Speaker 1: You're listening to a Muma Mia podcast. Mama Maya acknowledges
Speaker 1: the traditional owners of land and waters that this podcast
Speaker 1: is recorded on. I am pregnanty.
Speaker 2: Welcome to Hello Bump.
Speaker 3: We're making pregnancy less overwhelming and more manageable, hopefully.
Speaker 2: I am Grace Rubray.
Speaker 3: I'm pregnant for the first time and you might be
Speaker 3: feeling like, am I still pregnant?
Speaker 1: I'm done. I've done it six times, so I'm a
Speaker 1: mother of six. My name's Jana Pittman. I am a
Speaker 1: former olympian and I'm now training to be an obstetrician
Speaker 1: and gynecologist.
Speaker 3: Each episode will be holding your hand week by week
Speaker 3: through the mysterious, perplexing, and sometimes long miracle that is pregnancy,
Speaker 3: all the way from a poppy seed to a pumpkin.
Speaker 1: Week thirty eight, What.
Speaker 3: Size is our baby? Definitely still a large watermelon.
Speaker 1: Yeah exactly, and just getting bigger and bigger and fatter
Speaker 1: and cuter. A lightweight kettlebell is what I've got.
Speaker 2: I think that's that's what it feels like.
Speaker 3: Yeah, that's a nice visual too, feeling connection.
Speaker 1: Yeah exactly, and you can pick it up in the gymerdation. Yeah, right,
Speaker 1: this is what's inside me, in my placenta and all
Speaker 1: my fluid and yea, yeah. So we're about three point
Speaker 1: one to three point three kilos on average, But again
Speaker 1: we are thirty eight weeks, which means some babies approaching
Speaker 1: four kilos now and some are still down around two.
Speaker 1: So we're very, very varied at this point in pregnancy.
Speaker 2: A couple of.
Speaker 3: Girls at work told me that you'll have good muscles
Speaker 3: in your legs at this point because you're essentially carrying
Speaker 3: around a weighted vest exactly.
Speaker 2: I love that.
Speaker 1: But it's also when your back starts getting a lot
Speaker 1: of discomfort, you can get the belly belts and things
Speaker 1: like that that if you have any sacro which basically
Speaker 1: means pain in your sacral area in your back and
Speaker 1: in your pubic bone, that can actually kind of support
Speaker 1: and almost rigain that muscle strength. So if that is
Speaker 1: a problem, that's well, you can look online and just
Speaker 1: get something for the last couple of weeks.
Speaker 2: And what are they developing or are they pretty much good?
Speaker 1: They're pretty good. They're starting to make that immerconium that
Speaker 1: baby poo that we were talking about at this point.
Speaker 1: If they were born, they might still have a bit
Speaker 1: of vernix, that nice white creamy stuff that helps protect
Speaker 1: the babies in from the amniotic fluid and the acidity
Speaker 1: in the uterus. But they're very ready to be born.
Speaker 1: So I think from a mummy perspective, it's now about
Speaker 1: how can we get your baby out so we can
Speaker 1: try starting all those techniques grace around. How can we
Speaker 1: bring about labor? Now? There's lots of old live tales
Speaker 1: like do not drink castor oil. Guys, Like that's this
Speaker 1: old one that my grandma told me when I was
Speaker 1: forty weeks pregnant in my third Pregnancy's like, go and
Speaker 1: drink the yackie oil. It is cast well one other oil.
Speaker 1: It makes you sick, gives you diarrhea, and does not work. Okay,
Speaker 1: there's no evidence.
Speaker 3: This was in my tool kit, but let's bring it
Speaker 3: up now. I want to know if these ones are correct.
Speaker 3: Curb walking dates, raspberry leaf tea, sex, I.
Speaker 2: Was ready for that sex, sex a glass.
Speaker 3: Actually, a friend on the weekend said she felt so
Speaker 3: unsexy the whole time that her pregnancy was bookended by,
Speaker 3: like she had sex and got pregnant and then had
Speaker 3: sex at the end and nothing in between.
Speaker 1: You, Yeah, well, but it's very common.
Speaker 3: These are the things that I have read of. Do
Speaker 3: you know if any of these actually work?
Speaker 1: Yeah, so it ras belief tea a little bit of evidence.
Speaker 1: The strongest evidence actually is intercourse because the prostatecure land
Speaker 1: and in seement is very similar to what we use if
Speaker 1: we need to make your cervix soft to do an induction.
Speaker 1: We also know that a stretch and sweep is effective.
Speaker 1: So if you don't know what that is, and everyone's like,
Speaker 1: what is a stretch and sweep, it is basically a
Speaker 1: vaginal exam, very similar like you would have in labor,
Speaker 1: and we basically feel for where your cervix is now.
Speaker 1: It does two things. It tells us how close to
Speaker 1: labor are you now. It's not a crystal ball. We
Speaker 1: can't dictate exactly what it is. But if your servix
Speaker 1: is soft and a little bit open already, that's a
Speaker 1: great sign. And so doctors and midwives can do this.
Speaker 1: Please don't do it yourself. I did do it to myself.
Speaker 1: Not a great idea, okay, because I knew what I
Speaker 1: was doing. Still wasn't a great idea. Get someone who
Speaker 1: knows what they're doing to do it from a comfort perspective,
Speaker 1: But what they try to do is actually try to
Speaker 1: reach inside the cervix a little bit, stretches tiny bit
Speaker 1: and actually literally release the membranes because obviously the amniotic
Speaker 1: that has membranes around it from the uterus slightly. So
Speaker 1: it's thought to sort of stimulate proteins to break down
Speaker 1: and hopefully start labor to come on. So that is
Speaker 1: definitely something that there's good research on to do it
Speaker 1: one or two times from thirty eight weeks on from
Speaker 1: this week, not before, not before thirty eight weeks, but
Speaker 1: from thirty eight weeks onwards, you can do it one, two,
Speaker 1: even three times a week, and there's good research that
Speaker 1: it doesn't there's less chance of pronging and needing an
Speaker 1: induction after forty one weeks?
Speaker 2: Is this normal?
Speaker 1: Normal?
Speaker 2: Is this normal?
Speaker 1: Is?
Speaker 3: If you are having an elective cesarean and you already
Speaker 3: know that that's what you're having, what can you be
Speaker 3: doing at this point to prepare? And I guess does
Speaker 3: it change things you've had caesareans as well?
Speaker 1: Happen? Are you?
Speaker 2: Who?
Speaker 1: Yes?
Speaker 3: But I guess what's the headspace when you're when you're
Speaker 3: talking to your patients then around knowing the exact date.
Speaker 1: They know the birth date well sometimes because babies have
Speaker 1: a habit of coming before they had booked caesarean dates.
Speaker 1: So in most cases for an elective cesarian section. Now
Speaker 1: I remember that the Australian rates of cesarians are at
Speaker 1: around forty forty two percent, depending if it's public or
Speaker 1: private hospital. I think it's important to remember that between
Speaker 1: twenty five and twenty eight percent of labors will actually
Speaker 1: end up with a cesarean in first time mums, a
Speaker 1: bit less in subsequent who's had previous vaginal births. So
Speaker 1: that's quite a high rate. And I certainly talk to
Speaker 1: a lot women who bok an elective cesarian section. It
Speaker 1: might because their baby's a little bit bigger, it might
Speaker 1: be because they've had a previous bad birth, or often
Speaker 1: it is that anxiety around well, if I'm gonna have
Speaker 1: if I've got a twenty five percent chance of caesarian anyway,
Speaker 1: I'd prefer to planet no my date, organized my childcare,
Speaker 1: organize my family, my support system I don't have. There's
Speaker 1: lots of reasons why women make that decision. Now, if
Speaker 1: you're only having one baby, it's a great decision guys,
Speaker 1: because there's the risk of a cesarean section largely is
Speaker 1: around the subsequent pregnancies. The first one, what we call
Speaker 1: a virgin abdomen, is very easy, even that very junior
Speaker 1: registrars are allowed to do the first time cesarean sections
Speaker 1: because there's nothing there that's a concern. It's whip baby
Speaker 1: comes out so back together and it's quite a simple,
Speaker 1: simple surgery. But scarring and things can cause problems for
Speaker 1: future pregnancies, as can the scar on the uterus for
Speaker 1: labor can break apart. So the risk is actually, if
Speaker 1: you want five or six kids, an elective cesarian is
Speaker 1: probably not the best choice. But as you know, we
Speaker 1: do lots of vaginal births after cesarean sections in Australia,
Speaker 1: particularly my hospital. We've got lots and lots of ladies
Speaker 1: having bebacks because we know it is safe with monitoring
Speaker 1: and the right sort of decisions and spontaneous labor for
Speaker 1: the subsequent one.
Speaker 3: If people are feeling nervous about their sea section, the
Speaker 3: only thing that I know about it is that it
Speaker 3: is quite quick from when you're rolled in.
Speaker 2: This is true about fifteen minutes. Can you talk us
Speaker 2: through you.
Speaker 1: Mean the baby comes out.
Speaker 3: In here, the baby comes out, but then there's being
Speaker 3: sewn up.
Speaker 2: Can you in maybe like a Graz's anatomy version where.
Speaker 1: It's not too much, not too hotel.
Speaker 3: Of what is actually going to happen to I guess
Speaker 3: dispel the if people haven't been in an operating room
Speaker 3: like I have, and it is terrifying.
Speaker 2: What are we going to see and what's going to point.
Speaker 1: Lots of people. Okay, so it's a busy space, it's
Speaker 1: very bright lights. You can still have your music, you
Speaker 1: can still have your support partner like. It can be
Speaker 1: a very beautiful situation. I've done two maternally assisted cesarians too,
Speaker 1: which were just gorgeous, where the mum took the baby
Speaker 1: straight off me like as it helped me birth the
Speaker 1: baby onto her, which was wonderful.
Speaker 2: I think she could lean forward.
Speaker 1: Yeah, so basically as soon as yeah, not for everyone,
Speaker 1: but really beautiful for me. It was one of the
Speaker 1: most beautiful births I've been in because the mum wasn't
Speaker 1: appropriate for a vaginal birth and she was very keen
Speaker 1: to be part of the delivery process, and so as
Speaker 1: soon as the little one head came through, I basically
Speaker 1: reached forward and then she was able to sort of
Speaker 1: assist the birth on to her, and that means baby
Speaker 1: went director mum to breast and all that kind of stuff.
Speaker 1: So there's lots of different ways and means of how
Speaker 1: they go ahead, but you basically come in at six
Speaker 1: o'clock in the morning, no food. They have a dual
Speaker 1: chat with you. I usually or whoever's coming and doing
Speaker 1: the surgery comes and says hello. Then they will you
Speaker 1: downstairs or walk you downstairs? You lie down. They pop
Speaker 1: an epidural in your back most of the time and
Speaker 1: providing that covers you well enough, you're awake for the
Speaker 1: whole thing. You're right. We basically test your tummy. We
Speaker 1: pop an eye DC so test that you can't feel anything.
Speaker 1: So it's nice and that's good. Yes, that's good.
Speaker 2: You want that, great?
Speaker 1: You want that. They pop a little catherin in your bladder.
Speaker 1: So that's the only thing that a lot of women
Speaker 1: don't know, but that comes out the next dates because
Speaker 1: you won't be able to walk around in the afternoon.
Speaker 1: Dumb question is that through the in through the urethras
Speaker 1: so basically it just below the glitterists where where you're
Speaker 1: we from. You pop a little catheter in there, and
Speaker 1: then the surgery starts and you're right for a first time, Caesar,
Speaker 1: if you've not had previous scarring or no other surgery
Speaker 1: on your own abdomen in the past. I mean, we've
Speaker 1: had babies come out in three or four minutes, but
Speaker 1: it's usually about ten and bubbies out and then from
Speaker 1: there you don't really remember the rest because you're so beautiful,
Speaker 1: you know, mixed up with your beautiful little human. But
Speaker 1: it takes about, depending on skill set, between you know,
Speaker 1: twenty and fifty minutes to close up from there.
Speaker 2: What do you do if people get anxious?
Speaker 3: Like I sort of said last episode that I worry
Speaker 3: that I would get panicky, There's.
Speaker 1: Lots of things. So we're a team. So in the
Speaker 1: birth unit, they'll be me and an assistant, So the
Speaker 1: primary surgeon and an assistant. There'll be an anesthetic doctor
Speaker 1: and his assistant. There'll be a scrub nurse and nurse
Speaker 1: holding and giving me the instruments and things, and there'll
Speaker 1: be also another nurse in the room just to help out.
Speaker 1: So there is seven or eight people in there, and
Speaker 1: I think it's something that people don't expect, So it
Speaker 1: is to be aware of you're all very modestly covered up.
Speaker 1: There is a mix of male and female in the room. Often,
Speaker 1: quite often the birth theme is women these days, because
Speaker 1: it's a lot of eighty percent of training obstritions in
Speaker 1: our female And the anesthetic doctor will give you something
Speaker 1: for those nerves if required, they'll give you something for
Speaker 1: that nause And that's one thing I do think that
Speaker 1: people don't know about. It is regularly you get nauseous in
Speaker 1: a in a caesarean section. Firstly because the anesthetic medication
Speaker 1: can make you feel a bit sick, and secondly because
Speaker 1: sorry guys, but we are rummaging around in your tummy
Speaker 1: a little bit, so it's a really lovely opportunity to
Speaker 1: check your ovaries and and and obviously the uterus is
Speaker 1: being moved around when we're bringing baby out. So please
Speaker 1: be aware that commonly someone feels a bit anxious and
Speaker 1: a bit nervous and often gets.
Speaker 3: Nauseous, nauseous to the point of vomiting. Regularly, you vomit
Speaker 3: when half of you is numb.
Speaker 1: And it just moves and then we pause. Your whole
Speaker 1: body vomits up because you're only you're not You're not
Speaker 1: numb from the like, you're only you don't want to
Speaker 1: if you grace, if we numbed you to the top
Speaker 1: of your neck, you wouldn't breathe, darling, So it has to.
Speaker 3: Be don't understand medicine. You are you are, you are medicine.
Speaker 3: I am curiosity.
Speaker 1: You're the fund in our relationship. But no so from
Speaker 1: the you can but you can still high rotate to
Speaker 1: like vomit into it a bag. Okay, you can move
Speaker 1: your whole upper body, your whole arms and hands are
Speaker 1: free of your boobs up work.
Speaker 2: The videos of the photos of like, you've got your arms.
Speaker 1: Are board, you don't have to No, you've got your
Speaker 1: arms are on the boards at all. That's only if
Speaker 1: you're asleep. Okay, yeah, now, and I want to be
Speaker 1: just one last thing in this space is that some
Speaker 1: women do decide to have a general anesthetic to go
Speaker 1: to sleep again. That comes around anxiety. So if you
Speaker 1: are truly nervous about that space, that is actually an option.
Speaker 1: You don't have to be awake for the birth of
Speaker 1: your baby. Most people choose to be, but you don't
Speaker 1: have to.
Speaker 3: If there is a partner who is feeling nervous, could
Speaker 3: you please share how many birth partners you've seen who
Speaker 3: have either vomited or passed out?
Speaker 1: Oh gosh, I'd say ten percent. Okay, it's quite high,
Speaker 1: and it's just being aware of which ones are going
Speaker 1: to do that, and some of the spotted we can
Speaker 1: spot it, yes, straight away. It's great, and most of
Speaker 1: them know. To be honest, most of them know, I mean,
Speaker 1: but to be honest, in the vast majority of them,
Speaker 1: even the ones that expect they're going to are so
Speaker 1: overwhelmed by the love and the tears that come when
Speaker 1: their baby arrives, and how incredibly impressed with their with
Speaker 1: their partner they are, that they forget that they're going
Speaker 1: to be nauseous, so they forget that it's going to
Speaker 1: be difficult, and they're just so wrapped up in.
Speaker 2: The situation, all that anticipation, all that.
Speaker 1: Anticipation, and that's why I think you've got to remember
Speaker 1: there's going to be the positives out of it as
Speaker 1: well as not all daire.
Speaker 2: We hope you enjoyed this episode of Hello Bump.
Speaker 3: We have so many episodes of this series filled with
Speaker 3: tips and stories from women and experts who've been through
Speaker 3: it all.
Speaker 2: Before.
Speaker 1: You can go back and listen to everything else Hello
Speaker 1: Bump related in this podcast feed.
Speaker 3: And while you're there, we'd love if you could give
Speaker 3: us a five star rating and maybe leave us a
Speaker 3: review or even shared this episode with a friend.
Speaker 1: This episode was produced by Courtney Ammenhauser with audio production
Speaker 1: by Tom Lyon We'll catch you next time.
Speaker 3: This episode of Hello Bump was made in partnership with
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