Speaker 1: You're listening to a Muma Mia podcast. Mama Maya acknowledges
Speaker 1: the traditional owners of land and waters that this podcast
Speaker 1: is recorded on.
Speaker 2: I am pregnanty.
Speaker 1: Welcome to Hello Bump. We're making pregnancy less overwhelming and
Speaker 1: more manageable. I'm Grace Ruprey. I'm pregnant for the first
Speaker 1: time and it's probably at the point to start making
Speaker 1: bets on the day that your baby will come.
Speaker 2: I'm Jana Pittman. I'm a former Olympian, mother of six
Speaker 2: little humans, and I'm a training obstetrician and gynocologist.
Speaker 1: Each week, we'll be holding your hand, week by week
Speaker 1: through the mysterious, perplexing, and sometimes very silly miracle that
Speaker 1: is pregnancy, all the way from a poppy seed to
Speaker 1: a pumpkin.
Speaker 2: Week Oh, get this thing out of me.
Speaker 1: Thirty nine? What size is our baby?
Speaker 2: I don't know what a jack fruit is, but apparently
Speaker 2: that's what Google says a baby is at this size.
Speaker 1: I wrote, just big, just big.
Speaker 2: Yes baby, Well, we hope babies just big at this point,
Speaker 2: but yes, most babies are nice grown between around the
Speaker 2: three point four to three point five kilos by now.
Speaker 1: And what have they developed or they're just ready. They're ready.
Speaker 2: Thirty nine weeks is that milestone. So a lot of
Speaker 2: obstetricians are sort of saying, okay, anytime now, all right,
Speaker 2: let's come baby, let's go, let's go, because we know
Speaker 2: that at this point you have done a wonderful job.
Speaker 2: The baby's fully grown. There's very little benefit. I mean,
Speaker 2: don't get me wrong, there's still the growth of fat,
Speaker 2: the nutrition and all that kind of stuff that mummy
Speaker 2: can provide, and we certainly do not do in most
Speaker 2: public hospitals won't do an induction before forty one weeks
Speaker 2: for a well healthy mummy. We wait for the spontaneous
Speaker 2: lay because we know that's better for baby's lungs, it's
Speaker 2: better for mum's overall experience, and it's better because baby
Speaker 2: will get into a good position to come, hopefully in
Speaker 2: the birth space. But you know that, we do know
Speaker 2: that if Bubby needs to come, it is very very safe. Now,
Speaker 2: even if it's just mum's choice to have a baby
Speaker 2: to be birthed.
Speaker 1: What's happening. What's happening to me and what is happening
Speaker 1: to our bodies?
Speaker 2: Your stretch marks are getting more if they're going to
Speaker 2: be there your cervix is hopefully thinning out and getting
Speaker 2: very ready for birth lot more discharged. So it's very
Speaker 2: similar to the last two to three weeks. It's just
Speaker 2: that now it's real. So now tightenings are probably contractions.
Speaker 2: Your leaking is probably amniotic fluid. So all the things
Speaker 2: that we query as to whether it might be labor
Speaker 2: are very likely now labor.
Speaker 1: Well, look, I'm not a doctor. When your placenta gets
Speaker 1: tired or old, when it comes out, does that does
Speaker 1: it look like it's organ that has gotten tired and old?
Speaker 2: Occasionally, Yeah, so we call all placcea insufficiency. When when
Speaker 2: I like to say calls tired and placenta gets tired.
Speaker 2: You can sometimes see it smaller in size. You know,
Speaker 2: it's got everything, and it's just particular like it's just little.
Speaker 2: Sometimes the vessels. It's got this quartz called Warburton jelly
Speaker 2: around the cord. Sometimes it's just a really skinny, I'm sorry,
Speaker 2: but pathetic looking little cord. Sometimes it's got the li
Speaker 2: infunctions all over it. So little areas where it's obviously blown,
Speaker 2: like little parts where the placenta's actually died. It's sometimes
Speaker 2: you can even see blood clots or it's abrupted, and
Speaker 2: sometimes you can just see calcifications. Now, calcifications percenter after
Speaker 2: forty weeks is actually some are quite common, so it's
Speaker 2: not a sign of placentlence efficiency. It's just a sign
Speaker 2: that it's been working really hard for forty plus weeks.
Speaker 2: But it's amazing. I love placenters, just say ye, so
Speaker 2: I inspect all the placenters afterwards because I just I
Speaker 2: don't know. I find them so incredible that we grow
Speaker 2: a whole organ to support our baby and then it's done.
Speaker 1: How many women want to see their placenta?
Speaker 2: Oh that's okay, I thought the don's how many people
Speaker 2: want to eat their whole center? But okay, I do.
Speaker 1: Have that question as well, because I know that they
Speaker 1: can become a pill of some sort encapsulate them.
Speaker 2: Yeah, right, most people want to see their placenter, so
Speaker 2: there's lots of well, I think it's more that they
Speaker 2: want to have a little look and gross. I just
Speaker 2: it's just very do you want to see your placenta
Speaker 2: when That's why I laughed.
Speaker 1: They're so beautiful.
Speaker 2: They've got one side is obviously it's all covered in
Speaker 2: the beautiful veins as well, so you can actually see
Speaker 2: how the blood flow actually flowed into the placenta there.
Speaker 2: I mean, you don't have to You can always get
Speaker 2: someone to take a photo of it and have a
Speaker 2: look later.
Speaker 1: If you have a cesarean, do you have the same
Speaker 1: option of being shown it?
Speaker 2: Yeah? Absolutely, Okay, yeah, we exactly the same thing. So
Speaker 2: the same process is that gets put in a little
Speaker 2: white bucket and then they ask mum afterwards, would you
Speaker 2: like to see it now. The caveat there is if
Speaker 2: there's something wrong with your placenta and we need to
Speaker 2: send it for pathology, so we can still usually show
Speaker 2: you pretty quickly, but occasionally there might be a reason
Speaker 2: we send your placenta for histopathology, which means we look
Speaker 2: at it to see if there's anything abnormal with it,
Speaker 2: or it might get used you know for like, you know,
Speaker 2: if there's something wrong with your baby, to check if
Speaker 2: there's a genetic issue and things like that. So we
Speaker 2: use the placenta sometimes for a diagnostic reason.
Speaker 1: Interesting, but otherwise.
Speaker 2: You can usually get thrown out. When I say ninety
Speaker 2: to nine persent of the time we get thrown out.
Speaker 2: Some people take it home and bury it under trees
Speaker 2: and things like that certain religious groups and things that
Speaker 2: do that, and there's definitely some people encapsulate it.
Speaker 1: When do they put that request in to keep their placenta.
Speaker 2: Well, look, we ideally have it before you arrive because
Speaker 2: often hospitals don't have fridges, and it's obviously human. It's
Speaker 2: a human product, so they don't love them just sitting
Speaker 2: around unrefrigerated and whatnot. So it normally needs to be
Speaker 2: something where we sign a document like a release of
Speaker 2: tissue document, and the plasenta needs to be picked up
Speaker 2: quickly by a friend or family member.
Speaker 1: In an esque.
Speaker 2: It's in a little white to little like a little
Speaker 2: white almost looks like a paint tin, interesting with your
Speaker 2: with your MRN and your logo and your name on it,
Speaker 2: so it doesn't get mex up.
Speaker 1: So people who do put it in a capsule or
Speaker 1: get it in a capsule one. I have no idea
Speaker 1: where these services exist. But what are the perceived benefits
Speaker 1: of it? Yeah, I think perceived is a great way.
Speaker 1: And look, I have lots and lots of people who've
Speaker 1: done it. I've certainly looked into it myself because you know,
Speaker 1: animals in the wild do it. So I think one
Speaker 1: of the arguments is that animals eat their own placentas,
Speaker 1: whether it's for a huge boost in iron. You know,
Speaker 1: we eat animals livers and things for the same iron
Speaker 1: increase and things like that, because it's a very dense source.
Speaker 1: The flip side of that argument is the animals eat
Speaker 1: it so that predators don't come, so we don't know.
Speaker 1: We can't ask, you know, a kangaroo why things happen
Speaker 1: that way? Or sheep is the one I've seen most.
Speaker 1: They eat their percenters very quickly. The positives I guess
Speaker 1: may be that it helps with breast milk and when
Speaker 1: you've lost blood during birth. That's the main argument.
Speaker 2: The flip side of it in Australia is it's not
Speaker 2: TGA approved yet, so you don't know who is encapsulating,
Speaker 2: what storage messogs they're using, what type of preservation methods
Speaker 2: they're using for that. So again, guys, it's a personal
Speaker 2: just ye you know, I think if you want to
Speaker 2: eat it raw, fine, that's your choice. As long as
Speaker 2: you're aware that there could be something infectious that may
Speaker 2: make you sick, then it's a discussion. You have to
Speaker 2: have these for yourself, and I know where I sit
Speaker 2: on it, but As a medical person, I'd keep very
Speaker 2: neutral in this space, but it's one to have a
Speaker 2: discussion with your midwife about. There's plenty of duelers that
Speaker 2: do it. It's definitely in other countries something that's un
Speaker 2: more commonly, but here you just gotta be really careful
Speaker 2: and find out very strictly how they preserve and how
Speaker 2: they encapsulate them. Is this normal? Is normal?
Speaker 1: I've got it? Is this normal question around? You can
Speaker 1: be one to two centiment is dilated for potentially days
Speaker 1: or weeks correct one not even know or be having
Speaker 1: like contractions and just be living life for and not
Speaker 1: technically in labor.
Speaker 2: That's right. You service could be very dynamic and look
Speaker 2: after after thirty seven weeks. We don't really mind. If
Speaker 2: your service is open, it'll eventually either open up and
Speaker 2: have a baby or it won't. But it's definitely a
Speaker 2: fear that people have, is that am I just going
Speaker 2: to drop a baby in the street? Most of the
Speaker 2: time not. There are definitely women though, that have what
Speaker 2: we call soolent labors and feel nothing and they come
Speaker 2: in for a review and they're found to.
Speaker 1: Be fully dilated.
Speaker 2: But it is rare, It's very rare. It's not actually
Speaker 2: something you want, so people go, oh gosh, I wish
Speaker 2: that was me. The problem is they can't feel their
Speaker 2: contractions to push, and so it becomes hard in that
Speaker 2: second stage of labor because you actually need to push
Speaker 2: your baby out, and if you've got no contractions or
Speaker 2: no idea when they're happening, you don't have that extra
Speaker 2: support to help bear down and push baby down. So
Speaker 2: there's pros and cons to both, and you know, I
Speaker 2: sort of look at it and think, Okay, look, an
Speaker 2: open service is always a good thing after thirty eight
Speaker 2: weeks because it means that hopefully, if worse clam scenario
Speaker 2: and we needed to do an induction, we at least
Speaker 2: get that process started with minimal intervention.
Speaker 1: My toolkit of this week is about preparing animals if
Speaker 1: you have them. This is the only stuff that I've read,
Speaker 1: and I want to know if you know more about this,
Speaker 1: it's probably like you're not the expert.
Speaker 2: No, No, I'm going to have a lot of animals.
Speaker 1: Yes, but personally, this is where I'm asking for your
Speaker 1: mother hats mother hat. I like it. I can put
Speaker 1: that on. I've got two cats. One of the cats
Speaker 1: is already sleeping in the cops. Yes, so we've tried
Speaker 1: to put stuff in it. But one of the things
Speaker 1: that I've read about is like bringing something home from
Speaker 1: the hospital for them to smell before. I don't know
Speaker 1: if that's more cats than dogs.
Speaker 2: I think it's both from what we've heard.
Speaker 1: And then anything to watch out for. What are the
Speaker 1: things to watch out for when the baby does come home.
Speaker 2: It's a really tricky one because they're your loved ones too,
Speaker 2: aren't they, especially dogs and cats, And unfortunately it's not
Speaker 2: safe to have them sleeping in the same room as
Speaker 2: the baby. And I think it's a really hard one.
Speaker 2: And I have woken up to my cats sitting on
Speaker 2: top of my baby and I was like, oh god,
Speaker 2: I forgot and it just it just did and I
Speaker 2: was like, oh my god. Go And you think, oh,
Speaker 2: it's so sweet. But they're doing it because the bubby
Speaker 2: is warm, not because they're loving the baby. Okay, they
Speaker 2: don't love that baby just yet. It's cries and it
Speaker 2: makes noise and cats don't like that. So it is
Speaker 2: the warmth of your bubby and it's not moving, and
Speaker 2: it just likes to sit in that space. So largely
Speaker 2: things may not go wrong, but the last thing you
Speaker 2: want to do is wake up and find the cat
Speaker 2: sitting on the little one's face. It's the same thing
Speaker 2: of removing things like, you know, the cords on your
Speaker 2: blinds and just taking them of the way so toddlers
Speaker 2: can't reach them, and things like that. So it's an
Speaker 2: introduction space that, yes, maybe bringing something home is a
Speaker 2: good idea, and then introducing them slowly during daylight hours
Speaker 2: and you can leave baby unattended. The cat's not always
Speaker 2: going to get in the way, but just being aware
Speaker 2: that both are in the same space.
Speaker 1: Is there any chance that they'll show an allergy to
Speaker 1: them this early on?
Speaker 2: Theoretically, I suppose they could. They build that the IgE
Speaker 2: response in the first couple of months of life. So
Speaker 2: I assume that theoretically, But you know, that's have to
Speaker 2: be a question for a pediatrician, but it's worth asking
Speaker 2: someone might be able to write into us and let
Speaker 2: us say, yes, what the answer to that is if
Speaker 2: they've had a child that's had allergies. I mean, if
Speaker 2: you have allergies, the chances are there's an atopic picture
Speaker 2: in the genetic composition of mum and dad, then babies
Speaker 2: likely to have them, but it tends to be a
Speaker 2: little bit more later than that, but they can get
Speaker 2: food allergies, like if you think about babies can be
Speaker 2: allergic to lactose and things. So that immune mediator response
Speaker 2: is there. So I guess you have to be careful.
Speaker 1: Do you have any checklists for week thirty nine?
Speaker 2: If you have to have an induction? Now we've talked
Speaker 2: about that plenty already, but it doesn't just mean coming
Speaker 2: in and having a putting put in your arms. So
Speaker 2: we want to optimize your cervix. So that is called
Speaker 2: cervical ripening, ladies. It's not the nicest word. It's obviously
Speaker 2: been as I by a man in the past. Anyway,
Speaker 2: moving on, Basically, it means we need your servix to
Speaker 2: be open enough for us to be able to break
Speaker 2: your waters, because we know that if that's the case,
Speaker 2: you have a much better chance of that medicine we
Speaker 2: put in your arm, called sintocinin working nicely to continue
Speaker 2: the labor in it in as most a natural way
Speaker 2: as possible. And sometimes when your first time mum, your
Speaker 2: cervix is going to be very long and closed, even
Speaker 2: at thirty nine and forty weeks and so we have
Speaker 2: to ripen it, which basically means make it soft. So
Speaker 2: you have two options, which one is we put it
Speaker 2: with a servidil, which is a progesterone medication that helps
Speaker 2: soften and open it up. And the other one is
Speaker 2: we put a folies which is actually a catholic just
Speaker 2: like you put in the bladder inside the cervix and
Speaker 2: it's a balloon. It's called a mechanical ripening, so we
Speaker 2: actually open the cervix mechanically and that usually goes in
Speaker 2: the day before. So if a doctor at thirty nine
Speaker 2: weeks is starting to tell you, okay, guys, it's starting
Speaker 2: to think about an induction, they'll have to do a
Speaker 2: vaginal exam to assess your cervix. So my thing is
Speaker 2: be prepared for that. If an induction is on the cards,
Speaker 2: we have to do a vaginal exam, so I guess
Speaker 2: just feel prepared and ready to have that.
Speaker 1: We hope you enjoyed this episode of Hello Bump. We
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Speaker 1: and stories from women and experts who've been through it
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Speaker 2: This episode was produced by Courtney Ammenhauser with audio production
Speaker 2: by Tom Lyon.
Speaker 1: We'll catch you next time. This episode of Hello Bump
Speaker 1: was made in partnership with Huggies Bye Bye