1
00:00:11,149 --> 00:00:13,909
Speaker 1: You're listening to a Muma Mia podcast.

2
00:00:14,829 --> 00:00:17,869
Speaker 2: Mom and Maya acknowledges the traditional owners of land and

3
00:00:17,949 --> 00:00:20,069
Speaker 2: waters that this podcast is recorded on.

4
00:00:21,389 --> 00:00:23,909
Speaker 3: I am pregnanty.

5
00:00:27,389 --> 00:00:28,429
Speaker 1: Welcome to Hello Bump.

6
00:00:28,469 --> 00:00:31,949
Speaker 2: We're making pregnancy less overwhelming and more manageable, hopefully. I'm

7
00:00:31,949 --> 00:00:33,909
Speaker 2: grace through very I'm pregnant for the first time and

8
00:00:34,109 --> 00:00:35,909
Speaker 2: things are getting exciting.

9
00:00:35,589 --> 00:00:37,709
Speaker 1: Because you're a full term at thirty seven weeks.

10
00:00:37,709 --> 00:00:39,989
Speaker 3: It's amazing. I'm Jana Pittman, I'm a former Olympian, I'm

11
00:00:39,989 --> 00:00:42,229
Speaker 3: a mother of six, and I'm training to be an obstetrician.

12
00:00:42,269 --> 00:00:44,949
Speaker 3: And it is really exciting because thirty seven weeks is

13
00:00:44,949 --> 00:00:47,229
Speaker 3: a massive milestone for any woman full term.

14
00:00:47,789 --> 00:00:50,269
Speaker 2: Each episode, Yonder and I will be holding your hand

15
00:00:50,309 --> 00:00:53,629
Speaker 2: week by week through the mysterious, perplexing and exciting miracle

16
00:00:53,669 --> 00:00:56,269
Speaker 2: that is pregnancy, all the way from a poppy seed

17
00:00:56,269 --> 00:00:56,789
Speaker 2: to a pumpkin.

18
00:00:59,269 --> 00:01:04,429
Speaker 1: Week thirty seven, I've got that our baby is a leak.

19
00:01:04,669 --> 00:01:08,149
Speaker 1: But that feels that's small fair, Yeah, but I mean

20
00:01:08,189 --> 00:01:10,589
Speaker 1: I guess if it's long, it's lots. Okay, We'll go

21
00:01:10,629 --> 00:01:12,389
Speaker 1: with the length of a lace kith.

22
00:01:12,069 --> 00:01:15,669
Speaker 3: And the size of a watermelon, yes, or a throw pillow.

23
00:01:17,229 --> 00:01:18,909
Speaker 3: I do just feel like that. You know, mums when

24
00:01:18,909 --> 00:01:20,549
Speaker 3: you're a kid used to shove the pillow up your tummy.

25
00:01:20,629 --> 00:01:22,349
Speaker 3: Yes to baby's look pregnant, and it comes through.

26
00:01:22,989 --> 00:01:23,869
Speaker 1: Yeah, I like that.

27
00:01:24,109 --> 00:01:27,189
Speaker 3: Baby's about two point nine to three kilos on average,

28
00:01:27,469 --> 00:01:29,749
Speaker 3: and so yes, full term is important, but it doesn't

29
00:01:29,749 --> 00:01:31,789
Speaker 3: mean baby's ready to come. So we get a lot

30
00:01:31,789 --> 00:01:33,309
Speaker 3: of mums at this point that really go, oh, I'm

31
00:01:33,349 --> 00:01:35,549
Speaker 3: so jack of pregnancy. Please induce me. And we're gonna

32
00:01:35,549 --> 00:01:37,229
Speaker 3: talk a bit about induction. I know today because I've

33
00:01:37,229 --> 00:01:38,469
Speaker 3: got some questions for you and you can have something

34
00:01:38,469 --> 00:01:39,869
Speaker 3: from me. I'll try and answer them the best of

35
00:01:39,909 --> 00:01:42,549
Speaker 3: my ability. But it's not time yet. There's still a

36
00:01:42,549 --> 00:01:45,509
Speaker 3: lot of growing and development for baby to do. So

37
00:01:45,549 --> 00:01:47,589
Speaker 3: it's laying down the fat, it's the brain maturity and

38
00:01:47,629 --> 00:01:50,509
Speaker 3: things like that. So we know that all the research

39
00:01:50,549 --> 00:01:53,029
Speaker 3: says that up until thirty nine weeks, there's still as

40
00:01:53,109 --> 00:01:55,389
Speaker 3: long as mum's safe and there's no medical reason it's

41
00:01:55,389 --> 00:01:58,589
Speaker 3: better to stay pregnant. Ironically, though, after thirty nine weeks

42
00:01:58,589 --> 00:02:01,189
Speaker 3: it's more about mum's comfort and baby has done all

43
00:02:01,189 --> 00:02:03,149
Speaker 3: it's growing, it will do equally well on the outside

44
00:02:03,149 --> 00:02:03,789
Speaker 3: as it went on the.

45
00:02:04,029 --> 00:02:06,029
Speaker 1: So it comes about us. Now that's nice.

46
00:02:06,269 --> 00:02:08,469
Speaker 3: Yeah, so exactly I had the whole friend, it's been

47
00:02:08,509 --> 00:02:10,549
Speaker 3: a bear and then now it's about mum. So it

48
00:02:10,629 --> 00:02:12,629
Speaker 3: is a question that people get, is why is wise

49
00:02:12,749 --> 00:02:15,309
Speaker 3: term thirty seven weeks? Well, baby's really beautifully developed at

50
00:02:15,309 --> 00:02:17,629
Speaker 3: this point, but there's still a great benefit to keeping

51
00:02:17,669 --> 00:02:22,429
Speaker 3: them inside for two more weeks if we can. And

52
00:02:22,469 --> 00:02:24,749
Speaker 3: what's happening to our bodies, Well, you can't predict when

53
00:02:24,789 --> 00:02:26,349
Speaker 3: labor's going to start, but at some point you're going

54
00:02:26,389 --> 00:02:29,269
Speaker 3: to start feeling changes in your body towards labor. So

55
00:02:29,749 --> 00:02:32,189
Speaker 3: things obviously the Old wives tales like you start getting

56
00:02:32,189 --> 00:02:33,869
Speaker 3: dire every year and things like that. But your cervix

57
00:02:33,909 --> 00:02:35,589
Speaker 3: will start to come anteriorly. So at the moment it

58
00:02:35,669 --> 00:02:37,509
Speaker 3: SIT's really right up near your back passage. We call

59
00:02:37,509 --> 00:02:40,549
Speaker 3: it a posterior cervix, which means it's holding your cervix closed.

60
00:02:40,669 --> 00:02:43,789
Speaker 3: It'll start moving forward, it'll start softening. You might find

61
00:02:43,789 --> 00:02:45,869
Speaker 3: you have a lot more mucous at this point in pregnancy.

62
00:02:46,229 --> 00:02:48,349
Speaker 3: You're starting to pee even more than last week. Don't

63
00:02:48,349 --> 00:02:50,069
Speaker 3: know how that's possible, but it is, and it's very

64
00:02:50,149 --> 00:02:52,709
Speaker 3: normal to have even more anxiety because birth is approaching

65
00:02:52,749 --> 00:02:53,989
Speaker 3: and you don't know what it's going to be like.

66
00:02:54,229 --> 00:02:56,829
Speaker 2: Is it rare for the placenta to move down? I

67
00:02:56,829 --> 00:02:59,469
Speaker 2: can't remember what it's called when it, Oh, if low lying?

68
00:02:59,909 --> 00:03:02,669
Speaker 2: Will it ever become low lying at this point as

69
00:03:02,709 --> 00:03:03,869
Speaker 2: you get closer.

70
00:03:03,869 --> 00:03:05,229
Speaker 3: Not that I've ever heard of. So we know the

71
00:03:05,309 --> 00:03:07,589
Speaker 3: placenta goes the other way. So hopefully if you had

72
00:03:07,589 --> 00:03:09,629
Speaker 3: a low lying placenta, found it morphology, So that's around

73
00:03:09,629 --> 00:03:12,989
Speaker 3: the twenty week We should have importantly done an ultrasound

74
00:03:13,029 --> 00:03:14,829
Speaker 3: around the thirty four week mark to rule it out.

75
00:03:14,949 --> 00:03:17,269
Speaker 3: Most placentas actually move up, so as you're the lower

76
00:03:17,309 --> 00:03:20,309
Speaker 3: segment of the uterus is created, so basically as your

77
00:03:20,389 --> 00:03:23,549
Speaker 3: whole uterus change of shape and grows up towards your diaphragm,

78
00:03:23,829 --> 00:03:26,709
Speaker 3: this placenta usually gets dragged with it. So it's very

79
00:03:26,789 --> 00:03:28,589
Speaker 3: rare for percenters to stay down. But there are a

80
00:03:28,629 --> 00:03:31,109
Speaker 3: whole what we call a creative spectrum, so all different

81
00:03:31,149 --> 00:03:33,389
Speaker 3: types of placentas. Some of them are butt the offs,

82
00:03:33,429 --> 00:03:35,389
Speaker 3: which basically is where the baby comes out from where

83
00:03:35,429 --> 00:03:37,789
Speaker 3: the cervic starts. Some of them are a centimeter or

84
00:03:37,789 --> 00:03:40,789
Speaker 3: two away, and some of them cross completely. Sometimes vessels

85
00:03:40,829 --> 00:03:43,829
Speaker 3: run across the cervix. So there's all these different and

86
00:03:43,949 --> 00:03:46,149
Speaker 3: all of those things. Guys, by now at thirty seven weeks,

87
00:03:46,349 --> 00:03:48,229
Speaker 3: you don't have it if your old doctor hasn't spoken

88
00:03:48,269 --> 00:03:49,829
Speaker 3: about it, So it's a little irrelevant.

89
00:03:49,869 --> 00:03:51,149
Speaker 1: You go checked, you're fine.

90
00:03:51,309 --> 00:03:52,949
Speaker 3: But if you look at your yellow card now which

91
00:03:52,989 --> 00:03:54,629
Speaker 3: most of us have, or your white card, depending on

92
00:03:54,669 --> 00:03:57,029
Speaker 3: what hospital you're at, and it says low lying placenta

93
00:03:57,229 --> 00:04:00,349
Speaker 3: and someone hasn't checked, you've just saved your baby's life.

94
00:04:00,389 --> 00:04:02,069
Speaker 3: Go and get an ultrasound now in triple check that

95
00:04:02,189 --> 00:04:03,749
Speaker 3: placenta is out of the way. That does not mean

96
00:04:03,789 --> 00:04:05,069
Speaker 3: if it doesn't say anything, you have to go and

97
00:04:05,109 --> 00:04:06,629
Speaker 3: get it. If you have an ultrasound, now it's just

98
00:04:06,669 --> 00:04:08,629
Speaker 3: for fun. Ninety nine percent of the chance will have

99
00:04:08,629 --> 00:04:10,909
Speaker 3: picked that up at a much earlier stations there. Now,

100
00:04:11,789 --> 00:04:13,189
Speaker 3: is this normal? Is normal?

101
00:04:13,629 --> 00:04:13,789
Speaker 2: Now?

102
00:04:13,949 --> 00:04:13,989
Speaker 3: My?

103
00:04:14,269 --> 00:04:17,189
Speaker 1: Is this normal? Is about interventions?

104
00:04:17,349 --> 00:04:20,869
Speaker 2: Okay, Well, it's something that I first learned about in

105
00:04:20,909 --> 00:04:25,149
Speaker 2: the birth courses, and that an intervention statistically leads to

106
00:04:25,949 --> 00:04:29,669
Speaker 2: other interventions like epidurals, forceps.

107
00:04:29,389 --> 00:04:32,949
Speaker 3: Vacuum cesarean sections, pain like yell everything, yeah.

108
00:04:32,669 --> 00:04:37,749
Speaker 1: Yes, So why do we induce such a loaded question?

109
00:04:37,909 --> 00:04:40,309
Speaker 3: It is a loaded question than some pausing me not

110
00:04:40,349 --> 00:04:43,829
Speaker 3: saying something is do you know again? We have already

111
00:04:43,829 --> 00:04:45,829
Speaker 3: said this a few times. And I think the hardest

112
00:04:45,909 --> 00:04:48,789
Speaker 3: situation here is women that feel forced into a decision.

113
00:04:49,549 --> 00:04:52,749
Speaker 3: I don't know any obstetricians that force someone to make

114
00:04:52,789 --> 00:04:55,109
Speaker 3: a decision unless they're really scared. Now our midwife, and

115
00:04:55,109 --> 00:04:56,989
Speaker 3: I know most of my friends are midwives more than doctors.

116
00:04:56,989 --> 00:04:59,389
Speaker 3: To be honest, say, well, doctors get too scared. You know,

117
00:04:59,549 --> 00:05:02,509
Speaker 3: birth is a very physiological process. It will happen, give

118
00:05:02,549 --> 00:05:05,429
Speaker 3: it time. All the statistics that you know are about

119
00:05:05,629 --> 00:05:08,229
Speaker 3: a particular woman. Every woman's different. You can't lob her

120
00:05:08,269 --> 00:05:11,309
Speaker 3: in with the same statistics as others. But ultimately, birth's

121
00:05:11,309 --> 00:05:12,949
Speaker 3: been happening for a long time. There's a lot of

122
00:05:12,949 --> 00:05:15,189
Speaker 3: research in this space, and so we know there's certain

123
00:05:15,229 --> 00:05:19,509
Speaker 3: parameters and certain diseases in pregnancy where a baby could

124
00:05:19,669 --> 00:05:22,789
Speaker 3: have a terrible outcome if we push pregnancy too long,

125
00:05:23,349 --> 00:05:25,869
Speaker 3: and so an induction is often offered to women with

126
00:05:25,949 --> 00:05:28,949
Speaker 3: certain risk factors. So it might be, for example, you

127
00:05:29,069 --> 00:05:32,509
Speaker 3: have a very small baby and you have preeclampsia or

128
00:05:32,549 --> 00:05:34,469
Speaker 3: you have diabetes, and we know the risk of still

129
00:05:34,469 --> 00:05:36,269
Speaker 3: birth around that thirty six week mark is real and

130
00:05:36,429 --> 00:05:38,669
Speaker 3: women with type one diabetes, we know that babies that

131
00:05:38,709 --> 00:05:40,589
Speaker 3: are very, very big, you know, in the ninety fifth

132
00:05:40,629 --> 00:05:42,669
Speaker 3: to ninety eighth centile do have a risk of shoulder

133
00:05:42,709 --> 00:05:46,149
Speaker 3: dustotia or peranial trauma, and so that it be offered. Now,

134
00:05:46,149 --> 00:05:47,989
Speaker 3: that's a circumstance where a woman might say, no, I'm

135
00:05:48,029 --> 00:05:50,709
Speaker 3: okay with having a tear. I'd prefer a vaginal birth,

136
00:05:50,749 --> 00:05:52,789
Speaker 3: even if I have a fourth degree. That's her choice,

137
00:05:53,109 --> 00:05:55,389
Speaker 3: but the recommendation has to be given that this is

138
00:05:55,429 --> 00:05:57,549
Speaker 3: what we would do or this is what the recommended

139
00:05:57,589 --> 00:05:59,869
Speaker 3: research would say is the safest way for mum and

140
00:05:59,869 --> 00:06:02,309
Speaker 3: baby to come out of this with a positive experience.

141
00:06:03,309 --> 00:06:05,309
Speaker 3: Now that's where it gets tricky, is that if a

142
00:06:05,349 --> 00:06:07,469
Speaker 3: doctor offers it to you, ask questions. You know, it

143
00:06:07,549 --> 00:06:09,589
Speaker 3: is your right to know why, what is the research?

144
00:06:09,669 --> 00:06:11,509
Speaker 3: Why you saying this is the right thing for me

145
00:06:11,949 --> 00:06:13,109
Speaker 3: and the one that I struggle with.

146
00:06:13,149 --> 00:06:13,789
Speaker 1: But I know the reason.

147
00:06:13,789 --> 00:06:15,549
Speaker 3: I know I've got to get in trouble for this work.

148
00:06:15,789 --> 00:06:17,309
Speaker 3: But I am an ama mum, as I I am

149
00:06:17,309 --> 00:06:19,669
Speaker 3: an old woman, I had lots of babies, and often

150
00:06:19,709 --> 00:06:22,789
Speaker 3: women get asked or recommended to have an induction at

151
00:06:22,789 --> 00:06:25,069
Speaker 3: thirty nine or forty weeks when they're over forty years

152
00:06:25,109 --> 00:06:28,669
Speaker 3: of age, because we know the placenta is more likely

153
00:06:28,749 --> 00:06:31,389
Speaker 3: to get tired and we don't want a baby to

154
00:06:31,429 --> 00:06:33,189
Speaker 3: pass away. So where what we're afraid of is still

155
00:06:33,189 --> 00:06:34,509
Speaker 3: birth now.

156
00:06:34,389 --> 00:06:37,589
Speaker 1: Id is it's not delivering nutrients an exactly.

157
00:06:37,389 --> 00:06:39,989
Speaker 3: It's running around gas. Yeah, so it's no longer feeding

158
00:06:39,989 --> 00:06:42,389
Speaker 3: your baby the right way. And people will say, well,

159
00:06:42,389 --> 00:06:44,029
Speaker 3: I had an ultrasound at thirty six weeks and it

160
00:06:44,069 --> 00:06:45,989
Speaker 3: was normal. Baby looked great, But we have an ultra

161
00:06:46,029 --> 00:06:47,829
Speaker 3: sound on you in the last week or two, so

162
00:06:47,869 --> 00:06:50,349
Speaker 3: we don't know that hasn't changed. So again, fetal movements

163
00:06:50,389 --> 00:06:52,029
Speaker 3: and all that kind of come into play, and that's

164
00:06:52,029 --> 00:06:54,189
Speaker 3: where it's really tough. And there's lots of research saying that,

165
00:06:54,269 --> 00:06:56,749
Speaker 3: you know, you have to do a thousand inductions to

166
00:06:56,789 --> 00:06:58,589
Speaker 3: save one baby's life and things like that. You know,

167
00:06:58,669 --> 00:07:00,669
Speaker 3: there's all that sort of stuff, But you have to

168
00:07:00,709 --> 00:07:02,229
Speaker 3: decide what's right for you and what kind of risks

169
00:07:02,269 --> 00:07:04,469
Speaker 3: you're prepared to sit with. So they're the difficult inductions.

170
00:07:04,469 --> 00:07:06,749
Speaker 3: Whereas if I'm telling you need an induction for college stasis,

171
00:07:06,789 --> 00:07:08,909
Speaker 3: that has a really high chance of stillbirth. So therefore

172
00:07:08,909 --> 00:07:12,869
Speaker 3: there's preaclance that's the itching, but it's not just itching.

173
00:07:12,869 --> 00:07:14,509
Speaker 3: It's actually related to your liver and you've got liver

174
00:07:14,549 --> 00:07:16,869
Speaker 3: function and all these different reactions within the body that

175
00:07:16,909 --> 00:07:19,069
Speaker 3: we don't want that we know are linked.

176
00:07:18,869 --> 00:07:19,589
Speaker 1: To still birth.

177
00:07:19,909 --> 00:07:22,189
Speaker 3: And so when there's certain risk factors that we say,

178
00:07:22,229 --> 00:07:23,629
Speaker 3: this is the reason we think you should have an

179
00:07:23,629 --> 00:07:27,229
Speaker 3: induction of labor, and they're very strongly backed research. It's

180
00:07:27,229 --> 00:07:29,549
Speaker 3: a bit different. But again, the older age woman, the

181
00:07:29,589 --> 00:07:33,269
Speaker 3: IVF pregnancy, So definitely women have an IVF pregnancy. You know,

182
00:07:33,349 --> 00:07:36,429
Speaker 3: we say it's a very wanted pregnancy, So is every pregnancy.

183
00:07:36,509 --> 00:07:38,829
Speaker 3: You know, there's no pregnancy that's well not every pregnancy,

184
00:07:38,829 --> 00:07:41,269
Speaker 3: but most people getting to that point in wanting to

185
00:07:41,269 --> 00:07:43,429
Speaker 3: protect their baby, and it's equally as valuable as someone

186
00:07:43,429 --> 00:07:45,989
Speaker 3: who went through ten rounds of IVF. But there's that

187
00:07:46,029 --> 00:07:48,309
Speaker 3: tendency to think, well, why did that woman need IVF,

188
00:07:48,309 --> 00:07:50,389
Speaker 3: and therefore would you consider an induction. Now, my hospital

189
00:07:50,389 --> 00:07:52,909
Speaker 3: doesn't do it for IVF, for example, So you'd have

190
00:07:52,949 --> 00:07:55,149
Speaker 3: to have multiple risk factors like being forty two years

191
00:07:55,149 --> 00:07:57,509
Speaker 3: of age, IVF pregnancy in a small baby. There's a

192
00:07:57,629 --> 00:08:01,229
Speaker 3: real spectrum of when we would offer an induction. The

193
00:08:01,269 --> 00:08:03,389
Speaker 3: difficult ones, though, grace, are the ones that are women

194
00:08:03,429 --> 00:08:05,349
Speaker 3: are having a maternal or crest induction. So that is,

195
00:08:05,469 --> 00:08:07,749
Speaker 3: are we doing an induction because the woman has just

196
00:08:07,829 --> 00:08:11,549
Speaker 3: decided she doesn't want to continue with pregnancy. Now, that

197
00:08:11,629 --> 00:08:14,029
Speaker 3: might be for social reasons, it might because she's really uncomfortable.

198
00:08:14,069 --> 00:08:15,469
Speaker 3: It might because she has one or two of the

199
00:08:15,469 --> 00:08:19,349
Speaker 3: softer risk factors, and you know, there's her decision, is

200
00:08:19,589 --> 00:08:20,229
Speaker 3: that let's.

201
00:08:20,069 --> 00:08:20,749
Speaker 1: Have this baby.

202
00:08:21,029 --> 00:08:24,029
Speaker 3: They're the harder ones because yes, absolutely, induction of labor,

203
00:08:24,309 --> 00:08:26,789
Speaker 3: we know, leads to higher rates of evy dural which

204
00:08:26,789 --> 00:08:28,589
Speaker 3: means you're stuck on the bed, which means it's harder

205
00:08:28,629 --> 00:08:30,589
Speaker 3: to push, and it can lead to higher rates of

206
00:08:30,589 --> 00:08:33,629
Speaker 3: instrumental delivery, not caesareans, Funnily enough, although there is some

207
00:08:33,669 --> 00:08:35,469
Speaker 3: new research showing that there may be a slight increase

208
00:08:35,469 --> 00:08:38,029
Speaker 3: of caesarean rates too, But the moment, we don't counsel that.

209
00:08:38,469 --> 00:08:42,069
Speaker 2: Can I ask about the induction to having an appy zurule.

210
00:08:42,389 --> 00:08:46,269
Speaker 2: Why does that increase? Is it because labor stalls? Oh no, no,

211
00:08:46,269 --> 00:08:47,869
Speaker 2: it's so I've done it. So obviously again I can

212
00:08:48,109 --> 00:08:50,069
Speaker 2: step out of my doctors and into my mum's shoes here.

213
00:08:50,629 --> 00:08:52,909
Speaker 2: My second labor was an induction of labor, and it

214
00:08:52,989 --> 00:08:55,349
Speaker 2: just came on so fast. And like you know, we're

215
00:08:55,349 --> 00:08:56,949
Speaker 2: not thinking of tattoos in pregnancy, but I always think

216
00:08:56,989 --> 00:08:58,109
Speaker 2: if you have it. I don't know anyone who's had

217
00:08:58,109 --> 00:08:59,349
Speaker 2: a tattoo. I've got a few from.

218
00:08:59,229 --> 00:09:01,469
Speaker 3: Sport and limp and rings and things. But when it

219
00:09:01,509 --> 00:09:03,269
Speaker 3: first start help, it hurts so badly, but then you

220
00:09:03,269 --> 00:09:06,189
Speaker 3: get accustomed to it. So in labor, if you go

221
00:09:06,189 --> 00:09:08,509
Speaker 3: into spontaneous labor, you have a contraction every two or

222
00:09:08,509 --> 00:09:10,349
Speaker 3: three hours, and then then they're in every hour, and then

223
00:09:10,349 --> 00:09:11,389
Speaker 3: there are two or three and now, and then your

224
00:09:11,429 --> 00:09:14,389
Speaker 3: body builds up those contractions. The studies show that after

225
00:09:14,429 --> 00:09:16,269
Speaker 3: six centimeters the pain is no worse. So it's in

226
00:09:16,309 --> 00:09:18,309
Speaker 3: the discomfort or the surge, or however you want to

227
00:09:18,469 --> 00:09:20,829
Speaker 3: label your pain. It doesn't get worse. It's just becomes

228
00:09:20,829 --> 00:09:23,389
Speaker 3: more frequent. But you can cope with it. But when

229
00:09:23,429 --> 00:09:24,949
Speaker 3: you go from zero to sitting here like you and

230
00:09:24,989 --> 00:09:26,549
Speaker 3: I are, now, I stiff could drip on your arm

231
00:09:26,549 --> 00:09:29,549
Speaker 3: and I thump the sintocinin through. Your contractions come on

232
00:09:29,789 --> 00:09:32,149
Speaker 3: fast and thick, and that labor I had an epidural,

233
00:09:32,149 --> 00:09:33,229
Speaker 3: and it was the best thing I ever did, to

234
00:09:33,229 --> 00:09:35,229
Speaker 3: be honest with you, because it meant it meant that

235
00:09:35,229 --> 00:09:37,469
Speaker 3: I was able to just actually concentrate on my birth,

236
00:09:37,469 --> 00:09:39,549
Speaker 3: whereas before that I was climbing the walls and in

237
00:09:39,589 --> 00:09:42,189
Speaker 3: so much discomfort. And so that's where it comes from.

238
00:09:42,229 --> 00:09:46,509
Speaker 3: So the induction causes the contractions to come on quickly,

239
00:09:47,109 --> 00:09:50,029
Speaker 3: but you've got to remember that we're only mimicking what

240
00:09:50,069 --> 00:09:51,389
Speaker 3: your body does. We're not going to put you into

241
00:09:51,389 --> 00:09:55,029
Speaker 3: fifteen contractions in a minute. We're trying to replicate exactly

242
00:09:55,029 --> 00:09:58,589
Speaker 3: what your natural body is doing. The arguments come about, well,

243
00:09:58,629 --> 00:10:01,429
Speaker 3: sometimes there's more babies that are posterior, for example, because

244
00:10:01,469 --> 00:10:03,789
Speaker 3: we've started a labor before the babies decided it wants

245
00:10:03,869 --> 00:10:06,109
Speaker 3: to come. But it comes back to grace. We're doing

246
00:10:06,149 --> 00:10:08,389
Speaker 3: it for a medical reason. If it's a maternal request

247
00:10:08,429 --> 00:10:10,029
Speaker 3: that's different, then you really need to look at the

248
00:10:10,149 --> 00:10:12,629
Speaker 3: risks of induction and are you happy to have an epidural.

249
00:10:12,949 --> 00:10:14,109
Speaker 3: And a lot of the time these women are like,

250
00:10:14,109 --> 00:10:15,349
Speaker 3: I don't really care if I have a season yan

251
00:10:15,389 --> 00:10:17,429
Speaker 3: I'd be great. If I have a vaginal birth, wonderful,

252
00:10:17,469 --> 00:10:18,709
Speaker 3: But if it ends up with a season, I don't

253
00:10:18,709 --> 00:10:21,149
Speaker 3: really care. So I get it, You're like, it's all

254
00:10:21,189 --> 00:10:23,709
Speaker 3: about maternal choice. But if there is a reason why

255
00:10:23,749 --> 00:10:25,789
Speaker 3: I'm really worried about your baby so that I've said

256
00:10:25,789 --> 00:10:27,349
Speaker 3: to you, I think an induction is the best thing

257
00:10:27,349 --> 00:10:29,749
Speaker 3: for you, then you're sitting with the risks of a

258
00:10:29,749 --> 00:10:32,989
Speaker 3: potential epidural, a potential requirement for a vacuum assisted birth,

259
00:10:33,829 --> 00:10:36,509
Speaker 3: or a baby that's really compromised. That's when you have

260
00:10:36,549 --> 00:10:38,549
Speaker 3: to make these decisions more difficult, and that's when it's

261
00:10:38,589 --> 00:10:40,069
Speaker 3: really hard when there's a lot of language out in

262
00:10:40,109 --> 00:10:42,269
Speaker 3: social media at the moment sort of saying you know,

263
00:10:42,349 --> 00:10:45,949
Speaker 3: doctors are forcing inductions on women. No, we're recommending inductions.

264
00:10:45,949 --> 00:10:48,909
Speaker 3: You could always decline. You can say no to everything.

265
00:10:49,189 --> 00:10:50,789
Speaker 3: That's what I think women need to remember is you

266
00:10:50,829 --> 00:10:54,469
Speaker 3: don't have to say yes to anything, but do understand

267
00:10:54,509 --> 00:10:56,669
Speaker 3: that there's a consequence if you don't, and that has

268
00:10:56,749 --> 00:10:58,709
Speaker 3: to be on the person making that decision.

269
00:10:59,869 --> 00:11:01,189
Speaker 2: In terms of when you've been in labor for a

270
00:11:01,229 --> 00:11:04,549
Speaker 2: certain amount of time, there is a point where you

271
00:11:04,789 --> 00:11:07,549
Speaker 2: probably can't be rushed to an emergency c section because

272
00:11:07,549 --> 00:11:08,709
Speaker 2: the baby's already in the birth.

273
00:11:08,869 --> 00:11:09,989
Speaker 1: Yeah, it's a bit different.

274
00:11:10,149 --> 00:11:11,789
Speaker 3: That's when the vacuums in the forest.

275
00:11:11,509 --> 00:11:13,069
Speaker 2: When the vacuum and the forceps, because you know, you

276
00:11:13,149 --> 00:11:14,669
Speaker 2: see on TV where they're like, quick, let's go to

277
00:11:14,709 --> 00:11:16,709
Speaker 2: an emergency C section, but the baby's crowning.

278
00:11:16,709 --> 00:11:17,229
Speaker 1: I don't know.

279
00:11:18,829 --> 00:11:21,269
Speaker 3: Well, no, look, and this is where I want to

280
00:11:21,269 --> 00:11:23,429
Speaker 3: ask you. The question of you is what are you

281
00:11:23,469 --> 00:11:26,149
Speaker 3: more afraid of? The cesarean section or an instrumental birth.

282
00:11:26,589 --> 00:11:30,869
Speaker 1: That's a very good question, both cesarian.

283
00:11:30,989 --> 00:11:34,709
Speaker 2: I'm I am worried about being in the operating room

284
00:11:34,749 --> 00:11:37,189
Speaker 2: and not being out of feel like my legs and

285
00:11:37,309 --> 00:11:40,709
Speaker 2: panicking and what that would. But I think I worry

286
00:11:40,749 --> 00:11:44,709
Speaker 2: about that panic. My husband is terrified of blood and

287
00:11:44,829 --> 00:11:46,349
Speaker 2: things like. I know that they'll be the little thing,

288
00:11:46,389 --> 00:11:49,029
Speaker 2: but I worry about needing a support person and him

289
00:11:49,069 --> 00:11:51,469
Speaker 2: not being able to do that for me. I'm sure

290
00:11:51,469 --> 00:11:53,069
Speaker 2: they'll be a nurse that'll hold my hand if he

291
00:11:53,109 --> 00:11:55,109
Speaker 2: goes white and passes out. And I'm sure he won't

292
00:11:55,149 --> 00:11:56,229
Speaker 2: be the first person.

293
00:11:55,989 --> 00:11:58,269
Speaker 3: To be I've had plenty of several patients in the room,

294
00:11:58,349 --> 00:11:58,749
Speaker 3: let's say.

295
00:11:59,309 --> 00:12:02,389
Speaker 2: But then when it comes to forceps in vacuum, I

296
00:12:02,469 --> 00:12:06,389
Speaker 2: worry about pro labs, the damage.

297
00:12:05,949 --> 00:12:08,749
Speaker 1: To the baby's head with the vacuum with.

298
00:12:08,749 --> 00:12:11,789
Speaker 2: The vacuum, like, there's something that in that course I

299
00:12:11,909 --> 00:12:14,589
Speaker 2: learn about force ofs. My brain's just gone, don't hod

300
00:12:14,669 --> 00:12:17,149
Speaker 2: onto that. That's where I went, Oh, I'm okay with

301
00:12:17,189 --> 00:12:20,589
Speaker 2: an episiotomy. It was the best scenario, And I think

302
00:12:20,669 --> 00:12:22,749
Speaker 2: I liked the idea of trying not to do it

303
00:12:22,749 --> 00:12:25,829
Speaker 2: with an epidural because then you'd be able to feel it.

304
00:12:25,909 --> 00:12:27,389
Speaker 2: But then there was also a woman in the class

305
00:12:27,429 --> 00:12:30,429
Speaker 2: who said her labor stopped progressing and she was a

306
00:12:30,429 --> 00:12:33,109
Speaker 2: pelvic floor physio, so she actually got an epidural because

307
00:12:33,109 --> 00:12:36,269
Speaker 2: her labor stalled and she got it and then her

308
00:12:36,269 --> 00:12:38,269
Speaker 2: cervix did dilate the rest of the way. So I

309
00:12:38,309 --> 00:12:40,429
Speaker 2: was like, oh, okay, I see the point. But I

310
00:12:40,429 --> 00:12:43,429
Speaker 2: think I do have a lot of anxiety about intervention.

311
00:12:43,509 --> 00:12:47,069
Speaker 2: And it's no judgment on pain relief. I'm not woo

312
00:12:47,069 --> 00:12:51,349
Speaker 2: woo namastae. Shouldn't women squat it in fields? Oh my god, I'm.

313
00:12:51,189 --> 00:12:53,629
Speaker 1: Not like that at all. I'm like, I'll have gas

314
00:12:53,629 --> 00:12:54,629
Speaker 1: can I who has?

315
00:12:54,909 --> 00:12:58,309
Speaker 2: But there's just I guess there's some anxiety around, you know,

316
00:12:58,389 --> 00:13:00,029
Speaker 2: TOUCH would have been very lucky to not be in

317
00:13:00,029 --> 00:13:03,189
Speaker 2: an o R. And I don't know what my anxiety

318
00:13:03,349 --> 00:13:04,509
Speaker 2: will be in like in that room.

319
00:13:04,749 --> 00:13:06,509
Speaker 3: I think it's very I'm sure there's lots of people

320
00:13:06,509 --> 00:13:08,349
Speaker 3: listening that will feel exactly the same. And I think

321
00:13:08,389 --> 00:13:10,949
Speaker 3: the thing is that everybody's experience and thoughts and feelings

322
00:13:10,949 --> 00:13:13,149
Speaker 3: around this are going to be very different. And part

323
00:13:13,149 --> 00:13:16,189
Speaker 3: of it is actually acknowledging what are those fears, because

324
00:13:16,229 --> 00:13:17,949
Speaker 3: if you can have a discussion with your birth team

325
00:13:17,989 --> 00:13:19,909
Speaker 3: around what those fears are, we can hopefully help you

326
00:13:20,189 --> 00:13:21,829
Speaker 3: reduce some of those. And if you end up in

327
00:13:21,829 --> 00:13:23,469
Speaker 3: that space, it might be that we need to keep

328
00:13:23,509 --> 00:13:24,909
Speaker 3: the drapes up a little bit more, that we don't

329
00:13:24,949 --> 00:13:26,389
Speaker 3: drop the when Bobby comes out, because it's a bit

330
00:13:26,389 --> 00:13:28,629
Speaker 3: more blood in that setting. And can we put some

331
00:13:28,749 --> 00:13:31,189
Speaker 3: music on? Can we educate you on different things? Is

332
00:13:31,229 --> 00:13:33,789
Speaker 3: there a real hard no on some of the options

333
00:13:33,789 --> 00:13:36,269
Speaker 3: that we're offering in birth, because I think there's a

334
00:13:36,269 --> 00:13:40,149
Speaker 3: few big points in the birth scenario. Is that epidriols

335
00:13:40,149 --> 00:13:41,909
Speaker 3: are not just for pain. You kind of mentioned just then.

336
00:13:41,949 --> 00:13:43,709
Speaker 3: We often use them for women with type pelvic floor

337
00:13:43,789 --> 00:13:45,509
Speaker 3: as well, and so for example, we might be eight

338
00:13:45,589 --> 00:13:48,949
Speaker 3: centimeters and just not quite getting there. It actually relaxes

339
00:13:48,949 --> 00:13:50,829
Speaker 3: her whole pelvic floor and lets it open up. We

340
00:13:50,869 --> 00:13:53,789
Speaker 3: give it for prolonged labor. Someone who's been laboring beautifully

341
00:13:53,869 --> 00:13:56,349
Speaker 3: like a queen for two days, who's absolutely smashed and

342
00:13:56,389 --> 00:13:58,189
Speaker 3: needs a break for a few hours to be able

343
00:13:58,229 --> 00:14:00,269
Speaker 3: to lie down and actually recover, and in that time

344
00:14:00,309 --> 00:14:02,549
Speaker 3: her whole body relaxes and she pelvic opens up, baby

345
00:14:02,629 --> 00:14:04,829
Speaker 3: rotates into a great position and she has a beautiful birth.

346
00:14:05,349 --> 00:14:07,589
Speaker 3: If you need an instrumental birth, and epidurol is much

347
00:14:07,589 --> 00:14:11,669
Speaker 3: easier because you don't feel the application. Again, I've done

348
00:14:11,709 --> 00:14:13,509
Speaker 3: lots of for steps and back in birth. That's what

349
00:14:13,549 --> 00:14:15,749
Speaker 3: my job is as an obstetrician. I don't love doing them.

350
00:14:15,789 --> 00:14:17,669
Speaker 3: I don't go into work saying today I want to

351
00:14:17,669 --> 00:14:19,709
Speaker 3: do five four steps. That's what I've signed up for.

352
00:14:19,989 --> 00:14:22,189
Speaker 3: I get tickled pink when I come into the room

353
00:14:22,189 --> 00:14:23,349
Speaker 3: and they don't need me, and I just get to

354
00:14:23,349 --> 00:14:25,629
Speaker 3: watch a beautiful birth like that, to me is the

355
00:14:25,709 --> 00:14:27,749
Speaker 3: highlight of my day. Is that the woman as a

356
00:14:27,829 --> 00:14:30,069
Speaker 3: queen and a power. But they're there for a reason.

357
00:14:30,349 --> 00:14:32,429
Speaker 3: We use them when your baby is sick. So if

358
00:14:32,469 --> 00:14:35,069
Speaker 3: we notice on the CTG, on the measuring that their

359
00:14:35,069 --> 00:14:37,909
Speaker 3: little heart rate is dropping really low. If you're pushing

360
00:14:37,949 --> 00:14:40,549
Speaker 3: and you're pushing, and you're pushing, and you're pushing. The

361
00:14:40,589 --> 00:14:43,549
Speaker 3: prolats risk comes from a baby sitting on that perineum

362
00:14:43,949 --> 00:14:46,669
Speaker 3: for too long. And so we do a disservice to

363
00:14:46,709 --> 00:14:48,749
Speaker 3: you if we let you push for three or four hours,

364
00:14:48,789 --> 00:14:51,069
Speaker 3: because that baby and that pressure and all those peranial

365
00:14:51,109 --> 00:14:53,869
Speaker 3: muscles and all the pelvic floor of your pelvic diaphragm,

366
00:14:53,909 --> 00:14:57,029
Speaker 3: not the harbor diaphram, the one in your whole pelvis

367
00:14:57,469 --> 00:14:59,629
Speaker 3: get stretched and stretch and stretch and stretched and stretched.

368
00:14:59,829 --> 00:15:02,429
Speaker 3: There's also a massive increased risk of bleeding afterwards. When

369
00:15:02,429 --> 00:15:04,109
Speaker 3: that uterus is what we call a tonic, it just

370
00:15:04,149 --> 00:15:06,789
Speaker 3: sits open. It's contracting for hours and hours and hours

371
00:15:06,829 --> 00:15:09,549
Speaker 3: and hours, and so there is a It's so hard

372
00:15:09,589 --> 00:15:11,989
Speaker 3: because giving all this information scares women, but there is

373
00:15:12,109 --> 00:15:15,389
Speaker 3: reasons why we expedite birth, either for mum or for baby.

374
00:15:15,509 --> 00:15:17,189
Speaker 3: But I can wholeheartedly tell you that none of us

375
00:15:17,189 --> 00:15:20,189
Speaker 3: do it without a lot of consideration beforehand. You just

376
00:15:20,229 --> 00:15:22,309
Speaker 3: have to again make sure you know the doctor in

377
00:15:22,309 --> 00:15:23,989
Speaker 3: the room, because it's only doctors that do the midwives

378
00:15:24,029 --> 00:15:26,989
Speaker 3: don't do the instrumental births. Be confident that that person's

379
00:15:27,029 --> 00:15:29,349
Speaker 3: got your back. And when you lock eyes with them,

380
00:15:29,349 --> 00:15:30,749
Speaker 3: which is what I do with my women. I hold

381
00:15:30,749 --> 00:15:32,549
Speaker 3: her hand and I say I need to do this

382
00:15:32,589 --> 00:15:34,909
Speaker 3: to help you and your baby, and she's like okay,

383
00:15:35,229 --> 00:15:36,989
Speaker 3: and we do it together. I like, look at her

384
00:15:37,029 --> 00:15:39,029
Speaker 3: and we go and I grunt with her and I

385
00:15:39,109 --> 00:15:40,669
Speaker 3: count with her, and we're in it. We're like a

386
00:15:40,709 --> 00:15:42,989
Speaker 3: full team in that space. Well, that's what I think

387
00:15:43,029 --> 00:15:45,109
Speaker 3: it's about. That's what birth is is. It's the woman

388
00:15:45,149 --> 00:15:47,149
Speaker 3: doing the work, but just there you're there to support her.

389
00:15:48,869 --> 00:15:50,869
Speaker 2: I've just got a quick one for my tool kid,

390
00:15:50,949 --> 00:15:53,309
Speaker 2: which is a new mantra that I learned from a friend,

391
00:15:53,589 --> 00:15:55,709
Speaker 2: which is you can do anything for sixty seconds.

392
00:15:56,189 --> 00:15:59,509
Speaker 1: I love it. I can't beat that. Just it's gonna.

393
00:15:59,349 --> 00:16:01,309
Speaker 2: Be sure to be yeah, but you can do anything

394
00:16:01,349 --> 00:16:02,149
Speaker 2: for sixty seconds.

395
00:16:02,229 --> 00:16:07,149
Speaker 1: I repeat. We hope you enjoyed this episode of Hello Bump.

396
00:16:07,269 --> 00:16:09,989
Speaker 2: We have so many episodes of this series filled with

397
00:16:10,189 --> 00:16:12,189
Speaker 2: tips and stories from women and.

398
00:16:12,149 --> 00:16:13,989
Speaker 1: Experts who've been through it all before.

399
00:16:14,309 --> 00:16:16,149
Speaker 3: You can go back and listen to everything else Hello

400
00:16:16,189 --> 00:16:17,909
Speaker 3: Bump related in this podcast feed.

401
00:16:17,869 --> 00:16:19,629
Speaker 2: And while you're there, we'd love if you could give

402
00:16:19,709 --> 00:16:21,389
Speaker 2: us a five star rating and maybe leave us a

403
00:16:21,389 --> 00:16:23,749
Speaker 2: review or even share this episode with a friend.

404
00:16:23,909 --> 00:16:27,069
Speaker 3: This episode was produced by Courtney Ammenhauser with audio production

405
00:16:27,149 --> 00:16:27,829
Speaker 3: by Tom Lyon.

406
00:16:27,869 --> 00:16:28,829
Speaker 1: We'll catch You next Time.

407
00:16:28,909 --> 00:16:31,229
Speaker 2: This episode of Hello Bump was made in partnership with

408
00:16:31,309 --> 00:16:35,189
Speaker 2: Huggies Bye Bye