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Speaker 1: Said, you're listening to a Muma Mia podcast.

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Speaker 2: Mom and Mayor acknowledges the traditional owners of land and

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Speaker 2: waters that this podcast is recorded on.

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Speaker 3: I am pregnanty.

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Speaker 1: Welcome to Hello Bump.

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Speaker 2: We're making pregnancy less overwhelming and more manageable.

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Speaker 1: I'm Grace Reubray. I am pregnant for the first time.

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Speaker 2: I also this week turned thirty five, which I think

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Speaker 2: means that I am described as geriatric, so I'm feeling

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Speaker 2: great about that.

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Speaker 3: I'm yat a pittment. I'm a former Olympian mother of six.

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Speaker 3: I was a geriatric pregnancy and a grand multipara, so

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Speaker 3: I sounded like quite different, let's say, but I am

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Speaker 3: now training to be an obstitian and gynocologist, which means

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Speaker 3: I get to be with you in the birth unit

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Speaker 3: and help you meet your baby.

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Speaker 2: Each episode, Yana and I will be holding your hand

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Speaker 2: week by week through the mysterious, perplexing, and sometimes quite

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Speaker 2: humbling miracle that is pregnancy.

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Speaker 1: Week twenty five. How big is the baby this week?

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Speaker 3: Your baby is now the size of a papaya or

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Speaker 3: a culiflower.

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Speaker 1: I've got a wide brimmed fedora.

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Speaker 3: And ossie animal will go with a little penguin. Not

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Speaker 3: always Assie, but we've got a lot of little people.

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Speaker 2: This week there's native penguins down in Melbourne on the piss.

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Speaker 3: I love going down to Philip Island. It's one of

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Speaker 3: my favorite things to do with the kids.

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Speaker 1: See yes, it's so kid. Anyway, anyway, back to our baby.

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Speaker 3: Baby's about thirty four centimeters between six hundred and eighty

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Speaker 3: and seven hundred and ninety gram so again putting on.

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Speaker 1: Some more weight, which is great. Most a quilo.

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Speaker 3: I know, it's a big look A kilo used to

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Speaker 3: be the big milestone. He goes, Oh, my baby's aquilo.

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Speaker 3: It's going to do really well. So yeah, it's amazing

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Speaker 3: where the world's come in.

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Speaker 2: Medicine and what are they developing this week.

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Speaker 3: Baby's heart is now beating at about one hundred and

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Speaker 3: forty beats for minutes, so it starts off quite high,

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Speaker 3: actually starts a really low, then gets really high and

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Speaker 3: then settles back down and around one forty. You'll notice

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Speaker 3: your midwife will be monitoring that baby's heart beat almost

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Speaker 3: every time you see them in the anti natal clinic.

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Speaker 3: So when you come in now.

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Speaker 1: You have your blood brosure checked.

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Speaker 3: We'll get onto that soon they measure that funnel height,

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Speaker 3: see how your baby's growing outside without ultrasound, and then

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Speaker 3: they listen to the baby's heartbeat.

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Speaker 2: Yeah, what I've noticed is when they put the doppler on,

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Speaker 2: it goes quite high, and then they stay there to

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Speaker 2: wait for it to calm down because or maybe this

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Speaker 2: is just her she doesn't like people in her space.

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Speaker 3: Man, her heart rate does go We need it too,

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Speaker 3: So that's actually really good because I assume people know that,

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Speaker 3: but you're probably right. So well, they have babies have

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Speaker 3: and it's funny because you know, the nervous system has

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Speaker 3: been developing throughout pregnancy, and certainly at this gestation there's

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Speaker 3: not a huge variation, but they do have sympathetic and

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Speaker 3: parasympathetic drive the same as us. So they get the

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Speaker 3: higher heartbeat and the lower heartbeat. And that's what we call,

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Speaker 3: as doctors and midwives, variability, and we want to see that.

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Speaker 3: So we want to see the heart rate has a

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Speaker 3: nice up and down, up and down, and then it

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Speaker 3: goes on what we call a little acceleration, which basically

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Speaker 3: means it's gone for a little sprint, and that goes

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Speaker 3: really high. So if your baby's heart rate's about one forty.

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Speaker 3: It might jump up to one sixty, sit there for

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Speaker 3: fifteen to thirty seconds, and then cut back down again

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Speaker 3: and then it goes into like a sleeky pattern. So

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Speaker 3: we want to see this cyclic activity, and when you

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Speaker 3: have your doppler, that's what we see on those big

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Speaker 3: long monitoring But even when you're with your midwife, she'll

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Speaker 3: listen for what he will listen and for about sixty

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Speaker 3: seconds to hear that variation. We like to hear that

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Speaker 3: it's the signs of a nice and robust, healthy baby.

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Speaker 2: What what's happening to me, and what's happening to the mother?

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Speaker 1: What's happening to us?

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Speaker 3: So for mum, you might be feeling pretty uncomfortable right now,

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Speaker 3: baby's right up under your ribs, heartburns creeping in, and

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Speaker 3: you're definitely noticing that increase in weight gain, more cramps

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Speaker 3: at night, so it's getting even worse. This is the

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Speaker 3: time we sometimes do see infection, so starting to see

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Speaker 3: the sort of flus and colds and UTIs and stuff,

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Speaker 3: which is interesting because it's also the time your own

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Speaker 3: baby's immune system is continuing to develop and their bone

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Speaker 3: marrow is actually making immune cells so it's quite an

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Speaker 3: impressive time for the whole immuno sort of genesis of

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Speaker 3: baby and you there's a lot happening.

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Speaker 1: It's a lot happening.

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Speaker 2: Is this normal?

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Speaker 1: Is it normal? So? Is this normal? I do want

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Speaker 1: to ask about geriatric pregnancy. Goods go there.

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Speaker 2: When I felt pregnant, I was thirty four and then

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Speaker 2: the age that you've become geriatric, but the internet says

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Speaker 2: is thirty five, and some would say high risk. Is

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Speaker 2: anything that I need to know about or any change

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Speaker 2: in the care or do.

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Speaker 1: I need to flag with anyone that I'm now old? Old?

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Speaker 3: Yeah? Old, isn't it fabulous? It's such a lovely label,

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Speaker 3: well funnily enough in my hospital, and it is changing

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Speaker 3: around the world. So there's actually different definitions, and it

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Speaker 3: is a moving space because in some places we consider

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Speaker 3: geriotic pregnancy now over forty years of age rather than

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Speaker 3: thirty five. So theoretically in my book, you're kind off

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Speaker 3: the hook for a bit.

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Speaker 1: Now.

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Speaker 3: Look, it's still important to say, thirty five is the

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Speaker 3: time when you're u sight, so you'll actually eggs start

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Speaker 3: to go down in numbers. So even though you're currently

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Speaker 3: pregnant and most of the listeners will be if you've

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Speaker 3: got a friend who's on the fence and loving seeing

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Speaker 3: you pregnant, but he's thirty five and hasn't considered family yet,

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Speaker 3: it is time to have a little gentle conversation with her,

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Speaker 3: because we do see a decline in our fertility. So

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Speaker 3: that is around the conversation risks though, so the further

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Speaker 3: along in life we get, whilst we get wonderful experience,

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Speaker 3: things just don't work quite as well. So you have

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Speaker 3: a higher chance of diabetes in pregnancy, you have a

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Speaker 3: higher chance of blood pressure issues in pregnancy. We also

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Speaker 3: have a higher chance of our placenta not working as well,

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Speaker 3: and that's the one we worry about most. So the

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Speaker 3: thing we see more commonly is women around a thirty

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Speaker 3: nine week mark being offered an induction of labor because

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Speaker 3: they have an AMA pregnancy, which means an advanced maternal

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Speaker 3: age pregnancy, and that's over forty years, and hence we

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Speaker 3: now move the definition to roughly forty years. Some hospitals

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Speaker 3: still use thirty five. But the intervention, in other words,

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Speaker 3: we change the outcome of your pregnancy purely based on

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Speaker 3: your age. Is that induction date where we say after

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Speaker 3: forty weeks, the chances of placental insufficiency, which means a

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Speaker 3: placenta that's tired, just like apparently you are, being forty,

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Speaker 3: is higher two to three times higher that you have

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Speaker 3: a chance of that placenta becoming dysfunctional, and obviously that

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Speaker 3: could lead to a still birth, and we all want

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Speaker 3: to avoid that.

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Speaker 2: Do they ever take into account your fitness level in

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Speaker 2: Really it's just like there's a hard cut off with

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Speaker 2: an age.

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Speaker 3: I think it's because you have to draw a line

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Speaker 3: in the sand. So it's not that you're right. Don't

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Speaker 3: get me wrong. We have lots of women who come

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Speaker 3: in who are forty and as incredibly fit and fabulous

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Speaker 3: as you've ever seen. Funnily enough, a lot of I

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Speaker 3: think you've got to think of that. A lot of

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Speaker 3: IVF pregnancies are later this time see thirty eight, thirty nine.

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Speaker 3: Forty forty one two can sometimes be an IVF pregnancy. Interestingly,

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Speaker 3: in our current guidelines, that's not a reason for induction.

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Speaker 3: It doesn't increase your risk as being older, but for

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Speaker 3: many people that makes a pregnancy even more precious. Not

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Speaker 3: that all pregnancies aren't, We're all incredibly precious, but if

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Speaker 3: you've gone to external extrat lengths to get pregnant, sometimes

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Speaker 3: they kind of whack that in and with your AMA

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Speaker 3: and IVF. Many women are off at that induction. Doesn't

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Speaker 3: matter whether you're A B A I one hundred or you.

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Speaker 1: Know, twenty once on our checklist for twenty five weeks.

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Speaker 3: So I think at this point it's just a question

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Speaker 3: around making sure you're not having any red flag symptoms.

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Speaker 3: So at some point being it now, I start thinking, right,

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Speaker 3: it's time each day to check in with you. Are

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Speaker 3: you weaning normally? Any burning, stinging frequency, all that sort

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Speaker 3: of stuff. Uti, how's your headache? No?

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Speaker 1: Great? Fabulous?

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Speaker 3: If you're having headaches, you might have the hormonal headaches

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Speaker 3: that a lot of people doing pregnancy. But it's time

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Speaker 3: to tell your midwife that they're there, and they can

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Speaker 3: coincide with checking your blood pressuren't because we know, you know,

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Speaker 3: preclamps here at this gestation does happen. It's pretty rare,

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Speaker 3: and to be honest, if it happens now, it's it's

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Speaker 3: pretty crappy. So do sometimes do birth women at twenty

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Speaker 3: five twenty six weeks because of pre eclamps here? So

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Speaker 3: it does happen early on set.

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Speaker 2: Does aspirin still work at this point or if you

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Speaker 2: hopefully it's become a different problem.

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Speaker 1: If you're diagnosed with preclampsy this late, we certainly wouldn't start.

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Speaker 3: Well, I shouldn't say certainly some people do, and I

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Speaker 3: was literally talking to my consult about this yesterday that

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Speaker 3: some may, but the recommendation has to start before sixteen weeks,

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Speaker 3: or it doesn't have because the placenta's fully formed by

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Speaker 3: this point, so we want to remodel those help rebodeling

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Speaker 3: those arteries. And it's happened. So it's all happened. Your

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Speaker 3: preclampsia risk developed around the ten to fifteen week mark.

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Speaker 3: So unfortunately this gestation there is very minimal we can do.

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Speaker 3: So what often happens is a woman will come in

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Speaker 3: with no risk in her pregnancy, and for some you know,

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Speaker 3: she might be thin and young, she might have a

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Speaker 3: mother who had preclamps here that might be her risk,

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Speaker 3: or she might have had you know, a higher risk

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Speaker 3: papa a result in her early tremessus screening, but somehow

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Speaker 3: didn't start on aspirin, and it just happens she comes

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Speaker 3: in her blood pressures through the roof, we start putting

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Speaker 3: her on anti hypertensive medications. There's multiple agents we can

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Speaker 3: give to try and bring her blood pressure down. Unfortunately,

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Speaker 3: for real preaclamps here, the only way to fix it

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Speaker 3: is to birth the baby. And it becomes this really

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Speaker 3: fine balance between what's good for the mother. In other words,

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Speaker 3: it's her renal function normal, her kidney is still working normal,

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Speaker 3: what's happening with her cardiac and respiratory function. Because people

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Speaker 3: become really odemitous, their liver function goes off, they can

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Speaker 3: go into something called help syndromes. There's all these really

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Speaker 3: really complex mechanisms, all caused by that placenta that can

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Speaker 3: knock off the way the mother is feeling, and unfortunately

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Speaker 3: the result is often fetal as well. So sometimes the

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Speaker 3: baby will stop growing well, the placenta stops working as well,

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Speaker 3: the baby's much much smaller on ultrasound than we're expecting it,

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Speaker 3: or worse, sometimes the blood flow from that placenda starts

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Speaker 3: to change and we get what's called abnormal dopplers. Now again,

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Speaker 3: there is nothing you guys need to think about. Your

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Speaker 3: obstetric team will monitor this very very closely. At twenty

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Speaker 3: five to twenty six weeks of gestation. There needs to

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Speaker 3: be a lot happening for the mother for you to

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Speaker 3: birth the baby. So we see women with rip roaring

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Speaker 3: preaclamps here at this point managed very very closely. We're

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Speaker 3: not talking in impatient. A couple of times a day

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Speaker 3: having baby, said, are having monitoring a baby's heartbeat, four

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Speaker 3: hourly blood pressure, sometimes even hourly or fifteen minute blood pressures.

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Speaker 3: That we've pushed the envelope really hard here to keep

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Speaker 3: you pregnant.

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Speaker 2: And that's why blood pressure is taken at every single

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Speaker 2: of everyone, Yeah.

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Speaker 3: Because sometimes you don't even know you've got high blood pssure.

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Speaker 3: Like I saw a lady several months ago who had

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Speaker 3: the worst preclamps you've ever seen on zerology, which means

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Speaker 3: we basically send blood test to look at all your

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Speaker 3: organ functions. But other than a bit of elevated blood pressure,

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Speaker 3: she was completely asymptomatic. She looked completely normal, whereas we've

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Speaker 3: had other ladies. So one of the other signs of

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Speaker 3: it is you get really weird reflexes, so you get

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Speaker 3: lots of swelling, so we're probably good to go through

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Speaker 3: it grace. The things are headaches, So if you get headaches,

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Speaker 3: call your GP or your midwife or your obstetrition, weird

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Speaker 3: blurry vision, funny vision changes, unable to pass year, and well,

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Speaker 3: weird swelling that's come quickly. So you know, we all

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Speaker 3: have a bit of swelling by eight twenty six, twenty

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Speaker 3: eight weeks. But if you've got swelling that's come over night,

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Speaker 3: or you've put on a huge amount of weight that

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Speaker 3: you weren't expecting, you need to get checked. You've got

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Speaker 3: a history of preclamps so you need to get checked.

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Speaker 3: So all of those sort of things you can even go.

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Speaker 3: You're not saying go and mut out and buy a

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Speaker 3: blood pressure monitor and check every day.

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Speaker 1: That's too much.

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Speaker 3: You know they might ask you to at some point

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Speaker 3: to do that, but it's definitely not what a low

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Speaker 3: rich woman needs to do. Getting checked by your midwife

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Speaker 3: regularly is enough, and if you concern you can go

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Speaker 3: to chemist. You chemist has got a blood pressure monitor.

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Speaker 3: Just remember there's also I think called white coat hypertensions.

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Speaker 3: If you're scared you've got it, probably gonna have elevated

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Speaker 3: blood pressure. So sometimes it's better to sit down, don't

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Speaker 3: speak as fast as me, and have your blood pressure taken.

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Speaker 1: When you're a littlekarma, my toolkit.

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Speaker 2: This week is just some good stretches for leg crams,

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Speaker 2: which is and electrolytes.

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Speaker 1: Yes, water are electrolytes.

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Speaker 2: Yeah, the hydrolylte the baraca bring that back in and

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Speaker 2: also just to stretch through the cramp that the eye

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Speaker 2: of it will go.

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Speaker 1: It will.

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Speaker 3: And actually I have a really great product called Motherhood

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Speaker 3: hydration powder. It's by Franjo's. I usued to use it

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Speaker 3: many times before just because I don't know about you,

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Speaker 3: but I don't love the taste of water and it

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Speaker 3: just gives us a nice flavor.

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Speaker 1: We hope you enjoyed this episode of Hello bumb.

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Speaker 2: We have so many episodes of this series filled with

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Speaker 2: tips and stories from women and experts who've been through

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Speaker 2: it all before.

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Speaker 3: You can go back and listen to everything else Hello

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Speaker 3: Bump related in this podcast.

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Speaker 2: Feed, and while you're there, we'd love if you could

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Speaker 2: give us a five star rating and maybe leave us

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Speaker 2: a review or even share this episode with a friend.

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Speaker 3: This episode was produced by Courtney Ammenhauser with audio production

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Speaker 3: by Tom Lyon. We'll catch you next time.

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Speaker 2: This episode of Hello Bump was made in partnership with Huggies.

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Speaker 1: Bye Bye