WEBVTT - Week 39: The Final Countdown

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<v Speaker 1>You're listening to a Muma Mia podcast. Mama Maya acknowledges

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<v Speaker 1>the traditional owners of land and waters that this podcast

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<v Speaker 1>is recorded on.

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<v Speaker 2>I am pregnanty.

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<v Speaker 1>Welcome to Hello Bump. We're making pregnancy less overwhelming and

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<v Speaker 1>more manageable. I'm Grace Ruprey. I'm pregnant for the first

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<v Speaker 1>time and it's probably at the point to start making

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<v Speaker 1>bets on the day that your baby will come.

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<v Speaker 2>I'm Jana Pittman. I'm a former Olympian, mother of six

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<v Speaker 2>little humans, and I'm a training obstetrician and gynocologist.

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<v Speaker 1>Each week, we'll be holding your hand, week by week

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<v Speaker 1>through the mysterious, perplexing, and sometimes very silly miracle that

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<v Speaker 1>is pregnancy, all the way from a poppy seed to

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<v Speaker 1>a pumpkin.

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<v Speaker 2>Week Oh, get this thing out of me.

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<v Speaker 1>Thirty nine? What size is our baby?

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<v Speaker 2>I don't know what a jack fruit is, but apparently

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<v Speaker 2>that's what Google says a baby is at this size.

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<v Speaker 1>I wrote, just big, just big.

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<v Speaker 2>Yes baby, Well, we hope babies just big at this point,

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<v Speaker 2>but yes, most babies are nice grown between around the

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<v Speaker 2>three point four to three point five kilos by now.

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<v Speaker 1>And what have they developed or they're just ready. They're ready.

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<v Speaker 2>Thirty nine weeks is that milestone. So a lot of

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<v Speaker 2>obstetricians are sort of saying, okay, anytime now, all right,

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<v Speaker 2>let's come baby, let's go, let's go, because we know

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<v Speaker 2>that at this point you have done a wonderful job.

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<v Speaker 2>The baby's fully grown. There's very little benefit. I mean,

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<v Speaker 2>don't get me wrong, there's still the growth of fat,

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<v Speaker 2>the nutrition and all that kind of stuff that mummy

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<v Speaker 2>can provide, and we certainly do not do in most

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<v Speaker 2>public hospitals won't do an induction before forty one weeks

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<v Speaker 2>for a well healthy mummy. We wait for the spontaneous

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<v Speaker 2>lay because we know that's better for baby's lungs, it's

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<v Speaker 2>better for mum's overall experience, and it's better because baby

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<v Speaker 2>will get into a good position to come, hopefully in

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<v Speaker 2>the birth space. But you know that, we do know

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<v Speaker 2>that if Bubby needs to come, it is very very safe. Now,

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<v Speaker 2>even if it's just mum's choice to have a baby

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<v Speaker 2>to be birthed.

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<v Speaker 1>What's happening. What's happening to me and what is happening

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<v Speaker 1>to our bodies?

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<v Speaker 2>Your stretch marks are getting more if they're going to

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<v Speaker 2>be there your cervix is hopefully thinning out and getting

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<v Speaker 2>very ready for birth lot more discharged. So it's very

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<v Speaker 2>similar to the last two to three weeks. It's just

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<v Speaker 2>that now it's real. So now tightenings are probably contractions.

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<v Speaker 2>Your leaking is probably amniotic fluid. So all the things

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<v Speaker 2>that we query as to whether it might be labor

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<v Speaker 2>are very likely now labor.

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<v Speaker 1>Well, look, I'm not a doctor. When your placenta gets

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<v Speaker 1>tired or old, when it comes out, does that does

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<v Speaker 1>it look like it's organ that has gotten tired and old?

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<v Speaker 2>Occasionally, Yeah, so we call all placcea insufficiency. When when

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<v Speaker 2>I like to say calls tired and placenta gets tired.

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<v Speaker 2>You can sometimes see it smaller in size. You know,

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<v Speaker 2>it's got everything, and it's just particular like it's just little.

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<v Speaker 2>Sometimes the vessels. It's got this quartz called Warburton jelly

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<v Speaker 2>around the cord. Sometimes it's just a really skinny, I'm sorry,

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<v Speaker 2>but pathetic looking little cord. Sometimes it's got the li

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<v Speaker 2>infunctions all over it. So little areas where it's obviously blown,

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<v Speaker 2>like little parts where the placenta's actually died. It's sometimes

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<v Speaker 2>you can even see blood clots or it's abrupted, and

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<v Speaker 2>sometimes you can just see calcifications. Now, calcifications percenter after

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<v Speaker 2>forty weeks is actually some are quite common, so it's

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<v Speaker 2>not a sign of placentlence efficiency. It's just a sign

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<v Speaker 2>that it's been working really hard for forty plus weeks.

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<v Speaker 2>But it's amazing. I love placenters, just say ye, so

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<v Speaker 2>I inspect all the placenters afterwards because I just I

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<v Speaker 2>don't know. I find them so incredible that we grow

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<v Speaker 2>a whole organ to support our baby and then it's done.

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<v Speaker 1>How many women want to see their placenta?

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<v Speaker 2>Oh that's okay, I thought the don's how many people

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<v Speaker 2>want to eat their whole center? But okay, I do.

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<v Speaker 1>Have that question as well, because I know that they

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<v Speaker 1>can become a pill of some sort encapsulate them.

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<v Speaker 2>Yeah, right, most people want to see their placenter, so

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<v Speaker 2>there's lots of well, I think it's more that they

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<v Speaker 2>want to have a little look and gross. I just

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<v Speaker 2>it's just very do you want to see your placenta

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<v Speaker 2>when That's why I laughed.

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<v Speaker 1>They're so beautiful.

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<v Speaker 2>They've got one side is obviously it's all covered in

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<v Speaker 2>the beautiful veins as well, so you can actually see

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<v Speaker 2>how the blood flow actually flowed into the placenta there.

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<v Speaker 2>I mean, you don't have to You can always get

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<v Speaker 2>someone to take a photo of it and have a

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<v Speaker 2>look later.

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<v Speaker 1>If you have a cesarean, do you have the same

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<v Speaker 1>option of being shown it?

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<v Speaker 2>Yeah? Absolutely, Okay, yeah, we exactly the same thing. So

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<v Speaker 2>the same process is that gets put in a little

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<v Speaker 2>white bucket and then they ask mum afterwards, would you

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<v Speaker 2>like to see it now. The caveat there is if

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<v Speaker 2>there's something wrong with your placenta and we need to

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<v Speaker 2>send it for pathology, so we can still usually show

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<v Speaker 2>you pretty quickly, but occasionally there might be a reason

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<v Speaker 2>we send your placenta for histopathology, which means we look

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<v Speaker 2>at it to see if there's anything abnormal with it,

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<v Speaker 2>or it might get used you know for like, you know,

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<v Speaker 2>if there's something wrong with your baby, to check if

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<v Speaker 2>there's a genetic issue and things like that. So we

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<v Speaker 2>use the placenta sometimes for a diagnostic reason.

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<v Speaker 1>Interesting, but otherwise.

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<v Speaker 2>You can usually get thrown out. When I say ninety

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<v Speaker 2>to nine persent of the time we get thrown out.

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<v Speaker 2>Some people take it home and bury it under trees

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<v Speaker 2>and things like that certain religious groups and things that

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<v Speaker 2>do that, and there's definitely some people encapsulate it.

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<v Speaker 1>When do they put that request in to keep their placenta.

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<v Speaker 2>Well, look, we ideally have it before you arrive because

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<v Speaker 2>often hospitals don't have fridges, and it's obviously human. It's

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<v Speaker 2>a human product, so they don't love them just sitting

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<v Speaker 2>around unrefrigerated and whatnot. So it normally needs to be

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<v Speaker 2>something where we sign a document like a release of

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<v Speaker 2>tissue document, and the plasenta needs to be picked up

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<v Speaker 2>quickly by a friend or family member.

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<v Speaker 1>In an esque.

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<v Speaker 2>It's in a little white to little like a little

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<v Speaker 2>white almost looks like a paint tin, interesting with your

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<v Speaker 2>with your MRN and your logo and your name on it,

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<v Speaker 2>so it doesn't get mex up.

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<v Speaker 1>So people who do put it in a capsule or

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<v Speaker 1>get it in a capsule one. I have no idea

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<v Speaker 1>where these services exist. But what are the perceived benefits

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<v Speaker 1>of it? Yeah, I think perceived is a great way.

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<v Speaker 1>And look, I have lots and lots of people who've

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<v Speaker 1>done it. I've certainly looked into it myself because you know,

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<v Speaker 1>animals in the wild do it. So I think one

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<v Speaker 1>of the arguments is that animals eat their own placentas,

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<v Speaker 1>whether it's for a huge boost in iron. You know,

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<v Speaker 1>we eat animals livers and things for the same iron

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<v Speaker 1>increase and things like that, because it's a very dense source.

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<v Speaker 1>The flip side of that argument is the animals eat

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<v Speaker 1>it so that predators don't come, so we don't know.

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<v Speaker 1>We can't ask, you know, a kangaroo why things happen

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<v Speaker 1>that way? Or sheep is the one I've seen most.

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<v Speaker 1>They eat their percenters very quickly. The positives I guess

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<v Speaker 1>may be that it helps with breast milk and when

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<v Speaker 1>you've lost blood during birth. That's the main argument.

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<v Speaker 2>The flip side of it in Australia is it's not

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<v Speaker 2>TGA approved yet, so you don't know who is encapsulating,

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<v Speaker 2>what storage messogs they're using, what type of preservation methods

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<v Speaker 2>they're using for that. So again, guys, it's a personal

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<v Speaker 2>just ye you know, I think if you want to

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<v Speaker 2>eat it raw, fine, that's your choice. As long as

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<v Speaker 2>you're aware that there could be something infectious that may

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<v Speaker 2>make you sick, then it's a discussion. You have to

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<v Speaker 2>have these for yourself, and I know where I sit

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<v Speaker 2>on it, but As a medical person, I'd keep very

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<v Speaker 2>neutral in this space, but it's one to have a

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<v Speaker 2>discussion with your midwife about. There's plenty of duelers that

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<v Speaker 2>do it. It's definitely in other countries something that's un

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<v Speaker 2>more commonly, but here you just gotta be really careful

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<v Speaker 2>and find out very strictly how they preserve and how

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<v Speaker 2>they encapsulate them. Is this normal? Is normal?

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<v Speaker 1>I've got it? Is this normal question around? You can

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<v Speaker 1>be one to two centiment is dilated for potentially days

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<v Speaker 1>or weeks correct one not even know or be having

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<v Speaker 1>like contractions and just be living life for and not

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<v Speaker 1>technically in labor.

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<v Speaker 2>That's right. You service could be very dynamic and look

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<v Speaker 2>after after thirty seven weeks. We don't really mind. If

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<v Speaker 2>your service is open, it'll eventually either open up and

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<v Speaker 2>have a baby or it won't. But it's definitely a

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<v Speaker 2>fear that people have, is that am I just going

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<v Speaker 2>to drop a baby in the street? Most of the

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<v Speaker 2>time not. There are definitely women though, that have what

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<v Speaker 2>we call soolent labors and feel nothing and they come

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<v Speaker 2>in for a review and they're found to.

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<v Speaker 1>Be fully dilated.

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<v Speaker 2>But it is rare, It's very rare. It's not actually

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<v Speaker 2>something you want, so people go, oh gosh, I wish

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<v Speaker 2>that was me. The problem is they can't feel their

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<v Speaker 2>contractions to push, and so it becomes hard in that

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<v Speaker 2>second stage of labor because you actually need to push

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<v Speaker 2>your baby out, and if you've got no contractions or

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<v Speaker 2>no idea when they're happening, you don't have that extra

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<v Speaker 2>support to help bear down and push baby down. So

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<v Speaker 2>there's pros and cons to both, and you know, I

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<v Speaker 2>sort of look at it and think, Okay, look, an

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<v Speaker 2>open service is always a good thing after thirty eight

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<v Speaker 2>weeks because it means that hopefully, if worse clam scenario

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<v Speaker 2>and we needed to do an induction, we at least

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<v Speaker 2>get that process started with minimal intervention.

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<v Speaker 1>My toolkit of this week is about preparing animals if

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<v Speaker 1>you have them. This is the only stuff that I've read,

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<v Speaker 1>and I want to know if you know more about this,

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<v Speaker 1>it's probably like you're not the expert.

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<v Speaker 2>No, No, I'm going to have a lot of animals.

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<v Speaker 1>Yes, but personally, this is where I'm asking for your

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<v Speaker 1>mother hats mother hat. I like it. I can put

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<v Speaker 1>that on. I've got two cats. One of the cats

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<v Speaker 1>is already sleeping in the cops. Yes, so we've tried

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<v Speaker 1>to put stuff in it. But one of the things

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<v Speaker 1>that I've read about is like bringing something home from

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<v Speaker 1>the hospital for them to smell before. I don't know

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<v Speaker 1>if that's more cats than dogs.

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<v Speaker 2>I think it's both from what we've heard.

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<v Speaker 1>And then anything to watch out for. What are the

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<v Speaker 1>things to watch out for when the baby does come home.

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<v Speaker 2>It's a really tricky one because they're your loved ones too,

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<v Speaker 2>aren't they, especially dogs and cats, And unfortunately it's not

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<v Speaker 2>safe to have them sleeping in the same room as

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<v Speaker 2>the baby. And I think it's a really hard one.

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<v Speaker 2>And I have woken up to my cats sitting on

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<v Speaker 2>top of my baby and I was like, oh god,

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<v Speaker 2>I forgot and it just it just did and I

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<v Speaker 2>was like, oh my god. Go And you think, oh,

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<v Speaker 2>it's so sweet. But they're doing it because the bubby

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<v Speaker 2>is warm, not because they're loving the baby. Okay, they

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<v Speaker 2>don't love that baby just yet. It's cries and it

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<v Speaker 2>makes noise and cats don't like that. So it is

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<v Speaker 2>the warmth of your bubby and it's not moving, and

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<v Speaker 2>it just likes to sit in that space. So largely

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<v Speaker 2>things may not go wrong, but the last thing you

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<v Speaker 2>want to do is wake up and find the cat

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<v Speaker 2>sitting on the little one's face. It's the same thing

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<v Speaker 2>of removing things like, you know, the cords on your

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<v Speaker 2>blinds and just taking them of the way so toddlers

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<v Speaker 2>can't reach them, and things like that. So it's an

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<v Speaker 2>introduction space that, yes, maybe bringing something home is a

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<v Speaker 2>good idea, and then introducing them slowly during daylight hours

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<v Speaker 2>and you can leave baby unattended. The cat's not always

0:09:21.269 --> 0:09:22.629
<v Speaker 2>going to get in the way, but just being aware

0:09:22.629 --> 0:09:23.829
<v Speaker 2>that both are in the same space.

0:09:24.109 --> 0:09:26.109
<v Speaker 1>Is there any chance that they'll show an allergy to

0:09:26.149 --> 0:09:27.029
<v Speaker 1>them this early on?

0:09:27.549 --> 0:09:30.309
<v Speaker 2>Theoretically, I suppose they could. They build that the IgE

0:09:30.389 --> 0:09:31.909
<v Speaker 2>response in the first couple of months of life. So

0:09:31.909 --> 0:09:34.229
<v Speaker 2>I assume that theoretically, But you know, that's have to

0:09:34.269 --> 0:09:36.069
<v Speaker 2>be a question for a pediatrician, but it's worth asking

0:09:36.149 --> 0:09:37.549
<v Speaker 2>someone might be able to write into us and let

0:09:37.629 --> 0:09:39.229
<v Speaker 2>us say, yes, what the answer to that is if

0:09:39.269 --> 0:09:41.709
<v Speaker 2>they've had a child that's had allergies. I mean, if

0:09:41.749 --> 0:09:44.549
<v Speaker 2>you have allergies, the chances are there's an atopic picture

0:09:44.549 --> 0:09:46.669
<v Speaker 2>in the genetic composition of mum and dad, then babies

0:09:46.789 --> 0:09:48.309
<v Speaker 2>likely to have them, but it tends to be a

0:09:48.309 --> 0:09:49.829
<v Speaker 2>little bit more later than that, but they can get

0:09:49.829 --> 0:09:51.509
<v Speaker 2>food allergies, like if you think about babies can be

0:09:51.509 --> 0:09:54.869
<v Speaker 2>allergic to lactose and things. So that immune mediator response

0:09:54.949 --> 0:09:57.069
<v Speaker 2>is there. So I guess you have to be careful.

0:09:57.629 --> 0:10:00.269
<v Speaker 1>Do you have any checklists for week thirty nine?

0:10:00.829 --> 0:10:02.429
<v Speaker 2>If you have to have an induction? Now we've talked

0:10:02.429 --> 0:10:05.309
<v Speaker 2>about that plenty already, but it doesn't just mean coming

0:10:05.309 --> 0:10:07.149
<v Speaker 2>in and having a putting put in your arms. So

0:10:07.189 --> 0:10:09.149
<v Speaker 2>we want to optimize your cervix. So that is called

0:10:09.189 --> 0:10:12.389
<v Speaker 2>cervical ripening, ladies. It's not the nicest word. It's obviously

0:10:12.389 --> 0:10:13.829
<v Speaker 2>been as I by a man in the past. Anyway,

0:10:14.229 --> 0:10:16.589
<v Speaker 2>moving on, Basically, it means we need your servix to

0:10:16.589 --> 0:10:18.189
<v Speaker 2>be open enough for us to be able to break

0:10:18.189 --> 0:10:20.109
<v Speaker 2>your waters, because we know that if that's the case,

0:10:20.109 --> 0:10:21.829
<v Speaker 2>you have a much better chance of that medicine we

0:10:21.829 --> 0:10:24.829
<v Speaker 2>put in your arm, called sintocinin working nicely to continue

0:10:24.869 --> 0:10:26.829
<v Speaker 2>the labor in it in as most a natural way

0:10:26.829 --> 0:10:29.709
<v Speaker 2>as possible. And sometimes when your first time mum, your

0:10:29.709 --> 0:10:32.149
<v Speaker 2>cervix is going to be very long and closed, even

0:10:32.189 --> 0:10:34.629
<v Speaker 2>at thirty nine and forty weeks and so we have

0:10:34.749 --> 0:10:36.949
<v Speaker 2>to ripen it, which basically means make it soft. So

0:10:37.069 --> 0:10:38.589
<v Speaker 2>you have two options, which one is we put it

0:10:38.709 --> 0:10:41.669
<v Speaker 2>with a servidil, which is a progesterone medication that helps

0:10:41.869 --> 0:10:43.789
<v Speaker 2>soften and open it up. And the other one is

0:10:43.789 --> 0:10:45.669
<v Speaker 2>we put a folies which is actually a catholic just

0:10:45.669 --> 0:10:47.269
<v Speaker 2>like you put in the bladder inside the cervix and

0:10:47.309 --> 0:10:49.429
<v Speaker 2>it's a balloon. It's called a mechanical ripening, so we

0:10:49.469 --> 0:10:52.589
<v Speaker 2>actually open the cervix mechanically and that usually goes in

0:10:52.589 --> 0:10:54.629
<v Speaker 2>the day before. So if a doctor at thirty nine

0:10:54.669 --> 0:10:56.549
<v Speaker 2>weeks is starting to tell you, okay, guys, it's starting

0:10:56.549 --> 0:10:58.589
<v Speaker 2>to think about an induction, they'll have to do a

0:10:58.669 --> 0:11:01.709
<v Speaker 2>vaginal exam to assess your cervix. So my thing is

0:11:01.829 --> 0:11:04.789
<v Speaker 2>be prepared for that. If an induction is on the cards,

0:11:04.909 --> 0:11:07.909
<v Speaker 2>we have to do a vaginal exam, so I guess

0:11:07.989 --> 0:11:09.589
<v Speaker 2>just feel prepared and ready to have that.

0:11:12.269 --> 0:11:14.389
<v Speaker 1>We hope you enjoyed this episode of Hello Bump. We

0:11:14.509 --> 0:11:17.549
<v Speaker 1>have so many episodes of this series filled with tips

0:11:17.589 --> 0:11:20.389
<v Speaker 1>and stories from women and experts who've been through it

0:11:20.469 --> 0:11:21.029
<v Speaker 1>all before.

0:11:21.389 --> 0:11:23.229
<v Speaker 2>You can go back and listen to everything else Hello

0:11:23.229 --> 0:11:24.989
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0:11:24.509 --> 0:11:26.589
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0:11:28.389 --> 0:11:30.829
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0:11:30.989 --> 0:11:34.149
<v Speaker 2>This episode was produced by Courtney Ammenhauser with audio production

0:11:34.229 --> 0:11:34.909
<v Speaker 2>by Tom Lyon.

0:11:34.949 --> 0:11:37.189
<v Speaker 1>We'll catch you next time. This episode of Hello Bump

0:11:37.269 --> 0:11:42.109
<v Speaker 1>was made in partnership with Huggies Bye Bye