WEBVTT - Week 40: Why Am I Still Pregnant? 0:00:11.149 --> 0:00:13.909 You're listening to a Muma Mia podcast. 0:00:14.829 --> 0:00:17.869 Mom and Maya acknowledges the traditional owners of land and 0:00:17.949 --> 0:00:23.789 waters that this podcast is recorded on. I am pregnanty. 0:00:27.189 --> 0:00:30.389 Welcome to Hello Bump. We're making pregnancy less overwhelming and 0:00:30.429 --> 0:00:32.549 we hopefully have made it more manageable for you. I'm 0:00:32.589 --> 0:00:35.429 Grace Reebray, I'm pregnant for the first time, and we're 0:00:35.469 --> 0:00:36.629 all about to become a parent. 0:00:37.709 --> 0:00:40.229 I'm young A Pittman. I'm a former Olympian mother of six. 0:00:40.269 --> 0:00:42.309 I'm definitely not about to become a parent. I am 0:00:42.349 --> 0:00:44.549 now training to be an obstetric and Guiney registrar. 0:00:44.669 --> 0:00:47.269 Hopefully. Each week we have been holding your hand through 0:00:47.309 --> 0:00:50.709 the mysterious, perplexing and wonderful miracle that is pregnancy, all 0:00:50.789 --> 0:00:52.749 the way from a poppy seed to a pumpkin. 0:00:55.469 --> 0:00:58.749 Oh week forty. 0:00:58.709 --> 0:01:01.629 What size are we? Can you get bigger than a melon? 0:01:01.749 --> 0:01:03.589 Well, babies could be up to five and a half kilos. 0:01:03.589 --> 0:01:04.789 I don't know. If you've looked up the Guinness Book 0:01:04.789 --> 0:01:07.229 of Records. They could be bog You remember that when 0:01:07.229 --> 0:01:07.909 you're a kid's gna? 0:01:08.029 --> 0:01:08.149 Yes? 0:01:08.429 --> 0:01:08.709 Yes. 0:01:09.629 --> 0:01:11.709 The biggest baby I've ever birth, though, is only four 0:01:11.709 --> 0:01:13.149 point nine so I've still got a bit of a 0:01:13.149 --> 0:01:14.389 way to go. A couple of my friends have had 0:01:14.429 --> 0:01:14.949 bigger baby. 0:01:14.989 --> 0:01:15.989 What's that one pounds? 0:01:17.029 --> 0:01:17.989 Twelvesh lots? 0:01:18.429 --> 0:01:22.069 Yeah, okay, okay, okay, But most babies Grace will be 0:01:22.069 --> 0:01:24.549 between three point four and three point six kilos at 0:01:24.669 --> 0:01:26.989 full term. Now, remember there is still two weeks before 0:01:26.989 --> 0:01:30.389 we consider a baby beyond post dates, so it still postdates. Now, 0:01:30.429 --> 0:01:33.309 even anytime after forty weeks is postdates. But the normal 0:01:33.429 --> 0:01:36.389 as in term baby pregnancy is thirty seven to forty two. 0:01:36.469 --> 0:01:39.149 So even though we're finished with this podcast, there is 0:01:39.189 --> 0:01:41.949 still women who'll be pregnant for at least another two weeks. 0:01:41.989 --> 0:01:45.269 What's the maximum cutoff you would ever let a woman 0:01:45.349 --> 0:01:45.629 get to. 0:01:45.989 --> 0:01:49.389 I think that's an interesting number because or interesting word, because, 0:01:49.429 --> 0:01:51.469 of course, our recommendation is to have a baby by 0:01:51.549 --> 0:01:54.109 forty two weeks, again because of that personal insufficiency we've 0:01:54.109 --> 0:01:56.309 talked about, but there are lots of women that decline. 0:01:56.389 --> 0:01:59.229 Now you know, I personally wouldn't, but there's definitely women 0:01:59.269 --> 0:02:01.629 who feel very strongly about natural labor and they wait 0:02:01.749 --> 0:02:05.029 beyond forty three weeks. But I think, if this is you, 0:02:05.269 --> 0:02:07.029 I just really want you to have a conversation with 0:02:07.069 --> 0:02:09.309 your midwife, be really open minded. And again I come 0:02:09.349 --> 0:02:11.749 back to it again, we don't do things to you 0:02:11.789 --> 0:02:13.549 because we want to hurt you. We do things because 0:02:13.589 --> 0:02:15.589 we want to see a good outcome. So for both 0:02:15.589 --> 0:02:17.829 of you, it just needs to be very well monitored, 0:02:17.869 --> 0:02:20.389 lots of lots of CTG monitoring and things like that. 0:02:20.429 --> 0:02:23.629 And if it's your choice, it's always always the woman's choice. 0:02:24.629 --> 0:02:27.109 Now I'm guessing there's no updates to what the baby 0:02:27.149 --> 0:02:27.989 is doing this week. 0:02:28.109 --> 0:02:31.029 It's getting fatter, like quite a bit fatter and quite 0:02:31.029 --> 0:02:33.349 a bit bigger. So I think that is where we 0:02:33.429 --> 0:02:35.869 start thinking about babies. That if you know, at thirty 0:02:35.909 --> 0:02:37.949 six weeks you had a big, little chunky monkey on 0:02:37.949 --> 0:02:40.229 board who was already on the ninety fifth centile, for example, 0:02:41.149 --> 0:02:43.589 I'd be thinking now about having a baby and doing 0:02:43.589 --> 0:02:45.669 all those things to bring this little one on naturally, 0:02:46.389 --> 0:02:48.549 and you know, and just being really open to the 0:02:48.589 --> 0:02:49.949 idea of what it would look like to have a 0:02:50.029 --> 0:02:51.669 four and a half kilo baby, because it is a 0:02:51.829 --> 0:02:52.709 it's a little unit. 0:02:53.749 --> 0:02:55.829 It's in like know, double low sized. 0:02:55.589 --> 0:02:58.629 Clothes, yeah, oh when they come out double over big 0:02:58.909 --> 0:03:03.869 about and quadruploths, I'm excited to learn those sizes because 0:03:03.869 --> 0:03:06.029 I've got a bunch of stuff, but I just don't 0:03:06.029 --> 0:03:07.949 know what she's going to come out at to know 0:03:08.309 --> 0:03:09.909 what I need more of or what I don't even 0:03:09.949 --> 0:03:10.549 need at all. 0:03:10.709 --> 0:03:14.029 Well, even even big babies are still little babies, Like 0:03:14.069 --> 0:03:16.029 even like a big four and a half is still tiny, 0:03:16.109 --> 0:03:19.029 Like they're still inter blows. They're little guys, but they're 0:03:19.069 --> 0:03:20.909 just certainly a lot bigger than your premier babies that 0:03:20.949 --> 0:03:22.589 come out at you know, two kilos and one kilo 0:03:22.669 --> 0:03:25.709 and five hundred grams. So a mixture of everything would 0:03:25.709 --> 0:03:26.509 be my answer to that. 0:03:26.629 --> 0:03:29.309 This is a Roague question. Do any patients who are 0:03:29.349 --> 0:03:31.909 having an elective cesarean do you ever work with them 0:03:31.909 --> 0:03:35.549 to wait for labor to come on naturally so they 0:03:35.549 --> 0:03:38.989 can feel the body is ready and then have a cesarean. 0:03:39.189 --> 0:03:41.069 And we like it when that happens, but it means 0:03:41.069 --> 0:03:44.709 it's not an elective labor. It's actually considered an emergency 0:03:44.709 --> 0:03:47.749 caesar because they'll come in laboring. So now regularly when 0:03:47.829 --> 0:03:50.469 this happens, is a woman who'd love, love love a VBAC. 0:03:50.669 --> 0:03:53.669 And because we many doctors won't do an induction because 0:03:53.669 --> 0:03:55.669 that sintosin and increases the risk of that rupture of 0:03:55.709 --> 0:03:58.109 the scar from the first pregnancy, so they won't start 0:03:58.109 --> 0:04:00.269 that sintosin and drip. So we book the caesar date 0:04:00.309 --> 0:04:02.869 as late as possible, like as in as late as possible, 0:04:02.949 --> 0:04:05.469 with the hope you'll go into spontaneous labor. But I 0:04:05.549 --> 0:04:08.109 reckon I wouldn't know the exact percent, but a lot 0:04:08.189 --> 0:04:10.109 of women who with book cesarians come in with rupture 0:04:10.229 --> 0:04:13.229 membranes or early labor, and all that means is we 0:04:13.269 --> 0:04:15.709 do the season earlier. And in most cases, like you know, 0:04:15.829 --> 0:04:17.389 I guess we have to be a bit honest. Here 0:04:17.429 --> 0:04:19.869 in rural settings, maybe we can't open a theater as quickly, 0:04:19.989 --> 0:04:22.749 but in Sydney and some of the major states around Australia, 0:04:22.749 --> 0:04:24.829 there's a hospital pretty close and they can usually get 0:04:24.869 --> 0:04:27.789 a labour team there to do the birth fairly, fairly swiftly. 0:04:27.909 --> 0:04:29.509 So it's not a bad thing because it means your 0:04:29.509 --> 0:04:31.869 baby's picked its judate and and you still had that 0:04:31.909 --> 0:04:33.149 elective season that you've wanted. 0:04:33.589 --> 0:04:37.869 What what's happening to me? What's happening to our bodies? 0:04:37.949 --> 0:04:42.949 Apart from probably being really uncomfortable and angry at the world. 0:04:42.869 --> 0:04:43.789 Because it's just not happy. 0:04:44.669 --> 0:04:47.229 Maybe people have a lot of bliss. Maybe I'm looking 0:04:47.269 --> 0:04:50.069 at this through a negative lens, but what is happening 0:04:50.109 --> 0:04:50.909 to our bodies. 0:04:50.909 --> 0:04:52.509 I don't know many women that haven't got to forty 0:04:52.509 --> 0:04:54.469 weeks and think they've had enough. You know, even women 0:04:54.509 --> 0:04:57.469 who are very very pro spontaneous vaginal birth and really 0:04:57.509 --> 0:04:59.749 wanting minimal intervention and you know, a water birth at home, 0:05:00.149 --> 0:05:01.629 are happy to have a baby at forty weeks. 0:05:01.629 --> 0:05:02.749 They just want it to happen naturally. 0:05:02.829 --> 0:05:06.909 Yeah, you're heavy, you're uncomfortable, everything hurts, you know, it's 0:05:06.989 --> 0:05:09.389 not fun. No one, no one is happy at forty 0:05:09.429 --> 0:05:12.269 weeks pregnant. So but you know, it happens a lot, 0:05:12.469 --> 0:05:14.469 and so we just have to roll with those punches. 0:05:14.509 --> 0:05:17.269 But babies just getting bigger at this point, they're fully developed. 0:05:17.589 --> 0:05:21.029 And now again it is extremely important to watch those movements. 0:05:21.269 --> 0:05:24.429 The highest risk of plus senal insufficiency is beyond forty weeks. 0:05:24.469 --> 0:05:26.349 So if you go postates that's what we call it. 0:05:26.389 --> 0:05:28.669 After forty weeks, we'll start seeing you a little more. 0:05:28.749 --> 0:05:31.509 So you'll usually get what's called a postate's ultrasound providing 0:05:31.509 --> 0:05:33.469 your low risk just to check the baby's growing still 0:05:33.469 --> 0:05:35.109 well and that placenta is still fine. They'll check the 0:05:35.149 --> 0:05:37.349 dopplers and things. They'll check the fluid around baby because 0:05:37.349 --> 0:05:38.869 one of the signs of a bubby getting tired and 0:05:38.909 --> 0:05:42.509 the placenta getting insufficient is that the fluid volume drops down. 0:05:42.589 --> 0:05:44.989 That's the amniotic fluid around the baby. So there's all 0:05:44.989 --> 0:05:47.189 those signs. They'll check in with you if everything goes well. 0:05:47.189 --> 0:05:49.469 We just hope you go into spontaneous labor by forty 0:05:49.469 --> 0:05:53.229 one and five days. Otherwise ninety percent of places will 0:05:53.229 --> 0:05:55.229 say we think you should have an induction of labor. 0:05:55.349 --> 0:05:57.549 And if the amniotic fluid is dropping down, is that 0:05:57.589 --> 0:05:59.589 the only way for that to drop is to come 0:05:59.709 --> 0:06:02.789 like out your vagina like you will notice or. 0:06:02.909 --> 0:06:05.829 No, So it's the baby's absorption, so it actually is less. 0:06:05.989 --> 0:06:08.269 So it's very good question because you're right that you 0:06:08.269 --> 0:06:10.629 would assume it means you're leaking from the vagina. If 0:06:10.669 --> 0:06:12.589 you're leaking from the vagina, that means your labor is 0:06:12.629 --> 0:06:15.069 hopefully starting because your waters are broken, or we would 0:06:15.069 --> 0:06:17.029 again offer an induction. We don't like someone sitting on 0:06:17.029 --> 0:06:20.109 broken waters, particularly at term, for much longer than ideally 0:06:20.149 --> 0:06:22.869 twenty four hours. Is the recommendation. We will wait three 0:06:22.989 --> 0:06:25.669 days with raptured water, provided there's no signs of infection 0:06:25.709 --> 0:06:29.309 and no gbs. You know, that's fine, that's a woman's decision. 0:06:29.389 --> 0:06:32.429 But if you're leaking, it's it's baby time. No, it's 0:06:32.429 --> 0:06:34.789 actually because your baby is not getting as much volume 0:06:34.829 --> 0:06:37.549 and nutrition from the placenta. Your bubby's not weaning as much, 0:06:37.589 --> 0:06:40.389 so it's actually not swallowing and creating that much urine. 0:06:40.389 --> 0:06:42.589 So it basically shows us that the fetus is distressed. 0:06:42.789 --> 0:06:45.829 So not always it's a soft sign, but it's okay, 0:06:45.909 --> 0:06:47.669 one of the only ones we have. So if your 0:06:47.669 --> 0:06:50.069 post dates and your baby's not moving as much and 0:06:50.109 --> 0:06:52.669 there's not as much fluid around, that's a really strong 0:06:52.709 --> 0:06:54.869 indication to bring you to start your labor. 0:06:55.869 --> 0:06:56.509 Is this normal? 0:06:56.629 --> 0:06:57.269 Is normal? 0:06:57.509 --> 0:07:00.469 Way? Is this normal? Questions are about when will all 0:07:00.509 --> 0:07:02.869 the bad pregnancy stuff go away? 0:07:04.029 --> 0:07:05.949 Well, do you mean like the big belly in the scene, 0:07:06.709 --> 0:07:07.269 a big belly? 0:07:07.309 --> 0:07:10.709 I feel like I'm quite I feel like I'm informed 0:07:10.749 --> 0:07:15.389 that the bounce back is weeks. In terms of months, yeah, months, 0:07:15.389 --> 0:07:19.029 in terms of your uterus shrinking, I'm talking about nausea reflux. 0:07:19.589 --> 0:07:21.229 It's probably just the blood pressure yeah. 0:07:21.229 --> 0:07:23.869 Blood yeah, blood pressure, yeah, exactly, and diabetes and things 0:07:23.909 --> 0:07:26.269 like that. So look, in most cases, things happen fairly 0:07:26.309 --> 0:07:27.989 quickly in the first few days after birth. Now, for 0:07:28.029 --> 0:07:30.509 certain conditions like the nausea, it often goes away almost 0:07:30.549 --> 0:07:32.869 as soon as you've had your baby. It's phenomenal. I know, 0:07:32.949 --> 0:07:37.349 you breathe a sigh of relief. Things like blood pressure. Unfortunately, 0:07:37.549 --> 0:07:39.269 when your baby comes out, it basically is like a 0:07:39.269 --> 0:07:41.429 big boost of blood back to your system. So your 0:07:41.469 --> 0:07:44.069 kind of output goes even up higher straight after birth 0:07:44.549 --> 0:07:49.229 than it did in pregnancy. So the swelling gets worse 0:07:49.229 --> 0:07:51.189 sometimes for a few days before it gets better. Your 0:07:51.229 --> 0:07:53.829 body swelling, your blood pressure can actually be the worst 0:07:53.869 --> 0:07:56.149 on day four and five postpartum. So there are a 0:07:56.189 --> 0:07:57.869 few things to sort of watch out for in that space, 0:07:57.909 --> 0:07:59.349 which is why if you do have pre plants yea, 0:07:59.429 --> 0:08:01.109 we often ask you to stay longer in hospital for 0:08:01.109 --> 0:08:03.629 four up to four or five days after and we 0:08:03.669 --> 0:08:07.149 can really tyitrate your medications. For ladies with GDM, you 0:08:07.189 --> 0:08:08.749 don't have to worry about it. The minute your baby 0:08:08.749 --> 0:08:09.869 comes out, you can go back to it. Well, we 0:08:10.269 --> 0:08:11.949 still want you to be careful because remember there is 0:08:11.949 --> 0:08:14.149 a real risk with GDM that you will actually develop 0:08:14.389 --> 0:08:16.909 type two diabetes within the next ten to fifteen years. 0:08:16.909 --> 0:08:18.829 So we don't want you to go back to chocolates 0:08:18.869 --> 0:08:21.229 and macers forever. But you are very welcome to have 0:08:21.309 --> 0:08:22.109 any real. 0:08:21.949 --> 0:08:23.069 And we don't have to watch your blood. 0:08:23.069 --> 0:08:25.309 You'll the levels, they can have whatever they want. 0:08:25.389 --> 0:08:27.589 Yea, that in those couple of days and things. But yeah, 0:08:27.989 --> 0:08:30.429 so yeah, your body will bounce back. It's remarkable. We're 0:08:30.429 --> 0:08:31.709 made to do this as women. 0:08:31.909 --> 0:08:35.069 So what are the stats on how long it takes 0:08:35.069 --> 0:08:37.629 for your uterus to shrink back to its original size. 0:08:38.029 --> 0:08:41.109 Well, it happens quite quickly, so we monitor that afterwards. 0:08:41.149 --> 0:08:43.949 We like your uterus to be under your umbilical so 0:08:44.029 --> 0:08:46.109 under your belly button or ready by the next day. 0:08:46.349 --> 0:08:47.749 And so you'll get someone who'll come and give this 0:08:47.909 --> 0:08:49.589 nasty rub on your tummy and be like oh, you'd 0:08:49.629 --> 0:08:50.589 be like, oh my god. 0:08:50.469 --> 0:08:51.909 Al leave me alone. 0:08:51.949 --> 0:08:54.589 I just did this thing exactly because we're going to 0:08:54.669 --> 0:08:56.709 check that uterus has shrunk down and it's central. We 0:08:56.709 --> 0:08:58.589 don't want it to be deviated because that can sometimes 0:08:58.589 --> 0:09:01.229 mean there's a bit of percenter left or something like that. 0:09:01.349 --> 0:09:03.429 So you will also check your pad. Now, remember there is 0:09:03.469 --> 0:09:06.269 that chance of bleeding and pregnancy and certainly in birth, 0:09:06.589 --> 0:09:08.349 and we check that pad afterwards to make sure that 0:09:08.349 --> 0:09:09.549 the bleeding is not too excessive. 0:09:10.109 --> 0:09:12.989 What are the stages of how much bleeding is normal? 0:09:13.149 --> 0:09:15.389 And at what point do you call your midwife or 0:09:15.429 --> 0:09:16.669 call the hospital and come back in. 0:09:16.749 --> 0:09:19.029 Yeah, great question, And in birth vaginal birth normals up 0:09:19.029 --> 0:09:20.309 to five hundred mils. It sounds like a lot, but 0:09:20.349 --> 0:09:21.909 remember you've got that extra two to three liters on 0:09:21.949 --> 0:09:23.549 board anyway up in a cesara and it's up to 0:09:23.589 --> 0:09:26.989 a litera still considered a big bleed, but we tolerate 0:09:27.029 --> 0:09:29.269 it and we often repeat your bloods the next day 0:09:29.269 --> 0:09:31.069 if you've bled a bit too much in labor. So 0:09:31.149 --> 0:09:32.949 things to look out for in that postpart and period 0:09:33.029 --> 0:09:36.109 is if you're passing clots, unless you've been lying down 0:09:36.149 --> 0:09:38.149 for a long time. Therefore it's just like coagulated and 0:09:38.189 --> 0:09:39.869 you stand up and it comes straight out. There's never 0:09:39.909 --> 0:09:42.909 really a good time that clots should be happening. Abnormal discharge. 0:09:42.909 --> 0:09:45.309 So if it smells funny, if you've got pain, we 0:09:45.349 --> 0:09:48.269 can get endometritis, which is an infection inside the uterus. 0:09:48.389 --> 0:09:50.749 That's a concern if you're bleeding stops and then it 0:09:50.789 --> 0:09:53.589 comes back heavy. That's a concern. So you will bleed 0:09:53.589 --> 0:09:55.669 like a heavy period for two or three weeks can 0:09:55.669 --> 0:09:58.629 be quite normal. Beyond that, we need to investigate, and 0:09:58.669 --> 0:10:00.909 any kind of weird pain and discharge is something we 0:10:00.989 --> 0:10:04.349 need to just review and check because, look, it's not common, 0:10:04.389 --> 0:10:06.149 but there sometimes can be a little bit of placenta, 0:10:06.189 --> 0:10:09.549 a little bit of the membrane still inside, and in 0:10:09.589 --> 0:10:11.709 most cases your body will pass it out naturally, but 0:10:11.749 --> 0:10:13.229 we need to do an ultracent and check that there's 0:10:13.269 --> 0:10:16.629 nothing large, because placentas is something we didn't talk about before. 0:10:16.629 --> 0:10:18.749 Actually percentas can usually be round, but sometimes there are 0:10:18.749 --> 0:10:21.989 actually this two percenters there's an extra lobe of the placenta, 0:10:22.229 --> 0:10:23.509 and we just need to make sure the whole things 0:10:23.509 --> 0:10:23.789 come out. 0:10:23.829 --> 0:10:27.269 Why wouldn't they do an ultrasound of your uterus to 0:10:27.269 --> 0:10:30.109 make sure there's nothing of the placenta when you're still 0:10:30.109 --> 0:10:30.749 in the hospital. 0:10:31.229 --> 0:10:32.749 There's a lot of blood in there, and it's quite 0:10:32.749 --> 0:10:37.789 hard to differentiate between tissue and blood associated and the 0:10:37.829 --> 0:10:40.629 uterine lining coming away, So it's initially quite hard. I 0:10:40.669 --> 0:10:42.589 mean you can I certainly there's a big bees oft plercenta, 0:10:42.629 --> 0:10:44.589 you'll see it. And so certainly if someone has a 0:10:44.629 --> 0:10:46.869 retained placenter, which we haven't talked about, but that's when 0:10:47.189 --> 0:10:49.949 after birth, between thirty and forty five minutes afterwards, despite 0:10:49.989 --> 0:10:51.629 having the injection in your leg to help it birth, 0:10:51.629 --> 0:10:53.109 it's still inside and. 0:10:53.069 --> 0:10:56.109 That injection is to help eat up percenter delivery. 0:10:56.269 --> 0:10:58.269 Yeah, it makes the uterus contract to hopefully then let 0:10:58.349 --> 0:11:01.149 it release off the wall. But unfortunately, some placentas do 0:11:01.189 --> 0:11:03.389 get stuck, particularly if you've had a previous arian section. 0:11:03.429 --> 0:11:04.749 It could be around that front of that womb. But 0:11:04.749 --> 0:11:07.069 again that's when we worry about placenta cretors and things 0:11:07.149 --> 0:11:09.709 that's gone. If you've had your baby vaginally, you don't 0:11:09.749 --> 0:11:11.669 have to worry that, but we just need to make 0:11:11.669 --> 0:11:13.029 sure that whole ples center comes out. And they do 0:11:13.069 --> 0:11:15.869 get stuck. It's not an uncommon thing to see. I'd see, 0:11:16.109 --> 0:11:17.389 you know, once or twice a week we get a 0:11:17.469 --> 0:11:19.749 stuck a placenter at my hospital. And so that is 0:11:19.789 --> 0:11:22.269 a time unfortunately, even if you've had a beautiful vaginal birth, 0:11:22.269 --> 0:11:24.309 that you may end up going to the operating theater 0:11:24.349 --> 0:11:26.149 because it's the safest place to remove it. 0:11:26.309 --> 0:11:29.589 And what can we expect hospital stay wise. Best case 0:11:29.589 --> 0:11:32.429 scenario for both a cesarean and a vaginal birth. 0:11:32.709 --> 0:11:34.549 Sure, So I mean we have an I did with 0:11:34.629 --> 0:11:37.549 my fourth women who leave five hours after vaginal birth 0:11:37.589 --> 0:11:38.989 from the birth un it, I mean we have people 0:11:38.989 --> 0:11:41.629 at birth at home. Remember like women are very, very amazing. 0:11:41.949 --> 0:11:44.309 It'll depend so if you've had risk factors, you'll have 0:11:44.309 --> 0:11:46.229 to say a few days. But I'd say most women 0:11:46.229 --> 0:11:47.949 go home. They say, one night in hospital in a 0:11:47.949 --> 0:11:50.389 public hospital and go home the next day. In private 0:11:50.389 --> 0:11:53.429 hospitals you get five nights of free accommodation, lactation consultants, 0:11:53.429 --> 0:11:56.349 peroneal care, and most places even let you leave your 0:11:56.349 --> 0:11:58.349 baby for an evening to go out for a dinner meal. 0:11:58.469 --> 0:12:00.869 So it very much depends on what model of care 0:12:00.909 --> 0:12:02.949 you've had, and so therefore it ranges from sort of 0:12:02.949 --> 0:12:04.949 one to five. And I think it's probably at this 0:12:04.949 --> 0:12:06.229 point when we should talk about a little bit of 0:12:06.269 --> 0:12:08.629 the postpartum stuff. So you need to see your GP 0:12:08.709 --> 0:12:11.349 in about two weeks after earth just to check on things. 0:12:11.589 --> 0:12:13.829 Paraneal care is really important. If you've had some stitches, 0:12:13.909 --> 0:12:16.789 Let's be honest, most people have, it's important to clear 0:12:16.789 --> 0:12:18.909 them really clean and dry, Please don't put any soap 0:12:18.949 --> 0:12:21.189 on them, keep them just you know, change your pad regularly. 0:12:21.189 --> 0:12:23.749 Every time you open your boughs. Wash with warm water, 0:12:23.909 --> 0:12:26.749 no soap, just salty your warm water. If you're concerned, 0:12:26.789 --> 0:12:29.429 call up monitor your cesarean wound. The dressings come off 0:12:29.549 --> 0:12:32.109 usually day five to seven. There's no stitches, are all internal. 0:12:32.149 --> 0:12:34.669 There's nothing to do there. But things to sort of 0:12:34.749 --> 0:12:37.109 keep an eye on are infections, paining your tummy, pain 0:12:37.149 --> 0:12:40.429 in your wounds, feeling sick, feeling hot and bothered, all 0:12:40.429 --> 0:12:41.629 of those sort of things. You need to go back 0:12:41.669 --> 0:12:43.109 to the birth unit, even if you went home on 0:12:43.109 --> 0:12:43.749 the same day. 0:12:44.029 --> 0:12:46.509 What about those who feel quite a lot of anxiety 0:12:46.669 --> 0:12:48.189 around the first pooh. 0:12:48.589 --> 0:12:52.669 Yes, your boughs get very particularly with cesarean sections, because 0:12:52.749 --> 0:12:54.949 it's sort of being moved around in that cason space. 0:12:55.989 --> 0:12:59.189 It feels weird having done it multiple times, it just 0:12:59.189 --> 0:13:02.429 feels uncomfortable. You can sometimes have and it's very normal 0:13:02.469 --> 0:13:04.389 to have a bit of flatus in continents. In other words, 0:13:04.389 --> 0:13:05.509 you fight and you can't hold it in. 0:13:05.829 --> 0:13:06.389 Very normal. 0:13:06.989 --> 0:13:10.429 It comes back to usually comes back providing your hat 0:13:10.429 --> 0:13:12.709 haven't had a big fourth degree tere in a couple 0:13:12.709 --> 0:13:14.229 of in a couple of days, if not a week. 0:13:14.949 --> 0:13:16.629 I think the big thing to highlight there is if 0:13:16.669 --> 0:13:19.669 your urinary contents is the same, you're not going to 0:13:19.749 --> 0:13:21.349 make it to the toilet half the time. You're going 0:13:21.389 --> 0:13:22.669 to be sort of waddling to the toilet. 0:13:22.709 --> 0:13:23.589 You're going to leak. Again. 0:13:23.629 --> 0:13:26.309 That's very it's just been stunned during the birth. It 0:13:26.389 --> 0:13:28.749 comes back over a week or two. I am a 0:13:28.749 --> 0:13:30.869 big believer no matter what birth, you have to book 0:13:30.869 --> 0:13:33.589 in with a pelvic physiotherapist. It's really strongly believe in it, 0:13:33.629 --> 0:13:36.629 no matter what birth you've had. Women as a approach 0:13:36.669 --> 0:13:39.229 perimenopause and menopause are going to have problems within continents 0:13:39.229 --> 0:13:42.349 and bladder issues. So preparing yourself to retrain after birth, 0:13:42.389 --> 0:13:45.069 to me is a no brainer. So if you're having 0:13:45.309 --> 0:13:47.789 excessive concerns, see it earlier. Otherwise start looking at that 0:13:47.789 --> 0:13:50.389 process in about six weeks. I'm also a big believer 0:13:50.469 --> 0:13:53.029 if you choose to breastfeed, to get a breastfeeding consultant 0:13:53.029 --> 0:13:55.269 because they can just sort of nullify some of the 0:13:55.269 --> 0:13:56.669 issues that are flying around in your head. 0:14:00.789 --> 0:14:04.549 For my toolkit, again, it's just questions. I'm just I've 0:14:04.549 --> 0:14:06.629 got you here at the end I cut you here, 0:14:06.629 --> 0:14:08.829 so I'm just gonna mind you for knowledge. I want 0:14:08.869 --> 0:14:11.469 to talk about two things. If you have a birth 0:14:11.509 --> 0:14:14.589 plan that you don't get and the mental health around that. 0:14:14.589 --> 0:14:17.429 That's the first one. So what are the risk factors 0:14:17.549 --> 0:14:22.189 when someone does have a plan and it doesn't plan 0:14:22.389 --> 0:14:25.709 go to plan? And I mean risk factors for their 0:14:25.749 --> 0:14:28.509 mental health? Certainly, obviously some people are going to be 0:14:28.549 --> 0:14:31.069 like who cares? But there are some people who are 0:14:31.069 --> 0:14:34.989 going to be very traumatized, very traumatized, and well really 0:14:34.989 --> 0:14:37.629 held onto an idea of how they wanted it to go. 0:14:38.069 --> 0:14:40.469 I think that's a huge thing to unpack. But I 0:14:40.469 --> 0:14:43.349 think most people don't get the birth they thought they 0:14:43.349 --> 0:14:45.069 were going to have. And I think if we go 0:14:45.109 --> 0:14:46.949 in with that attitude of with a really open mind 0:14:46.949 --> 0:14:48.829 of this is what I would love to happen, but 0:14:48.869 --> 0:14:52.069 I accept that it may or may not be that way. Again, 0:14:52.189 --> 0:14:54.629 a bit like the breastfeeding consultant and the pelvic physiotherapist, 0:14:54.709 --> 0:14:57.349 I think booking in a psychology appointment after birth, no 0:14:57.429 --> 0:14:59.749 matter how your birth is, is a great idea. We 0:14:59.789 --> 0:15:01.189 know that women are going to get postan or blues 0:15:01.189 --> 0:15:02.709 on day three to four. Anyway, it's as your milk 0:15:02.749 --> 0:15:05.429 comes in and your hormones change and everybody cries. The 0:15:05.469 --> 0:15:07.789 strongest woman will have a good cry and it's appropriate 0:15:07.789 --> 0:15:10.629 and normal, and we see is reassuring, but that can 0:15:10.709 --> 0:15:14.149 sometimes last longer than that having an identifiable or someone 0:15:14.189 --> 0:15:16.669 in your world that can actually identify that you're out 0:15:16.709 --> 0:15:19.389 of character and knowing where those resources are to go 0:15:19.429 --> 0:15:21.709 and get help, so you know there are lots of 0:15:21.709 --> 0:15:24.029 good online and good resources to try and look at 0:15:24.069 --> 0:15:27.629 from a postcanner depression perspective, but birth trauma definitely can 0:15:27.989 --> 0:15:29.869 make it a lot worse because if you're going there 0:15:29.989 --> 0:15:32.309 wanting and desperately hoping this is what your birth's going 0:15:32.349 --> 0:15:34.029 to be, and then it doesn't go to how you plan, 0:15:34.589 --> 0:15:36.469 it's a really hard language to say to yourself, well, 0:15:36.469 --> 0:15:38.469 I did everything humanly possible for it to plan, it 0:15:38.509 --> 0:15:40.229 didn't go that way, and I'm proud of myself. Most 0:15:40.269 --> 0:15:42.629 women just feel defeated by it. And I think it's 0:15:42.669 --> 0:15:44.909 actually our responsibility, particularly people like you and I who 0:15:44.909 --> 0:15:46.549 get on social media and talk about this, to be 0:15:46.549 --> 0:15:49.469 able to really highlight that it doesn't regularly go to 0:15:49.509 --> 0:15:52.389 plan and therefore you have done brilliantly. Even if you 0:15:52.509 --> 0:15:56.229 end up with a really bad case scenario, because there's 0:15:56.269 --> 0:15:59.389 no person that goes into that situation with that idea 0:15:59.429 --> 0:16:02.149 in mind. You go in with the best intentions and 0:16:02.189 --> 0:16:03.949 no matter if as long as you come out knowing 0:16:03.989 --> 0:16:05.589 that you tried the best you can and even if 0:16:05.629 --> 0:16:06.869 you didn't, even if you went in there with a 0:16:06.909 --> 0:16:08.429 whole plan and then bailed the first time you had 0:16:08.429 --> 0:16:11.549 a contraction, that's okay too, because there are no heroes 0:16:11.669 --> 0:16:14.229 in the birth environment. There's just a happy, well mum 0:16:14.269 --> 0:16:15.749 and a beautiful baby at the end of it. 0:16:15.869 --> 0:16:17.909 I really like this clip that you actually played just 0:16:17.949 --> 0:16:20.509 before we started recording, which is I don't know if 0:16:20.549 --> 0:16:24.669 they're obstectric. Yeah, I'm saying that this sentence is so 0:16:24.709 --> 0:16:27.149 problematic of you were given a baby you were meant 0:16:27.149 --> 0:16:27.909 to birth. 0:16:28.029 --> 0:16:30.149 Yeah, and you can't grow a baby that you weren't 0:16:30.149 --> 0:16:31.629 meant to birth, or your body is made to have 0:16:31.669 --> 0:16:32.149