Speaker 1: You're listening to a Muma Mia podcast.
Speaker 2: Mom and Maya acknowledges the traditional owners of land and
Speaker 2: waters that this podcast is recorded on.
Speaker 3: I am pregnanty.
Speaker 1: Welcome to Hello Bump.
Speaker 2: We're making pregnancy less overwhelming and more manageable.
Speaker 1: I'm Grace Rubrey.
Speaker 2: I'm pregnant for the first time and the rings on
Speaker 2: my fingers are starting to feel a little tight.
Speaker 3: Oh shame. I'm Yana Pittman. I'm a former Olympian mother
Speaker 3: of six, and I'm training to be an obstetrician.
Speaker 2: Each week, we'll be holding your hand week by week
Speaker 2: through the mysterious perplexing where every day is a whole
Speaker 2: new symptom, but still a miracle. It is pregnancy all
Speaker 2: the way from a poppy seed to a pumpkin.
Speaker 1: Week twenty eight, How big is our baby?
Speaker 3: So we're kind of looking at a baby that's around
Speaker 3: the size of a coconut.
Speaker 2: Now it is a large eggplant, loafe of bread, lofe
Speaker 2: of bread.
Speaker 1: One of those half ones are like a full one.
Speaker 1: It's a half one.
Speaker 2: Yeah, you to compare it to the goga dar a
Speaker 2: full one feels aggress see it if it was like
Speaker 2: maybe full term yeah, yeah, that's a full time baby.
Speaker 1: Yeah, a big sour dough full term baby.
Speaker 3: And an animal from Australia as a potteroo.
Speaker 1: What's the potter room? I don't really know. I was
Speaker 1: hoping you could tell me. I googled that one. It
Speaker 1: feels like some type of marsupial. That's a right greatly.
Speaker 3: Something, but it's about a kilo in size by if
Speaker 3: you're actually thinking about the measurement per se.
Speaker 2: And what's our placenta measuring? Like, wait wise, because if
Speaker 2: we're starting to feel uncomfortable and like we aren't carrying
Speaker 2: more weight, if the baby's only one kilo, what's our
Speaker 2: placenta's sort of way well?
Speaker 3: Percenters and will change through out pregnancy depending on how
Speaker 3: much nutrition is going through and whether you've got preclamps
Speaker 3: or anything like that. But you've also got the amniotic fluids.
Speaker 3: You got to think there's a lot more than just
Speaker 3: your percent to your baby and your own blood volumes.
Speaker 3: There's a whole lot more changing in your body at
Speaker 3: this point.
Speaker 1: The blood volume, keep your exact blood volume.
Speaker 2: Yeah, and how has that baby developed this week?
Speaker 3: Baby's growing rapidly at this point, so he or she
Speaker 3: in your case, she is now starting to develop sleep
Speaker 3: wake cycles and might even be having rem sleep, which
Speaker 3: I think is really cute to think that they're actually
Speaker 3: having those similar cycles that they will when they're a
Speaker 3: kid in adult and they're now seeing more defined grooves
Speaker 3: in their brain, so that brain isn't again growing and differentiating.
Speaker 2: And this is that theory of like the sleep cycle
Speaker 2: is every ninety minutes or so, you should probably feel something.
Speaker 3: In field movements exactly. And you might find this point
Speaker 3: if you've gone in with the CREASFIITL movements to the hospital.
Speaker 3: For example, they'll put on a little CTG where they
Speaker 3: actually monitor baby's heart rate and we actually can see
Speaker 3: it on the scan. You can actually see when the
Speaker 3: baby has like a lower heart rate, when it's actually
Speaker 3: dropping and not doing very much activity, and then it
Speaker 3: becomes really active.
Speaker 1: And that's what we.
Speaker 3: Call those sleepwake cycles. And we do want you to
Speaker 3: watch that because sometimes if there's no movements, it's a
Speaker 3: little one sleeping. But if that is going on for
Speaker 3: too long, then we need to really adjust how we're
Speaker 3: thinking about our baby's movements and potentially go and see
Speaker 3: the hospital.
Speaker 2: It is a hard one because sometimes if you're busy,
Speaker 2: you haven't really checked in with your body. I even
Speaker 2: had it just this morning. I was like, I haven't
Speaker 2: felt her normally. I feel her when I'm laying down
Speaker 2: in bed. And then I was busy and I went
Speaker 2: and had food, and then I came and lay on
Speaker 2: the couch and I was like, just check in, and
Speaker 2: then she moved.
Speaker 1: I was like, okay, but I.
Speaker 3: Think you hit the nail on the head there. So
Speaker 3: taking some time out is your first step if you
Speaker 3: think your babies, if you haven't really during the day
Speaker 3: you think, oh, maybe they're not moving as much, is
Speaker 3: to just take that twenty minutes time out, have something
Speaker 3: to eat, drinks and water, because often they do have
Speaker 3: less movement. When you're a little bit dehydrated, lie down
Speaker 3: and see if you can check in with your little one.
Speaker 1: What's happening, what's happening to me, and what's happening to
Speaker 1: our bodies.
Speaker 3: Well, I think we'll go into this quite a bit,
Speaker 3: but now your uterus is pushing up very much underneath
Speaker 3: that rib cage, so there's a lot less movement of
Speaker 3: that diaphragm and your lung, so you're going to feel
Speaker 3: a lot more breathless. So and I think women are
Speaker 3: still trying to do a lot twenty eight weeks and
Speaker 3: it's starting to get harder. So all bending down, tying
Speaker 3: your shoelaces, all that sort of stuff is now going
Speaker 3: to become just that little bit more challenging.
Speaker 1: Yes, that's definitely happening for me.
Speaker 2: And I wanted to ask about when they're sort of
Speaker 2: up around your ribs, that you're starting to feel that discomfort.
Speaker 2: But then one of the biggest things that you hear
Speaker 2: about preoclampsia is pain underneath the ribs.
Speaker 1: It's differentiating.
Speaker 2: It's like everything in pregnancy is like a normal symptom
Speaker 2: or like you should go to the hospital, and it's
Speaker 2: just whether it's paired with the right amount of things.
Speaker 2: So how do we figure out the difference between the
Speaker 2: discomfort and when we should be worried.
Speaker 3: That's a tough question to say. Look, I think things
Speaker 3: like preclamps is obviously related to blood pressure, and that's
Speaker 3: to do with the way your capsule around your liver
Speaker 3: is being irritated or swelling. So it's a late stage
Speaker 3: of preclamps And now that's and I know my fellow
Speaker 3: obstetric trainees and bosses will go, oh, that's not correct
Speaker 3: going or it can be the first stage, because there's
Speaker 3: definitely different ways that preclamps you can eventuate. But in
Speaker 3: most cases you leave the fighter baby that's small and ultrasound,
Speaker 3: and then they look for a reason why, or a
Speaker 3: woman has increased dema quickly and sometimes unilateral. Sometimes it
Speaker 3: happens more.
Speaker 1: You know, all of us swelling.
Speaker 3: Pregnant emma is swelling, Yes, swelling exactly. Sorry, yes, thank
Speaker 3: you for the non medical deal. But it happens more quickly,
Speaker 3: so we do expect to see some swelling again, can
Speaker 3: be normal, can be a problem. Headaches is a big one.
Speaker 3: Changes in your vision, so any of those kind of
Speaker 3: things clue us into what's going on. But again, headaches
Speaker 3: are normal in pregnancy.
Speaker 1: Vision changes not so much.
Speaker 3: If you have diabetes. It's a really big one when
Speaker 3: you have to check in with your eyesight because it
Speaker 3: can deteriorate ord written not with the in pregnancy. But
Speaker 3: all of those things can be very normal. And that's
Speaker 3: the hardest part is if you're concerned, that's what a
Speaker 3: midwife and a doctor's for. Give them a call, tell
Speaker 3: them what you're symptoms are. They'll either reassure you or
Speaker 3: tell you to come in for an assessment.
Speaker 2: Yeah.
Speaker 1: Look, I have made calls to my midwife.
Speaker 2: I was sitting at a high bench at a pub
Speaker 2: and my calves were swollen and I was like, oh
Speaker 2: my gosh, another DBT or yeahah yeah, and I had
Speaker 2: a slight headache as well, and I was like, this
Speaker 2: is it.
Speaker 1: It's like it's the end.
Speaker 2: And then she I just called and she was like, no,
Speaker 2: it's sort of be like swelling and it doesn't go down. Yeah,
Speaker 2: it's like look for your face, your hands, but the hands.
Speaker 1: Get itchy too.
Speaker 3: Not yet, hopefully in pregnancy if you can get to
Speaker 3: think called colystasis, which is when you get itchy hens
Speaker 3: and feet. We actually had a lady this week come
Speaker 3: in with rip rowing colystasis, and the only symptoms she
Speaker 3: had was itchy hens and otherwise a completely healthy pregnancy
Speaker 3: had been It was her second pregnancy, no concerns in
Speaker 3: the last one, and this one we had to unfortunately
Speaker 3: birth her earlier because she had significant problems with her liver. Again,
Speaker 3: liver pain could be a symptom.
Speaker 1: Of that as well.
Speaker 3: So there's all these different things in pregnancy that can
Speaker 3: point to different directions of what's going on.
Speaker 2: It is that thing of like, every symptom is normal,
Speaker 2: every symptom is problematic. Potentially sorry, yeah, potential problematic, And
Speaker 2: it's okay to call.
Speaker 3: In fact, we want we want you to. I think
Speaker 3: the biggest thing that comes out of that is if
Speaker 3: you're concerned. It's most public hospitals are a twenty four
Speaker 3: to seven service. So that's why we're there, is for reassurance,
Speaker 3: but also to occasionally pick up on what mum's intuition
Speaker 3: is saying, because often it's the thing to go by most.
Speaker 1: Is this normal is normal?
Speaker 2: Is this normal is about nipples?
Speaker 1: Okay?
Speaker 2: Sometimes they are a little bit crusty when I take
Speaker 2: off my bra at nighttime, and I just don't know
Speaker 2: if that's is that too early for colostrum or what
Speaker 2: are the changes around this time that we can start
Speaker 2: to see.
Speaker 3: Well, your breasts start changing in first tremester already you
Speaker 3: notice that the size change yet Okay, sure, think but
Speaker 3: it's also that the ductal developments. Everything's changing to get
Speaker 3: you in preparation for breastfeeding. It's not too early. We
Speaker 3: do have women that have colostrum at twenty eight thirty weeks.
Speaker 3: It's normally closer to thirty four and thirty six. We
Speaker 3: don't want you to stimulate your breasts, ladies, at this gestation,
Speaker 3: because pre term labor is not something we want to induce,
Speaker 3: and it's very much an old wives tale, and certainly
Speaker 3: in countries that don't have sintocin and things like that,
Speaker 3: where they actually get women to stimulate their nipples in
Speaker 3: early labor to try and get that labor starting. So
Speaker 3: we don't want that just yet, but it's usually a
Speaker 3: good sign. If you can get some closterum coming naturally,
Speaker 3: it means that you've got a better chance of being
Speaker 3: out of breastfeed if that's what you choose to do.
Speaker 2: And still even if you are, haven't cost them now.
Speaker 2: It's not an indication of how well or how easy.
Speaker 2: It's just a real mix bag. I think one of
Speaker 2: the things that I've been told by a lot of
Speaker 2: pregnant friends is how hard breastfeeding is, and they were
Speaker 2: just not prepared for how hard it was going to be.
Speaker 3: And I think that's a lovely message to even be
Speaker 3: saying now, because there should be no judgment in this space.
Speaker 3: Yet there is so much judgment, and there's so much
Speaker 3: on social media, and so many women walk out of
Speaker 3: that experience feeling like they've let them and their babies down,
Speaker 3: when ultimately I have breastfed most of my babies. One
Speaker 3: of them was particularly difficult, and I like the saying
Speaker 3: fedti's best. But if you can't, the relationship with your
Speaker 3: baby could being greatly affected if you push that envelope
Speaker 3: too hard and it's not working, and it's sometimes just
Speaker 3: nicer for the entire relationship to say this isn't working.
Speaker 3: I've sought out all the options, I've tried everything. Congrats,
Speaker 3: I've done a great job. And stop it earlier than before.
Speaker 3: You're really hitting a brick wall with it.
Speaker 2: And what can we do this week? What are some
Speaker 2: important things to book in or.
Speaker 3: Look that for. I think twenty eight weeks is a
Speaker 3: really important time because this is when we start actually
Speaker 3: looking for babies that may be struggling. So we sort
Speaker 3: of touched on preclamps here, and obviously there's things like diabetes,
Speaker 3: So around twenty eight weeks is when we first look
Speaker 3: for signs in your baby via ultrasound. So if you
Speaker 3: have a higher risk pregnancy, even just being a bit
Speaker 3: older unfortunately puts.
Speaker 1: Through in that categories.
Speaker 3: Sometimes we like to do an ultrasound at twenty eight
Speaker 3: weeks because we actually start looking at babies growth and
Speaker 3: then compare it at thirty two and thirty six weeks
Speaker 3: to make sure they're not either becoming too big in
Speaker 3: the case of diabetes, which is called macrosomia, or becoming
Speaker 3: too small in the case of growth restriction. So we
Speaker 3: also look at dopplers now, so we start looking at
Speaker 3: the vessels that feed your baby, and the particular vessels
Speaker 3: for example, in the baby's brain and around their liver,
Speaker 3: around how they're coping with the pregnancy as a whole.
Speaker 2: Well, for my talk kit this week, I wanted to
Speaker 2: actually ask you a question about iron tablets versus an
Speaker 2: iron infusion. So I was on iron tablets and just
Speaker 2: taking them every second day was what I was prescribed.
Speaker 2: They've redone my iron, hemoglobin and vitamin D and it
Speaker 2: was mostly fun except my iron had gone down even
Speaker 2: though I was on iron tablets every second day, and
Speaker 2: they just said to go well, up your tablets to
Speaker 2: every day now. But why isn't it going straight to
Speaker 2: an iron infusion. Why would we be waiting at twenty
Speaker 2: eight weeks?
Speaker 3: Yeah, great question, now, I think the big thing is
Speaker 3: I actually learned this only two weeks ago, which shows
Speaker 3: I'm really.
Speaker 1: Still training guys.
Speaker 3: Okay, so there's a lot of smarter doctor other than me.
Speaker 3: But we actually excrete a lot more of the components
Speaker 3: that make up iron and hemoglobin through the urine when
Speaker 3: we're pregnant because we've got leakia glamarola. Like basically your
Speaker 3: kidneys work harder and so you're losing some of that
Speaker 3: ability to hold onto your iron. Plus the baby takes
Speaker 3: your iron, Plus you're obviously using it more to create
Speaker 3: more hemoglobin, which is how you carry oxygen around your body.
Speaker 3: So you are definitely going to be depleted. And so
Speaker 3: ooral ion is fantastic. We don't absorb enough of it,
Speaker 3: which is why sometimes women all require or they get
Speaker 3: really constipated, let's be honest, and they can't tolerate taking
Speaker 3: oral Ion's probably the biggest reason women don't take it.
Speaker 3: Then we start looking at an infusion. But why do
Speaker 3: we want this? It's optimizing birth, So it's actually not
Speaker 3: about now, Yes, it helps fatigue in things, but you
Speaker 3: know you're going to lose a bit of blood when
Speaker 3: you actually have your baby, and so if you go
Speaker 3: into that space with a low hemoglobe, so a low
Speaker 3: carrying capacity of oxygen, you're going to feel terrible. So
Speaker 3: if we do it now, though, it's just a little
Speaker 3: too early, so unless we think your labor is coming soon.
Speaker 3: So if there's some an indication that you've either had
Speaker 3: a bleed, for example, if you've got an aph, if
Speaker 3: you're bleeding regularly and your ions dropped significantly and you've
Speaker 3: got a low, really low hemoglob and then of course
Speaker 3: we'll do an iron infusion or sometimes a blood transfusion,
Speaker 3: but ideally we wait till about thirty four to thirty
Speaker 3: six weeks to make sure the ooral didn't work and
Speaker 3: that we're giving it close enough to birth that's going
Speaker 3: to support you when you need it most, which is
Speaker 3: in labor and that postpartum period.
Speaker 2: We hope you enjoyed this episode of Hello Bump. We
Speaker 2: have so many episodes of this series filled with tips
Speaker 2: and stories from women and.
Speaker 1: Experts who've been through it all before.
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Speaker 2: And while you're there, we'd love if you could give
Speaker 2: us a flying star rating and maybe leave us a review,
Speaker 2: or even share this episode with a friend.
Speaker 3: This episode was produced by Courtne Ammenhauser with audio production
Speaker 3: by Tom Lyon We'll catch you next time.
Speaker 2: This episode of Hello Bump was made in partnership with
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