WEBVTT - Week 30: Why Do I Need Additional Growth Scans And Will My Baby Change Position?

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<v Speaker 1>You're listening to a Muma Mia podcast.

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

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

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<v Speaker 3>I am pregnanty.

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

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<v Speaker 2>more manageable. I'm Gracery Ray. I'm pregnant for the first time.

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<v Speaker 2>I'm in the wrong week thirty weeks, thirty weeks, thirty weeks. Sorry,

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<v Speaker 2>I'm Gracey Ray. I'm pregnant for the first time and

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<v Speaker 2>things are getting uncomfortable. I thought they were uncomfortable, but

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<v Speaker 2>now they're uncomfortable and.

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<v Speaker 1>That's gonna get work. Sorry guys listening.

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<v Speaker 3>I'm young A Pittman. I'm a former sportsperson for Australia.

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<v Speaker 3>I'm a mother of six little humans, and I'm training

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<v Speaker 3>to be an obstetrician.

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<v Speaker 2>Each episode, we will be holding your hand week by

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<v Speaker 2>week through the mysterious, perplexing and often uncomfortable but still

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<v Speaker 2>miracle that is pregnancy, all the way from a poppy

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<v Speaker 2>seed to a pumpkin.

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<v Speaker 3>Week thirty five five, Oh hang on, no, that's right,

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<v Speaker 3>and in o stetch weeks we see that it's a

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<v Speaker 3>big milestone week. So this is often the goal of

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<v Speaker 3>people who are unfortunately in preterm labor or concern their

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<v Speaker 3>babies coming early to reach that thirty week mark. Babies

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<v Speaker 3>have really really good outcomes from this point.

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<v Speaker 2>Forward pretty much. What's the percentage of viable? Would you say?

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<v Speaker 3>Very close to ninety five and above? So we have

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<v Speaker 3>I mean again, it depends on what condition that little

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<v Speaker 3>baby is born in. So but if that little one

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<v Speaker 3>comes out and has had steroids to mature its lungs

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<v Speaker 3>and sometimes what we call some magnesium sulfate for its

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<v Speaker 3>brain development, then we have a very good chance that

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<v Speaker 3>they'll do well.

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<v Speaker 1>Still a prolonged stay in you qugo.

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<v Speaker 3>Yeah, they're going to be there for a few months,

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<v Speaker 3>and things like feeding and whether they get an infection

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<v Speaker 3>in the noon. Adult care unities will determine the prognosis.

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<v Speaker 3>But like ninety five is pretty quid. Yeah, getting up

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<v Speaker 3>there now.

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<v Speaker 2>And for their size. I have a little mini beach ball.

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<v Speaker 1>I like that, like one of those little red and

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<v Speaker 1>white ones. Yeah, yes, I love it, you love it?

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<v Speaker 1>Love it?

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<v Speaker 3>A bag of sugar great, and a blackfooted ferret cute?

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<v Speaker 1>Do we have those in Australia?

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<v Speaker 2>It sounds cute?

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<v Speaker 1>Right, We'll go with that or a pest or a pest.

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<v Speaker 2>Which is both it could be one yeah, yeah, And scientifically,

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<v Speaker 2>how big are they.

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<v Speaker 3>Well, we're getting up to about one point five kilos now,

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<v Speaker 3>but again the variation is super kicking in at this point,

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<v Speaker 3>so we can have some babies down at seven eight

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<v Speaker 3>hundred grams because they're really growth restricted, and we're.

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<v Speaker 1>Definitely starting to zee babies now starting to lay on

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<v Speaker 1>some of that fat.

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<v Speaker 3>Which is one of the biggest things we start seeing

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<v Speaker 3>with Bubby now is that though they start looking plumper

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<v Speaker 3>on the ultrasounds and they're actually starting to put some

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<v Speaker 3>of those fat stores down, different fat from what we've got.

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<v Speaker 3>They have brown fat more than we do because that's

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<v Speaker 3>where we'll keep them warm when they're actually born. They've

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<v Speaker 3>got that Lanugo hair. So if you ever see babies

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<v Speaker 3>that are born early that have really fluffy like hair,

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<v Speaker 3>that'll start actually moving around and disappearing now and they'll

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<v Speaker 3>start growing toenails, which is I think very cute.

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<v Speaker 2>That's weird. It's weird what's happening to me and what's

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<v Speaker 2>happening to us.

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<v Speaker 3>So you're continuing to grow as you'll be feeling. I

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<v Speaker 3>have to say I'm glad it's not me. I've done

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<v Speaker 3>it so many times. But the ligaments and muscles are

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<v Speaker 3>certainly stretching around. That uterus is really pushing up under

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<v Speaker 3>that ribcage now. So you might find you get some

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<v Speaker 3>aches and pains, you're walking along, your knees get a

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<v Speaker 3>bit wobbly, your hips start getting a bit looser because

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<v Speaker 3>you are around ten weeks away from having your baby.

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<v Speaker 2>I haven't a question that I'm hoping is optimistic. If

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<v Speaker 2>I haven't got stretched months yet, does that mean I

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<v Speaker 2>won't or you're pretty lucky.

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<v Speaker 3>People see their linear albo getting darker. That's big, the

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<v Speaker 3>dark line from their pubic bone up towards their belly button.

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<v Speaker 3>Most people start feeling stretched earlier than this. You still can,

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<v Speaker 3>don't get me wrong. It can happen at any time

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<v Speaker 3>if you have a big rapid growth. What we do

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<v Speaker 3>find women sometimes started to feel is that separation in

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<v Speaker 3>the rectus muscle. So you might find you literally sit

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<v Speaker 3>up in night and you feel this big separation and

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<v Speaker 3>you do need to watch that, and it is something

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<v Speaker 3>that can be worked on with physiotherapy after birth. But

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<v Speaker 3>now it's actually important that when you sit up, you

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<v Speaker 3>don't actually.

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<v Speaker 1>Pull yourself up.

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<v Speaker 3>We want you to roll to your side and then

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<v Speaker 3>actually use your hand to help you push yourself up.

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<v Speaker 3>And I'll actually protect your abdominal muscles as you move

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<v Speaker 3>through the next few weeks of pregnancy.

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<v Speaker 2>And I even from rolling like I'm obviously sleeping on

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<v Speaker 2>my side, even going from one side to the other

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<v Speaker 2>side is a bit of effort.

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<v Speaker 3>It is becoming more and more exactly, and it'll get

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<v Speaker 3>even more difficult through the night. And it's actually a

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<v Speaker 3>good point to raise at the moment. We definitely want

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<v Speaker 3>you to sleep on your side, so we do. At

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<v Speaker 3>this point most of your midwives will be encouraging are

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<v Speaker 3>you sleeping on your side? But let's burst that bubble

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<v Speaker 3>there as well. If you find yourself awake on your

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<v Speaker 3>back at night.

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<v Speaker 2>It's okay, we haven't, right, we can't.

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<v Speaker 1>You haven't. You haven't stopped your baby's growth.

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<v Speaker 3>Now. The reason we do it is because you're actually

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<v Speaker 3>sitting on your big vessels. So you order you and

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<v Speaker 3>your IVC, which is returning the blood flow from your

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<v Speaker 3>lower limbs up to your heart so you can get

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<v Speaker 3>more demail, which is swelling in the lower legs, and

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<v Speaker 3>ultimately you know, we want to have that percent of

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<v Speaker 3>being nice and fueled by your blood. But you can't

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<v Speaker 3>stop what you do when you sleep, guys, so you

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<v Speaker 3>just try your best. Start on your side and if

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<v Speaker 3>you roll onto your back and you wake up, just

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<v Speaker 3>roll back to your side.

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<v Speaker 2>Is this normal?

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<v Speaker 1>Normal?

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<v Speaker 2>Haven't? Is this normal that I think is quite common

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<v Speaker 2>and it's having to be sent for additional growth scans? Yeah?

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<v Speaker 3>Great?

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<v Speaker 1>One.

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<v Speaker 2>So they measure in my midwife appointments, they measure is

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<v Speaker 2>it called fundl height, Yes, you got it. So they

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<v Speaker 2>measured my fund to height every two weeks and it

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<v Speaker 2>was like twenty eight point five centimeters, and then two

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<v Speaker 2>weeks later it was twenty nine centimeters, and then two

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<v Speaker 2>weeks later it was twenty nine centimeters. Again. Interesting, So

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<v Speaker 2>they said, you just haven't. They said, look, that could

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<v Speaker 2>be the position, like she could have moved from. She

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<v Speaker 2>would be transfers right transversely. I don't know any of

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<v Speaker 2>the other terms, but one which they said, we're not worried,

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<v Speaker 2>but let's just send you for another scan and any

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<v Speaker 2>additional tests is just petrifying for people who don't understand.

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<v Speaker 2>When I did start sending texts to friends, it turns

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<v Speaker 2>out like a lot of women have had to have

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<v Speaker 2>additional scans. But then the commentary online is also to

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<v Speaker 2>be sent for growth scans is also controversial because it's

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<v Speaker 2>hard to.

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<v Speaker 1>Interpret them properly.

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<v Speaker 3>Yes, that's right, So there is a lot of information there.

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<v Speaker 3>I mean, the first one is your fundle Height's amazing.

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<v Speaker 3>It actually matches your gestation in most cases. So when

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<v Speaker 3>you're thirty two weeks, you'll have a thirty two centimeter

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<v Speaker 3>fund to height, and we measure it from your pubic

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<v Speaker 3>bone to the top of your funders, which is the

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<v Speaker 3>very top of your uterus, the highest roundest point. And

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<v Speaker 3>so yes, if you're two to three centimeters either way

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<v Speaker 3>above your gestation or below, that is warrant for an

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<v Speaker 3>ultrasound because it can indicate the baby's in the tubug

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<v Speaker 3>too small. Again, as you said, beautifully, ultra sounds u

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<v Speaker 3>notoriously wrong. They can be quite a couple of hundred

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<v Speaker 3>grams either side wrong. So someone might say, and we

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<v Speaker 3>see it all the time. We see a lady being

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<v Speaker 3>induced for a big baby and it's supposed to be

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<v Speaker 3>four point five kilos and it comes out at three

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<v Speaker 3>point eight. So it's not a perfect science, but it's

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<v Speaker 3>the best thing we have, and what it does pick

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<v Speaker 3>up is those very very small babies and those very

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<v Speaker 3>very macrosomic large forgestational aged babies where things need to

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<v Speaker 3>be monitored because we don't want someone going to forty

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<v Speaker 3>two weeks with a five and a half kilo baby.

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<v Speaker 3>That is difficult and leads to things like shouldered destocia

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<v Speaker 3>and really bad paraneal tearing. The same goes if you

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<v Speaker 3>have a little baby, we don't want to be pushing

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<v Speaker 3>her or him to forty weeks if we know that

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<v Speaker 3>that placenta is no longer working well. And that's what

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<v Speaker 3>those growth scans are for, so if we're concerned, we

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<v Speaker 3>check it. We check the dopplers, the flow of blood

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<v Speaker 3>to the baby, from the placenta to baby, and how

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<v Speaker 3>that baby's distributing the blood around its body. So for example,

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<v Speaker 3>if it's struggling from the placental perspective, it'll start sending

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<v Speaker 3>more blood to the brain and ensuring that the vital

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<v Speaker 3>organs get more and so you might see the baby

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<v Speaker 3>has a smaller tummy, which is called its ac so

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<v Speaker 3>it's abdominal circumference might get smaller because it's preserving its

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<v Speaker 3>energy and its nutrition. For its heart and its brain.

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<v Speaker 3>So there's all these amazing signs that we can see

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<v Speaker 3>on the ultrasound, but please don't read into it entirely.

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<v Speaker 3>The weight is always wrong. And the biggest thing is

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<v Speaker 3>the closer you get in gestation to term, the harder

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<v Speaker 3>it is to accurately measure the size of your baby.

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<v Speaker 3>So if you look at your report, it'll often say

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<v Speaker 3>three point two kilos plus or minus four hundred and

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<v Speaker 3>fifty grams, So that means your baby's actually either two

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<v Speaker 3>point eight or it's three point seven. You know, like

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<v Speaker 3>there's a very big difference if your baby's actually three

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<v Speaker 3>point two versus much much smaller versus much bigger. So

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<v Speaker 3>it's a window that we can look into, which I

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<v Speaker 3>think the last thing is important is why that's how

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<v Speaker 3>we do we call serial growth scans, because I wh're

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<v Speaker 3>not looking at the baby in a split second of time.

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<v Speaker 3>We want to see what it was at twenty eight weeks,

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<v Speaker 3>what it was at thirty weeks, what was at thirty

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<v Speaker 3>four weeks, so you can actually see that change in

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<v Speaker 3>growth as the baby develops in utero. Is this normal?

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<v Speaker 1>Normal?

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<v Speaker 2>So one of the things that my midwife also said

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<v Speaker 2>is you know, book in for your thirty four weeks

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<v Speaker 2>or your thirty six week scan, And she didn't try

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<v Speaker 2>to get me to not book it, but just said,

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<v Speaker 2>this can open a can of worms.

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<v Speaker 1>Yeah, I love this.

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<v Speaker 2>This is going good because of this exact thing that

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<v Speaker 2>people can get freaked out about it head correct or

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<v Speaker 2>I should induce because of all of these things, which

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<v Speaker 2>can then again open another can of worms. So what's

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<v Speaker 2>your opinion on it?

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<v Speaker 3>Look, it's hard because if you're having an ultrasound for

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<v Speaker 3>the right reason, if you've got diabetes, if you're a smoker,

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<v Speaker 3>if you've had a previously pre termed baby that was tiny,

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<v Speaker 3>they're all very good reasons to have ultrasounds.

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<v Speaker 1>Don't get me wrong.

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<v Speaker 3>I liked having LCOT sounds because I liked looking at

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<v Speaker 3>my baby, so I probably had a few more than

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<v Speaker 3>I needed. And certainly in my first pregnancy, I was

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<v Speaker 3>training full time for the Olympics and there was no

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<v Speaker 3>data out there as to how much was okay to train,

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<v Speaker 3>so I was having them two weekly because we were

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<v Speaker 3>worried that the amount I was training might affect the bubby.

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<v Speaker 3>Not a concern at all, Just so we all know now,

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<v Speaker 3>because everyone trains in pregnancy, But so I think if

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<v Speaker 3>there's a good medical reason to have them, then yes,

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<v Speaker 3>because you know, the last thing you want to do

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<v Speaker 3>is have and I'm sorry to say this guy's it's

0:09:05.429 --> 0:09:07.669
<v Speaker 3>very serious, but it's a baby that passes away inside

0:09:07.709 --> 0:09:10.509
<v Speaker 3>because we've missed those early warning signs. And that's what

0:09:10.549 --> 0:09:12.709
<v Speaker 3>all this is about. Those fundel how it measurements. Is

0:09:13.029 --> 0:09:14.829
<v Speaker 3>your baby doing well where we expect him or her

0:09:14.829 --> 0:09:17.789
<v Speaker 3>to be. Does that ultrasound look relatively normal, because remember

0:09:17.789 --> 0:09:20.109
<v Speaker 3>it's a percentage of normal, so you know, there has

0:09:20.149 --> 0:09:21.789
<v Speaker 3>to be ninety eight centil babies and there has to

0:09:21.789 --> 0:09:24.269
<v Speaker 3>be second centil babies, and we just need to know

0:09:24.349 --> 0:09:25.989
<v Speaker 3>where your little one sits so that we can make

0:09:26.029 --> 0:09:28.109
<v Speaker 3>plans around what's safe for your birth. But the one

0:09:28.149 --> 0:09:29.989
<v Speaker 3>I do worry about is the ultra sand at thirty

0:09:29.989 --> 0:09:32.429
<v Speaker 3>six weeks, which tells you've got an enormous baby and

0:09:32.469 --> 0:09:34.749
<v Speaker 3>you don't have diabetes and you don't have any medical

0:09:34.749 --> 0:09:37.509
<v Speaker 3>reason why your baby's huge. That's one I think that

0:09:37.549 --> 0:09:39.109
<v Speaker 3>you need to really have a long discussion with your

0:09:39.109 --> 0:09:41.789
<v Speaker 3>midwife about because they're the ones where you start making

0:09:41.789 --> 0:09:45.109
<v Speaker 3>decisions around birth and induction, which may or may not

0:09:45.509 --> 0:09:48.029
<v Speaker 3>be the right decision for you, Amoe with the diabetes

0:09:48.069 --> 0:09:50.709
<v Speaker 3>that's not well controlled. With a big baby, that's a

0:09:50.869 --> 0:09:53.029
<v Speaker 3>very very different story, and that's when an induction of

0:09:53.109 --> 0:09:55.669
<v Speaker 3>labor for a big baby can avoid the very real

0:09:55.749 --> 0:09:56.789
<v Speaker 3>risk of should of destocia.

0:09:59.229 --> 0:10:01.509
<v Speaker 2>And what can we do this week? What's important at

0:10:01.509 --> 0:10:02.389
<v Speaker 2>week thirty I.

0:10:02.349 --> 0:10:03.909
<v Speaker 3>Think the big thing we need to watch this week

0:10:04.029 --> 0:10:05.349
<v Speaker 3>is to we kind of touch on a little bit

0:10:05.349 --> 0:10:07.749
<v Speaker 3>of the funnel height. Actually, is to not worry about what

0:10:07.789 --> 0:10:11.669
<v Speaker 3>position your baby is in because you're right, a transverse baby,

0:10:11.669 --> 0:10:14.509
<v Speaker 3>which basically means a baby that's lying sideways at thirty weeks,

0:10:14.549 --> 0:10:18.309
<v Speaker 3>makes absolutely no difference at all, unless you unfortunately break

0:10:18.309 --> 0:10:20.509
<v Speaker 3>your waters today and go into labor, then it does matter.

0:10:20.869 --> 0:10:22.949
<v Speaker 3>But most of these little ones are going to either

0:10:22.989 --> 0:10:25.549
<v Speaker 3>go kethalic which means head down or breach, which means

0:10:25.549 --> 0:10:27.989
<v Speaker 3>bum down, and most of the time bum down is

0:10:28.029 --> 0:10:30.389
<v Speaker 3>where you're presenting with their little bottom or their feet. Now, again,

0:10:30.429 --> 0:10:32.309
<v Speaker 3>there's lots of complexities around that we don't need to

0:10:32.309 --> 0:10:34.109
<v Speaker 3>go into because the bottom line is, at thirty weeks,

0:10:34.149 --> 0:10:37.109
<v Speaker 3>it does not matter what position your baby is in,

0:10:37.109 --> 0:10:38.749
<v Speaker 3>but what it can do is affect your fundl height

0:10:38.749 --> 0:10:40.949
<v Speaker 3>because obviously, if you haven't got a longitudinal baby that's

0:10:40.989 --> 0:10:43.509
<v Speaker 3>lying length wise in the uterus, it can misshape in

0:10:43.509 --> 0:10:45.149
<v Speaker 3>your uterus a little bit and change what that funnel

0:10:45.189 --> 0:10:45.629
<v Speaker 3>hight does.

0:10:45.869 --> 0:10:49.109
<v Speaker 2>I have a dumb question, no questions, dube, how much

0:10:49.229 --> 0:10:53.429
<v Speaker 2>range of moving around do babies have? Because when I

0:10:53.549 --> 0:10:56.429
<v Speaker 2>have gone in for measurements a lot of them, and

0:10:56.469 --> 0:11:00.989
<v Speaker 2>when you've also felt my ballet in this record, she's

0:11:01.069 --> 0:11:05.029
<v Speaker 2>always been head down in some way, but then maybe

0:11:05.069 --> 0:11:08.509
<v Speaker 2>just other times gone slightly transverse, which is great because

0:11:08.509 --> 0:11:10.789
<v Speaker 2>I'd love to deliver vaginally, But is there a world

0:11:10.829 --> 0:11:13.549
<v Speaker 2>in which she just flips up and is breach? If

0:11:13.549 --> 0:11:16.909
<v Speaker 2>she's been quite in this place down position for.

0:11:16.909 --> 0:11:18.469
<v Speaker 1>Weeks, it can change, you know.

0:11:18.509 --> 0:11:20.469
<v Speaker 3>Obviously, if her baby's been committed to head down, there's

0:11:20.549 --> 0:11:23.189
<v Speaker 3>less likely, and the closer towards full term you get,

0:11:23.229 --> 0:11:25.149
<v Speaker 3>the less likely babies move because I just don't have

0:11:25.149 --> 0:11:27.309
<v Speaker 3>the room to do so. But certainly at thirty weeks

0:11:27.349 --> 0:11:29.349
<v Speaker 3>your baby could change four or five times a day

0:11:29.389 --> 0:11:32.109
<v Speaker 3>from cathalic as in head down to bum down to

0:11:32.189 --> 0:11:36.389
<v Speaker 3>ankle down to foot to shoulder and it's okay. So

0:11:36.829 --> 0:11:38.589
<v Speaker 3>as we get closer to birth, if your baby that

0:11:38.629 --> 0:11:40.829
<v Speaker 3>actually is what we call an unstable lie. We don't

0:11:40.869 --> 0:11:42.549
<v Speaker 3>like it as much, but it even does happen. At

0:11:42.589 --> 0:11:45.309
<v Speaker 3>thirty eight and thirty nine weeks in fact, Grace I

0:11:45.349 --> 0:11:47.389
<v Speaker 3>was in the middle of doing a cesarean section.

0:11:47.429 --> 0:11:49.029
<v Speaker 1>I ultra sounded her before I went in.

0:11:49.509 --> 0:11:52.389
<v Speaker 3>She was definitely Catholic, but it came out bump first,

0:11:52.549 --> 0:11:54.349
<v Speaker 3>so that little one turned in labor.

0:11:54.709 --> 0:11:56.549
<v Speaker 1>And so it absolutely does happen.

0:11:56.909 --> 0:11:58.989
<v Speaker 2>And should you be worried if they're not having a

0:11:58.989 --> 0:12:01.749
<v Speaker 2>lot of movement, like there's obviously like I feel like movement,

0:12:02.469 --> 0:12:05.749
<v Speaker 2>but if they're not having big position changes or do

0:12:05.829 --> 0:12:08.629
<v Speaker 2>babies just get a spot they like and get comfortable.

0:12:08.509 --> 0:12:10.549
<v Speaker 3>Again, every baby's different, and it's so it's so funny

0:12:10.549 --> 0:12:12.549
<v Speaker 3>because I reckon if I had a dollar for every

0:12:12.589 --> 0:12:14.709
<v Speaker 3>question someone asked me how much movement is normal for

0:12:14.749 --> 0:12:17.149
<v Speaker 3>my baby, I would not be working at all. Any

0:12:17.189 --> 0:12:19.549
<v Speaker 3>might be retired, living in Hamilton Island or something. But

0:12:19.629 --> 0:12:22.229
<v Speaker 3>because we can't tell you, every baby is different. So

0:12:22.269 --> 0:12:24.589
<v Speaker 3>it's about their own pattern and what they do. But

0:12:24.629 --> 0:12:27.029
<v Speaker 3>if you've got absent movements or decreased movements from what

0:12:27.069 --> 0:12:29.029
<v Speaker 3>they're normally doing, that's when you need to come in

0:12:29.389 --> 0:12:32.069
<v Speaker 3>as you get closer to term. They don't do as

0:12:32.109 --> 0:12:33.989
<v Speaker 3>bigger movements because there's not as much room, but the

0:12:34.029 --> 0:12:35.709
<v Speaker 3>frequency and the strength should still be there.

0:12:38.229 --> 0:12:40.389
<v Speaker 2>We hope you enjoyed this episode of Hello Bump. We

0:12:40.509 --> 0:12:43.549
<v Speaker 2>have so many episodes of this series filled with tips

0:12:43.589 --> 0:12:46.389
<v Speaker 2>and stories from women and experts who've been through it

0:12:46.469 --> 0:12:47.029
<v Speaker 2>all before.

0:12:47.309 --> 0:12:49.109
<v Speaker 3>You can go back and listen to everything else Hello

0:12:49.149 --> 0:12:50.829
<v Speaker 3>Bump related in this podcast.

0:12:50.429 --> 0:12:52.469
<v Speaker 2>Feed, and while you're there, we'd love if you could

0:12:52.469 --> 0:12:54.269
<v Speaker 2>give us a flying star rating and maybe leave us

0:12:54.309 --> 0:12:56.709
<v Speaker 2>a review, or even share this episode with a friend.

0:12:56.909 --> 0:12:59.989
<v Speaker 3>This episode was produced by Courtney Ammenhauser with audio production

0:13:00.109 --> 0:13:00.789
<v Speaker 3>by Tom Lyon.

0:13:00.869 --> 0:13:01.789
<v Speaker 1>We'll catch you next time.

0:13:01.869 --> 0:13:04.789
<v Speaker 2>This episode of Hello Bump was made in partnership with Huggies.

0:13:04.949 --> 0:13:12.309
<v Speaker 2>Bye Bye