Speaker 1: You're listening to a MoMA Mia podcast.
Speaker 2: Mama Maya acknowledges the traditional owners of land and waters
Speaker 2: that this podcast is recorded on.
Speaker 3: I am pregnant.
Speaker 2: Welcome to Hello Bump. We're making pregnancy less overwhelming and
Speaker 2: more manageable. I'm Grace Rubrey, i am pregnant for the
Speaker 2: very first time, and my throat is on fire.
Speaker 1: I'm young a pitman.
Speaker 3: I'm a former Olympian, mother of six babies, and an
Speaker 3: obstetrics and guyiny registrar.
Speaker 2: Each week, we'll be holding your hand, week by week
Speaker 2: through the mysterious, perplexing and sometimes quite uncomfortable miracle that
Speaker 2: is pregnancy.
Speaker 1: Welcome to Week twenty three. What size is our baby?
Speaker 1: A squash? We've got back to a burrito again, but
Speaker 1: I'm not sure.
Speaker 3: I'm pretty sure maybe it's a fact burrito this time
Speaker 3: because we had a burrito in the past.
Speaker 1: Fool Buredo.
Speaker 2: As someone who's had a lot of goodsman and go mas,
Speaker 2: you can get a like a mini one, So we're
Speaker 2: a regular one now, not the mini, not the media anymore.
Speaker 3: And we're going to animals as sugar lighter so ozzy animals,
Speaker 3: sugar a little bit more lug Oh, I love that.
Speaker 2: I do too.
Speaker 3: So twenty nine centimeter, it's almost a rulele length inside
Speaker 3: you at twenty twenty three weeks and five hundred grams,
Speaker 3: which also marks what we call, for most hospitals, the viability.
Speaker 3: So five hundred grams is what we need a baby
Speaker 3: to be. We know has good outcomes from us from
Speaker 3: a size perspective.
Speaker 2: And what else are they growing? What else is making
Speaker 2: them closer to that viability?
Speaker 3: Well, I think that's what it is. This is the
Speaker 3: most important week really in pregnancy. I mean there's other Obviously,
Speaker 3: full term is probably the most important because that's where
Speaker 3: maybe's exit strategy has to start being planned. But medically
Speaker 3: it's a significant week because for our guys there's a
Speaker 3: big caveat around here. It depends where you birth, it
Speaker 3: depends on your risk factors, it depends on your baby.
Speaker 3: There's lots of factors that it comes down to. But
Speaker 3: in most major hospitals worldwide, we consider resuscitation from now,
Speaker 3: so as soon as you're twenty three weeks in one day,
Speaker 3: in fact, we even start talking about it at twenty
Speaker 3: two weeks and six days that we give you steroids
Speaker 3: to mature baby's lungs and magnesium sulfate for baby's brains.
Speaker 3: So there's medications that we will be asking you do
Speaker 3: you want to consider now. For the vast majority of
Speaker 3: people listening to this, this won't be a conversation you
Speaker 3: need to have because you're going to be pregnant for
Speaker 3: a lot lot longer than today. But I think it's
Speaker 3: a really important topic because there will be one or
Speaker 3: two of you who this will happen to in the
Speaker 3: next few weeks, and I think it's nice to have
Speaker 3: information because you have to make the most difficult decisions
Speaker 3: you're ever going to make, which is is it a
Speaker 3: yes or is it a no? And it's still in
Speaker 3: a window where you can say no if you don't
Speaker 3: want or don't like the risks that are associated to this. Now,
Speaker 3: if you were if you were birthing in a tiny
Speaker 3: rural hospital and there was no time to move your
Speaker 3: baby to a tertiary center, you might be a no
Speaker 3: because it hasn't had a chance to have the steroids.
Speaker 3: You haven't got a big unit with neronectologists that can
Speaker 3: look after and put your little baby on a respiratory
Speaker 3: respirator because they need to be intubated, they need to
Speaker 3: be fed around the clock with a nasal gastric tube.
Speaker 3: They need their monitoring really well. They sometimes need a
Speaker 3: blood transfusion. They often need antibody. So there's a lot
Speaker 3: of things this little guy's going to need to survive.
Speaker 3: So that's a long conversation. The great thing is, though,
Speaker 3: it will happen. In other words, a doctor will come in,
Speaker 3: usually one of myself, an obstetrician in training, or a
Speaker 3: consultant will talk to you from our perspective what birth
Speaker 3: looks like. And the neotologist will come as well and say, right,
Speaker 3: so these are your chances. So they might say something
Speaker 3: along the probabilities. So the probabilities at twenty three weeks
Speaker 3: is your baby has about a twenty to forty percent
Speaker 3: chance of survival, with a disability rate of around fifty
Speaker 3: percent in those that do survive.
Speaker 1: So it's stilly percent. It's like it's getting better.
Speaker 3: Yeah, some centers say up to seventy to eighty percent
Speaker 3: already at this gestation. But again, weird things that determines,
Speaker 3: like is your baby coming out head first? Is it
Speaker 3: a vaginal birth, is it a cesarean section? And some
Speaker 3: people think okay, no, I want this baby at all costs.
Speaker 3: It's had steroids. I want a cesarean section because it's
Speaker 3: the best chance for my baby to survive. The problem
Speaker 3: is you then get left with a scar on a
Speaker 3: transverse incision, so on a what we call a classical incision,
Speaker 3: which means it's up and down like the old school
Speaker 3: how people used to do Cesaian sections many years ago.
Speaker 3: But it can cause significant problems for pain, but it
Speaker 3: also causes problems for future pregnancy and problems of placenta
Speaker 3: are is where where the placenter actually grows and gets
Speaker 3: stuck or covers you us again, like we were talking
Speaker 3: about last week, the placenta spectrum disorders.
Speaker 1: It's a massive.
Speaker 3: Conversation to have, and I think it's just going in
Speaker 3: with an open mind with you and your partner that
Speaker 3: probably at some points won't be on the same page,
Speaker 3: but being aware that this is around the time the
Speaker 3: conversation happens, and the hardest time is this week because
Speaker 3: at twenty four weeks the survival rate goes up to
Speaker 3: forty to sixty percent, and then at twenty five weeks
Speaker 3: sixty to eighty percent, and then the twenty six weeks
Speaker 3: seventy five to eighty percent, and where you are now,
Speaker 3: you're sitting at eighty five to ninety to ninety percent
Speaker 3: survival rates. So it's the hardest when those odds are
Speaker 3: really low.
Speaker 1: What hap what's happening to me?
Speaker 2: If everything is going well? What are some of the
Speaker 2: things that verns and mother can be expecting it at
Speaker 2: this moment?
Speaker 1: Any symptoms?
Speaker 3: Nothing?
Speaker 1: This is the lovely part of pregnancy. This is the time.
Speaker 3: Hopefully baby's wriggling around and you're feeling it a little bit.
Speaker 3: You're not too pregnant, you can't do things, you know,
Speaker 3: your heartburn is still horrible. Let's be honest. Hopefully nauseous disappeared.
Speaker 3: So it is the well for me, certainly, it was
Speaker 3: the loveliest part and pregnancy on the planet because you
Speaker 3: feel fantastic and you're starting to feel real because the
Speaker 3: baby's moving enough and your tummy is big enough. So yes,
Speaker 3: So if you're if you are out one of our
Speaker 3: lovely low risk women, Let's be honest, most of us are.
Speaker 3: This is the best time in your life. Is this normal?
Speaker 3: Is it normal?
Speaker 2: Is this normal? Is about babies movements? Because all of
Speaker 2: the pamphlets, all of the apps. Everything says to start
Speaker 2: figuring out the pattern, but what's about I don't know
Speaker 2: what the pattern is, so I have started My placenta
Speaker 2: is anterior at the front yep, which meause you don't
Speaker 2: feel as much. So I don't feel as much, and
Speaker 2: I don't I rarely feel anything in the center. It
Speaker 2: is on the sides. In terms of starting to figure
Speaker 2: out when she's moving, I'm not quite sure how to
Speaker 2: pick up on those patterns. And then one of the
Speaker 2: things that the apps say is make sure it's like
Speaker 2: ten movements every hour or ten movements every two hours,
Speaker 2: which is quite a stressful thing to count. What is
Speaker 2: the in your experience as both someone who's had six
Speaker 2: children and also speaking to very anxious pregnant people, what
Speaker 2: are we looking for?
Speaker 3: This is probably the most common conversation I have every week,
Speaker 3: because everyone comes in with what we call decreased feedal movements.
Speaker 3: Even now at twenty three, twenty four weeks, we get
Speaker 3: women coming in. Now, guys, we will not be putting
Speaker 3: a CTG, which is the continuous monitoring on your baby.
Speaker 1: It's too early. We start that hunt around.
Speaker 3: Twenty four weeks, so next week, but we can't tell
Speaker 3: you the answer. I would love a Crystal Wald to
Speaker 3: be able to say what it means and what it's
Speaker 3: going to do. Every baby is its own little person
Speaker 3: and has its own little movements, so it's literally trying
Speaker 3: to work out what is normal for her. So what
Speaker 3: does she do? Is she a night kicker? Is she
Speaker 3: a day kicker? Is she not a particularly big kicker?
Speaker 3: And when you notice a change, that's when you need
Speaker 3: to call us. And I think the biggest thing here
Speaker 3: is it's never wrong to call the unit if you're concerned.
Speaker 3: You know that we are, especially if it's a public hospital.
Speaker 3: We're a twenty four to seven servants. We're paid to
Speaker 3: be there, so it's completely okay. And it's also really nice.
Speaker 3: Think about it from a flip sid perspective. I deliver
Speaker 3: some crappy news pretty regularly.
Speaker 1: I have to be in pretty high risk, sometimes really
Speaker 1: horrible outcome situation.
Speaker 3: It's really nice to reassure a mum her baby's perfect
Speaker 3: and fine and send her off with a smile. So
Speaker 3: it's fine if you come in, just for us to
Speaker 3: at least allow you to go, yes, I'm good. I
Speaker 3: saw my baby on the ultrasound. The heartbeat looks great,
Speaker 3: I'm reassured, I'll go home.
Speaker 2: This might be a dumb question or one that's hard
Speaker 2: to answer, but what other type of movements are there?
Speaker 2: Because there's kicks and there's butterflies, but what other things
Speaker 2: could be happening that you.
Speaker 3: Might not know is a movement? So sure, that's a
Speaker 3: good questions. Hiccups another one. Mum's feel that tummy just
Speaker 3: like regularly feels a little hick you feel. Kicking obviously
Speaker 3: is the main one. Now, one of the funny things
Speaker 3: is if your baby is feet down, you might feel
Speaker 3: increased bladder. Like I said, it's jumping and having a
Speaker 3: party on your butter So you'll feel your movements wherever
Speaker 3: your baby's limbs are sort of pointing. And that's what
Speaker 3: also can change when you've got an anteria placenters, you
Speaker 3: do feel them like laterally is you said, on the
Speaker 3: outsides or in different areas and not expecting. But movements
Speaker 3: are just that. Most of the time, it starts off
Speaker 3: as flutters and then it gets stronger, and then it
Speaker 3: gets stronger sort of twenty eight to thirty four weeks,
Speaker 3: it's pretty regular, big strong movements. I'm rolling over towards
Speaker 3: later pregnancy though, that don't have as much room, so
Speaker 3: if the frequency and intensity should still be the same,
Speaker 3: but you might find they're not as giant. They're more
Speaker 3: like a whack on mum here, I am all my god,
Speaker 3: that hurts, but not quite as huge, big rolling movements
Speaker 3: because we don't you know, once baby's head down, we
Speaker 3: kind of like them to stay there.
Speaker 2: What is something we can do this week? What's on
Speaker 2: our checklist or to do list?
Speaker 3: Probably this time of the pregnancy is time to start
Speaker 3: thinking about what type of anti enatal classes you'd like
Speaker 3: to do. So we're early, obviously, got plenty of time
Speaker 3: another fifteen weeks or so, but I think again, if
Speaker 3: baby was to have another agenda and come a little earlier,
Speaker 3: it's nice to have, you know, your tool kit started.
Speaker 3: So we have lots of options. You have great things
Speaker 3: like calm birthing classes, she birthing classes.
Speaker 1: I'm a big fan of hypno birthing.
Speaker 3: As I've said before, all of them are strategies to
Speaker 3: help you through your later.
Speaker 2: What is the difference between she birthing and hypno birthing
Speaker 2: or active birth or I mean.
Speaker 1: They're all pretty similar.
Speaker 3: They'll give you strategies to Actually, it's a lot of
Speaker 3: things and it's good to chat. They give you how
Speaker 3: to have a conversation with your medical team. Will start
Speaker 3: thinking what you'd like for birth. What is you know,
Speaker 3: what are your priorities in terms of pain relief, in
Speaker 3: terms of not having an interventional birth. I mean, sometimes
Speaker 3: we can't help it. We are going to say, do
Speaker 3: you we recommend a cesarean for example, But you can
Speaker 3: start thinking about what you would like your birth to
Speaker 3: look like, and also teaching you to breathe, teaching you
Speaker 3: about what labor is, what things to expect, What are
Speaker 3: the scary things because you need to know them versus
Speaker 3: what are the normal things? My answer, that are not
Speaker 3: much normal about labor. It kind of is very different
Speaker 3: for everybody, and there's lots of variations of what is
Speaker 3: normal and what's not. But at least it arms you
Speaker 3: with information.
Speaker 2: My toolkit this week is actually about booking classes and
Speaker 2: that the hospital that I will be giving birth, that
Speaker 2: they offer newborn care, breastfeeding, early breastfeeding rate, and also
Speaker 2: baby CPR.
Speaker 1: Oh that's fantastic, which it terrifies me.
Speaker 2: But I would have no idea what to do if
Speaker 2: a baby was choking or I'm not sure blue, or yeah,
Speaker 2: if this goes into a CID's territory or something like that,
Speaker 2: because that's just a.
Speaker 3: Whole scary but it arms you. It's all about with information,
Speaker 3: isn't it. So I mean I don't have that, but
Speaker 3: I would definitely say, if you can find a first
Speaker 3: aid course for your baby before being parents, that's fantastic.
Speaker 1: Grandparents too. Ideally, Mmmm, that's awesome.
Speaker 2: We hope you enjoyed this episode of Hello Bump. We
Speaker 2: have so many episodes of this series filled with tips
Speaker 2: and stories from women and experts who've been through it
Speaker 2: all before.
Speaker 3: You can go back and listen to everything else Hello
Speaker 3: bumb related in this podcast.
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Speaker 3: This episode was produced by Courtney Ammenhauser with audio production
Speaker 3: by Tom Lyon.
Speaker 1: We'll catch you next time. Bye.
Speaker 2: This episode of Hello Bump was made in partnership with
Speaker 2: Huggis