1 00:00:03,720 --> 00:00:06,800 Speaker 1: Welcome to the kick your Expert led podcast, helping you 2 00:00:06,920 --> 00:00:10,880 Speaker 1: explore and learn everything about getting pregnant, pregnancy, birth, and 3 00:00:10,920 --> 00:00:11,719 Speaker 1: becoming a parent. 4 00:00:12,080 --> 00:00:15,880 Speaker 2: On the podcast and our online pregnancy program grow My Baby, 5 00:00:16,000 --> 00:00:19,800 Speaker 2: we share my experience of helping more than four thousand babies. 6 00:00:19,400 --> 00:00:22,000 Speaker 1: To be born, and our experience of running a women's 7 00:00:22,040 --> 00:00:23,960 Speaker 1: health clinic and parenting for boys. 8 00:00:24,200 --> 00:00:27,200 Speaker 2: We're here to help everyone to feel empowered in pregnancy 9 00:00:27,320 --> 00:00:30,160 Speaker 2: and birth with real life, practical information. 10 00:00:32,520 --> 00:00:34,720 Speaker 1: Welcome everyone. N I'm Bridgid Maloney. 11 00:00:34,320 --> 00:00:36,840 Speaker 2: And I'm obstatrician doctor Patrick Maloney. 12 00:00:36,560 --> 00:00:39,800 Speaker 1: And today we're actually recording on a super special day 13 00:00:40,880 --> 00:00:42,199 Speaker 1: our annual calendar. 14 00:00:42,440 --> 00:00:46,480 Speaker 2: It is St Patrick's Day. Nay, it's our. 15 00:00:46,400 --> 00:00:50,600 Speaker 1: Wedding anniversary, which is hilarious because my maiden name's O'Sullivan 16 00:00:50,680 --> 00:00:54,440 Speaker 1: and I'm married to Maloney on Saint Patrick's Day. Pat, 17 00:00:54,440 --> 00:00:56,480 Speaker 1: I thought we could just share with our listeners something 18 00:00:56,520 --> 00:01:00,040 Speaker 1: about our wedding day, and I thought I'd ask you 19 00:01:00,880 --> 00:01:05,680 Speaker 1: what was your favorite most memorable thing that happened on 20 00:01:05,680 --> 00:01:07,039 Speaker 1: your wedding day, apart from marrying me? 21 00:01:07,720 --> 00:01:11,000 Speaker 2: Yes, well, I remember one funny thing that happened. We 22 00:01:11,000 --> 00:01:13,800 Speaker 2: had a very fancy caterer and they were they made 23 00:01:13,800 --> 00:01:16,160 Speaker 2: a least beautiful little entrees. 24 00:01:16,680 --> 00:01:17,960 Speaker 1: It was a feast, wasn't it? 25 00:01:18,000 --> 00:01:23,880 Speaker 2: Absolute absolute face of really good, really really good food. 26 00:01:24,240 --> 00:01:29,560 Speaker 2: And one of the little or dervs was was called 27 00:01:30,160 --> 00:01:33,640 Speaker 2: steak and chips or something astrac It had a little 28 00:01:33,720 --> 00:01:35,760 Speaker 2: tiny piece of beef and started and a little wafer 29 00:01:35,760 --> 00:01:38,600 Speaker 2: of potato. And I went over to the kids table 30 00:01:39,200 --> 00:01:41,120 Speaker 2: and I said, to the kids, you're having someone to 31 00:01:41,160 --> 00:01:42,959 Speaker 2: eat and they said, no, no, we're waiting for the 32 00:01:43,000 --> 00:01:47,319 Speaker 2: steaken chips. I said, I think that was it. 33 00:01:47,319 --> 00:01:49,240 Speaker 1: It was more of a homage. 34 00:01:48,960 --> 00:01:51,240 Speaker 2: Homage to steak and chips, which I said to them, 35 00:01:51,280 --> 00:01:53,440 Speaker 2: I said, I think it was more homage to steak 36 00:01:53,440 --> 00:01:57,640 Speaker 2: and chips. And I've never seen more blank faces like 37 00:01:58,040 --> 00:02:02,120 Speaker 2: shut up, I'm still for the stone here. 38 00:02:02,200 --> 00:02:04,360 Speaker 1: Yeah, And we're like, oh what the quail wasn't enough? No, 39 00:02:04,920 --> 00:02:08,520 Speaker 1: it was very very fancy food, all right. My not 40 00:02:08,600 --> 00:02:13,280 Speaker 1: that you asked, but my favorite, my favorite memory I 41 00:02:13,440 --> 00:02:15,760 Speaker 1: got so many from our wedding. It was just such 42 00:02:15,880 --> 00:02:20,680 Speaker 1: a beautiful wedding. And for listeners, first time listeners, it 43 00:02:20,800 --> 00:02:23,120 Speaker 1: was my second time round, and I didn't think I 44 00:02:23,120 --> 00:02:25,079 Speaker 1: would enjoy I know, I knew I would enjoy it, 45 00:02:25,120 --> 00:02:29,800 Speaker 1: but I just didn't. I didn't think that, like you know, 46 00:02:29,880 --> 00:02:33,080 Speaker 1: it was so different, so so much love in the room. Anyway. 47 00:02:34,240 --> 00:02:38,200 Speaker 1: One of the things also that listeners may or may 48 00:02:38,200 --> 00:02:41,480 Speaker 1: not know was I was five months pregnant and so 49 00:02:41,639 --> 00:02:47,400 Speaker 1: I was the only non drunk person in the room 50 00:02:47,880 --> 00:02:50,960 Speaker 1: and we were in this venue that actually didn't have 51 00:02:51,000 --> 00:02:53,280 Speaker 1: an end point, So we were still dancing at four 52 00:02:53,320 --> 00:02:57,440 Speaker 1: am in the morning, and as a five month pregnant woman, 53 00:02:57,480 --> 00:02:59,919 Speaker 1: I was still dancing. I'm very proud of myself. Yeah, 54 00:03:00,200 --> 00:03:02,720 Speaker 1: So as the only sober person in the room, I 55 00:03:02,760 --> 00:03:04,960 Speaker 1: not only had to lock up, but I had to 56 00:03:04,960 --> 00:03:08,600 Speaker 1: get our DJ back to Melbourne and ordering him a 57 00:03:08,600 --> 00:03:11,120 Speaker 1: cab because he had no way of getting back to Melbourne. 58 00:03:11,120 --> 00:03:13,760 Speaker 1: And he just sat plank on the steps of the 59 00:03:13,960 --> 00:03:16,920 Speaker 1: venue saying, well, lady, I don't know what you're going 60 00:03:17,000 --> 00:03:18,320 Speaker 1: to do about it, but I got to get back 61 00:03:18,320 --> 00:03:23,720 Speaker 1: to Melbourne. But my most favorite was saying good bye everybody. 62 00:03:23,800 --> 00:03:26,160 Speaker 1: Then you and I are going to the fancy Craig's 63 00:03:26,480 --> 00:03:31,160 Speaker 1: Royal Hotel at four am, and you giggling and you 64 00:03:31,280 --> 00:03:35,200 Speaker 1: not being able to take your own shoes off. So 65 00:03:35,280 --> 00:03:38,120 Speaker 1: I'm gosh, I hope this isn't the sign of things 66 00:03:38,120 --> 00:03:41,600 Speaker 1: to come here, I am four am, five months pregnant 67 00:03:41,600 --> 00:03:45,560 Speaker 1: and untying your shoelaces while you're giggling. It was honestly 68 00:03:45,720 --> 00:03:48,720 Speaker 1: one of my real joys that I just still keep 69 00:03:48,720 --> 00:03:50,040 Speaker 1: that memory very close. 70 00:03:49,880 --> 00:03:51,240 Speaker 2: A very very happy day. 71 00:03:51,640 --> 00:03:56,480 Speaker 1: So today, Patty, we want to talk about and share 72 00:03:57,320 --> 00:04:00,920 Speaker 1: Jesse from Muma Mia, her story of a twins. 73 00:04:01,440 --> 00:04:01,720 Speaker 2: Yes. 74 00:04:02,160 --> 00:04:06,600 Speaker 1: Now, we have done stories before that we've moderated, which 75 00:04:06,600 --> 00:04:11,000 Speaker 1: has been great, and we know that stories about birth 76 00:04:11,040 --> 00:04:14,200 Speaker 1: are so popular. People love listening to stories about birth, 77 00:04:14,920 --> 00:04:19,360 Speaker 1: and we don't tend to do many because yeah, that's 78 00:04:19,400 --> 00:04:22,719 Speaker 1: the domain of other podcasts, but we try to do 79 00:04:22,880 --> 00:04:28,640 Speaker 1: educational content. Yes, And stories are a personal account. 80 00:04:28,839 --> 00:04:31,760 Speaker 2: Yes, and that's fine. A personal account is fine, And 81 00:04:31,800 --> 00:04:34,960 Speaker 2: to listen to the story purely because it's interesting or 82 00:04:35,080 --> 00:04:38,400 Speaker 2: entertaining is also fine. But we try and pull the 83 00:04:38,520 --> 00:04:41,560 Speaker 2: educational gems out of the stories that we hear so 84 00:04:41,560 --> 00:04:43,120 Speaker 2: that we can use that for teaching. 85 00:04:43,360 --> 00:04:46,320 Speaker 1: Yeah, and so there's a couple of those in Jesse's story. 86 00:04:46,320 --> 00:04:48,520 Speaker 1: I'm going to give a bit of background. So Jesse 87 00:04:48,680 --> 00:04:53,240 Speaker 1: and Luca are expecting their second baby, which happens to 88 00:04:53,240 --> 00:04:57,800 Speaker 1: be babies. It's a twin pregnancy and She's been sharing 89 00:04:57,800 --> 00:05:00,600 Speaker 1: it on the out Loud podcast the whole time, so 90 00:05:00,600 --> 00:05:03,080 Speaker 1: people has just been waiting with baited breath, how she's 91 00:05:03,080 --> 00:05:07,240 Speaker 1: going to have these babies, these twins. And she tells 92 00:05:07,279 --> 00:05:10,599 Speaker 1: her story on the out Loud podcast, and I thoroughly 93 00:05:10,640 --> 00:05:12,920 Speaker 1: recommend you go and have a listen, and then come 94 00:05:12,960 --> 00:05:15,360 Speaker 1: and have a listen to this, and then you can say, oh, 95 00:05:15,400 --> 00:05:17,680 Speaker 1: what did that actually mean. So we're going to pick 96 00:05:17,760 --> 00:05:21,760 Speaker 1: up the story at her waters have broken at thirty 97 00:05:21,800 --> 00:05:25,039 Speaker 1: three weeks. So the first thing that we wanted to 98 00:05:25,040 --> 00:05:28,240 Speaker 1: talk about was the use of steroids in her pregnancy. 99 00:05:29,480 --> 00:05:33,520 Speaker 3: And met me at hospital and they had by that point. 100 00:05:34,000 --> 00:05:37,000 Speaker 3: They give you steroids, which kills. 101 00:05:36,800 --> 00:05:38,840 Speaker 1: What the steroids for Jesse. 102 00:05:39,560 --> 00:05:44,880 Speaker 3: So the steroids are to develop and strengthen the baby's lungs, 103 00:05:45,480 --> 00:05:46,719 Speaker 3: and so they give you steroids. 104 00:05:46,720 --> 00:05:48,760 Speaker 4: They take twenty four hours to kick in, and they 105 00:05:48,760 --> 00:05:49,400 Speaker 4: love to give you. 106 00:05:49,320 --> 00:05:52,880 Speaker 3: Two doses if possible, so that the babies can breathe 107 00:05:52,880 --> 00:05:56,520 Speaker 3: when they're born. So they had checked to see if 108 00:05:56,720 --> 00:06:00,280 Speaker 3: I had started dilating, and I hadn't. It was one 109 00:06:00,279 --> 00:06:02,719 Speaker 3: of the most painful parts. I hate that speculum. Shit 110 00:06:02,960 --> 00:06:07,040 Speaker 3: really hurts. They did the steroids, they started on antibiotics 111 00:06:07,440 --> 00:06:10,760 Speaker 3: and then they give me something to stop labor, essentially 112 00:06:10,880 --> 00:06:12,840 Speaker 3: to go how can we slow this down? 113 00:06:13,080 --> 00:06:15,040 Speaker 4: So they gave me some drugs for that. 114 00:06:15,480 --> 00:06:18,080 Speaker 3: And that morning, as I was laying there, one of 115 00:06:18,080 --> 00:06:20,599 Speaker 3: the doctors came in and said, you could be here 116 00:06:20,800 --> 00:06:24,039 Speaker 3: till thirty seven weeks. I was thirty three weeks and 117 00:06:24,120 --> 00:06:27,279 Speaker 3: two days, and she said, if we can stop this 118 00:06:27,360 --> 00:06:29,200 Speaker 3: and keep them in, we will. 119 00:06:29,160 --> 00:06:31,400 Speaker 1: Because the theory is they're better to be in there. 120 00:06:32,480 --> 00:06:34,440 Speaker 4: Yeah, they're better to be in there. We don't want 121 00:06:34,480 --> 00:06:35,080 Speaker 4: them out yet. 122 00:06:35,880 --> 00:06:39,839 Speaker 3: And I was going, oh my god, like because once 123 00:06:39,880 --> 00:06:42,039 Speaker 3: your waters are broken, you're on bed rest, like you 124 00:06:42,120 --> 00:06:45,720 Speaker 3: can't really go for a walk. I messaged a few 125 00:06:45,720 --> 00:06:49,680 Speaker 3: friends about it, and one friend was like, you're allowed 126 00:06:49,720 --> 00:06:53,520 Speaker 3: to secretly want them out, Like, don't feel guilty for thinking. 127 00:06:54,400 --> 00:06:57,240 Speaker 3: I don't think I can lay here in discomfort and 128 00:06:57,279 --> 00:07:01,200 Speaker 3: pain with a toddler at home three and a half 129 00:07:01,240 --> 00:07:05,320 Speaker 3: four weeks waiting for these babies to grow and grow. 130 00:07:05,400 --> 00:07:07,880 Speaker 3: I mean, it was irrelevant what I wanted because my 131 00:07:07,920 --> 00:07:09,320 Speaker 3: body was going to do what it was going to do, 132 00:07:09,560 --> 00:07:12,920 Speaker 3: and my obstetric was like, you know, we keep them 133 00:07:12,920 --> 00:07:17,280 Speaker 3: in as long as we can, regardless of how everyone feels. 134 00:07:17,000 --> 00:07:20,000 Speaker 1: About They're not giving you a choice about that. It's 135 00:07:20,080 --> 00:07:22,520 Speaker 1: just that that, yeah, you're going through that in your head, 136 00:07:22,800 --> 00:07:25,880 Speaker 1: so they can't stop it forever. It's like holding back 137 00:07:25,920 --> 00:07:26,600 Speaker 1: a tide. 138 00:07:26,800 --> 00:07:27,320 Speaker 4: Exactly. 139 00:07:27,400 --> 00:07:30,720 Speaker 3: If your body wants to deliver these babies, they will deliver, 140 00:07:30,840 --> 00:07:33,680 Speaker 3: but they can they can try and slow it, and 141 00:07:33,720 --> 00:07:36,320 Speaker 3: that's what they were trying to do. The thing about 142 00:07:36,360 --> 00:07:41,040 Speaker 3: the steroids is that if you have gestational diabetes, it 143 00:07:41,840 --> 00:07:45,560 Speaker 3: surges your blood sugar. So all of a sudden, I'm 144 00:07:45,600 --> 00:07:51,400 Speaker 3: fingerpricking every hour. I am being filled with bags of insulin, 145 00:07:51,480 --> 00:07:53,400 Speaker 3: which I hadn't had to take up until that point. 146 00:07:53,960 --> 00:07:57,360 Speaker 3: The eating was a nightmare. The hospital doesn't have a 147 00:07:57,400 --> 00:08:01,560 Speaker 3: gestational diabetes meals that are appropriate, so everything I ate 148 00:08:01,600 --> 00:08:05,320 Speaker 3: had to be brought in and I could eat a 149 00:08:05,400 --> 00:08:08,200 Speaker 3: salad and my blood sugar was just the worst it 150 00:08:08,200 --> 00:08:12,480 Speaker 3: it ever been. So that was horrible. And again I'm 151 00:08:12,480 --> 00:08:15,880 Speaker 3: going this could be weeks a week with this, Yeah, 152 00:08:16,160 --> 00:08:18,600 Speaker 3: And then twenty four hours later they're like, great, you're 153 00:08:18,640 --> 00:08:22,280 Speaker 3: still pregnant. We're gonna give you more steroids, and we'd 154 00:08:22,360 --> 00:08:26,000 Speaker 3: love this to have twenty four hours to work, and 155 00:08:26,040 --> 00:08:29,080 Speaker 3: my obstetrition came in and yeah, I just cried and 156 00:08:29,240 --> 00:08:32,560 Speaker 3: was like, oh, come on, this is really am I 157 00:08:32,600 --> 00:08:36,720 Speaker 3: gonna sit here? And he said to me, the chances 158 00:08:36,760 --> 00:08:38,679 Speaker 3: of you still being pregnant at the end of this 159 00:08:38,720 --> 00:08:43,240 Speaker 3: week are so minimal, Like every day you have a 160 00:08:43,280 --> 00:08:45,680 Speaker 3: fifty percent chance of just going into labor. 161 00:08:47,120 --> 00:08:50,160 Speaker 1: So, but could we just talk about the use of 162 00:08:50,320 --> 00:08:54,520 Speaker 1: steroids in a premature labor like this and follow on 163 00:08:54,679 --> 00:08:59,160 Speaker 1: with how does that interrupt or impact your gestational diabetes 164 00:08:59,200 --> 00:09:00,560 Speaker 1: and your insulin levels? 165 00:09:00,760 --> 00:09:07,440 Speaker 2: Sure, so this is really quite standard stuff for a 166 00:09:07,480 --> 00:09:09,920 Speaker 2: baby that is well, babies that are luck that it 167 00:09:10,040 --> 00:09:13,720 Speaker 2: come early. So for example, it's thirty three weeks typical 168 00:09:13,760 --> 00:09:16,440 Speaker 2: classic time for the waters to break into twin pregnancy. 169 00:09:17,400 --> 00:09:21,240 Speaker 2: But most of the prematurity related to twins is that's 170 00:09:21,320 --> 00:09:25,760 Speaker 2: just nature. It just happens. And I think at thirty 171 00:09:25,760 --> 00:09:28,839 Speaker 2: three weeks at twin pregnancy, the belly is probably getting 172 00:09:28,880 --> 00:09:31,280 Speaker 2: up towards as big as it wants to get. It's 173 00:09:31,280 --> 00:09:34,280 Speaker 2: already bigger than a term sigules and pregnancy by that point. 174 00:09:34,640 --> 00:09:36,720 Speaker 2: And you know, the water's a bag full of fluid 175 00:09:36,720 --> 00:09:44,400 Speaker 2: and it'll break, so gush of fluid happens. The woman 176 00:09:44,400 --> 00:09:48,439 Speaker 2: comes into the hospital. And because we know that by 177 00:09:48,480 --> 00:09:51,440 Speaker 2: far the most likely thing to happen in the hours 178 00:09:51,520 --> 00:09:53,880 Speaker 2: or days following the water's breaking is that the labor 179 00:09:53,920 --> 00:09:56,400 Speaker 2: will come and one way or the other or the 180 00:09:56,440 --> 00:10:00,160 Speaker 2: other those babies coming out. Then we can prepare for 181 00:10:00,200 --> 00:10:03,760 Speaker 2: that by giving a dose of antenatal steroids. And people 182 00:10:04,080 --> 00:10:08,200 Speaker 2: sometimes people just understand this is not steroids like anabolic steroids. 183 00:10:08,200 --> 00:10:12,239 Speaker 2: It's not to make the babies bigger or stronger. It's cortizone. 184 00:10:12,320 --> 00:10:17,440 Speaker 2: It's just cortizone, and it goes through into the woman's arm, down, 185 00:10:17,480 --> 00:10:19,600 Speaker 2: through her body, downlook down the cord, into the baby 186 00:10:19,679 --> 00:10:22,400 Speaker 2: and in the baby. A shot of cortizone has a 187 00:10:22,520 --> 00:10:29,800 Speaker 2: very well established effect at causing the lungs maturity to accelerate, 188 00:10:30,559 --> 00:10:33,160 Speaker 2: and so the babies will come out as long as 189 00:10:33,200 --> 00:10:36,440 Speaker 2: they're born a day or so after the steroids are given. 190 00:10:36,640 --> 00:10:38,880 Speaker 2: The babies will come out with a real benefit from 191 00:10:38,880 --> 00:10:42,319 Speaker 2: that antenatal steroid, and the lungs come out much more 192 00:10:42,360 --> 00:10:44,240 Speaker 2: like a thirty five or thirty six weeker than a 193 00:10:44,240 --> 00:10:48,040 Speaker 2: thirty three weeker, and that has a massive benefit for babies, 194 00:10:48,280 --> 00:10:52,120 Speaker 2: from survival, to decrease time in the nursery, to better 195 00:10:52,120 --> 00:10:56,000 Speaker 2: respiratory function in early life, all sorts of known benefits, 196 00:10:56,080 --> 00:10:58,439 Speaker 2: Just like cortizone does for anyone with diabetes, it makes 197 00:10:58,440 --> 00:11:02,000 Speaker 2: the sugars way worse if you've got if you've got 198 00:11:02,000 --> 00:11:04,480 Speaker 2: insulin dependent diabetes, and you go on a whole lot 199 00:11:04,480 --> 00:11:10,080 Speaker 2: of quartizone to treat some other medical condition like your 200 00:11:12,080 --> 00:11:17,280 Speaker 2: rumatoid arthritis or your or your asthma, then it'll have 201 00:11:17,320 --> 00:11:21,440 Speaker 2: an effect on the body's sugar metabolism and how much 202 00:11:21,600 --> 00:11:24,080 Speaker 2: insulin you need. So if we look at something like 203 00:11:24,120 --> 00:11:27,120 Speaker 2: a twin pregnancy, where gestational diabetes is much more common 204 00:11:27,160 --> 00:11:29,800 Speaker 2: and prematurity in the need for cortizone is much more common, 205 00:11:30,120 --> 00:11:34,880 Speaker 2: then those things would quite commonly go together. So when 206 00:11:35,400 --> 00:11:38,920 Speaker 2: a woman's got gestational diabetes and it's non insulin requiring, 207 00:11:39,160 --> 00:11:42,679 Speaker 2: she's likely to be going just fine managing the sugars 208 00:11:42,760 --> 00:11:48,199 Speaker 2: by eating well and exercising. But you throw the cortizone 209 00:11:48,240 --> 00:11:51,760 Speaker 2: in there, and suddenly that that control is no longer possible, 210 00:11:52,280 --> 00:11:56,559 Speaker 2: and then insulin's required, and again it can be hard 211 00:11:56,600 --> 00:11:58,840 Speaker 2: to know how much intine they need to give, so 212 00:11:59,080 --> 00:12:01,800 Speaker 2: sometimes in that a few days, the woman might wind 213 00:12:01,880 --> 00:12:04,040 Speaker 2: up on something called a sliding scale, where several times 214 00:12:04,080 --> 00:12:07,320 Speaker 2: a day, the sugar's being taken and a variable dose 215 00:12:07,360 --> 00:12:10,560 Speaker 2: of insulin is being given according to what the sugar 216 00:12:10,640 --> 00:12:12,640 Speaker 2: is at that time. And that all sounds like a 217 00:12:12,679 --> 00:12:15,440 Speaker 2: colossal pain in the bum, which it is, but in 218 00:12:15,480 --> 00:12:19,320 Speaker 2: reality it's not required for long because the baby's likely 219 00:12:19,400 --> 00:12:24,320 Speaker 2: come out soon one way about anyway, and that and 220 00:12:24,360 --> 00:12:26,160 Speaker 2: then of course once the babi's are out, the gestational 221 00:12:26,200 --> 00:12:27,000 Speaker 2: diabetes goes away. 222 00:12:27,000 --> 00:12:30,679 Speaker 1: Anyway, Okay, Pat, you said that she gets an injection 223 00:12:30,760 --> 00:12:34,160 Speaker 1: into her arm, and Jesse said that it's painful. Why 224 00:12:34,200 --> 00:12:34,800 Speaker 1: is it painful? 225 00:12:34,960 --> 00:12:36,200 Speaker 2: I'm sure, I don't know you have to have it 226 00:12:36,200 --> 00:12:37,600 Speaker 2: in your arm. I'm sure you can have it anywhere. 227 00:12:37,640 --> 00:12:40,640 Speaker 2: But it's big. It's the volume is big. Yeah, so 228 00:12:40,679 --> 00:12:42,839 Speaker 2: there's a lot of it's like a big injection. 229 00:12:42,679 --> 00:12:45,040 Speaker 1: Yeah, right, all right, now, I want to pick up 230 00:12:45,160 --> 00:12:49,040 Speaker 1: Jesse's story about when she starts talking about her water's 231 00:12:49,040 --> 00:12:51,000 Speaker 1: breaking and. 232 00:12:51,000 --> 00:12:53,199 Speaker 3: Every time I have a contraction more water, because that's 233 00:12:53,200 --> 00:12:56,360 Speaker 3: the thing. My waters were breaking the whole time. 234 00:12:57,160 --> 00:13:00,560 Speaker 4: I didn't know this. Your water's just refilled. 235 00:13:00,360 --> 00:13:01,800 Speaker 1: You know, they don't. 236 00:13:02,080 --> 00:13:06,000 Speaker 5: It doesn't make sense because from it isn't where where 237 00:13:06,360 --> 00:13:07,160 Speaker 5: That's my question. 238 00:13:07,320 --> 00:13:09,240 Speaker 1: But that's so I didn't know that either. When you 239 00:13:09,280 --> 00:13:11,400 Speaker 1: told me about the water's breaking, I thought, well, that's 240 00:13:11,640 --> 00:13:14,280 Speaker 1: that same yeah, And. 241 00:13:14,200 --> 00:13:16,040 Speaker 3: That's why I thought they had to give you antibiotics 242 00:13:16,040 --> 00:13:19,680 Speaker 3: because I'm imagining that I'm just flapping open, yeah, flapping 243 00:13:19,720 --> 00:13:25,600 Speaker 3: open with the pooh wee baby substance, like who knows 244 00:13:25,760 --> 00:13:27,960 Speaker 3: someone going to do a pooh and then it's gonna 245 00:13:28,800 --> 00:13:32,520 Speaker 3: But they did a scan on the Sunday and they're like, oh, yeah, 246 00:13:32,520 --> 00:13:34,240 Speaker 3: they're both floating and amniotic fluid. 247 00:13:34,240 --> 00:13:36,640 Speaker 4: And I was like, but the unondiotic fluid is in 248 00:13:36,679 --> 00:13:37,520 Speaker 4: my socks. 249 00:13:37,400 --> 00:13:41,360 Speaker 5: And I can see it doesn't make I don't understand. 250 00:13:41,480 --> 00:13:44,560 Speaker 5: It's like, where does not come from? It's the same question. 251 00:13:44,960 --> 00:13:46,760 Speaker 1: Women are incredible being. 252 00:13:47,400 --> 00:13:48,640 Speaker 4: It just keeps feeling. 253 00:13:48,840 --> 00:13:51,600 Speaker 3: And it was it was Twine, it was boy who 254 00:13:51,600 --> 00:13:54,080 Speaker 3: had broken his sack. I have a theory Margo did it. 255 00:13:54,120 --> 00:13:58,960 Speaker 1: But yeah, I love these women like I listened to 256 00:13:59,040 --> 00:14:02,079 Speaker 1: out louders We three times a week. Every single thing 257 00:14:02,120 --> 00:14:05,000 Speaker 1: that they produce I'm listening to, so I feel like 258 00:14:05,040 --> 00:14:06,720 Speaker 1: they're my buddy. 259 00:14:06,840 --> 00:14:09,480 Speaker 2: Good. You could be around this table and you could 260 00:14:09,520 --> 00:14:13,360 Speaker 2: be saying most of the fluid in the third trimester 261 00:14:13,360 --> 00:14:16,000 Speaker 2: thro is feedal urate, so it's come through the baby 262 00:14:16,160 --> 00:14:19,920 Speaker 2: several times. They weird out, fills out, then they eat, 263 00:14:19,960 --> 00:14:22,320 Speaker 2: some swallow, some goes through their system. 264 00:14:22,400 --> 00:14:23,920 Speaker 1: They're swallowing amniotic fluid. 265 00:14:24,000 --> 00:14:26,360 Speaker 2: Yeah, and then it goes through and then they turn 266 00:14:26,400 --> 00:14:28,880 Speaker 2: it into weed, just like we would turn anything we 267 00:14:28,960 --> 00:14:31,320 Speaker 2: drink into we and we'd out again. So it's in. 268 00:14:31,440 --> 00:14:35,360 Speaker 2: It's circulating like that. And if you make a little 269 00:14:35,400 --> 00:14:37,960 Speaker 2: hole in the waters that you don't have to make 270 00:14:37,960 --> 00:14:39,840 Speaker 2: a very big hole for a real trickle to happen, 271 00:14:41,000 --> 00:14:43,480 Speaker 2: especially if there's no presenting part in the pelvis. So 272 00:14:43,600 --> 00:14:47,600 Speaker 2: remember with twins, you might have neither balm and neither 273 00:14:47,680 --> 00:14:50,120 Speaker 2: head right down there in the pelvis, so it's not 274 00:14:50,160 --> 00:14:53,520 Speaker 2: making much of a plug plug exactly. So a tiny 275 00:14:53,560 --> 00:14:55,600 Speaker 2: hole in one of the sacks would leak out a 276 00:14:55,600 --> 00:14:58,840 Speaker 2: fair bit of water. But then occasionally that can reseal. 277 00:14:59,360 --> 00:15:03,400 Speaker 2: And women with ruptured membranes who have not yet met 278 00:15:03,560 --> 00:15:08,280 Speaker 2: criteria to be to be born babies are fine. Not 279 00:15:08,400 --> 00:15:11,280 Speaker 2: too much water is coming out, there's no sign of infection. 280 00:15:11,680 --> 00:15:15,560 Speaker 2: We might watch those those women for months. You know, 281 00:15:16,240 --> 00:15:17,800 Speaker 2: if you if you have a leak in the water 282 00:15:17,840 --> 00:15:20,760 Speaker 2: is at twenty eight weeks, but everything's fine. You could 283 00:15:20,760 --> 00:15:25,200 Speaker 2: have that baby a term, you know, twelve weeks later, 284 00:15:25,880 --> 00:15:31,280 Speaker 2: so don't often get that far wage could. So we 285 00:15:31,320 --> 00:15:33,680 Speaker 2: look at how much waters around a baby, But if 286 00:15:33,680 --> 00:15:36,560 Speaker 2: the baby's just do away, there'll seem to be lots. Yeah, 287 00:15:36,760 --> 00:15:41,280 Speaker 2: and then the little hole. Sometimes they just keep on leaking. 288 00:15:41,280 --> 00:15:43,240 Speaker 2: But sometimes it's a little flat that will sort of 289 00:15:43,240 --> 00:15:43,920 Speaker 2: seal itself. 290 00:15:44,240 --> 00:15:46,080 Speaker 1: Oh, she was right when she said, I'm just out 291 00:15:46,080 --> 00:15:46,840 Speaker 1: there flapping. 292 00:15:46,960 --> 00:15:50,840 Speaker 2: Yeah, so there's you know, if the flap heals, it 293 00:15:51,000 --> 00:15:54,160 Speaker 2: heals itself. Remember, the cervix isn't dilated much at this point, 294 00:15:54,200 --> 00:15:56,560 Speaker 2: so there's every chance that the leak is further up 295 00:15:56,880 --> 00:15:58,840 Speaker 2: and it might just seal over. 296 00:15:59,760 --> 00:16:00,920 Speaker 5: And then. 297 00:16:02,600 --> 00:16:04,960 Speaker 2: Antibiotics are used because infection can get up from the 298 00:16:05,040 --> 00:16:08,520 Speaker 2: vagina up into the water around the baby. But it's 299 00:16:08,560 --> 00:16:12,080 Speaker 2: not because of the way baby's weining or pooing. The base. 300 00:16:12,320 --> 00:16:15,440 Speaker 2: Baby is supposed to be weaning and that's sterile and 301 00:16:15,480 --> 00:16:16,520 Speaker 2: they're not supposed to be. 302 00:16:16,440 --> 00:16:18,920 Speaker 1: Pooling that when they said that the baby would be pooing, 303 00:16:18,920 --> 00:16:19,800 Speaker 1: that is abnormal, isn't it? 304 00:16:20,000 --> 00:16:21,800 Speaker 2: Absolutely yeah, And they're not supposed to be pooing, and 305 00:16:21,840 --> 00:16:23,960 Speaker 2: even if they do, it's still sterip so there's no 306 00:16:24,040 --> 00:16:28,040 Speaker 2: bacteria in the count of the feeds so that their 307 00:16:28,080 --> 00:16:30,960 Speaker 2: poo doesn't smell like pooh. That's that smells from the 308 00:16:31,000 --> 00:16:38,400 Speaker 2: bacteria and it's and it's not infective. Yeah, So we 309 00:16:38,440 --> 00:16:40,640 Speaker 2: would be worried about a baby that had done a 310 00:16:40,680 --> 00:16:42,920 Speaker 2: pool on the inside, but that would be because it's 311 00:16:42,960 --> 00:16:46,280 Speaker 2: a marker of poor fetal condition, not because it's infective. 312 00:16:46,800 --> 00:16:49,120 Speaker 1: Yeah. And that's that black maconium, isn't it. 313 00:16:49,440 --> 00:16:49,680 Speaker 2: Yeah? 314 00:16:50,760 --> 00:16:52,840 Speaker 1: Good, Well, I hope that clears it up for everybody, 315 00:16:52,840 --> 00:16:55,320 Speaker 1: because everybody in that conversation was. 316 00:16:55,280 --> 00:16:57,360 Speaker 2: Really surprised, really surprised. 317 00:16:56,880 --> 00:16:58,360 Speaker 1: That their waters can refill. 318 00:16:58,520 --> 00:17:01,000 Speaker 2: Yeah, and that's not surprising at all. So so if 319 00:17:01,000 --> 00:17:04,159 Speaker 2: somebody has an obvious gush and then we do the 320 00:17:04,160 --> 00:17:06,280 Speaker 2: little vaginal test where you can get some of the 321 00:17:06,320 --> 00:17:09,280 Speaker 2: water and test it and prove that it's from around 322 00:17:09,280 --> 00:17:13,480 Speaker 2: a baby and not know urine or something, then then 323 00:17:13,480 --> 00:17:15,679 Speaker 2: you don't unerstand the next day there's still still seems 324 00:17:15,720 --> 00:17:17,160 Speaker 2: to be a phoebe to water around a baby. 325 00:17:17,200 --> 00:17:19,720 Speaker 1: That's normal and in actual fact that you kind of 326 00:17:19,720 --> 00:17:21,280 Speaker 1: want to see that, don't you, because that means the 327 00:17:21,320 --> 00:17:24,480 Speaker 1: baby's healthy if they're having a good urine output, and. 328 00:17:24,480 --> 00:17:27,040 Speaker 2: Also that if they've got a decent amount of water 329 00:17:27,200 --> 00:17:30,520 Speaker 2: around them still exactly that they're making urine, so that's 330 00:17:31,040 --> 00:17:34,440 Speaker 2: a sign of a healthy baby, but also that there's 331 00:17:34,440 --> 00:17:37,320 Speaker 2: still plenty of water around that baby to allow free 332 00:17:37,359 --> 00:17:42,160 Speaker 2: movement of the limbs. And that's where healthy musculoskly little 333 00:17:42,160 --> 00:17:43,919 Speaker 2: system is going to come from, because the baby has 334 00:17:43,960 --> 00:17:46,800 Speaker 2: to be able to move, and also if there's still 335 00:17:46,800 --> 00:17:50,480 Speaker 2: plenty of water around, that's where healthy ongoing pulmonary development, 336 00:17:50,560 --> 00:17:51,680 Speaker 2: lung development will come from. 337 00:17:51,720 --> 00:17:56,560 Speaker 1: Us right, I am researching at the moment about a 338 00:17:56,560 --> 00:18:01,119 Speaker 1: condition called taco phobia. It's fear of childbirth. I know, 339 00:18:01,200 --> 00:18:02,639 Speaker 1: you know that. I'm just saying that for them, the 340 00:18:02,720 --> 00:18:07,800 Speaker 1: rest of the listeners, and for some people knowing that 341 00:18:07,840 --> 00:18:12,480 Speaker 1: their baby amniotic fluid is basically their urine, is they 342 00:18:12,640 --> 00:18:14,960 Speaker 1: they're fearful of that. So I'm just wanting I'm just 343 00:18:15,000 --> 00:18:18,280 Speaker 1: saying that if anyone's listening to that and feeling quite disgusted, 344 00:18:19,720 --> 00:18:21,000 Speaker 1: this is pregnancy. 345 00:18:21,240 --> 00:18:26,200 Speaker 2: Yeah, yeah, yeah, I think it. Amniotic fluid has a 346 00:18:26,400 --> 00:18:28,560 Speaker 2: has its own smell, but it doesn't smell like a 347 00:18:28,600 --> 00:18:32,840 Speaker 2: grown up's urine or even a child's urine, because to 348 00:18:32,880 --> 00:18:34,919 Speaker 2: a certain extent, the smell of our urine might have 349 00:18:35,000 --> 00:18:37,200 Speaker 2: something to do with what we're eating or drinking. And 350 00:18:37,600 --> 00:18:41,200 Speaker 2: the urine from a fetuses it's basically serum, isn't It's 351 00:18:41,240 --> 00:18:44,119 Speaker 2: just like their blood that's coming into them, and you 352 00:18:44,160 --> 00:18:48,080 Speaker 2: know that they have blood circulating and they're making a 353 00:18:48,280 --> 00:18:49,879 Speaker 2: urine out of the liquid component of that. 354 00:18:50,240 --> 00:18:53,439 Speaker 1: Yeah, that's a really nice thing to say, Pat. I 355 00:18:53,440 --> 00:18:56,760 Speaker 1: hope someone who's listening to that and thinking that it's disgusting. 356 00:18:56,800 --> 00:19:00,879 Speaker 1: It's it's not like your human adult urine. No, no, 357 00:19:01,640 --> 00:19:03,960 Speaker 1: And it's the beginning of all the bodily fluids that 358 00:19:04,000 --> 00:19:04,520 Speaker 1: will happen. 359 00:19:05,200 --> 00:19:07,240 Speaker 2: I swear we all came from all. 360 00:19:07,320 --> 00:19:08,399 Speaker 1: Came from all. 361 00:19:08,480 --> 00:19:08,680 Speaker 2: Right. 362 00:19:09,320 --> 00:19:12,359 Speaker 1: I want to go on to where Jesse starts talking 363 00:19:12,359 --> 00:19:16,280 Speaker 1: about how her birth changes rapidly, rapidly. 364 00:19:16,440 --> 00:19:20,800 Speaker 3: Yes, I have one hour and Luca was sleeping at home, 365 00:19:20,840 --> 00:19:22,520 Speaker 3: so I had to call him and go, you need 366 00:19:22,560 --> 00:19:23,280 Speaker 3: to get here right now. 367 00:19:23,280 --> 00:19:24,200 Speaker 4: We're about to meet them. 368 00:19:24,320 --> 00:19:26,520 Speaker 5: And you tried to call me because I'm usually up 369 00:19:26,520 --> 00:19:29,200 Speaker 5: at the crack of dawn with Matilda, and that is. 370 00:19:29,160 --> 00:19:30,840 Speaker 4: The one morning she slept me. 371 00:19:31,480 --> 00:19:33,920 Speaker 5: I'm so mad I wanted to do it. 372 00:19:34,280 --> 00:19:36,639 Speaker 1: Were you scared, Jesse through all this time? Are you 373 00:19:36,720 --> 00:19:37,480 Speaker 1: like scared? 374 00:19:38,000 --> 00:19:39,560 Speaker 4: Yeah? I think I was. 375 00:19:39,760 --> 00:19:42,719 Speaker 3: I was really scared because I was also trying to 376 00:19:42,800 --> 00:19:46,320 Speaker 3: decide up until that moment, Like I could have gone, 377 00:19:47,200 --> 00:19:48,560 Speaker 3: let's get him out vaginally. 378 00:19:48,640 --> 00:19:51,360 Speaker 4: That was also an option, but I was getting. 379 00:19:51,160 --> 00:19:56,960 Speaker 3: Advice from very clever, very considerate, very sensitive doctors. We 380 00:19:57,000 --> 00:20:00,120 Speaker 3: do not know what Twin B is going to do. 381 00:20:00,800 --> 00:20:03,800 Speaker 3: Twin A we reckon. He'll come out in a second 382 00:20:04,200 --> 00:20:05,160 Speaker 3: because he's head down. 383 00:20:05,640 --> 00:20:08,640 Speaker 4: Twin B might spin, she might. 384 00:20:08,640 --> 00:20:12,520 Speaker 5: Crawl her way back up to your like yep. 385 00:20:12,720 --> 00:20:14,840 Speaker 3: And what we know about Twin B is that she's 386 00:20:14,880 --> 00:20:19,160 Speaker 3: the smaller one. She's not very robust because they're early, 387 00:20:19,880 --> 00:20:22,240 Speaker 3: and once a baby has descended into the birth canal, 388 00:20:22,280 --> 00:20:24,160 Speaker 3: it is coming out of the birth canal, no matter what 389 00:20:24,240 --> 00:20:28,879 Speaker 3: instruments we have to use. So if you want, and 390 00:20:28,920 --> 00:20:31,000 Speaker 3: if she hasn't descended through the birth canal, then we 391 00:20:31,040 --> 00:20:33,080 Speaker 3: do a C section and you end up recovering from 392 00:20:33,119 --> 00:20:33,760 Speaker 3: two births. 393 00:20:33,800 --> 00:20:36,400 Speaker 4: And that is I was given about a one in. 394 00:20:36,400 --> 00:20:40,240 Speaker 3: Five chance of that happening, So I went, all right, 395 00:20:40,560 --> 00:20:41,680 Speaker 3: what do you guys think I should do? 396 00:20:41,680 --> 00:20:42,600 Speaker 1: When they said c section? 397 00:20:42,680 --> 00:20:43,680 Speaker 4: I went great. 398 00:20:44,280 --> 00:20:47,680 Speaker 1: So things turned around really fast for Jesse, didn't they Yeah. 399 00:20:47,520 --> 00:20:51,960 Speaker 2: So this is what happens in a problematic scenario like 400 00:20:52,040 --> 00:20:56,560 Speaker 2: rupture membranes, twins, gestational diabetics, diabetic thirty three weeks. There's 401 00:20:56,600 --> 00:21:00,320 Speaker 2: a lot going on there, and sometimes people are really 402 00:21:00,359 --> 00:21:02,600 Speaker 2: surprised that one minute we're happy to sit and wait, 403 00:21:02,880 --> 00:21:05,399 Speaker 2: and literally the next minute we want to get the 404 00:21:05,440 --> 00:21:10,920 Speaker 2: babies out. And it just represents, I think, the evolving 405 00:21:11,119 --> 00:21:15,239 Speaker 2: nature of the situation. So we don't want babies to 406 00:21:15,240 --> 00:21:18,640 Speaker 2: come out any earlier than they need to, and we're 407 00:21:18,640 --> 00:21:22,040 Speaker 2: constantly asking ourselves is this baby better off in than out? 408 00:21:22,280 --> 00:21:25,320 Speaker 2: So the answer at five pm might be in definitely fine, 409 00:21:25,440 --> 00:21:29,240 Speaker 2: let's do some let's do some fetal surveillance at seven 410 00:21:29,359 --> 00:21:32,280 Speaker 2: thirty pm after dinner. You put the fetal heart rate 411 00:21:32,320 --> 00:21:34,959 Speaker 2: manter on at seven thirty pm and there are signs 412 00:21:35,000 --> 00:21:38,000 Speaker 2: on that that the babies are no longer Well, well, 413 00:21:38,080 --> 00:21:41,720 Speaker 2: we're not sitting on our hands for another minute, you know, 414 00:21:42,480 --> 00:21:49,120 Speaker 2: ivy line, theater and aesthetics section done in the scenario. 415 00:21:49,560 --> 00:21:53,439 Speaker 2: And sometimes things evolve very quickly. Someone's in the hospital 416 00:21:53,480 --> 00:21:56,520 Speaker 2: because they're at higher risk of bleeding, but they're not 417 00:21:56,600 --> 00:22:00,840 Speaker 2: actually bleeding. Then they do, so we act. Yeah, and 418 00:22:00,880 --> 00:22:05,199 Speaker 2: in obstetrics that things can change very quickly. They're not 419 00:22:05,359 --> 00:22:11,680 Speaker 2: always evolving things that evolve over over days or weeks. 420 00:22:11,920 --> 00:22:16,560 Speaker 2: They might evolve over minutes. So if you're ever if 421 00:22:16,600 --> 00:22:22,960 Speaker 2: you're ever experiencing a complex pregnancy and you're recommended for 422 00:22:23,080 --> 00:22:26,760 Speaker 2: observation in the hospital, that's not an old style thing 423 00:22:26,800 --> 00:22:28,399 Speaker 2: from one hundred years ago where they said, oh, we'll 424 00:22:28,400 --> 00:22:29,800 Speaker 2: put you in the hospital and keep it either keep 425 00:22:29,800 --> 00:22:31,320 Speaker 2: it have a look at you over a few weeks. 426 00:22:31,320 --> 00:22:34,720 Speaker 2: No to wear in hospital bed these days. It's because 427 00:22:34,760 --> 00:22:38,359 Speaker 2: we know that something may evolve so quickly that we 428 00:22:38,400 --> 00:22:40,160 Speaker 2: want you right there and then so we can loise 429 00:22:40,200 --> 00:22:41,439 Speaker 2: around and have the baby if we need to. 430 00:22:42,000 --> 00:22:46,080 Speaker 1: What when the nursing the nurse is there and she 431 00:22:46,280 --> 00:22:48,879 Speaker 1: or he's doing the obs what are the things that 432 00:22:48,880 --> 00:22:49,760 Speaker 1: they're looking at. 433 00:22:50,440 --> 00:22:54,200 Speaker 2: Well, in a ruptured membrane situation, we're on the lookout 434 00:22:54,359 --> 00:23:01,360 Speaker 2: for infection at all times. So, for example, if somebody's pregnant, 435 00:23:01,359 --> 00:23:03,840 Speaker 2: they've ruptured their membranes, but they are not in labor, 436 00:23:04,080 --> 00:23:08,199 Speaker 2: then it's perfectly reasonable to stay pregnant, not deliver, and 437 00:23:08,320 --> 00:23:12,800 Speaker 2: wait for more gestation unless there's evidence of infection. And 438 00:23:12,840 --> 00:23:14,320 Speaker 2: this is another one of those things that can change 439 00:23:14,359 --> 00:23:17,800 Speaker 2: very quickly. So in the morning might be fine ten 440 00:23:18,560 --> 00:23:25,000 Speaker 2: am to develop a fever, need immediate delivery. So babies 441 00:23:25,080 --> 00:23:28,440 Speaker 2: will go all right if we get them out at 442 00:23:28,480 --> 00:23:32,480 Speaker 2: the first sign of trouble of infection, but extremely poorly 443 00:23:32,520 --> 00:23:38,200 Speaker 2: if they come out badly infected. So we act immediately 444 00:23:39,080 --> 00:23:42,800 Speaker 2: and we don't sit around waiting for the woman necessarily 445 00:23:42,880 --> 00:23:45,640 Speaker 2: to develop a really high fever. We might have missed 446 00:23:45,760 --> 00:23:50,080 Speaker 2: the hours beforehand that are important, so we would be 447 00:23:50,119 --> 00:23:54,600 Speaker 2: looking at other more subtle signs, like the maternal heart rate, 448 00:23:55,640 --> 00:23:57,760 Speaker 2: whether she's got any pain, having an infection in the 449 00:23:57,880 --> 00:24:01,840 Speaker 2: uterus is painful. Those things will sometimes tip us off 450 00:24:01,840 --> 00:24:07,560 Speaker 2: to a developing coriomionitis, an infection of the membranes placenta 451 00:24:07,920 --> 00:24:10,200 Speaker 2: in the water around the baby, before the woman even 452 00:24:10,280 --> 00:24:14,359 Speaker 2: develops a fever. And it's just a true in obstetrics 453 00:24:14,359 --> 00:24:16,879 Speaker 2: that if you've got evidence, any evidence that that is 454 00:24:16,880 --> 00:24:20,200 Speaker 2: happening or even might be happening, then you're better off 455 00:24:20,240 --> 00:24:25,320 Speaker 2: getting the babies out because any benefit from another half 456 00:24:25,320 --> 00:24:28,320 Speaker 2: a day of gestation will be totally wiped out by 457 00:24:28,400 --> 00:24:30,400 Speaker 2: the risk the babies have been brought infected. 458 00:24:31,240 --> 00:24:34,040 Speaker 1: And the decision making around why it went straight to 459 00:24:34,400 --> 00:24:41,320 Speaker 1: caesarean and not a sorry, a vaginal bird. Can you 460 00:24:41,359 --> 00:24:41,960 Speaker 1: talk about that? 461 00:24:42,080 --> 00:24:47,399 Speaker 2: Yeah, that's an interesting one because often that decision perhaps 462 00:24:47,400 --> 00:24:50,240 Speaker 2: has already been made or is in the process of 463 00:24:50,320 --> 00:24:54,080 Speaker 2: being made, when suddenly all of this extra stuff happens. 464 00:24:54,440 --> 00:25:00,200 Speaker 2: So I always think about vaginal birth of twins as needing, 465 00:25:00,520 --> 00:25:02,879 Speaker 2: as needing to meet a certain criteria to be safe, 466 00:25:03,760 --> 00:25:05,920 Speaker 2: and I think a lot of people would be looking 467 00:25:05,960 --> 00:25:09,320 Speaker 2: for gestation a fair bit more than thirty three weeks. Yeah. So, 468 00:25:09,480 --> 00:25:12,720 Speaker 2: historically the poor outcomes for twins have been related to 469 00:25:13,200 --> 00:25:15,600 Speaker 2: how well the second baby goes. The first baby tens 470 00:25:15,600 --> 00:25:17,600 Speaker 2: to come out okay, but the second baby can get 471 00:25:17,600 --> 00:25:18,960 Speaker 2: a bit lost on the way out with all of 472 00:25:19,000 --> 00:25:23,520 Speaker 2: the extra room and can often present sideways or free 473 00:25:23,560 --> 00:25:30,040 Speaker 2: first or I hadn't have complexities relating to getting that 474 00:25:30,200 --> 00:25:34,080 Speaker 2: baby out, And so if you add all of that 475 00:25:34,920 --> 00:25:37,399 Speaker 2: to the risk of being premature in the first place, 476 00:25:37,920 --> 00:25:39,920 Speaker 2: it can tip us over a threshold we're all comfortable 477 00:25:39,960 --> 00:25:41,800 Speaker 2: with it, we might be more likely to recommend a caesar. 478 00:25:42,800 --> 00:25:47,399 Speaker 2: So I think this proceeded according to pretty much what 479 00:25:48,160 --> 00:25:51,399 Speaker 2: would be usually recommended. It's just that if there was 480 00:25:51,440 --> 00:25:54,560 Speaker 2: still a question around vaginal birth, it may be because 481 00:25:54,600 --> 00:25:57,760 Speaker 2: that hadn't been fully decided and then suddenly fade into venes, 482 00:25:57,920 --> 00:26:03,119 Speaker 2: water's breaks, and it all becomes more urgent and more 483 00:26:04,000 --> 00:26:08,160 Speaker 2: risks involved. In compounding that the potential risk of vaginal 484 00:26:08,480 --> 00:26:11,640 Speaker 2: twin birth with the complexity of only being thirty three 485 00:26:11,680 --> 00:26:15,000 Speaker 2: weeks same pregnancy, no rupture. Membranes might have gone on 486 00:26:15,119 --> 00:26:19,280 Speaker 2: another five weeks and certainly been suitable for vaginal birth. Yeah. 487 00:26:19,520 --> 00:26:24,720 Speaker 2: So that's another thing that can happen when fade intervenes 488 00:26:24,720 --> 00:26:27,960 Speaker 2: and things get complex is sometimes all that time we 489 00:26:28,000 --> 00:26:29,640 Speaker 2: thought we had to make up our mind about these 490 00:26:29,680 --> 00:26:32,199 Speaker 2: things can go off the table pretty quickly. 491 00:26:32,480 --> 00:26:35,520 Speaker 1: Yeah. And as people go back and listen to Jesse 492 00:26:35,640 --> 00:26:39,040 Speaker 1: talk about it, she only had just finished work and 493 00:26:39,280 --> 00:26:43,199 Speaker 1: either that night or the next day, Yeah, she's her 494 00:26:43,240 --> 00:26:45,520 Speaker 1: water's broken. So you know, she thought she had lots 495 00:26:45,560 --> 00:26:48,320 Speaker 1: of time to pack even little alone think about. 496 00:26:48,560 --> 00:26:53,119 Speaker 2: Yeah. So often busy working people have left those things, 497 00:26:53,160 --> 00:26:55,480 Speaker 2: setting up nursery and getting all the. 498 00:26:55,680 --> 00:26:57,439 Speaker 1: You think you've got all this time, what else am 499 00:26:57,440 --> 00:26:57,840 Speaker 1: I going to do? 500 00:26:58,359 --> 00:27:00,359 Speaker 2: People have given you all those sort of things for 501 00:27:00,400 --> 00:27:02,480 Speaker 2: this magic time at the end between finishing work and 502 00:27:02,520 --> 00:27:04,680 Speaker 2: having the baby, and then suddenly the baby comes straight. 503 00:27:04,480 --> 00:27:10,679 Speaker 1: Away or in my case, in my first pregnancy, I 504 00:27:10,720 --> 00:27:14,399 Speaker 1: didn't I finished at thirty six weeks, but didn't go 505 00:27:14,480 --> 00:27:18,720 Speaker 1: into labor until like forty one and five days or something, 506 00:27:18,760 --> 00:27:20,800 Speaker 1: so I had way too much time on my hand. 507 00:27:20,840 --> 00:27:23,879 Speaker 1: So you just never know d the unpredictability of birth. 508 00:27:24,160 --> 00:27:27,200 Speaker 1: All right, I want to finish with something that pertains 509 00:27:27,240 --> 00:27:30,119 Speaker 1: to us. But like they are hilarious. They go on 510 00:27:30,160 --> 00:27:32,800 Speaker 1: and talking about, you know, lots of different things that 511 00:27:33,320 --> 00:27:35,200 Speaker 1: I think people would find really interesting. But we're just 512 00:27:35,240 --> 00:27:37,919 Speaker 1: really focusing on some education points. And the next one 513 00:27:37,920 --> 00:27:43,119 Speaker 1: I want to focus on is plus center rummaging. Let's 514 00:27:43,119 --> 00:27:43,679 Speaker 1: talk about that. 515 00:27:45,040 --> 00:27:48,720 Speaker 3: Go to them, check that they're okay. And I was 516 00:27:48,800 --> 00:27:56,800 Speaker 3: laying there and started feeling really bad, like lightheaded, nauseous, 517 00:27:57,760 --> 00:28:02,080 Speaker 3: out of it. There's no way I'd just had two babies. 518 00:28:02,560 --> 00:28:05,720 Speaker 3: And then the anethe test. I could hear the obstrition saying, 519 00:28:05,960 --> 00:28:07,840 Speaker 3: whenever you're giving her, you need to give her more 520 00:28:08,760 --> 00:28:11,840 Speaker 3: because the placenta wouldn't soften. 521 00:28:11,880 --> 00:28:13,119 Speaker 4: There was an issue with the placenta. 522 00:28:13,720 --> 00:28:15,919 Speaker 3: I heard them say that I'd lost a fair bit 523 00:28:15,960 --> 00:28:19,000 Speaker 3: of blood and the uneth test and said to me, 524 00:28:19,560 --> 00:28:21,359 Speaker 3: I hate having to do this, but I'm about to 525 00:28:21,359 --> 00:28:22,919 Speaker 3: give you some drugs that they are going to make 526 00:28:22,960 --> 00:28:26,280 Speaker 3: you feel really bad, like they're going to make you 527 00:28:26,320 --> 00:28:29,320 Speaker 3: feel really sick. And basically when you have twins, like 528 00:28:29,359 --> 00:28:32,199 Speaker 3: the two placentas, I think were like hardening, like they 529 00:28:32,240 --> 00:28:34,560 Speaker 3: weren't soft enough to get them out, so I could 530 00:28:34,640 --> 00:28:37,800 Speaker 3: feel them. And then I turned to the uneath test 531 00:28:37,800 --> 00:28:38,880 Speaker 3: and I was like, I feel really sick, and he 532 00:28:38,920 --> 00:28:42,200 Speaker 3: said it's a mixture of the drugs and the rummaging. 533 00:28:42,800 --> 00:28:46,040 Speaker 4: Oh you feel that rummage? 534 00:28:45,920 --> 00:28:46,160 Speaker 5: Yeah? 535 00:28:46,440 --> 00:28:50,640 Speaker 3: And actually when Margot came so they got harry and 536 00:28:50,680 --> 00:28:54,440 Speaker 3: then it felt like the Obstecucian was sitting on my 537 00:28:54,600 --> 00:28:58,800 Speaker 3: ribs the strength he had to use to get her out, 538 00:28:58,840 --> 00:29:00,440 Speaker 3: and he later told me that it was like they 539 00:29:00,440 --> 00:29:02,760 Speaker 3: were like they were a little fish that were like 540 00:29:03,000 --> 00:29:05,320 Speaker 3: swimming in circles and he was trying to catch. 541 00:29:07,280 --> 00:29:08,960 Speaker 5: She's like, don't get me, don't get me, don't get me. 542 00:29:09,000 --> 00:29:10,320 Speaker 4: And it's like don't get me, don't get me, don't 543 00:29:10,320 --> 00:29:13,560 Speaker 4: get me, which I was like, I'm very glad you 544 00:29:13,640 --> 00:29:14,000 Speaker 4: came out. 545 00:29:14,000 --> 00:29:17,880 Speaker 3: The Sunday I was to play chasing No in the 546 00:29:17,920 --> 00:29:19,440 Speaker 3: birth can out all. 547 00:29:19,400 --> 00:29:23,200 Speaker 1: Right, so many things there, So firstly, what would the 548 00:29:23,240 --> 00:29:25,400 Speaker 1: unethetist have given her to make it feel sick. 549 00:29:26,400 --> 00:29:29,520 Speaker 2: So we commonly use medication to try and get the uterus. 550 00:29:29,520 --> 00:29:31,680 Speaker 2: So this is after the baby's out right, not beforehand. 551 00:29:32,760 --> 00:29:36,720 Speaker 2: So the babies are out and then the uterus won't 552 00:29:36,720 --> 00:29:38,760 Speaker 2: stop bleeding until it's clamped down, and it can't really 553 00:29:38,760 --> 00:29:44,240 Speaker 2: clamp down unless the placenters come out neatly, So we 554 00:29:44,320 --> 00:29:48,560 Speaker 2: often give medication to try and sqush the get the 555 00:29:48,600 --> 00:29:49,760 Speaker 2: uterus to clamp down harder. 556 00:29:50,560 --> 00:29:51,680 Speaker 1: And does the neatheris do that? 557 00:29:52,560 --> 00:29:55,760 Speaker 2: They give all the medications. Yeah, because we're up in 558 00:29:55,800 --> 00:29:58,920 Speaker 2: the scrubbed area, the sterile area, so it's the uneath. 559 00:29:58,960 --> 00:30:01,200 Speaker 2: This just got access to the intravenous line. 560 00:30:01,440 --> 00:30:03,480 Speaker 1: Yeah, So more sintosinin, is it? 561 00:30:03,840 --> 00:30:08,360 Speaker 2: Yeah, well we don't. We use sintosinine usually for augmentation 562 00:30:08,480 --> 00:30:12,800 Speaker 2: of labor or sometimes for third stage, but more often 563 00:30:13,560 --> 00:30:16,960 Speaker 2: for third stage, we'll use a medication called sintimetron, which 564 00:30:17,000 --> 00:30:20,680 Speaker 2: is an which is a combination of sintosin and a 565 00:30:20,720 --> 00:30:25,880 Speaker 2: drug called ergometro, which is a really powerful contractor of 566 00:30:25,960 --> 00:30:28,320 Speaker 2: the of the uterus. So at a caesar will tend 567 00:30:28,400 --> 00:30:35,120 Speaker 2: to give a standard shot of a long acting version 568 00:30:35,160 --> 00:30:37,760 Speaker 2: of sintosin and that will take care of most of 569 00:30:37,760 --> 00:30:39,320 Speaker 2: the time. But if there's still too much bleeding and 570 00:30:39,320 --> 00:30:41,680 Speaker 2: too much trouble and too much difficult getting the placenters out, 571 00:30:41,880 --> 00:30:46,880 Speaker 2: then we'll use a drug drug called ergo, and it 572 00:30:46,960 --> 00:30:51,720 Speaker 2: really makes you spew. It causes intense, very very unpleasant 573 00:30:55,040 --> 00:30:59,640 Speaker 2: nausea and vomiting. So it's a really great drug. It's 574 00:30:59,680 --> 00:31:04,400 Speaker 2: a life saving drug. It's if you've got to use it, 575 00:31:04,440 --> 00:31:08,160 Speaker 2: you've got to use it, but it's you'd rather not, 576 00:31:08,520 --> 00:31:10,480 Speaker 2: you know, it's nice to be in a situation where 577 00:31:10,480 --> 00:31:11,800 Speaker 2: you don't need to use it in the first place. 578 00:31:12,440 --> 00:31:15,960 Speaker 1: She talks about placenta hardening. Is that just actually her 579 00:31:16,000 --> 00:31:17,960 Speaker 1: feeling her uterus harden? Perhaps? 580 00:31:18,800 --> 00:31:21,040 Speaker 2: Yeah, I'm not sure quite what she's describing there. I 581 00:31:21,040 --> 00:31:26,800 Speaker 2: don't think the placenta is any harder in a twin 582 00:31:26,840 --> 00:31:30,760 Speaker 2: pregnancy than singleton pregnancy. Certainly placenters can get hard when 583 00:31:30,760 --> 00:31:32,960 Speaker 2: there's high blood pressure, preclams here, those sort of things. 584 00:31:33,560 --> 00:31:35,760 Speaker 2: But more likely I think there was a problem with 585 00:31:35,880 --> 00:31:40,080 Speaker 2: uterine tone and that therefore the uterus was splitting too much, 586 00:31:40,120 --> 00:31:41,360 Speaker 2: and they were doing all of this to try and 587 00:31:41,400 --> 00:31:43,840 Speaker 2: fix that. It's a very very common standard, you know, 588 00:31:44,040 --> 00:31:48,520 Speaker 2: very common thing to happen with a twin pregnancy because 589 00:31:48,560 --> 00:31:52,440 Speaker 2: the uterus has been overstretched and it doesn't contract very 590 00:31:52,440 --> 00:31:57,720 Speaker 2: well if it's so big. Yeah, imagine any other muscle 591 00:31:57,720 --> 00:31:59,600 Speaker 2: in your body if you're over if you stretched it 592 00:31:59,600 --> 00:32:02,720 Speaker 2: out to twice as long as it usually was, then 593 00:32:02,800 --> 00:32:06,440 Speaker 2: it wouldn't contract very well. And that's what tends to 594 00:32:06,480 --> 00:32:12,600 Speaker 2: happen with twins. So this type of postpartum hemorrhage needing 595 00:32:12,600 --> 00:32:15,960 Speaker 2: these fancier drugs is a really common thing to happen 596 00:32:16,480 --> 00:32:21,840 Speaker 2: in a pregnancy where the uterine muscle has been overstretched, 597 00:32:22,000 --> 00:32:30,400 Speaker 2: so twins, triplets, big baby, or excess amniotic fluids so 598 00:32:30,480 --> 00:32:33,440 Speaker 2: called polyhydromials, where that all of the muscle has been 599 00:32:33,480 --> 00:32:36,000 Speaker 2: overstretched and doesn't contract very well when it needs to. 600 00:32:37,280 --> 00:32:42,520 Speaker 2: And you know, because these postpartum hemorrhage is the everyday emergency, 601 00:32:42,680 --> 00:32:45,360 Speaker 2: it's not, it's not rare. It's just that we've become 602 00:32:45,440 --> 00:32:47,200 Speaker 2: very very good at managing it over the years. 603 00:32:47,360 --> 00:32:49,640 Speaker 1: And you know, we've done it before an episode on 604 00:32:49,680 --> 00:32:52,560 Speaker 1: it before, But it's not rare. Also, in cesarean section 605 00:32:53,040 --> 00:32:55,000 Speaker 1: more uncommon, but it still can happen. 606 00:32:55,120 --> 00:32:58,320 Speaker 2: Yeah, And the rummaging, poor old, the rummaging that that 607 00:32:59,080 --> 00:33:01,840 Speaker 2: she was feeling that's an episode firstly to get a 608 00:33:01,920 --> 00:33:04,920 Speaker 2: baby's out and then to get the and then to 609 00:33:05,200 --> 00:33:07,960 Speaker 2: get the placentas to come out. And it is I 610 00:33:08,000 --> 00:33:13,960 Speaker 2: think very unpleasant for people. Excess rummaging and it's I 611 00:33:13,960 --> 00:33:19,640 Speaker 2: don't know, but I think pressure. That it's because the block, 612 00:33:19,800 --> 00:33:22,920 Speaker 2: the spinal block is excellent at blocking pain, but it 613 00:33:22,960 --> 00:33:26,840 Speaker 2: doesn't really block pressure. It doesn't. It doesn't block a 614 00:33:26,880 --> 00:33:31,880 Speaker 2: feeling that someone's ruming around on your insides. And once 615 00:33:31,920 --> 00:33:34,719 Speaker 2: we you know, people think maybe the cut will hurt. 616 00:33:34,800 --> 00:33:37,400 Speaker 2: Cut never hurts, but once you're inside and if you 617 00:33:37,440 --> 00:33:39,400 Speaker 2: have to rub the outside of the uterus a lot 618 00:33:39,480 --> 00:33:42,080 Speaker 2: to get it to contract when when it's seemed to 619 00:33:42,080 --> 00:33:44,360 Speaker 2: when the babies and the placentas are out, then yeah, 620 00:33:45,200 --> 00:33:48,760 Speaker 2: it can feel very unpleasant. It's a deep pit of 621 00:33:48,800 --> 00:33:52,360 Speaker 2: the stomach unpleasantness that isn't well blocked by the spiral. 622 00:33:53,160 --> 00:34:00,760 Speaker 1: I think from my full caesareans that feeling is the 623 00:34:00,800 --> 00:34:03,880 Speaker 1: only thing that would be very similar or slightly similar 624 00:34:04,080 --> 00:34:07,520 Speaker 1: is when you're really anethetized in your mouth and a 625 00:34:07,680 --> 00:34:11,400 Speaker 1: dentist is pulling a tooth you've ever had, oh, I 626 00:34:11,400 --> 00:34:13,040 Speaker 1: had my wisdom teeth done in the chair. But like 627 00:34:13,120 --> 00:34:16,600 Speaker 1: it's sort of like that really deep sort of pulling 628 00:34:16,920 --> 00:34:23,200 Speaker 1: and pressure feeling. And I remember that from my Cesarean 629 00:34:23,239 --> 00:34:26,760 Speaker 1: sections where it just you did feel like the obstration 630 00:34:26,920 --> 00:34:30,080 Speaker 1: was on you tummy, but you know they're just pushing 631 00:34:30,200 --> 00:34:33,080 Speaker 1: a lot of putting a lot of pressure in and yeah, 632 00:34:33,120 --> 00:34:37,120 Speaker 1: it's none it's unpleasant feeling. 633 00:34:38,320 --> 00:34:38,520 Speaker 2: For me. 634 00:34:38,600 --> 00:34:41,160 Speaker 1: It didn't last too long, sure so, But and it's 635 00:34:41,200 --> 00:34:44,640 Speaker 1: the feeling after the baby's been pulled out, like it's 636 00:34:44,680 --> 00:34:48,759 Speaker 1: just like like it feels like it's a suction, you know, 637 00:34:48,840 --> 00:34:51,040 Speaker 1: like a plunger is just you know, you've taken a 638 00:34:51,040 --> 00:34:54,120 Speaker 1: plunger off the plug hole or something like it. Really 639 00:34:54,800 --> 00:34:57,799 Speaker 1: that it's a feeling that you don't have any other 640 00:34:57,840 --> 00:35:00,000 Speaker 1: way to describe it because it probably never ever happened 641 00:35:00,120 --> 00:35:02,200 Speaker 1: to you in any other way apart from having a 642 00:35:02,239 --> 00:35:07,359 Speaker 1: teeth pulled. So she then finishes with saying that once 643 00:35:07,440 --> 00:35:10,000 Speaker 1: the first twin was out, the second twin sort of 644 00:35:10,040 --> 00:35:12,680 Speaker 1: did move around a bit, you know, described by fish 645 00:35:12,719 --> 00:35:15,719 Speaker 1: circling around in a in a uterus just like you. 646 00:35:15,680 --> 00:35:18,440 Speaker 2: Said, like, yeah, so that uterus hasn't contracted yet, right, 647 00:35:18,480 --> 00:35:20,359 Speaker 2: because it can't because the second baby's still in there. 648 00:35:20,560 --> 00:35:22,480 Speaker 2: So there's all this sort of extra room, and then 649 00:35:22,520 --> 00:35:27,160 Speaker 2: that baby problematically will often stretch out and move around 650 00:35:27,239 --> 00:35:33,200 Speaker 2: and wriggle, and sometimes it's convenient that the head of 651 00:35:33,239 --> 00:35:36,360 Speaker 2: the second baby will come straight up towards the caesar cart. 652 00:35:36,400 --> 00:35:38,320 Speaker 2: And that's great. You just break the waters on the second, 653 00:35:38,320 --> 00:35:41,440 Speaker 2: sack that and squeeze that baby's head out the same 654 00:35:41,440 --> 00:35:44,560 Speaker 2: way to the first. But it's common with the second 655 00:35:44,600 --> 00:35:46,640 Speaker 2: baby to grab them by the feet and bring the 656 00:35:46,719 --> 00:35:49,440 Speaker 2: second baby out as a breach extraction, even if the 657 00:35:49,520 --> 00:35:52,040 Speaker 2: baby wasn't in the breach position. That can just be 658 00:35:52,480 --> 00:35:55,879 Speaker 2: feeder easier to grab than the head, right, And if 659 00:35:55,920 --> 00:35:57,680 Speaker 2: you grab the feet, you can hold on and then 660 00:35:57,719 --> 00:35:59,279 Speaker 2: they can wriggle all they like, which you've got them, 661 00:35:59,280 --> 00:36:01,040 Speaker 2: and then they'll they'll come out. Yeah. 662 00:36:01,080 --> 00:36:01,400 Speaker 1: Wow. 663 00:36:02,440 --> 00:36:07,440 Speaker 2: So you know, even a twin caesar, it's that can 664 00:36:07,440 --> 00:36:10,440 Speaker 2: be challenging and it needs a lot of lot of training. 665 00:36:12,120 --> 00:36:15,279 Speaker 1: Well, I highly recommend, Like we have done a twin 666 00:36:15,320 --> 00:36:22,080 Speaker 1: pregnancy podcast before, and you know, we've had mixed, mainly 667 00:36:22,120 --> 00:36:24,160 Speaker 1: positive reviews on that, like, oh thank god we listened 668 00:36:24,200 --> 00:36:26,439 Speaker 1: to it, because that's exactly what happened to ours. We've 669 00:36:26,440 --> 00:36:28,279 Speaker 1: had one or two people over the years during this 670 00:36:28,400 --> 00:36:31,080 Speaker 1: five years or so now that have said. 671 00:36:30,840 --> 00:36:36,160 Speaker 6: Look, it's it's it's all bad news in our in 672 00:36:36,200 --> 00:36:40,600 Speaker 6: our pregnant, in our twin Pregnancy podcast, and we've denied 673 00:36:40,719 --> 00:36:41,839 Speaker 6: a little bit about. 674 00:36:42,320 --> 00:36:47,160 Speaker 1: Redoing that twin Pregnancy podcast. But again and again and 675 00:36:47,200 --> 00:36:50,399 Speaker 1: again people say that is exactly how my pregnancy went. 676 00:36:50,800 --> 00:36:53,280 Speaker 1: You know, I had my babies at thirty three weeks. 677 00:36:53,440 --> 00:36:55,279 Speaker 1: We went to the special care nursery, or we went 678 00:36:55,320 --> 00:36:58,480 Speaker 1: to NIKU. It was an emergency cisera and it was 679 00:36:58,560 --> 00:37:00,319 Speaker 1: you know, so yes, yeah. 680 00:37:00,120 --> 00:37:04,000 Speaker 2: Look, I think that that is really true, especially of 681 00:37:04,840 --> 00:37:12,239 Speaker 2: multiple pregnancy. It's I think to fully understand what the 682 00:37:12,360 --> 00:37:15,720 Speaker 2: value of the interventions are when it comes to multiple births, 683 00:37:16,239 --> 00:37:18,600 Speaker 2: you have to understand how poor the outcomes used to 684 00:37:18,680 --> 00:37:22,920 Speaker 2: be before scientific before scientific principles were applied to the process. 685 00:37:24,320 --> 00:37:27,640 Speaker 2: And you know, there's no doubt if you look at 686 00:37:28,320 --> 00:37:31,000 Speaker 2: a healthy young woman having a single baby one a time, 687 00:37:31,800 --> 00:37:35,719 Speaker 2: that plenty of people don't need intervention. But if you 688 00:37:35,760 --> 00:37:40,920 Speaker 2: look at multiples, pretty much everybody needs some intervention. If 689 00:37:40,960 --> 00:37:44,040 Speaker 2: we've got any hope of getting the data for twins 690 00:37:44,280 --> 00:37:47,080 Speaker 2: or dripleerts to be anywhere near as good as the 691 00:37:47,160 --> 00:37:50,600 Speaker 2: data for singletons, and I always think that's where we 692 00:37:50,600 --> 00:37:55,640 Speaker 2: should be starting. Yeah, so, I think it is realistic 693 00:37:56,320 --> 00:38:02,800 Speaker 2: for parents of whether the one's pregnant with twins, to 694 00:38:03,280 --> 00:38:11,839 Speaker 2: be expecting some degree of intervention and medicalization of the 695 00:38:11,880 --> 00:38:16,440 Speaker 2: pregnancy in the birth more so, much more pressingly so 696 00:38:17,160 --> 00:38:20,200 Speaker 2: than if there's only one baby. And when I talk 697 00:38:20,239 --> 00:38:23,080 Speaker 2: to people about having a normal vaginal birth of twins, 698 00:38:23,360 --> 00:38:27,120 Speaker 2: I hesitate to use the word normal because it's actually 699 00:38:27,120 --> 00:38:33,120 Speaker 2: a highly inventional, highly medicalized birth. Yeah, if you want, 700 00:38:33,800 --> 00:38:35,600 Speaker 2: if you want the safety data that we can provide 701 00:38:35,600 --> 00:38:36,120 Speaker 2: by doing that. 702 00:38:36,280 --> 00:38:40,799 Speaker 1: Yeah, Well, I think Jesse's story is great listening even 703 00:38:40,840 --> 00:38:44,600 Speaker 1: if you're not pregnancy pregnant with twins. They go on 704 00:38:44,760 --> 00:38:48,280 Speaker 1: and talk about their journey after the twins were born, 705 00:38:48,480 --> 00:38:53,120 Speaker 1: and how they went to NICU and then special care nursery, 706 00:38:53,120 --> 00:38:56,160 Speaker 1: but then Margo the girl had to go back into 707 00:38:56,480 --> 00:39:00,600 Speaker 1: NIKU situation and moving hospitals and how that's been a 708 00:39:00,640 --> 00:39:04,719 Speaker 1: week on and what their job as parents, basically, they say, 709 00:39:04,920 --> 00:39:07,680 Speaker 1: is just to go and cuddle those babies, and how 710 00:39:07,680 --> 00:39:09,840 Speaker 1: beautiful and respectful the NIKU is. 711 00:39:10,600 --> 00:39:12,200 Speaker 2: And there's a lot of good listening there for Yeah. 712 00:39:12,239 --> 00:39:15,040 Speaker 1: Yeah, so go and have a listen. Come back to 713 00:39:15,080 --> 00:39:17,360 Speaker 1: this and see if you need further explanation of a 714 00:39:17,400 --> 00:39:20,920 Speaker 1: few things. And we hope that's been useful for you today. 715 00:39:21,719 --> 00:39:25,080 Speaker 1: All Right, everybody, that's all we've got until next week 716 00:39:25,160 --> 00:39:27,360 Speaker 1: when we're back in your ears. Have a great week 717 00:39:27,400 --> 00:39:28,720 Speaker 1: and keep growing those babies. 718 00:39:28,800 --> 00:39:29,920 Speaker 2: Thanks for listening, everybody. 719 00:39:29,960 --> 00:39:38,480 Speaker 1: Okay, bye for now. Hey, even though doctor Pat is 720 00:39:38,600 --> 00:39:41,000 Speaker 1: well a doctor and we get lots of other doctors 721 00:39:41,000 --> 00:39:43,840 Speaker 1: and other experts on our podcast, I just need to 722 00:39:43,840 --> 00:39:47,960 Speaker 1: remind you that this podcast is for informational purposes only. 723 00:39:48,600 --> 00:39:52,080 Speaker 1: We share lots of medical insights and experience, but everything 724 00:39:52,120 --> 00:39:55,120 Speaker 1: we talk about is general in nature and may not 725 00:39:55,200 --> 00:39:59,440 Speaker 1: apply to your specific situation. Please always consult with your 726 00:39:59,440 --> 00:40:03,279 Speaker 1: own health care provider for your individual medical advice when 727 00:40:03,280 --> 00:40:04,160 Speaker 1: you grow your baby.