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Speaker 1: You're listening to a Muma Mia podcast. Mama Maya acknowledges

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Speaker 1: the traditional owners of land and waters that this podcast

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Speaker 1: is recorded on. I am pregnanty.

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Speaker 2: Welcome to Hello Bump.

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Speaker 3: We're making pregnancy less overwhelming and more manageable, hopefully.

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Speaker 2: I am Grace Rubray.

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Speaker 3: I'm pregnant for the first time and you might be

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Speaker 3: feeling like, am I still pregnant?

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Speaker 1: I'm done. I've done it six times, so I'm a

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Speaker 1: mother of six. My name's Jana Pittman. I am a

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Speaker 1: former olympian and I'm now training to be an obstetrician

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Speaker 1: and gynecologist.

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Speaker 3: Each episode will be holding your hand week by week

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Speaker 3: through the mysterious, perplexing, and sometimes long miracle that is pregnancy,

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Speaker 3: all the way from a poppy seed to a pumpkin.

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Speaker 1: Week thirty eight, What.

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Speaker 3: Size is our baby? Definitely still a large watermelon.

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Speaker 1: Yeah exactly, and just getting bigger and bigger and fatter

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Speaker 1: and cuter. A lightweight kettlebell is what I've got.

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Speaker 2: I think that's that's what it feels like.

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Speaker 3: Yeah, that's a nice visual too, feeling connection.

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Speaker 1: Yeah exactly, and you can pick it up in the gymerdation. Yeah, right,

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Speaker 1: this is what's inside me, in my placenta and all

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Speaker 1: my fluid and yea, yeah. So we're about three point

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Speaker 1: one to three point three kilos on average, But again

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Speaker 1: we are thirty eight weeks, which means some babies approaching

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Speaker 1: four kilos now and some are still down around two.

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Speaker 1: So we're very, very varied at this point in pregnancy.

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Speaker 2: A couple of.

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Speaker 3: Girls at work told me that you'll have good muscles

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Speaker 3: in your legs at this point because you're essentially carrying

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Speaker 3: around a weighted vest exactly.

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Speaker 2: I love that.

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Speaker 1: But it's also when your back starts getting a lot

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Speaker 1: of discomfort, you can get the belly belts and things

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Speaker 1: like that that if you have any sacro which basically

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Speaker 1: means pain in your sacral area in your back and

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Speaker 1: in your pubic bone, that can actually kind of support

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Speaker 1: and almost rigain that muscle strength. So if that is

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Speaker 1: a problem, that's well, you can look online and just

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Speaker 1: get something for the last couple of weeks.

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Speaker 2: And what are they developing or are they pretty much good?

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Speaker 1: They're pretty good. They're starting to make that immerconium that

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Speaker 1: baby poo that we were talking about at this point.

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Speaker 1: If they were born, they might still have a bit

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Speaker 1: of vernix, that nice white creamy stuff that helps protect

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Speaker 1: the babies in from the amniotic fluid and the acidity

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Speaker 1: in the uterus. But they're very ready to be born.

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Speaker 1: So I think from a mummy perspective, it's now about

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Speaker 1: how can we get your baby out so we can

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Speaker 1: try starting all those techniques grace around. How can we

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Speaker 1: bring about labor? Now? There's lots of old live tales

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Speaker 1: like do not drink castor oil. Guys, Like that's this

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Speaker 1: old one that my grandma told me when I was

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Speaker 1: forty weeks pregnant in my third Pregnancy's like, go and

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Speaker 1: drink the yackie oil. It is cast well one other oil.

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Speaker 1: It makes you sick, gives you diarrhea, and does not work. Okay,

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Speaker 1: there's no evidence.

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Speaker 3: This was in my tool kit, but let's bring it

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Speaker 3: up now. I want to know if these ones are correct.

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Speaker 3: Curb walking dates, raspberry leaf tea, sex, I.

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Speaker 2: Was ready for that sex, sex a glass.

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Speaker 3: Actually, a friend on the weekend said she felt so

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Speaker 3: unsexy the whole time that her pregnancy was bookended by,

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Speaker 3: like she had sex and got pregnant and then had

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Speaker 3: sex at the end and nothing in between.

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Speaker 1: You, Yeah, well, but it's very common.

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Speaker 3: These are the things that I have read of. Do

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Speaker 3: you know if any of these actually work?

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Speaker 1: Yeah, so it ras belief tea a little bit of evidence.

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Speaker 1: The strongest evidence actually is intercourse because the prostatecure land

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Speaker 1: and in seement is very similar to what we use if

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Speaker 1: we need to make your cervix soft to do an induction.

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Speaker 1: We also know that a stretch and sweep is effective.

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Speaker 1: So if you don't know what that is, and everyone's like,

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Speaker 1: what is a stretch and sweep, it is basically a

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Speaker 1: vaginal exam, very similar like you would have in labor,

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Speaker 1: and we basically feel for where your cervix is now.

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Speaker 1: It does two things. It tells us how close to

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Speaker 1: labor are you now. It's not a crystal ball. We

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Speaker 1: can't dictate exactly what it is. But if your servix

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Speaker 1: is soft and a little bit open already, that's a

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Speaker 1: great sign. And so doctors and midwives can do this.

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Speaker 1: Please don't do it yourself. I did do it to myself.

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Speaker 1: Not a great idea, okay, because I knew what I

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Speaker 1: was doing. Still wasn't a great idea. Get someone who

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Speaker 1: knows what they're doing to do it from a comfort perspective,

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Speaker 1: But what they try to do is actually try to

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Speaker 1: reach inside the cervix a little bit, stretches tiny bit

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Speaker 1: and actually literally release the membranes because obviously the amniotic

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Speaker 1: that has membranes around it from the uterus slightly. So

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Speaker 1: it's thought to sort of stimulate proteins to break down

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Speaker 1: and hopefully start labor to come on. So that is

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Speaker 1: definitely something that there's good research on to do it

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Speaker 1: one or two times from thirty eight weeks on from

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Speaker 1: this week, not before, not before thirty eight weeks, but

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Speaker 1: from thirty eight weeks onwards, you can do it one, two,

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Speaker 1: even three times a week, and there's good research that

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Speaker 1: it doesn't there's less chance of pronging and needing an

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Speaker 1: induction after forty one weeks?

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Speaker 2: Is this normal?

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Speaker 1: Normal?

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Speaker 2: Is this normal?

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Speaker 1: Is?

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Speaker 3: If you are having an elective cesarean and you already

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Speaker 3: know that that's what you're having, what can you be

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Speaker 3: doing at this point to prepare? And I guess does

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Speaker 3: it change things you've had caesareans as well?

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Speaker 1: Happen? Are you?

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Speaker 2: Who?

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Speaker 1: Yes?

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Speaker 3: But I guess what's the headspace when you're when you're

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Speaker 3: talking to your patients then around knowing the exact date.

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Speaker 1: They know the birth date well sometimes because babies have

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Speaker 1: a habit of coming before they had booked caesarean dates.

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Speaker 1: So in most cases for an elective cesarian section. Now

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Speaker 1: I remember that the Australian rates of cesarians are at

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Speaker 1: around forty forty two percent, depending if it's public or

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Speaker 1: private hospital. I think it's important to remember that between

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Speaker 1: twenty five and twenty eight percent of labors will actually

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Speaker 1: end up with a cesarean in first time mums, a

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Speaker 1: bit less in subsequent who's had previous vaginal births. So

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Speaker 1: that's quite a high rate. And I certainly talk to

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Speaker 1: a lot women who bok an elective cesarian section. It

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Speaker 1: might because their baby's a little bit bigger, it might

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Speaker 1: be because they've had a previous bad birth, or often

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Speaker 1: it is that anxiety around well, if I'm gonna have

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Speaker 1: if I've got a twenty five percent chance of caesarian anyway,

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Speaker 1: I'd prefer to planet no my date, organized my childcare,

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Speaker 1: organize my family, my support system I don't have. There's

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Speaker 1: lots of reasons why women make that decision. Now, if

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Speaker 1: you're only having one baby, it's a great decision guys,

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Speaker 1: because there's the risk of a cesarean section largely is

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Speaker 1: around the subsequent pregnancies. The first one, what we call

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Speaker 1: a virgin abdomen, is very easy, even that very junior

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Speaker 1: registrars are allowed to do the first time cesarean sections

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Speaker 1: because there's nothing there that's a concern. It's whip baby

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Speaker 1: comes out so back together and it's quite a simple,

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Speaker 1: simple surgery. But scarring and things can cause problems for

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Speaker 1: future pregnancies, as can the scar on the uterus for

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Speaker 1: labor can break apart. So the risk is actually, if

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Speaker 1: you want five or six kids, an elective cesarian is

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Speaker 1: probably not the best choice. But as you know, we

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Speaker 1: do lots of vaginal births after cesarean sections in Australia,

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Speaker 1: particularly my hospital. We've got lots and lots of ladies

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Speaker 1: having bebacks because we know it is safe with monitoring

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Speaker 1: and the right sort of decisions and spontaneous labor for

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Speaker 1: the subsequent one.

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Speaker 3: If people are feeling nervous about their sea section, the

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Speaker 3: only thing that I know about it is that it

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Speaker 3: is quite quick from when you're rolled in.

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Speaker 2: This is true about fifteen minutes. Can you talk us

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Speaker 2: through you.

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Speaker 1: Mean the baby comes out.

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Speaker 3: In here, the baby comes out, but then there's being

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Speaker 3: sewn up.

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Speaker 2: Can you in maybe like a Graz's anatomy version where.

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Speaker 1: It's not too much, not too hotel.

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Speaker 3: Of what is actually going to happen to I guess

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Speaker 3: dispel the if people haven't been in an operating room

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Speaker 3: like I have, and it is terrifying.

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Speaker 2: What are we going to see and what's going to point.

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Speaker 1: Lots of people. Okay, so it's a busy space, it's

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Speaker 1: very bright lights. You can still have your music, you

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Speaker 1: can still have your support partner like. It can be

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Speaker 1: a very beautiful situation. I've done two maternally assisted cesarians too,

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Speaker 1: which were just gorgeous, where the mum took the baby

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Speaker 1: straight off me like as it helped me birth the

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Speaker 1: baby onto her, which was wonderful.

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Speaker 2: I think she could lean forward.

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Speaker 1: Yeah, so basically as soon as yeah, not for everyone,

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Speaker 1: but really beautiful for me. It was one of the

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Speaker 1: most beautiful births I've been in because the mum wasn't

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Speaker 1: appropriate for a vaginal birth and she was very keen

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Speaker 1: to be part of the delivery process, and so as

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Speaker 1: soon as the little one head came through, I basically

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Speaker 1: reached forward and then she was able to sort of

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Speaker 1: assist the birth on to her, and that means baby

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Speaker 1: went director mum to breast and all that kind of stuff.

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Speaker 1: So there's lots of different ways and means of how

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Speaker 1: they go ahead, but you basically come in at six

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Speaker 1: o'clock in the morning, no food. They have a dual

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Speaker 1: chat with you. I usually or whoever's coming and doing

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Speaker 1: the surgery comes and says hello. Then they will you

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Speaker 1: downstairs or walk you downstairs? You lie down. They pop

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Speaker 1: an epidural in your back most of the time and

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Speaker 1: providing that covers you well enough, you're awake for the

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Speaker 1: whole thing. You're right. We basically test your tummy. We

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Speaker 1: pop an eye DC so test that you can't feel anything.

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Speaker 1: So it's nice and that's good. Yes, that's good.

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Speaker 2: You want that, great?

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Speaker 1: You want that. They pop a little catherin in your bladder.

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Speaker 1: So that's the only thing that a lot of women

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Speaker 1: don't know, but that comes out the next dates because

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Speaker 1: you won't be able to walk around in the afternoon.

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Speaker 1: Dumb question is that through the in through the urethras

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Speaker 1: so basically it just below the glitterists where where you're

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Speaker 1: we from. You pop a little catheter in there, and

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Speaker 1: then the surgery starts and you're right for a first time, Caesar,

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Speaker 1: if you've not had previous scarring or no other surgery

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Speaker 1: on your own abdomen in the past. I mean, we've

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Speaker 1: had babies come out in three or four minutes, but

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Speaker 1: it's usually about ten and bubbies out and then from

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Speaker 1: there you don't really remember the rest because you're so beautiful,

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Speaker 1: you know, mixed up with your beautiful little human. But

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Speaker 1: it takes about, depending on skill set, between you know,

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Speaker 1: twenty and fifty minutes to close up from there.

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Speaker 2: What do you do if people get anxious?

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Speaker 3: Like I sort of said last episode that I worry

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Speaker 3: that I would get panicky, There's.

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Speaker 1: Lots of things. So we're a team. So in the

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Speaker 1: birth unit, they'll be me and an assistant, So the

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Speaker 1: primary surgeon and an assistant. There'll be an anesthetic doctor

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Speaker 1: and his assistant. There'll be a scrub nurse and nurse

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Speaker 1: holding and giving me the instruments and things, and there'll

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Speaker 1: be also another nurse in the room just to help out.

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Speaker 1: So there is seven or eight people in there, and

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Speaker 1: I think it's something that people don't expect, So it

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Speaker 1: is to be aware of you're all very modestly covered up.

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Speaker 1: There is a mix of male and female in the room. Often,

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Speaker 1: quite often the birth theme is women these days, because

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Speaker 1: it's a lot of eighty percent of training obstritions in

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Speaker 1: our female And the anesthetic doctor will give you something

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Speaker 1: for those nerves if required, they'll give you something for

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Speaker 1: that nause And that's one thing I do think that

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Speaker 1: people don't know about. It is regularly you get nauseous in

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Speaker 1: a in a caesarean section. Firstly because the anesthetic medication

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Speaker 1: can make you feel a bit sick, and secondly because

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Speaker 1: sorry guys, but we are rummaging around in your tummy

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Speaker 1: a little bit, so it's a really lovely opportunity to

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Speaker 1: check your ovaries and and and obviously the uterus is

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Speaker 1: being moved around when we're bringing baby out. So please

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Speaker 1: be aware that commonly someone feels a bit anxious and

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Speaker 1: a bit nervous and often gets.

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Speaker 3: Nauseous, nauseous to the point of vomiting. Regularly, you vomit

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Speaker 3: when half of you is numb.

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Speaker 1: And it just moves and then we pause. Your whole

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Speaker 1: body vomits up because you're only you're not You're not

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Speaker 1: numb from the like, you're only you don't want to

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Speaker 1: if you grace, if we numbed you to the top

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Speaker 1: of your neck, you wouldn't breathe, darling, So it has to.

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Speaker 3: Be don't understand medicine. You are you are, you are medicine.

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Speaker 3: I am curiosity.

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Speaker 1: You're the fund in our relationship. But no so from

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Speaker 1: the you can but you can still high rotate to

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Speaker 1: like vomit into it a bag. Okay, you can move

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Speaker 1: your whole upper body, your whole arms and hands are

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Speaker 1: free of your boobs up work.

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Speaker 2: The videos of the photos of like, you've got your arms.

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Speaker 1: Are board, you don't have to No, you've got your

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Speaker 1: arms are on the boards at all. That's only if

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Speaker 1: you're asleep. Okay, yeah, now, and I want to be

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Speaker 1: just one last thing in this space is that some

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Speaker 1: women do decide to have a general anesthetic to go

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Speaker 1: to sleep again. That comes around anxiety. So if you

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Speaker 1: are truly nervous about that space, that is actually an option.

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Speaker 1: You don't have to be awake for the birth of

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Speaker 1: your baby. Most people choose to be, but you don't

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Speaker 1: have to.

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Speaker 3: If there is a partner who is feeling nervous, could

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Speaker 3: you please share how many birth partners you've seen who

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Speaker 3: have either vomited or passed out?

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Speaker 1: Oh gosh, I'd say ten percent. Okay, it's quite high,

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Speaker 1: and it's just being aware of which ones are going

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Speaker 1: to do that, and some of the spotted we can

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Speaker 1: spot it, yes, straight away. It's great, and most of

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Speaker 1: them know. To be honest, most of them know, I mean,

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Speaker 1: but to be honest, in the vast majority of them,

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Speaker 1: even the ones that expect they're going to are so

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Speaker 1: overwhelmed by the love and the tears that come when

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Speaker 1: their baby arrives, and how incredibly impressed with their with

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Speaker 1: their partner they are, that they forget that they're going

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Speaker 1: to be nauseous, so they forget that it's going to

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Speaker 1: be difficult, and they're just so wrapped up in.

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Speaker 2: The situation, all that anticipation, all that.

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Speaker 1: Anticipation, and that's why I think you've got to remember

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Speaker 1: there's going to be the positives out of it as

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Speaker 1: well as not all daire.

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

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Speaker 3: We have so many episodes of this series filled with

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Speaker 3: tips and stories from women and experts who've been through

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Speaker 3: it all.

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Speaker 2: 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 feed.

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Speaker 3: And while you're there, we'd love if you could give

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Speaker 3: us a five star rating and maybe leave us a

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Speaker 3: review or even shared 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 We'll catch you next time.

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Speaker 3: This episode of Hello Bump was made in partnership with

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Speaker 3: Huggies Bye Bye