Speaker 1: You're listening to a MoMA Mia podcast. Mama Maya acknowledges
Speaker 1: the traditional owners of land and waters that this podcast
Speaker 1: is recorded on.
Speaker 2: I am pregnant.
Speaker 1: I'm Grace Rubray. I'm pregnant for the first time, and
Speaker 1: just like you, we are officially halfway through. That's so exciting.
Speaker 2: I'm out of Pittman. I'm a former Olympian, I'm a
Speaker 2: mother of six little humans, and I'm now training to
Speaker 2: be an obstetrician.
Speaker 1: Each episode will be holding your hand week by week
Speaker 1: through the mysterious, perplexing, and sometimes exciting miracle that is pregnancy. Yes,
Speaker 1: I said exciting, and we'll get to why. Because it
Speaker 1: is about morphology scan, it is about being halfway through.
Speaker 1: It is very exciting.
Speaker 2: Week twenty, your baby is about the size of a mango.
Speaker 1: Now that that feels like I can feel the weight
Speaker 1: of that. Yeah, big, it is big. I've put it
Speaker 1: could be a top not hair bun.
Speaker 2: And I'm not nice, Okay. An artichoke, I don't even
Speaker 2: know what an arch choke, but that's.
Speaker 1: I only know them as the canned version pizza. Yeah,
Speaker 1: I don't know what they look like in the wild.
Speaker 2: I hear, but for us to be visual sixteen point
Speaker 2: five centimeters and approaching three hundred grams now, so it's
Speaker 2: pretty cool.
Speaker 1: Yeah, that is hefty. It is hefty, It is afty,
Speaker 1: it's efty. And what are they developing?
Speaker 2: So your little one's head now has some hair on it,
Speaker 2: no color yet, so the pigmentation is still coming by
Speaker 2: twenty weeks baby is. If the baby's a female, her
Speaker 2: ovaries will carry all the eggs she'll ever have. Remember
Speaker 2: how we talked about the fact you you're carrying your
Speaker 2: grand babies already. Now they've splitten and they're actually considered
Speaker 2: all sights and this is the most she'll ever have
Speaker 2: in her whole life. She has several million eggs at
Speaker 2: the moment, which is kind of nuts. And then she'll
Speaker 2: basically every month you get less and less and less
Speaker 2: and less. From this point onwards, she's got the highest
Speaker 2: amount of eggs you'll ever have right now.
Speaker 1: That's wild nuts. So when you said about the hair,
Speaker 1: there is the myth about a hairy baby giving you
Speaker 1: more brief or more heartburn. Is there any truth to that?
Speaker 2: It's again a bit of a old wife tale. But
Speaker 2: we have done some there's been some good research in
Speaker 2: this space, I think because of people talking about it
Speaker 2: all the time, and they think the same sort of
Speaker 2: hormones that cause think about it. We talked about it
Speaker 2: with the progesterone and testosterone hormones that cause pregnancy accelerate
Speaker 2: hair growth. Can also make the sophageal sphincter, which is
Speaker 2: basically a muscle around where your stomach becomes your esophagus
Speaker 2: where your food sits, and then loosen and become weaker,
Speaker 2: and so you tend to reflux more food out of
Speaker 2: your tummy. So whether it's directly related alum the sens
Speaker 2: so some says yes and some says no. Doctor says
Speaker 2: not sure.
Speaker 1: What's happening to me and what is happening to our body?
Speaker 2: You're now halfway Obviously you've already highlighted that the uterus
Speaker 2: now takes up more room and is quite squishy inside
Speaker 2: your organs. It actually reaches just where your belly button is,
Speaker 2: So we actually think it's quite funny. This is the
Speaker 2: time we start measuring your fundel heights. So when you
Speaker 2: come to see us, you might have had earlier than this,
Speaker 2: but we like to start it. And that's where we
Speaker 2: take a tape measure from your pubic bone and measure
Speaker 2: your belly, and people.
Speaker 1: Are like, why are you doing that?
Speaker 2: It's very weird. You match twenty weeks, twenty centimeters, twenty
Speaker 2: one centimeters, twenty two centimeters, so your roughly gestational age
Speaker 2: of your baby will match the weakes of pregnancy that
Speaker 2: you are. Will they do that rather than weigh you,
Speaker 2: we weigh more for BMI, so we weigh more to
Speaker 2: has she put on too much weight or worse, has
Speaker 2: she actually not put on enough weight because of hyperremisis
Speaker 2: or nause'r and vomiting is adequate weight game being You
Speaker 2: can also see some conditions. For example, if the woman
Speaker 2: has a baby that's making too much amniotic fluid, she
Speaker 2: might have a sudden increase in weight. And unfortunately, things
Speaker 2: like preaclampsy you can do the same. So it's just
Speaker 2: a sort of a tool that we use to look
Speaker 2: at lots of things, weight gain issues in pregnancy, red
Speaker 2: flags that we might need to look at. The size
Speaker 2: of that fundus is the thing we look at most
Speaker 2: for the baby's growth. So say you're theoretically I mean
Speaker 2: twenty weeks, we don't worry about it too much.
Speaker 1: We just do it.
Speaker 2: Almost as a routine. But say you're thirty weeks and
Speaker 2: your baby's only measuring twenty six weeks, we get a
Speaker 2: little nervous that the baby might be small. Most of
Speaker 2: the time, it's just the baby's like in a transverse
Speaker 2: position or in a position that means it looks smaller
Speaker 2: because all bits of going sideways instead of up and down.
Speaker 2: But it's an interesting What will happen is you get
Speaker 2: a notch sound so we can look more formally at
Speaker 2: your baby's size. And obviously if it's big, big, big,
Speaker 2: and you're measuring forty weeks and you're only thirty weeks,
Speaker 2: the same thing. We just want to know what's going
Speaker 2: on inside?
Speaker 1: Is this normal? Is it normal? So this week I
Speaker 1: want to talk about the big twenty week morphology scan.
Speaker 1: And I'm sure I'm not alone that when I was
Speaker 1: watching the sonographer do their work, I was staring at
Speaker 1: their face for any sign of good news bad news.
Speaker 1: But they any news. But they don't give anything away.
Speaker 2: No, they're amazing, are they? They have like the most
Speaker 2: incredible clown face. You have no idea what's going on.
Speaker 1: And there's all these different shapes and then when they
Speaker 1: switch on the like showing like the blood flow. Yeah, yeah,
Speaker 1: and you're like, well, that big red thing and the
Speaker 1: big red and blue thing, is that normal because we
Speaker 1: have no idea what we're looking at.
Speaker 2: Yeah, Well, I'm really lucky I've had I did several
Speaker 2: weeks in the Elks Sound apartment with some of the
Speaker 2: best scenographers in the world in the last few weeks,
Speaker 2: and they taught that they don't want to give away
Speaker 2: because they're there to do the scans and find anything.
Speaker 2: And then what you don't realize is after that they
Speaker 2: send the images to the doctor who sits down and
Speaker 2: that doctor has strong knowledge about what is normal and
Speaker 2: what is not. So they're measuring compartments of the brain.
Speaker 2: They're looking at the size of the ventricles, they're actually
Speaker 2: looking at the whole anatomy of the brain. Is is
Speaker 2: there something there that's unusual? All the bits that should
Speaker 2: be there present, what could be absent? And so they
Speaker 2: methodically go through each of the major organ systems and
Speaker 2: look for anything that could highlight either a structural abnormality.
Speaker 2: In other words, sometimes it's sad to say, but sometimes
Speaker 2: something like an infection in pregnancy early in pregnancy can
Speaker 2: cause fetal growth restriction, and it can be quite obvious
Speaker 2: in the features. Sometimes it is a chromosomal abnormality that
Speaker 2: wasn't put picked up earlier, and there'll be those soft signs.
Speaker 2: Sometimes it's a genetic condition, like polycystic ovaries. There'll be
Speaker 2: a little ovaries that covered in little cysts, so they'll
Speaker 2: pick up all those.
Speaker 1: They can picks on the feeder.
Speaker 2: Polycystic kidney, sorry, could take.
Speaker 1: You for correcting me. Polsistic kidney.
Speaker 2: So they look at the kidneys and they could see
Speaker 2: similar not followicles. Little babies actually see the little cysts
Speaker 2: that shouldn't be there on the kidneys, so it's tumors
Speaker 2: even like little babies develop unusual tymbers, brain tumors and
Speaker 2: hydromas and things that shouldn't be there.
Speaker 1: One thing that I did want to bring up, just
Speaker 1: in case this has happened or if someone is listening
Speaker 1: before their twenty weeks scan is I was called back, Yes,
Speaker 1: good point, because well they actually didn't tell me why so, yeah,
Speaker 1: because it was a receptionist who I am. But then
Speaker 1: when I started this conversation with a lot of other women,
Speaker 1: common common Yeah, and it's to do mainly with and
Speaker 1: this is just the comms of not the doctor, so
Speaker 1: I will throw at you in a moment. Is it
Speaker 1: is done by a snographer, but it is looked at
Speaker 1: by a doctor who goes, I want another angle exactly, and.
Speaker 2: So it's your baby's fault. They've been on the wrong
Speaker 2: side of the of the ultrasound way and they're basically
Speaker 2: not cooperating. You might even find during your morphology the
Speaker 2: doctor gets gets you off and just go for a walk.
Speaker 2: Your babies positions not right. We can't see what we
Speaker 2: need to see. We haven't got the fortune, you know,
Speaker 2: for heart chamber of view. We need to get more.
Speaker 2: That's fine, So that's really common. Sometimes it might also
Speaker 2: be that they do see something that is a little
Speaker 2: bit unusual that the sonographer didn't quite see, and they
Speaker 2: want to get more imaging. So don't be alarmed with that.
Speaker 2: You know, it's obviously not an enormous.
Speaker 1: Rip roaring abnormality.
Speaker 2: Otherwise they would have seen it straight away. Because that's
Speaker 2: when I got talked to ultrasound, because it's part of
Speaker 2: my training is to be solid at ultrasound. It's one
Speaker 2: of those I need to see this severely severe abnormalities.
Speaker 2: So the smaller ones will be picked up by the doctors,
Speaker 2: but the one that the trained obstetric doctors or the
Speaker 2: MFM specialists who do this even more, they're the ones
Speaker 2: who are the pretty much the krem little creme of
Speaker 2: obstetricians in high risk pregnancies. But at this point you
Speaker 2: need to see what is grossly abnormal versus what is normal,
Speaker 2: and then you know you've got your images, but you're
Speaker 2: not always going to get them. They're still going to
Speaker 2: be sometimes where things just need a little bit.
Speaker 1: Of extra I was laying there and she wouldn't move,
Speaker 1: and they made me raise my ships like a bridge
Speaker 1: and wigg a come on, bubba, and then like, I
Speaker 1: don't know if other people have animals who maybe have
Speaker 1: taken an interest to a bump, I've always been like, oh,
Speaker 1: is that my cat? Are they pushing too hard? No,
Speaker 1: how hard those snographers were pushing to kind of get
Speaker 1: them into the right recision or even you've just touched
Speaker 1: me in this recording before, there's a lot of They
Speaker 1: can take a lot of pressure, is that correct? Correct?
Speaker 2: That's why they're cushioned inside. Like people have car accidents
Speaker 2: and babies are fine, Like not always you always always, guys,
Speaker 2: if you have a car acident, even if it's a
Speaker 2: small bump, need to go and get checked. Or a
Speaker 2: fall on your bottom, or a fall on your tummy
Speaker 2: or all of that, you need to go to the
Speaker 2: to the berth unit and get an assessment. Particularly in
Speaker 2: our twenty weeks, that means you don't have to go
Speaker 2: to your GP. Now it is birth unit, not d
Speaker 2: It's straight to where you're going to birth your baby.
Speaker 2: All of those things needs investigating. But yes, you're very
Speaker 2: robust in there, like very robust toddlers.
Speaker 1: Think about it.
Speaker 2: You're not yet on your second but I have had
Speaker 2: two or three children jump on my tummy at the
Speaker 2: same time.
Speaker 1: They're very very safe. Okay, what are some other things
Speaker 1: that we might need to think about it? Twenty weeks
Speaker 1: tough discussion.
Speaker 2: So twenty weeks mark's viability, not viability for the baby
Speaker 2: to live. That's twenty three weeks, but it marks the
Speaker 2: time when Medicare and the government, let's be honest, recognizes
Speaker 2: that your baby is a baby and not a miscarriage.
Speaker 2: So I really hope that no one listening to this
Speaker 2: goes into pre term labor at nineteen weeks and six days,
Speaker 2: which is literally that custody time as you turn twenty weeks.
Speaker 2: But I've already had the privilege of sitting with three
Speaker 2: women that have had to make that decision where we did.
Speaker 2: We knew she was going to pass the baby unfortunately
Speaker 2: and birth her little one. So it is a discussion
Speaker 2: to think about how what you would do in this case,
Speaker 2: but also to recognize that now your baby is a baby.
Speaker 2: So from this point forward, if you were one of
Speaker 2: the incredibly horribly unlucky person people to go into labor
Speaker 2: in the next couple of weeks before your baby was
Speaker 2: fully formed and able to be resuscitated, that your baby
Speaker 2: is considered it's our fetal loss. So it's a fetal
Speaker 2: death from this point onwards.
Speaker 1: And what does that mean in terms of how the
Speaker 1: government seems that, like, what are the steps that you
Speaker 1: would need to take or that you can take. Is
Speaker 1: it elective? What the next steps.
Speaker 2: Or partially partially not You can elect for the hospital
Speaker 2: do the burial in the cremation, but it is still
Speaker 2: something that happens. They get birth certificate, they get a
Speaker 2: death certificate. There's a bereavement package that can be given
Speaker 2: to the family for for example, time off work, because
Speaker 2: I mean, don't get me wrong, I think and this
Speaker 2: is why I think it's such an arbitrary number. And
Speaker 2: it's really hard because you get I know that if
Speaker 2: I had lost a baby at eighteen weeks, to me,
Speaker 2: that was a baby. There is no part of it
Speaker 2: being a miscarriage to me. I mean, we label it
Speaker 2: medically it's a miscarriage, it's a late miscarriage in the
Speaker 2: second trimester, but it's not clinically called a baby until
Speaker 2: that point. So there's a lot more paperwork for the
Speaker 2: medical team to do. They offer a lot more investigation,
Speaker 2: so they same baby off, a post mortem and things
Speaker 2: like that. If you want to know what the cause is,
Speaker 2: often it's just pre term labor. But if there's something
Speaker 2: that happens, like for example, you go fore ultras ount
Speaker 2: and there's no heartbeat, I think they can give you
Speaker 2: more information around that space. But the good thing is
Speaker 2: all of these major hospitals where you would birth your
Speaker 2: little one, or if you don't and it's a rural hospital,
Speaker 2: they can organize it. ADDI tertiary center is to have
Speaker 2: that counseling and that discussion around what the next steps
Speaker 2: are so you will be really well supported through this,
Speaker 2: you and.
Speaker 1: Your partner and your family. If that's what you choose.
Speaker 1: What are some companies or organizations that you know of
Speaker 1: that can provide supporting If someone's listening and that this
Speaker 1: does happen to them in the next few weeks, or
Speaker 1: if they've got a friend that goes through this, is
Speaker 1: there somewhere we can point them to.
Speaker 2: Well, I mean, this one's hard because of the gestation
Speaker 2: it's happened, But there's Pink Elephants is a really good
Speaker 2: one and I actually met the founder just recently. Her
Speaker 2: name is Sophie Smith. She's extraordinary and she runs running
Speaker 2: for premature babies. So she lost her triplets at her
Speaker 2: first little one came just after twenty one weeks, lived
Speaker 2: for an hour. Her second little boy came and lived
Speaker 2: for several hours, and the first one lived for several
Speaker 2: days or actually almost I think it's fifty eight days,
Speaker 2: she told me. So she has now nineteen years ago.
Speaker 2: Her triplets will be nineteen this year, and so she's
Speaker 2: set up an incredible space where women who have premature
Speaker 2: babies like this can bind together. And she's raised over
Speaker 2: nine million dollars for premature babies and nic U support.
Speaker 2: So pretty impressive woman, isn't she that she's through that loss.
Speaker 1: Yeah.
Speaker 2: I know it's a touching topic to talk about, guys,
Speaker 2: but unfortunately everyone listening to this, not all of you
Speaker 2: are going to go full term. So I think it's
Speaker 2: really important to have those resources in place and just
Speaker 2: recognize that it does happen very rarely, but it.
Speaker 1: Does for the tool. This week, I don't have anything practical,
Speaker 1: really or productive. I just said, take yourself out for
Speaker 1: dinner because you're halfway. Halfway.
Speaker 2: I think you celebrate with some apple sparkley, yeah, maake wine, yah.
Speaker 1: Some fakey fake something and have to be with your people, booth,
Speaker 1: your partner and congratulations. Yeah, perfectly said. We hope you
Speaker 1: enjoyed this episode of Hello Bump. We have so many
Speaker 1: episodes of this series filled with tips and stories from
Speaker 1: women and experts who've been through it all before.
Speaker 2: You can go back and listen to everything else Hello
Speaker 2: Bumb related in this podcast.
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Speaker 1: give us a five star rating and maybe leave us
Speaker 1: a review or even share this episode with a friend.
Speaker 2: This episode was produced by Courtney Ammenhauser, with audio production
Speaker 2: by Tom Lyon, we'll catch you next time. Bye.
Speaker 1: This episode of Hello Bump was made in partnership with
Speaker 1: Huggies