Speaker 1: You're listening to a Muma Mia podcast.
Speaker 2: Mom and Mayor acknowledges the traditional owners of land and
Speaker 2: waters that this podcast is recorded on.
Speaker 3: I am pregnanty.
Speaker 2: Welcome to Hello Bump. We're making pregnancy less overwhelming and
Speaker 2: more manageable. I'm Gracery Ray. I'm pregnant for the first time.
Speaker 2: I'm in the wrong week thirty weeks, thirty weeks, thirty weeks. Sorry,
Speaker 2: I'm Gracey Ray. I'm pregnant for the first time and
Speaker 2: things are getting uncomfortable. I thought they were uncomfortable, but
Speaker 2: now they're uncomfortable and.
Speaker 1: That's gonna get work. Sorry guys listening.
Speaker 3: I'm young A Pittman. I'm a former sportsperson for Australia.
Speaker 3: I'm a mother of six little humans, and I'm training
Speaker 3: to be an obstetrician.
Speaker 2: Each episode, we will be holding your hand week by
Speaker 2: week through the mysterious, perplexing and often uncomfortable but still
Speaker 2: miracle that is pregnancy, all the way from a poppy
Speaker 2: seed to a pumpkin.
Speaker 3: Week thirty five five, Oh hang on, no, that's right,
Speaker 3: and in o stetch weeks we see that it's a
Speaker 3: big milestone week. So this is often the goal of
Speaker 3: people who are unfortunately in preterm labor or concern their
Speaker 3: babies coming early to reach that thirty week mark. Babies
Speaker 3: have really really good outcomes from this point.
Speaker 2: Forward pretty much. What's the percentage of viable? Would you say?
Speaker 3: Very close to ninety five and above? So we have
Speaker 3: I mean again, it depends on what condition that little
Speaker 3: baby is born in. So but if that little one
Speaker 3: comes out and has had steroids to mature its lungs
Speaker 3: and sometimes what we call some magnesium sulfate for its
Speaker 3: brain development, then we have a very good chance that
Speaker 3: they'll do well.
Speaker 1: Still a prolonged stay in you qugo.
Speaker 3: Yeah, they're going to be there for a few months,
Speaker 3: and things like feeding and whether they get an infection
Speaker 3: in the noon. Adult care unities will determine the prognosis.
Speaker 3: But like ninety five is pretty quid. Yeah, getting up
Speaker 3: there now.
Speaker 2: And for their size. I have a little mini beach ball.
Speaker 1: I like that, like one of those little red and
Speaker 1: white ones. Yeah, yes, I love it, you love it?
Speaker 1: Love it?
Speaker 3: A bag of sugar great, and a blackfooted ferret cute?
Speaker 1: Do we have those in Australia?
Speaker 2: It sounds cute?
Speaker 1: Right, We'll go with that or a pest or a pest.
Speaker 2: Which is both it could be one yeah, yeah, And scientifically,
Speaker 2: how big are they.
Speaker 3: Well, we're getting up to about one point five kilos now,
Speaker 3: but again the variation is super kicking in at this point,
Speaker 3: so we can have some babies down at seven eight
Speaker 3: hundred grams because they're really growth restricted, and we're.
Speaker 1: Definitely starting to zee babies now starting to lay on
Speaker 1: some of that fat.
Speaker 3: Which is one of the biggest things we start seeing
Speaker 3: with Bubby now is that though they start looking plumper
Speaker 3: on the ultrasounds and they're actually starting to put some
Speaker 3: of those fat stores down, different fat from what we've got.
Speaker 3: They have brown fat more than we do because that's
Speaker 3: where we'll keep them warm when they're actually born. They've
Speaker 3: got that Lanugo hair. So if you ever see babies
Speaker 3: that are born early that have really fluffy like hair,
Speaker 3: that'll start actually moving around and disappearing now and they'll
Speaker 3: start growing toenails, which is I think very cute.
Speaker 2: That's weird. It's weird what's happening to me and what's
Speaker 2: happening to us.
Speaker 3: So you're continuing to grow as you'll be feeling. I
Speaker 3: have to say I'm glad it's not me. I've done
Speaker 3: it so many times. But the ligaments and muscles are
Speaker 3: certainly stretching around. That uterus is really pushing up under
Speaker 3: that ribcage now. So you might find you get some
Speaker 3: aches and pains, you're walking along, your knees get a
Speaker 3: bit wobbly, your hips start getting a bit looser because
Speaker 3: you are around ten weeks away from having your baby.
Speaker 2: I haven't a question that I'm hoping is optimistic. If
Speaker 2: I haven't got stretched months yet, does that mean I
Speaker 2: won't or you're pretty lucky.
Speaker 3: People see their linear albo getting darker. That's big, the
Speaker 3: dark line from their pubic bone up towards their belly button.
Speaker 3: Most people start feeling stretched earlier than this. You still can,
Speaker 3: don't get me wrong. It can happen at any time
Speaker 3: if you have a big rapid growth. What we do
Speaker 3: find women sometimes started to feel is that separation in
Speaker 3: the rectus muscle. So you might find you literally sit
Speaker 3: up in night and you feel this big separation and
Speaker 3: you do need to watch that, and it is something
Speaker 3: that can be worked on with physiotherapy after birth. But
Speaker 3: now it's actually important that when you sit up, you
Speaker 3: don't actually.
Speaker 1: Pull yourself up.
Speaker 3: We want you to roll to your side and then
Speaker 3: actually use your hand to help you push yourself up.
Speaker 3: And I'll actually protect your abdominal muscles as you move
Speaker 3: through the next few weeks of pregnancy.
Speaker 2: And I even from rolling like I'm obviously sleeping on
Speaker 2: my side, even going from one side to the other
Speaker 2: side is a bit of effort.
Speaker 3: It is becoming more and more exactly, and it'll get
Speaker 3: even more difficult through the night. And it's actually a
Speaker 3: good point to raise at the moment. We definitely want
Speaker 3: you to sleep on your side, so we do. At
Speaker 3: this point most of your midwives will be encouraging are
Speaker 3: you sleeping on your side? But let's burst that bubble
Speaker 3: there as well. If you find yourself awake on your
Speaker 3: back at night.
Speaker 2: It's okay, we haven't, right, we can't.
Speaker 1: You haven't. You haven't stopped your baby's growth.
Speaker 3: Now. The reason we do it is because you're actually
Speaker 3: sitting on your big vessels. So you order you and
Speaker 3: your IVC, which is returning the blood flow from your
Speaker 3: lower limbs up to your heart so you can get
Speaker 3: more demail, which is swelling in the lower legs, and
Speaker 3: ultimately you know, we want to have that percent of
Speaker 3: being nice and fueled by your blood. But you can't
Speaker 3: stop what you do when you sleep, guys, so you
Speaker 3: just try your best. Start on your side and if
Speaker 3: you roll onto your back and you wake up, just
Speaker 3: roll back to your side.
Speaker 2: Is this normal?
Speaker 1: Normal?
Speaker 2: Haven't? Is this normal that I think is quite common
Speaker 2: and it's having to be sent for additional growth scans? Yeah?
Speaker 3: Great?
Speaker 1: One.
Speaker 2: So they measure in my midwife appointments, they measure is
Speaker 2: it called fundl height, Yes, you got it. So they
Speaker 2: measured my fund to height every two weeks and it
Speaker 2: was like twenty eight point five centimeters, and then two
Speaker 2: weeks later it was twenty nine centimeters, and then two
Speaker 2: weeks later it was twenty nine centimeters. Again. Interesting, So
Speaker 2: they said, you just haven't. They said, look, that could
Speaker 2: be the position, like she could have moved from. She
Speaker 2: would be transfers right transversely. I don't know any of
Speaker 2: the other terms, but one which they said, we're not worried,
Speaker 2: but let's just send you for another scan and any
Speaker 2: additional tests is just petrifying for people who don't understand.
Speaker 2: When I did start sending texts to friends, it turns
Speaker 2: out like a lot of women have had to have
Speaker 2: additional scans. But then the commentary online is also to
Speaker 2: be sent for growth scans is also controversial because it's
Speaker 2: hard to.
Speaker 1: Interpret them properly.
Speaker 3: Yes, that's right, So there is a lot of information there.
Speaker 3: I mean, the first one is your fundle Height's amazing.
Speaker 3: It actually matches your gestation in most cases. So when
Speaker 3: you're thirty two weeks, you'll have a thirty two centimeter
Speaker 3: fund to height, and we measure it from your pubic
Speaker 3: bone to the top of your funders, which is the
Speaker 3: very top of your uterus, the highest roundest point. And
Speaker 3: so yes, if you're two to three centimeters either way
Speaker 3: above your gestation or below, that is warrant for an
Speaker 3: ultrasound because it can indicate the baby's in the tubug
Speaker 3: too small. Again, as you said, beautifully, ultra sounds u
Speaker 3: notoriously wrong. They can be quite a couple of hundred
Speaker 3: grams either side wrong. So someone might say, and we
Speaker 3: see it all the time. We see a lady being
Speaker 3: induced for a big baby and it's supposed to be
Speaker 3: four point five kilos and it comes out at three
Speaker 3: point eight. So it's not a perfect science, but it's
Speaker 3: the best thing we have, and what it does pick
Speaker 3: up is those very very small babies and those very
Speaker 3: very macrosomic large forgestational aged babies where things need to
Speaker 3: be monitored because we don't want someone going to forty
Speaker 3: two weeks with a five and a half kilo baby.
Speaker 3: That is difficult and leads to things like shouldered destocia
Speaker 3: and really bad paraneal tearing. The same goes if you
Speaker 3: have a little baby, we don't want to be pushing
Speaker 3: her or him to forty weeks if we know that
Speaker 3: that placenta is no longer working well. And that's what
Speaker 3: those growth scans are for, so if we're concerned, we
Speaker 3: check it. We check the dopplers, the flow of blood
Speaker 3: to the baby, from the placenta to baby, and how
Speaker 3: that baby's distributing the blood around its body. So for example,
Speaker 3: if it's struggling from the placental perspective, it'll start sending
Speaker 3: more blood to the brain and ensuring that the vital
Speaker 3: organs get more and so you might see the baby
Speaker 3: has a smaller tummy, which is called its ac so
Speaker 3: it's abdominal circumference might get smaller because it's preserving its
Speaker 3: energy and its nutrition. For its heart and its brain.
Speaker 3: So there's all these amazing signs that we can see
Speaker 3: on the ultrasound, but please don't read into it entirely.
Speaker 3: The weight is always wrong. And the biggest thing is
Speaker 3: the closer you get in gestation to term, the harder
Speaker 3: it is to accurately measure the size of your baby.
Speaker 3: So if you look at your report, it'll often say
Speaker 3: three point two kilos plus or minus four hundred and
Speaker 3: fifty grams, So that means your baby's actually either two
Speaker 3: point eight or it's three point seven. You know, like
Speaker 3: there's a very big difference if your baby's actually three
Speaker 3: point two versus much much smaller versus much bigger. So
Speaker 3: it's a window that we can look into, which I
Speaker 3: think the last thing is important is why that's how
Speaker 3: we do we call serial growth scans, because I wh're
Speaker 3: not looking at the baby in a split second of time.
Speaker 3: We want to see what it was at twenty eight weeks,
Speaker 3: what it was at thirty weeks, what was at thirty
Speaker 3: four weeks, so you can actually see that change in
Speaker 3: growth as the baby develops in utero. Is this normal?
Speaker 1: Normal?
Speaker 2: So one of the things that my midwife also said
Speaker 2: is you know, book in for your thirty four weeks
Speaker 2: or your thirty six week scan, And she didn't try
Speaker 2: to get me to not book it, but just said,
Speaker 2: this can open a can of worms.
Speaker 1: Yeah, I love this.
Speaker 2: This is going good because of this exact thing that
Speaker 2: people can get freaked out about it head correct or
Speaker 2: I should induce because of all of these things, which
Speaker 2: can then again open another can of worms. So what's
Speaker 2: your opinion on it?
Speaker 3: Look, it's hard because if you're having an ultrasound for
Speaker 3: the right reason, if you've got diabetes, if you're a smoker,
Speaker 3: if you've had a previously pre termed baby that was tiny,
Speaker 3: they're all very good reasons to have ultrasounds.
Speaker 1: Don't get me wrong.
Speaker 3: I liked having LCOT sounds because I liked looking at
Speaker 3: my baby, so I probably had a few more than
Speaker 3: I needed. And certainly in my first pregnancy, I was
Speaker 3: training full time for the Olympics and there was no
Speaker 3: data out there as to how much was okay to train,
Speaker 3: so I was having them two weekly because we were
Speaker 3: worried that the amount I was training might affect the bubby.
Speaker 3: Not a concern at all, Just so we all know now,
Speaker 3: because everyone trains in pregnancy, But so I think if
Speaker 3: there's a good medical reason to have them, then yes,
Speaker 3: because you know, the last thing you want to do
Speaker 3: is have and I'm sorry to say this guy's it's
Speaker 3: very serious, but it's a baby that passes away inside
Speaker 3: because we've missed those early warning signs. And that's what
Speaker 3: all this is about. Those fundel how it measurements. Is
Speaker 3: your baby doing well where we expect him or her
Speaker 3: to be. Does that ultrasound look relatively normal, because remember
Speaker 3: it's a percentage of normal, so you know, there has
Speaker 3: to be ninety eight centil babies and there has to
Speaker 3: be second centil babies, and we just need to know
Speaker 3: where your little one sits so that we can make
Speaker 3: plans around what's safe for your birth. But the one
Speaker 3: I do worry about is the ultra sand at thirty
Speaker 3: six weeks, which tells you've got an enormous baby and
Speaker 3: you don't have diabetes and you don't have any medical
Speaker 3: reason why your baby's huge. That's one I think that
Speaker 3: you need to really have a long discussion with your
Speaker 3: midwife about because they're the ones where you start making
Speaker 3: decisions around birth and induction, which may or may not
Speaker 3: be the right decision for you, Amoe with the diabetes
Speaker 3: that's not well controlled. With a big baby, that's a
Speaker 3: very very different story, and that's when an induction of
Speaker 3: labor for a big baby can avoid the very real
Speaker 3: risk of should of destocia.
Speaker 2: And what can we do this week? What's important at
Speaker 2: week thirty I.
Speaker 3: Think the big thing we need to watch this week
Speaker 3: is to we kind of touch on a little bit
Speaker 3: of the funnel height. Actually, is to not worry about what
Speaker 3: position your baby is in because you're right, a transverse baby,
Speaker 3: which basically means a baby that's lying sideways at thirty weeks,
Speaker 3: makes absolutely no difference at all, unless you unfortunately break
Speaker 3: your waters today and go into labor, then it does matter.
Speaker 3: But most of these little ones are going to either
Speaker 3: go kethalic which means head down or breach, which means
Speaker 3: bum down, and most of the time bum down is
Speaker 3: where you're presenting with their little bottom or their feet. Now, again,
Speaker 3: there's lots of complexities around that we don't need to
Speaker 3: go into because the bottom line is, at thirty weeks,
Speaker 3: it does not matter what position your baby is in,
Speaker 3: but what it can do is affect your fundl height
Speaker 3: because obviously, if you haven't got a longitudinal baby that's
Speaker 3: lying length wise in the uterus, it can misshape in
Speaker 3: your uterus a little bit and change what that funnel
Speaker 3: hight does.
Speaker 2: I have a dumb question, no questions, dube, how much
Speaker 2: range of moving around do babies have? Because when I
Speaker 2: have gone in for measurements a lot of them, and
Speaker 2: when you've also felt my ballet in this record, she's
Speaker 2: always been head down in some way, but then maybe
Speaker 2: just other times gone slightly transverse, which is great because
Speaker 2: I'd love to deliver vaginally, But is there a world
Speaker 2: in which she just flips up and is breach? If
Speaker 2: she's been quite in this place down position for.
Speaker 1: Weeks, it can change, you know.
Speaker 3: Obviously, if her baby's been committed to head down, there's
Speaker 3: less likely, and the closer towards full term you get,
Speaker 3: the less likely babies move because I just don't have
Speaker 3: the room to do so. But certainly at thirty weeks
Speaker 3: your baby could change four or five times a day
Speaker 3: from cathalic as in head down to bum down to
Speaker 3: ankle down to foot to shoulder and it's okay. So
Speaker 3: as we get closer to birth, if your baby that
Speaker 3: actually is what we call an unstable lie. We don't
Speaker 3: like it as much, but it even does happen. At
Speaker 3: thirty eight and thirty nine weeks in fact, Grace I
Speaker 3: was in the middle of doing a cesarean section.
Speaker 1: I ultra sounded her before I went in.
Speaker 3: She was definitely Catholic, but it came out bump first,
Speaker 3: so that little one turned in labor.
Speaker 1: And so it absolutely does happen.
Speaker 2: And should you be worried if they're not having a
Speaker 2: lot of movement, like there's obviously like I feel like movement,
Speaker 2: but if they're not having big position changes or do
Speaker 2: babies just get a spot they like and get comfortable.
Speaker 3: Again, every baby's different, and it's so it's so funny
Speaker 3: because I reckon if I had a dollar for every
Speaker 3: question someone asked me how much movement is normal for
Speaker 3: my baby, I would not be working at all. Any
Speaker 3: might be retired, living in Hamilton Island or something. But
Speaker 3: because we can't tell you, every baby is different. So
Speaker 3: it's about their own pattern and what they do. But
Speaker 3: if you've got absent movements or decreased movements from what
Speaker 3: they're normally doing, that's when you need to come in
Speaker 3: as you get closer to term. They don't do as
Speaker 3: bigger movements because there's not as much room, but the
Speaker 3: frequency and the strength should still be there.
Speaker 2: We hope you enjoyed this episode of Hello Bump. We
Speaker 2: have so many episodes of this series filled with tips
Speaker 2: and stories from women and experts who've been through it
Speaker 2: all before.
Speaker 3: You can go back and listen to everything else Hello
Speaker 3: Bump related in this podcast.
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Speaker 3: This episode was produced by Courtney Ammenhauser with audio production
Speaker 3: by Tom Lyon.
Speaker 1: We'll catch you next time.
Speaker 2: This episode of Hello Bump was made in partnership with Huggies.
Speaker 2: Bye Bye