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Speaker 1: You're listening to a Muma Mia podcast. Mama Maya acknowledges

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Speaker 1: the traditional owners of land and waters that this podcast

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Speaker 1: is recorded on.

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Speaker 2: I am pregnanty.

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Speaker 1: Welcome to Hello Bump. We're making pregnancy less overwhelming and

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Speaker 1: more manageable. I'm Grace Roubray. I'm pregnant for the first

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Speaker 1: time and I think my child has learned to kick

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Speaker 1: downwards towards my vagina, maybe looking for the exit. Oh

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Speaker 1: my cervix, Let's hope not. It's closed. It's long and close,

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Speaker 1: long and closed.

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Speaker 2: I'm Ana Pittman, i am a mother of six, I'm

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Speaker 2: training to be an obstetrician, and I'm a former Olympian

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Speaker 2: for Australia.

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Speaker 1: Each week, Yana and I will be holding your hand,

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Speaker 1: week by week through the mysterious, perplexing and sometimes silly

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Speaker 1: miracle that is pregnancy, all the way from a poppy

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Speaker 1: seed to a pumpkin. Week twenty nine, What animals and

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Speaker 1: fruits are we this week?

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Speaker 2: Animals and fruits are banana split, which somehow feels smaller

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Speaker 2: though than not a loaf of bread.

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Speaker 1: Last week, So it has to a bit a half

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Speaker 1: a loaf last week. Yeah, yeah, definitely definitely, or a

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Speaker 1: butter and nut squash.

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Speaker 2: Yeah, but that's a small wallaby.

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Speaker 1: Is the Aussie themed animal for this week in animal territory?

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Speaker 2: I think you have to because you know, how are

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Speaker 2: those apps You can have a choice, you can when

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Speaker 2: you have some of them, you can either have it

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Speaker 2: an animal of fruit. So I think since we're Aussies,

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Speaker 2: we'll go over there with an Aussi.

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Speaker 1: Animal before we get to melon territory, which is soon

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Speaker 1: a good point, good point.

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Speaker 2: Babies will really start showing some variation in size now,

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Speaker 2: so some little ones will be around one point one

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Speaker 2: kilos and up to one point four so we're going

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Speaker 2: to see some really big variation. We call that constitutional variation,

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Speaker 2: and that depends on mum and dad and how big

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Speaker 2: they are compared to baby. But it's also going to

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Speaker 2: depend a lot on nutrition, placental function, and lots of

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Speaker 2: other things that can influence your pregnancy now.

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Speaker 1: And why do things change with your placenta, like blood

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Speaker 1: flow or like things that they're watching out for. Why

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Speaker 1: does that change when we've been checked at the twenty

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Speaker 1: weeks again and we're all good.

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Speaker 2: Yeah, it's actually a great question and probably really important

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Speaker 2: to bring up now because things do change quite significantly,

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Speaker 2: and a lot of fear sets in in this next

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Speaker 2: couple of weeks because think you might be doing really well,

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Speaker 2: nothing's changing, and all of a sudden, your obstitution says

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Speaker 2: you're a high pregnancy. No one wants to hear that.

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Speaker 2: You're on your Midwiffree pathway, you're planning your home birth,

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Speaker 2: and all of a sudden you're sitting with me.

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Speaker 1: Not a great play, right, you're great, well, you know

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Speaker 1: what I mean.

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Speaker 2: But no one sets out on this adventure to need

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Speaker 2: to have a higher risk pregnancy. But things do start

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Speaker 2: changing now. A lot of it is going to be

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Speaker 2: your pre existing pregnancy condition. Do you have any type

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Speaker 2: of blood coagulation issues in terms of a thrompophilia, Do

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Speaker 2: you have diabetes? Do you have hypertension? All of those

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Speaker 2: things before your pregnancy will determine what's going to happen now.

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Speaker 2: But even the healthiest, slimmest, most what we would say,

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Speaker 2: you know, textbook woman, could run into issues that they

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Speaker 2: weren't expecting. Because we know that diabetes isn't just someone

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Speaker 2: who has a bigger BMI. There can be some genetic

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Speaker 2: predisposition or even underlying type one diabetes that is evolving

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Speaker 2: and it actually shows up in pregnancy, so it's tough.

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Speaker 2: It's tough to know what's going to change. But they're

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Speaker 2: the things that can affect your baby's growth. Because we

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Speaker 2: know preclampsy you can make small babies, because it can

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Speaker 2: lead to plucent on dysfunction. We know that diabetes can

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Speaker 2: lead to big babies, small babies, and unfortunately babies that

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Speaker 2: don't make it to term. So there are lots of

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Speaker 2: things now, which is why again we like to do

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Speaker 2: to check in. But our podcast obviously isn't for high

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Speaker 2: risks women. I hope, we hope that people are listening

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Speaker 2: that are in that case, some of this information will

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Speaker 2: be very much led by your obstrition and your obstetric team.

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Speaker 1: What's happening to me? All that leads us into what's

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Speaker 1: happening with us? Are there any updates that kind of

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Speaker 1: lead into this for the people giving birth to the

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Speaker 1: babies as well? We are totally the importial wise. What's

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Speaker 1: happening to me?

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Speaker 2: Yeah? Well, and funnily enough, your insulin resistance is becoming worse.

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Speaker 2: So this is why if you have if you have

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Speaker 2: diabetes before pregnancy, you might find that you are starting

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Speaker 2: to have a high insulin requirement. And if you've never

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Speaker 2: had diabetes in your life, you might have just found

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Speaker 2: out you've got gestational diabetes. So that's diabetes caused by

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Speaker 2: the pregnancy because it's a natural state of insulin resistance.

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Speaker 2: You might find you've been managing beautifully with diet, you're

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Speaker 2: doing everything right that doctor tells you to go for

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Speaker 2: a walk, and you're eating beautifully, and you still get

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Speaker 2: put on insulin at this point, and that is just

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Speaker 2: the way the body changes. Lots of things, lots of

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Speaker 2: hormones and placental lactrogen and things like that will actually

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Speaker 2: change the way your body reacts to insulin. And it's

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Speaker 2: because of the little parasite inside wanting that gluecoast. So

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Speaker 2: it's a hard place to manage. But again, you'll be

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Speaker 2: really tucked in with a good doctor at this point

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Speaker 2: to make sure that your glucose levels stays as normal

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Speaker 2: as possible.

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Speaker 1: Yeah, all of those week by week things where it's

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Speaker 1: like eat more nuts this week or eat more vegetables,

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Speaker 1: what should we be eating around this week than if

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Speaker 1: we are able or even if you have gestation like

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Speaker 1: diabetes or not well, I.

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Speaker 2: Think the thing, the biggest thing at this point in

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Speaker 2: pregnancy is you are feeling full and your baby's pushing

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Speaker 2: up on your stomach, You're getting reflux, all that sort

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Speaker 2: of stuff, So small regular meals is probably key to this.

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Speaker 2: As much protein as you can. Look, women are gonna

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Speaker 2: have a chocolate here and there, so I don't think

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Speaker 2: there's any point in saying no, it's just about moderation.

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Speaker 2: So it's basically the same as before, but your baby's

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Speaker 2: now growing rapidly, and in fact, the biggest growth is

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Speaker 2: actually in the next couple of weeks, so you'll find

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Speaker 2: you're hungrier, but then you feel full quickly because your

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Speaker 2: stomach smaller. So it's a matter of just trying to

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Speaker 2: fit what you can in what's healthier nutrition as much

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Speaker 2: as possible. And sometimes I'm a big believer in protein

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Speaker 2: shakes at this point because if you're not tolerating things,

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Speaker 2: just making sure you kick that nutrition in is really important.

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Speaker 1: I'm still having my protein shake every morning because it

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Speaker 1: just makes me stay full for longer and I feel

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Speaker 1: like I've got a lot more energy to work because

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Speaker 1: if you haven't taken maternity leave, which you might not

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Speaker 1: twenty nine weeks, You've still got to push through an

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Speaker 1: entire day, which feels illegal.

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Speaker 2: Sure. I actually worked right up until thirty eight weeks

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Speaker 2: and one day, and then I, on my fourth pregnancy,

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Speaker 2: literally walked into the hospital the next day, delivered a

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Speaker 2: baby in the car park by mistake, and then had

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Speaker 2: mine an hour later.

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Speaker 1: I was like, ok, I was an implantdi to Bertha

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Speaker 1: in the car park.

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Speaker 2: I just happened to be walking and I could hear

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Speaker 2: the very textbook grunting happening from a car as I

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Speaker 2: was walking in to have my own baby. And then

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Speaker 2: she the head was delivering, so I was like, that's great.

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Speaker 2: It was on my hands and knees, and then I

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Speaker 2: had an aarm, which means they ruptured my waters about

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Speaker 2: an hour and a half later. And I had a

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Speaker 2: very swift labor that time. So it was a busy day.

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Speaker 1: In four or five hours, I can't right, Yeah, me

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Speaker 1: tippity tappening at my computer. I've got nothing.

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Speaker 2: But I think let's go quickly that. I don't condone

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Speaker 2: that at all. If I had my time around. I

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Speaker 2: think the sensible and nicest, if you can afford it,

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Speaker 2: with life, is to go off at about thirty four weeks?

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Speaker 1: Is this normal? Is normal? I've got two? Is this

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Speaker 1: Normal's the chemical of nesting. I've heard a lot about nesting,

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Speaker 1: and I've felt some of it creep in. But it's

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Speaker 1: not about baby items. It's about getting like my life

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Speaker 1: in check, like things like I really should get my

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Speaker 1: tax done early, or I really should like write an

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Speaker 1: admin list of things that I feel like I'm just

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Speaker 1: not going to have capacity to do. But it hasn't.

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Speaker 1: I don't have a nursery. I just have to admit.

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Speaker 1: Do you have a nursery? But you've got your tax ready?

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Speaker 1: That's good? Yes? I what someone else could do the

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Speaker 1: nursery for you? Yeah? Well sleep with you? People have

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Speaker 1: told me you don't use the nursery for the first Yes.

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Speaker 2: You're correct, okay, correct, Like I mean most we even

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Speaker 2: say that, and even you know, since campaigns and things

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Speaker 2: say that the best place for a babies in the

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Speaker 2: mum and dad's bedroom at this point in a sidecot

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Speaker 2: or a spot close to the bed. So you're right.

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Speaker 2: What else you're gonna use nursery with other than stinking

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Speaker 2: of that when you're changing nappies? So?

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Speaker 1: But is that chemical hormone is that a real thing

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Speaker 1: that kicks in the nesting hormone.

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Speaker 2: Or not that I've ever read, but I would love

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Speaker 2: it if one of our listeners right so he says

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Speaker 2: what that is. There might be some psychologist or psychiatrist

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Speaker 2: that knows that. Again, I'll take it to my boss

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Speaker 2: this week and if there is something that's actually chemically there.

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Speaker 1: And my second one is the kicking down movement that

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Speaker 1: I've felt. Friends of mine have also explained that that

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Speaker 1: could be lightning crutch.

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Speaker 2: Sure is well, it can be. I mean lightning crutch

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Speaker 2: does tend to happen more later in pregnancy because as

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Speaker 2: the baby expands in size and the uterus is larger,

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Speaker 2: their feet or their or hopefully their head. We prefer

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Speaker 2: as you get through in gestation is pushing down and

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Speaker 2: actually trapping some of those nerves and the vessels and

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Speaker 2: the size of that baby in the pelvist. So you

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Speaker 2: actually can get quite significant and women have had to

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Speaker 2: be nodding along with us right now, significant sharp pains

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Speaker 2: down your legs. It can be one side, it can

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Speaker 2: be both sides. It can be in your crutch, it

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Speaker 2: can be in your vagina, it can be in your

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Speaker 2: glitterists all around that area, and it's largely related to

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Speaker 2: a nerve called the pedendal nerve, and there's a couple

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Speaker 2: other nerves in that area as well, obviously that are

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Speaker 2: being compressed by pregnancy. So we want that head to

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Speaker 2: move down really yeah, Like we don't want it to

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Speaker 2: stay there, we want it to come out.

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Speaker 1: The only thing that I've been told when I was like,

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Speaker 1: how will I know if it's lightning crutch? And I

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Speaker 1: get this dead pan look and they just go, you'll no, no, Okay.

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Speaker 2: You are correct. I've only had it a coup of times,

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Speaker 2: but you absolutely know. And for some it can literally

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Speaker 2: bowl you over in the street and have to sit down,

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Speaker 2: And it can happen a lot too, particular if you're

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Speaker 2: on your second third or like me, fifth and sixth children,

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Speaker 2: where you just have a little bit of a lax

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Speaker 2: pelvise and there's just more room and more compression with babies.

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Speaker 1: What can we do this week? What's something on the checklist?

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Speaker 1: Start thinking about?

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Speaker 2: I think you were going to have a discussion with

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Speaker 2: us around pregnancy classes and things, but I think now

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Speaker 2: is the time. If you haven't booked it, it's really

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Speaker 2: time to start thinking about what you're going to do

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Speaker 2: in that space, because we need to start booking in

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Speaker 2: and not missing out on those activities. Now I know this,

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Speaker 2: and I'm sorry for the people who will be no, Yah,

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Speaker 2: I don't like you anymore. But this is the time

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Speaker 2: to start discussing immunizations in pregnancy. So influenza and DTP

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Speaker 2: so DTPs are potassis. So we know that hooping cough

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Speaker 2: in non medical terms is unfortunately really prevalent, particularly in

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Speaker 2: Australia at the moment. So I'm sure you've heard lots

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Speaker 2: of people have that barking cough. So it's now a

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Speaker 2: discussion with your medical team around if that's the appropriate

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Speaker 2: thing for you. It's certainly what we recommend for women

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Speaker 2: is to have that around now. In pregnant we want

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Speaker 2: those antibodies to cross to your baby, so we know

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Speaker 2: those big idm antibodies can cross the center and help

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Speaker 2: your baby in the first few weeks of life. So

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Speaker 2: it's now it's now to start thinking about that discussion.

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Speaker 1: And they can't be vaccinated against that until there is

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Speaker 1: it six weeks old, so you're kind of building up

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Speaker 1: everything that they need for the first six weeks.

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Speaker 2: Which is a great actually a great point, because that's

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Speaker 2: also while we want other people to be vaccinated, so

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Speaker 2: your mums and your family and your friends that are

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Speaker 2: going to be coming, if they're open to it, then

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Speaker 2: just to reduce that risk of hooping cough. There's also

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Speaker 2: the RSV. You may have seen that in the news

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Speaker 2: recently that they're now encouraging women, particularly high risk women,

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Speaker 2: to have the RSV vaccination. So again it's a conversation

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Speaker 2: that we have great pamphlets for these guys, so just

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Speaker 2: go and ask for a pamphlet, have a discussion, and

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Speaker 2: then book in.

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Speaker 1: The one thing that I did like that I was

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Speaker 1: told about this is that I thought it was new,

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Speaker 1: and it's not that it's new, it's just that it's

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Speaker 1: more publicly available and the RSV vaccine that it has

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Speaker 1: been used in disadvantaged communities for quite a while exactly.

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Speaker 1: Obviously it's such a tricky topic, as you've said, but

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Speaker 1: it's just not a vaccine that's been pushed through quick

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Speaker 1: and well researched.

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Speaker 2: Yeah, absolutely, that's correct, and we are really glad that

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Speaker 2: it's becoming available because if you do choose to have

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Speaker 2: the vaccine, and we'll talk about herd community heard immunity.

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Speaker 2: In other words, there are people who really can't have it,

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Speaker 2: and it just means we try and reduce that risk

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Speaker 2: of bubbies getting sick.

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Speaker 1: In my toolkit, I did do an active birth course,

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Speaker 1: and I think I did it maybe at thirty weeks

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Speaker 1: or thirty one weeks, but I did want to bring

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Speaker 1: it up now because I booked it in perfect. So

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Speaker 1: this was like there was an online component which I

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Speaker 1: thought was really good for people who might not be

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Speaker 1: in a capital city, who yes, because they are a

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Speaker 1: lot of the big long weekend ones or night times.

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Speaker 1: But this was like you did a lot of the

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Speaker 1: pre reading, pre reading and videos I can pop in

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Speaker 1: the show notes as to the one that I did,

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Speaker 1: But then you did a course like a three hour

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Speaker 1: course practical course, and I'm sure we'll get to all

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Speaker 1: the different types of interventions as we go along. But

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Speaker 1: it did make me feel a lot more clarity around

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Speaker 1: what it is that I want in theory. When people

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Speaker 1: say what's your worth plan, I don't really know what

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Speaker 1: to say because I know that there are so many variables,

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Speaker 1: that's right, And.

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Speaker 2: I get asked this all the time because obviously I

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Speaker 2: was a dueler first before I went into medicine and

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Speaker 2: then I did a couple of years of Midwiffrey before

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Speaker 2: I became a training obstetrician, and I've obviously had multiple

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Speaker 2: babies come out of my vagina, so a lot of

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Speaker 2: people have asked what your birth plan is, and honestly, Grace,

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Speaker 2: the thing that I say is, you want happy and

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Speaker 2: safe baby and mum. In other words, that's what you're

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Speaker 2: there to do to have a baby on you.

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Speaker 1: So I love it.

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Speaker 2: I actually saw one a few weeks ago, as this

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Speaker 2: lady came in with this big white paper and it

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Speaker 2: just said have a baby. Yeah, And I was like,

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Speaker 2: you are amazing, and she had the most incredible birth

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Speaker 2: because there's the expectations were left at the door. But

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Speaker 2: I think I'm going to talk about this several times

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Speaker 2: over the next few weeks. I know this, but I

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Speaker 2: think the biggest sad thing I'm seeing in social media

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Speaker 2: at the moment is there's a real rift in women's

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Speaker 2: trust in the obstetric and medical team, in midwives and doctors.

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Speaker 2: And I've very, very rarely met someone who goes into

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Speaker 2: this job now in the last twenty years who doesn't

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Speaker 2: absolutely love women and love birth.

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Speaker 1: We are there.

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Speaker 2: It's one of the hardest jobs on the planet. But

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Speaker 2: we are there because we love being there and being

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Speaker 2: part of that incredible first moment of life. And so

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Speaker 2: it's been really heartbreaking that women are losing that trust

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Speaker 2: in our system. So if you come in with a

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Speaker 2: really open mind and say, I trust my medical team.

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Speaker 2: I want a happy and safe baby. I know there's

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Speaker 2: going to be some traumatic things that come out of this,

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Speaker 2: because I know birth trauma is huge at the moment.

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Speaker 2: We're all going to be traumatized from birth. That's not

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Speaker 2: going to be escaped. It's the toughest day of your life,

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Speaker 2: but it'll be the best outcome if you allow yourself

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Speaker 2: to go in with an open heart and know that

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Speaker 2: the people in that room are there for you because

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Speaker 2: they want to be.

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Speaker 1: I feel really more and I say this having not

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Speaker 1: done it yet, but more okay with pain that's going

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Speaker 1: to come from doing it. The course by they sort

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Speaker 1: of led us through a few things like mantras or

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Speaker 1: visualization or breathing visualization through in the bin for maybe

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Speaker 1: straight away not interesting, nah, but mantras and just pain.

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Speaker 1: It's like pain with purpose or the more pain that's

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Speaker 1: actually you're in the right position, which means your cervix

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Speaker 1: is opening, and just understanding, understanding that you're on the

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Speaker 1: right path if you're in, and to not fear it.

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Speaker 1: It's just finding tactics to deal with it, that's right. Yeah.

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Speaker 2: And I always had this little mant with all of

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Speaker 2: my babies, which is every contraction or every surge, because

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Speaker 2: I came from a hypno birthing background, is one step

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Speaker 2: closer to meeting your baby. And you know, we're working

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Speaker 2: together in this space, you know. And I did do

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Speaker 2: a bit of visualization, so whenever a tightening came, it

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Speaker 2: would be like a wave you're going in. I'd literally

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Speaker 2: imagine myself lying in the sea and we're cresting the

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Speaker 2: top of the wave, and as the surge started to dissipate,

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Speaker 2: then you're cresting off the other side, and then you're

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Speaker 2: sort of laying in the open water. So I mean, again,

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Speaker 2: it'll be different people who are visual visual learners or

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Speaker 2: view with their way they deal with things. And again,

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Speaker 2: just like we talked about it and everything else, some

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Speaker 2: people are going to find labor really tough. Others are

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Speaker 2: going to breeze through it, and we're just we don't

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Speaker 2: know which one you're going to be so.

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Speaker 1: Yeah to wait and see. You've got all the data,

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Speaker 1: and I don't know which one applies to me exactly.

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Speaker 2: And unfortunately it's the little guy in side's fault too,

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Speaker 2: because if that little baby is in an awkward position,

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Speaker 2: it can make a huge difference, like really different labors,

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Speaker 2: back labors, vaginal labors, really depending on what their baby's

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Speaker 2: head is.

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

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Speaker 1: have so many episodes of this series filled with tips

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Speaker 1: and stories from women and experts who've been through it

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Speaker 1: all before.

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Speaker 2: You can go back and listen to everything else Hello

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Speaker 2: Bump related in this podcast.

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Speaker 1: Feed, and while you're there, we'd love if you could

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Speaker 1: a review or even share this episode with a friend.

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Speaker 2: This episode was produced by Courtney Ammenhauser with audio production

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Speaker 2: by Tom Lyon.

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Speaker 1: We'll catch you next time. This episode of Hello Bump

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Speaker 1: was made in partnership with Huggies. Bye Bye,