific for those things. So you've got to remember

0:09:21.629 --> 0:09:23.589
<v Speaker 1>that even if you had an NIPT, I would still

0:09:23.589 --> 0:09:28.109
<v Speaker 1>recommend getting an ultrasound because it misses things like trip loidy. Now,

0:09:28.149 --> 0:09:29.869
<v Speaker 1>I have a very close friend who had this happen.

0:09:29.949 --> 0:09:33.509
<v Speaker 1>So she had a normal NIPT, completely low risk pregnancy,

0:09:34.109 --> 0:09:35.829
<v Speaker 1>got to fourteen weeks and had an ultra sunk. She

0:09:35.869 --> 0:09:37.709
<v Speaker 1>had some spotting, and the baby was found to be

0:09:38.069 --> 0:09:42.629
<v Speaker 1>morbidly disabled and so not sustainable with life after birth,

0:09:42.709 --> 0:09:44.829
<v Speaker 1>and so she had to make a very difficult decision

0:09:44.829 --> 0:09:47.429
<v Speaker 1>to end her pregnancy, but you don't get that alone

0:09:47.429 --> 0:09:50.269
<v Speaker 1>from the NIPT. It's not diagnostic. It cannot give you

0:09:50.309 --> 0:09:53.429
<v Speaker 1>all the answers. There's also an extended screen NIPT now

0:09:53.429 --> 0:09:55.949
<v Speaker 1>which basically looks for a whole lot of chromosome alumn nomalodies.

0:09:56.549 --> 0:09:59.149
<v Speaker 1>Kind of sounds exciting and cool. There's also a lot

0:09:59.149 --> 0:10:01.429
<v Speaker 1>of positive tests that are coming back that are false positives.

0:10:01.749 --> 0:10:03.229
<v Speaker 1>And then it puts you down the pathway of if

0:10:03.269 --> 0:10:05.029
<v Speaker 1>you have to have a good discussion with your obstecution

0:10:05.149 --> 0:10:06.629
<v Speaker 1>or you're guiding at that point to decide, well, the

0:10:06.669 --> 0:10:08.629
<v Speaker 1>risk of an amnios and tesis is miscarriage in one

0:10:08.669 --> 0:10:11.629
<v Speaker 1>of two hundred risk of a miscarriage is that too much?

0:10:11.669 --> 0:10:15.149
<v Speaker 2>And amosentsis I only know this because of Gray's anatomy. Yeah,

0:10:15.229 --> 0:10:18.749
<v Speaker 2>that's where the needle goes into your uterus from like

0:10:18.789 --> 0:10:21.589
<v Speaker 2>through your stomach. Ye, And those are invasive screenings.

0:10:21.669 --> 0:10:23.829
<v Speaker 1>Faces screen. That and the CVS, which is basically the

0:10:23.869 --> 0:10:26.149
<v Speaker 1>two tests that we look at to look for disability

0:10:26.629 --> 0:10:29.469
<v Speaker 1>because they take actual cells, one from the ambniotic fluid

0:10:29.469 --> 0:10:30.589
<v Speaker 1>and one from the placental mass.

0:10:30.629 --> 0:10:32.709
<v Speaker 2>I do have questions on that, but I might talk

0:10:32.709 --> 0:10:34.869
<v Speaker 2>about that in week twelve when I actually did elect

0:10:34.949 --> 0:10:37.829
<v Speaker 2>to do NIPT and booked it in so I do

0:10:37.909 --> 0:10:40.549
<v Speaker 2>have some questions on the data that comes back, but

0:10:40.589 --> 0:10:42.069
<v Speaker 2>we'll get to that in a couple of weeks. Time

0:10:43.989 --> 0:10:49.069
<v Speaker 2>talk it. This week, mine is just snack related. It's

0:10:49.149 --> 0:10:52.349
<v Speaker 2>getting like I mentioned before, Twisti's but I just getting

0:10:52.389 --> 0:10:56.069
<v Speaker 2>like little snack snackable packets of tiny little things and

0:10:56.149 --> 0:10:58.789
<v Speaker 2>just having them and also having even though it's going

0:10:58.869 --> 0:11:01.389
<v Speaker 2>to maybe feel hard depending on what your aversions are.

0:11:01.709 --> 0:11:04.589
<v Speaker 2>Almonds were really good because they are a small source

0:11:04.589 --> 0:11:08.549
<v Speaker 2>of protein to hopefully make you if your nausea is

0:11:08.629 --> 0:11:11.469
<v Speaker 2>tied to hunger, that might push you out a little

0:11:11.469 --> 0:11:13.269
<v Speaker 2>bit longer in terms of when you need to eat

0:11:13.269 --> 0:11:13.949
<v Speaker 2>that next meal.

0:11:14.269 --> 0:11:15.509
<v Speaker 1>And that's perfect. I think having lots of them in

0:11:15.509 --> 0:11:17.509
<v Speaker 1>your bag too, because you might decide one over the other.

0:11:18.589 --> 0:11:20.789
<v Speaker 2>You might just hate one one day. I hate so

0:11:20.829 --> 0:11:22.829
<v Speaker 2>many snacks at one point, I don't know, I'm.

0:11:22.669 --> 0:11:24.469
<v Speaker 1>Like, that's snacks.

0:11:24.869 --> 0:11:28.669
<v Speaker 2>I really went back to childhood, like basic, Oh that's gold.

0:11:28.949 --> 0:11:30.869
<v Speaker 1>Buy an ice drig bottle would be mine because I

0:11:30.869 --> 0:11:33.149
<v Speaker 1>think you can regulate how much water you're taking in.

0:11:33.189 --> 0:11:35.309
<v Speaker 1>But also if you like it, it's all pretty and you know,

0:11:35.509 --> 0:11:36.069
<v Speaker 1>dope meme.

0:11:36.669 --> 0:11:38.549
<v Speaker 2>We're just yeah, you enjoy.

0:11:38.389 --> 0:11:40.029
<v Speaker 1>The enjoy the pretty botle, and then you might drinkable.

0:11:40.149 --> 0:11:41.709
<v Speaker 2>Yeah. There's not a lot of perks at the moment,

0:11:41.869 --> 0:11:43.669
<v Speaker 2>not much, not at no weeks.

0:11:43.669 --> 0:11:44.549
<v Speaker 1>It's the worst of the worst.

0:11:47.149 --> 0:11:49.309
<v Speaker 2>We hope you enjoyed this episode of Hello Bump. We

0:11:49.429 --> 0:11:52.469
<v Speaker 2>have so many episodes of this series filled with tips

0:11:52.469 --> 0:11:55.309
<v Speaker 2>and stories from women and experts who've been through it

0:11:55.349 --> 0:11:55.949
<v Speaker 2>all before.

0:11:56.309 --> 0:11:58.109
<v Speaker 1>You can go back and listen to everything else Hello

0:11:58.149 --> 0:11:59.829
<v Speaker 1>Bump related in this podcast.

0:11:59.429 --> 0:12:01.469
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0:12:03.269 --> 0:12:05.709
<v Speaker 2>a review, or even share this episode with a friend.

0:12:05.909 --> 0:12:09.029
<v Speaker 1>This episode was produced by Courtney Ammenhauser with audio production

0:12:09.109 --> 0:12:10.789
<v Speaker 1>by Tom Lyon Next Time.

0:12:10.869 --> 0:12:13.189
<v Speaker 2>This episode of Hello Bump was made in partnership with

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<v Speaker 2>Huggies Bye Bye