1 00:00:00,440 --> 00:00:03,360 Hey, I'm Hypermobile, and if you're listening to this, I'm 2 00:00:03,360 --> 00:00:07,200 guessing that you might be too. Hi, my name is Alex and I'm your 3 00:00:07,200 --> 00:00:09,960 hypermobile host. And today we are talking all 4 00:00:09,960 --> 00:00:14,000 about a highly, highly requested topic that I've put off talking 5 00:00:14,000 --> 00:00:16,000 about for way too long. We're talking about 6 00:00:16,000 --> 00:00:17,600 hypermobility and pregnancy, folks. 7 00:00:18,160 --> 00:00:21,480 So hyperbolic pregnancy, you know, it's going to be complex. 8 00:00:21,480 --> 00:00:24,720 And for this reason, I want to stress as always, that this is 9 00:00:24,720 --> 00:00:26,880 not medical advice in any way, shape or form. 10 00:00:26,880 --> 00:00:28,840 If you have a health issue that you're concerned about, 11 00:00:29,040 --> 00:00:32,800 regardless of whether it relates to pregnancy or not, please be 12 00:00:32,800 --> 00:00:35,800 sure to speak with your medical doctor as well. 13 00:00:35,800 --> 00:00:38,600 I do want to stress that hyperbolic is a very sensitive 14 00:00:38,600 --> 00:00:40,720 subject, right? There are some people who have 15 00:00:40,720 --> 00:00:43,040 phobias of pregnancy and other things like that. 16 00:00:43,280 --> 00:00:45,320 So if you're not feeling this episode, if this is not 17 00:00:45,320 --> 00:00:48,000 something you're feeling up for today, or maybe up forever, 18 00:00:48,320 --> 00:00:49,120 please. There are. 19 00:00:49,120 --> 00:00:51,000 There are plenty of other amazing things out there you can 20 00:00:51,000 --> 00:00:54,440 go listen to, including previous episodes of the Help I'm 21 00:00:54,480 --> 00:00:57,480 Hypermobile podcast. And if you're someone who's 22 00:00:57,480 --> 00:01:00,680 feeling alone in all this, you want a super awesome community 23 00:01:00,680 --> 00:01:03,400 that you could be a part of. I do want to just give a shout 24 00:01:03,400 --> 00:01:05,360 out to the Hypermobility HQ private membership. 25 00:01:05,360 --> 00:01:09,040 It's a private membership run by yours truly, and we have weekly 26 00:01:09,040 --> 00:01:11,480 lives guest speakers. We did a special event last 27 00:01:11,920 --> 00:01:13,280 well, last week. It was just a few days ago 28 00:01:13,280 --> 00:01:15,440 actually, which was absolutely brilliant. 29 00:01:15,760 --> 00:01:18,080 If that interests you, check in the show now. 30 00:01:19,200 --> 00:01:23,240 It's pretty awesome. Anyways, moving on, let's get 31 00:01:23,240 --> 00:01:27,320 straight into today's episode Hypermobility and pregnancy. 32 00:01:27,720 --> 00:01:30,560 It's complicated if you're looking. 33 00:01:30,560 --> 00:01:32,040 Before we go, we go any further to it. 34 00:01:32,040 --> 00:01:33,840 I don't want to say please check the show notes. 35 00:01:33,840 --> 00:01:35,800 Seriously, for this episode, there are some great resources 36 00:01:35,800 --> 00:01:38,160 out there. The British Journal of Midwifery 37 00:01:38,160 --> 00:01:42,040 is an awesome resource. They have the best clinical 38 00:01:42,040 --> 00:01:44,680 summary that I've ever seen on pregnancy, at least online in my 39 00:01:44,680 --> 00:01:46,760 opinion. So please go read that. 40 00:01:46,760 --> 00:01:49,320 If you're someone who's getting pregnant, like that's the one 41 00:01:49,320 --> 00:01:50,960 thing. If I had to pick one thing for 42 00:01:50,960 --> 00:01:54,720 you to read it is that article. You will find it like very 43 00:01:54,720 --> 00:01:55,920 clearly marked in the show notes. 44 00:01:55,920 --> 00:01:59,640 OK, that is my my one like best piece of advice as well. 45 00:01:59,640 --> 00:02:01,960 Though of course there's Alexander Society and there's 46 00:02:01,960 --> 00:02:04,320 also heads together, HDDS together. 47 00:02:04,880 --> 00:02:07,600 So regardless of whether or not you have a diagnosis, because as 48 00:02:07,600 --> 00:02:10,680 we know, a diagnosis is a privilege and many people with 49 00:02:10,680 --> 00:02:14,920 HDDS do not have an HDDS diagnosis at the time of getting 50 00:02:14,920 --> 00:02:18,080 pregnant or ever in some cases. That's a great resource 51 00:02:18,080 --> 00:02:20,120 regardless of your diagnosis status. 52 00:02:20,120 --> 00:02:23,640 So please go check it out. But now my thoughts, because 53 00:02:23,640 --> 00:02:24,920 that's probably what you came here for. 54 00:02:25,600 --> 00:02:29,880 So the structure of today's show, I I went back and forth, 55 00:02:29,880 --> 00:02:32,400 you know, on this, right, because there's a lot of ways 56 00:02:32,400 --> 00:02:33,360 that we could have talked about this. 57 00:02:33,360 --> 00:02:35,440 We could have looked at it by body system. 58 00:02:35,560 --> 00:02:37,720 We could have looked at it by like kind of progression of the 59 00:02:37,720 --> 00:02:41,160 pregnancy and and stages. But what I'm going to do is 60 00:02:41,160 --> 00:02:44,320 pretend like I'm sitting down with my best friend or if I had 61 00:02:44,320 --> 00:02:45,880 a sister, like just sitting down. 62 00:02:46,280 --> 00:02:49,000 And I'm going to give you a heart to heart on what I think 63 00:02:49,000 --> 00:02:52,840 are the single most important, like topics that you understand 64 00:02:53,160 --> 00:02:55,960 if you're hyper mobile and you either are pregnant or you're 65 00:02:55,960 --> 00:03:00,800 thinking of getting pregnant. So topic one things can go well. 66 00:03:00,960 --> 00:03:04,960 OK, so I know online, especially in social media, we see a lot of 67 00:03:05,280 --> 00:03:08,320 negative experiences and these experiences do happen. 68 00:03:08,400 --> 00:03:10,920 Scary things happen. There are, there is an increased 69 00:03:10,920 --> 00:03:13,760 risk of some very scary things, like hemorrhage, for example, 70 00:03:13,760 --> 00:03:17,360 which scares me. But we also have people who have 71 00:03:17,680 --> 00:03:23,040 fairly unremarkable pregnancies. You know, if we use my mom for 72 00:03:23,040 --> 00:03:25,880 an example against someone who was never diagnosed but she 73 00:03:25,880 --> 00:03:28,840 loved being pregnant, she felt her best when she was pregnant. 74 00:03:28,840 --> 00:03:31,160 And we do know that a certain percentage of hypermobile people 75 00:03:31,480 --> 00:03:33,680 actually get on really well with pregnancy. 76 00:03:34,080 --> 00:03:37,360 But the reality is that some people do not get on well with 77 00:03:37,360 --> 00:03:39,360 pregnancy. Some people might be OK during 78 00:03:39,360 --> 00:03:41,840 the pregnancy and horrible and the postpartum and the rest of 79 00:03:41,840 --> 00:03:45,200 their lives potentially. And some people, the whole thing 80 00:03:45,360 --> 00:03:48,400 sucks massively. OK, So we have to create space 81 00:03:48,600 --> 00:03:51,680 and create room for everyone's experience. 82 00:03:51,680 --> 00:03:54,160 OK, so if you're a hyperbole person and you had a great 83 00:03:54,160 --> 00:03:57,400 pregnancy and you're feeling good now, like, hats off to you. 84 00:03:57,400 --> 00:03:58,800 That's awesome. And if you're a hypermobile 85 00:03:58,800 --> 00:04:01,440 person who is really, really worried about everything, and 86 00:04:01,440 --> 00:04:04,000 maybe your mom had a bad pregnancy and went on to have a 87 00:04:04,000 --> 00:04:06,920 lot of health issues later, then you're welcome here too. 88 00:04:06,920 --> 00:04:09,960 OK, everyone's experience is welcome and we we do really see 89 00:04:09,960 --> 00:04:11,720 that spectrum. This is the problem with all the 90 00:04:11,720 --> 00:04:14,120 hypermobility stuff. We see a mixture of experience, 91 00:04:14,120 --> 00:04:15,840 which is what makes it so confusing. 92 00:04:16,600 --> 00:04:20,279 Now the example that I think of is like rolling a die. 93 00:04:20,640 --> 00:04:23,560 So if we're going to roll a die, so there are 6 surfaces numbers 94 00:04:23,560 --> 00:04:26,280 one through 6. Again, this is not based on any 95 00:04:26,280 --> 00:04:29,440 statistics. OK, so do not try and say that 96 00:04:29,440 --> 00:04:32,480 I'm making up statistics here, but let's pretend like for a 97 00:04:32,480 --> 00:04:35,920 person who has no health issues at all and they get pregnant 98 00:04:36,160 --> 00:04:40,080 that the chances of something bad happening are like a one out 99 00:04:40,080 --> 00:04:42,680 of 6. So if they roll number 12345, 100 00:04:42,680 --> 00:04:45,120 like all good and number six is going to be like something bad 101 00:04:45,120 --> 00:04:48,800 happens for a hyper well person. I think the the risk of it's not 102 00:04:48,800 --> 00:04:50,200 that. I think it's that the research 103 00:04:50,200 --> 00:04:52,440 does suggest that the risk of some things happening which are 104 00:04:52,440 --> 00:04:56,480 problematic is higher. But it doesn't mean that no 105 00:04:56,480 --> 00:04:59,320 matter like what you roll on the die that you're going to 106 00:04:59,320 --> 00:05:02,760 necessarily have a bad outcome. Some people will have good 107 00:05:02,760 --> 00:05:06,440 outcomes, some people maybe some people will have those worst 108 00:05:06,440 --> 00:05:07,840 outcomes. So to go back to that die 109 00:05:07,840 --> 00:05:10,680 analogy, I think of the hypermobile person instead of 110 00:05:10,680 --> 00:05:14,000 just having like #6 mean a bad outcome, they might have numbers 111 00:05:14,000 --> 00:05:17,320 like 5 and six mean a bad outcome or 456 or whatever, 112 00:05:17,320 --> 00:05:19,080 right? There's just an increased risk 113 00:05:19,440 --> 00:05:22,120 of problems that that's all that means. 114 00:05:23,640 --> 00:05:25,720 Again, there's some, there's there's controversy throughout 115 00:05:25,720 --> 00:05:27,520 this entire podcast. Just if you hear me say 116 00:05:27,520 --> 00:05:30,680 anything, just imagine that someone else has been like it's 117 00:05:30,680 --> 00:05:32,880 controversial because it's all a bit controversial and the 118 00:05:32,880 --> 00:05:34,640 research is mixed and there's not enough of it. 119 00:05:34,640 --> 00:05:40,440 But when it comes to pregnancy classification in heds, again 120 00:05:40,600 --> 00:05:43,680 based on statistics from America and and in America, there are 121 00:05:43,680 --> 00:05:46,600 certain issues of course with the healthcare system and with 122 00:05:46,600 --> 00:05:49,640 specifically obstetrics and labor and delivery related 123 00:05:49,640 --> 00:05:52,920 health concerns and procedures and outcomes. 124 00:05:53,720 --> 00:05:56,640 It is classified as a high risk pregnancy. 125 00:05:57,320 --> 00:06:00,560 But whether heds and HSD are going to be classified as a high 126 00:06:00,560 --> 00:06:03,720 risk pregnancy really depends on the country that you're from and 127 00:06:03,720 --> 00:06:06,400 whether or not it will actually be a high risk pregnancy in 128 00:06:06,400 --> 00:06:09,200 terms of you as an individual depends on that individual 129 00:06:09,200 --> 00:06:11,920 symptom presentation. And This is why I love the 130 00:06:11,920 --> 00:06:14,000 British Journal of Midwifery because they really make that 131 00:06:14,000 --> 00:06:15,600 very clear. It does depend on the 132 00:06:15,600 --> 00:06:19,760 individual. However, what frustrated me a 133 00:06:19,760 --> 00:06:23,320 bit in in my research and then what I was looking at is how 134 00:06:23,320 --> 00:06:27,160 often there's this talk of like assemble your team of healthcare 135 00:06:27,160 --> 00:06:30,640 providers because how is anyone supposed to get a team of 136 00:06:30,640 --> 00:06:33,720 healthcare providers including like an anesthesiologist and a 137 00:06:33,720 --> 00:06:36,560 cardiologist and all these other things when you don't even have 138 00:06:36,560 --> 00:06:39,120 a diagnosis, right. So there's I feel like there's a 139 00:06:39,120 --> 00:06:44,160 a deep conflict between the advice which is online from some 140 00:06:44,160 --> 00:06:47,720 really high quality sources with the realities of what it's like 141 00:06:47,720 --> 00:06:49,840 to actually be a hyper mobile patient. 142 00:06:50,560 --> 00:06:52,920 So on that note, we're going to start to focus on things that 143 00:06:52,920 --> 00:06:56,360 are more in your control or things that you can do even 144 00:06:56,360 --> 00:06:57,880 potentially without a diagnosis. OK. 145 00:06:57,880 --> 00:06:59,480 And we're going to start at the very beginning. 146 00:06:59,680 --> 00:07:02,200 We're going to start maybe you're someone in your 20s and 147 00:07:02,200 --> 00:07:04,360 you're thinking of having a child in a few years or 148 00:07:04,360 --> 00:07:07,560 whatever, we're going to talk preconception. 149 00:07:07,760 --> 00:07:11,560 So I think that pregnancy really needs to be appreciated for the 150 00:07:11,560 --> 00:07:14,520 extremely physically, challengingly physically 151 00:07:14,520 --> 00:07:16,000 challenging. I'm losing my words 152 00:07:16,280 --> 00:07:19,800 psychologically challenging and just like complex event that it 153 00:07:19,800 --> 00:07:22,760 is. If I was someone like pre 154 00:07:22,760 --> 00:07:25,720 pregnancy thinking about all this stuff, I would be wanting 155 00:07:25,720 --> 00:07:28,040 to make sure that a few things were in order. 156 00:07:28,360 --> 00:07:30,680 Firstly I would want some blood work done. 157 00:07:30,680 --> 00:07:33,760 I'd like to know my vitamin D levels, maybe my B vitamin 158 00:07:33,760 --> 00:07:35,560 levels. We know that quite a few 159 00:07:35,560 --> 00:07:38,400 hypermobile people seem to have issues with folate in particular 160 00:07:38,400 --> 00:07:41,600 that's B9. I think it's sensible to speak 161 00:07:41,600 --> 00:07:44,880 with your medical doctor about maybe taking a version of folate 162 00:07:44,880 --> 00:07:48,400 called methylated folate simply because there is some research 163 00:07:48,400 --> 00:07:50,800 that suggests that there are some people who are hyper mobile 164 00:07:51,000 --> 00:07:54,920 who have issues actually metabolizing and absorbing the 165 00:07:54,920 --> 00:07:57,440 folate that they take. So they might be taking a 166 00:07:57,440 --> 00:08:00,840 regular like folic acid supplement, but just because 167 00:08:00,840 --> 00:08:02,840 they're taking it doesn't mean it's going in. 168 00:08:03,360 --> 00:08:06,720 And because folate affects the development of something called 169 00:08:06,720 --> 00:08:09,240 the the notochord, so it affects what goes on to be the the 170 00:08:09,240 --> 00:08:10,920 baby's neurological system long term. 171 00:08:11,160 --> 00:08:14,520 And it happened so early in in the whole development, the whole 172 00:08:14,520 --> 00:08:16,400 pregnancy is happening very, very, very early. 173 00:08:17,080 --> 00:08:21,760 For that reason, I would want to make sure that I had had my B 174 00:08:21,760 --> 00:08:25,520 vitamin levels checked and that I was taking a A supplement that 175 00:08:25,520 --> 00:08:29,000 was appropriate for me. And as far as I know, there are 176 00:08:29,000 --> 00:08:32,120 no drawbacks to taking a methylated folate supplement 177 00:08:32,120 --> 00:08:35,080 because all that's happened there is that a methyl group has 178 00:08:35,080 --> 00:08:37,960 been added to the folic acid, which just means that if you're 179 00:08:37,960 --> 00:08:40,440 someone whose body struggles to do that, it's already been done 180 00:08:40,440 --> 00:08:43,280 for you. It's like buying I buy chopped 181 00:08:43,280 --> 00:08:46,280 frozen onions because I'm tired and I don't want to chop onions. 182 00:08:46,480 --> 00:08:49,320 It's kind of just like having that that step taken care of and 183 00:08:49,880 --> 00:08:52,880 the price difference is there, but it's not significant. 184 00:08:52,880 --> 00:08:55,320 So I think it's something that if more people were aware of, 185 00:08:55,320 --> 00:08:57,800 they would probably want to do. So speak to your medical doctor 186 00:08:57,800 --> 00:09:01,400 about that as well. I would be wanting to be in the 187 00:09:01,400 --> 00:09:04,360 best physical health possible, and this is hard. 188 00:09:04,480 --> 00:09:08,720 This is so hard with HDS and HSD and undiagnosed symptomatic 189 00:09:08,720 --> 00:09:11,800 hypermobility. But I would want to make sure 190 00:09:11,880 --> 00:09:14,920 that my muscles and joints were feeling as good as they could 191 00:09:14,920 --> 00:09:17,600 possibly be. So if that meant trying to find 192 00:09:17,640 --> 00:09:20,000 a physio who I felt comfortable with or osteopath or 193 00:09:20,000 --> 00:09:23,320 chiropractor or whatever, if that meant maybe trying to do 194 00:09:23,320 --> 00:09:26,840 some safe and strategic exercise, maybe even some 195 00:09:26,840 --> 00:09:29,080 strength building. If you have the, you know, the 196 00:09:29,080 --> 00:09:31,200 time scale for that, like you're a year or two years out from 197 00:09:31,200 --> 00:09:34,280 pregnancy, that's the type of thing I would really be wanting 198 00:09:34,280 --> 00:09:36,600 to focus on. OK And and doing that safely 199 00:09:36,920 --> 00:09:41,120 because the more physically, well you can get pre pregnancy, 200 00:09:41,400 --> 00:09:44,280 the better able your body is to accommodate the stress like the 201 00:09:44,280 --> 00:09:46,680 stressful event of being pregnant. 202 00:09:47,120 --> 00:09:50,440 So I would want to, I would want to do prehab, that's what we 203 00:09:50,440 --> 00:09:51,720 call it in like the physio land, right. 204 00:09:51,720 --> 00:09:53,520 I want to do prehab for the pregnancy. 205 00:09:53,720 --> 00:09:57,440 Let's normalize prehab for pregnancy in heds and HSD. 206 00:09:57,440 --> 00:09:59,720 But that's what I'd be doing as well. 207 00:10:00,080 --> 00:10:03,440 I would want to make, I'd want to kind of assess, you know, 208 00:10:03,440 --> 00:10:05,640 look at my options and think about my situation. 209 00:10:06,160 --> 00:10:10,160 I would be wanting to think about OK is getting pregnant the 210 00:10:10,160 --> 00:10:13,960 right choice for me? There are different ways that 211 00:10:13,960 --> 00:10:17,400 people can live their lives. Not having children is a a very 212 00:10:17,400 --> 00:10:21,360 valid choice and something that I think we're going to keep 213 00:10:21,360 --> 00:10:24,120 seeing more people consider just because it's I think we're kind 214 00:10:24,120 --> 00:10:26,760 of like the first generation where it's becoming semi 215 00:10:26,760 --> 00:10:29,840 normalized to some extent. But I would want to say you, you 216 00:10:29,840 --> 00:10:33,000 know how can I understand what's really involved with with 217 00:10:33,000 --> 00:10:34,880 pregnancy and with being a parent. 218 00:10:35,200 --> 00:10:37,320 And this is something I've thought carefully about. 219 00:10:37,800 --> 00:10:41,880 You have to think of resources in terms of community or family. 220 00:10:41,880 --> 00:10:45,520 So let's say that something did happen during pregnancy or 221 00:10:45,520 --> 00:10:48,360 during postpartum or whatever. Do you have a support network 222 00:10:48,360 --> 00:10:52,120 of, like, family or really close friends or someone who can help 223 00:10:52,120 --> 00:10:55,640 care for your baby? What's your situation with your 224 00:10:55,640 --> 00:10:58,400 partner, partners, or whatever? Like, like, do you have anyone 225 00:10:58,400 --> 00:11:01,440 available to you to help out or are you going to be on your own? 226 00:11:01,440 --> 00:11:03,640 Because that changes things quite a bit. 227 00:11:04,120 --> 00:11:06,320 I think it's also important to think in terms of financial 228 00:11:06,320 --> 00:11:08,600 resources. So let's say for example, you're 229 00:11:08,600 --> 00:11:11,600 someone you don't have a lot of family and you don't have, you 230 00:11:11,600 --> 00:11:14,240 know, like a close community network, but maybe you can 231 00:11:14,240 --> 00:11:17,880 afford to have some type of like a nanny assistance in those 232 00:11:17,880 --> 00:11:20,000 early days that will make a difference. 233 00:11:20,000 --> 00:11:22,400 Let's say you're someone living in, I think it's the 234 00:11:22,400 --> 00:11:23,960 Netherlands. Is it the Netherlands? 235 00:11:24,120 --> 00:11:26,160 I can't remember, but let's say you live in a country where they 236 00:11:26,160 --> 00:11:29,520 have really good postpartum support services. 237 00:11:29,520 --> 00:11:31,800 I think it's the Netherlands where you get like 8 days of 238 00:11:31,800 --> 00:11:34,080 someone just living in your house, helping with laundry and 239 00:11:34,080 --> 00:11:37,960 cooking and cleaning and baby stuff that might like impact. 240 00:11:37,960 --> 00:11:41,040 You know how things go. So look at your life and see 241 00:11:41,040 --> 00:11:45,120 like what support do I have. And that's something which I 242 00:11:45,120 --> 00:11:47,120 think not enough people consider. 243 00:11:48,040 --> 00:11:51,080 It's something which can be changed. 244 00:11:51,080 --> 00:11:54,000 In some instances, it's something which maybe moving to 245 00:11:54,000 --> 00:11:56,520 a different city can affect it or planning your life around it 246 00:11:56,520 --> 00:11:59,160 or just, you know, taking a moment to check in with what's 247 00:11:59,160 --> 00:12:01,880 accessible to you and it's something which might help you 248 00:12:01,880 --> 00:12:03,400 make the decision that's right for you. 249 00:12:03,400 --> 00:12:05,800 And it's not a fun discussion, but I think it's an important 250 00:12:05,800 --> 00:12:09,680 discussion to have. Additionally, I think it's 251 00:12:09,680 --> 00:12:15,000 extremely important to think of the possibility of what if 252 00:12:15,160 --> 00:12:18,160 something happens down the line. So something I see in the 253 00:12:18,160 --> 00:12:21,840 patients I work with is there will be patients who have more 254 00:12:22,360 --> 00:12:24,080 pronounced presentations of symptoms, right. 255 00:12:24,080 --> 00:12:27,640 There are patients who rely on mobility AIDS and who will have 256 00:12:27,640 --> 00:12:29,840 you know who will not be able to work a regular example, a 257 00:12:29,880 --> 00:12:32,960 regular schedule for example. And there are some patients who 258 00:12:32,960 --> 00:12:36,320 kind of are able to work a regular schedule and have a more 259 00:12:36,320 --> 00:12:38,680 minimal presentation or are able to better cope with those 260 00:12:38,680 --> 00:12:41,120 symptoms or have maybe more support networks and so on. 261 00:12:41,640 --> 00:12:43,920 And I think it's really important to understand with 262 00:12:43,920 --> 00:12:47,440 this stuff that you can be someone who identifies as well, 263 00:12:47,440 --> 00:12:50,080 or you can be someone who is relatively well, and then 264 00:12:50,080 --> 00:12:53,000 something can happen in your life, heaven forbid, like an 265 00:12:53,000 --> 00:12:56,200 infection or what not, right? And that can be the thing which 266 00:12:56,200 --> 00:12:59,360 kind of makes you less well than you have been. 267 00:12:59,720 --> 00:13:01,600 So if you're someone out there listening to this being like, 268 00:13:01,600 --> 00:13:03,200 you know what? I got it. 269 00:13:03,360 --> 00:13:06,200 I have all my my good physio, I have my whatever, all my 270 00:13:06,200 --> 00:13:07,840 supports in place. I'm doing great. 271 00:13:08,200 --> 00:13:11,960 It's just always so important to remember that feeling really 272 00:13:11,960 --> 00:13:15,120 good now doesn't necessarily mean feeling great in five years 273 00:13:15,120 --> 00:13:17,520 or 10 years or 20 years or however long we have to be a 274 00:13:17,520 --> 00:13:19,240 parent for life. But I I hear that. 275 00:13:19,720 --> 00:13:21,840 I hear that most of the work is in the first, like, I don't 276 00:13:21,840 --> 00:13:24,760 know, 20 years or so. I don't have any children 277 00:13:24,760 --> 00:13:28,040 myself, by the way. I'm I'm just a cat mom anyways. 278 00:13:28,880 --> 00:13:34,280 In terms of other things pre pregnancy, I'm a big fan of 279 00:13:34,360 --> 00:13:36,520 people improving their cardiovascular fitness. 280 00:13:36,520 --> 00:13:38,640 I think it makes a huge difference in terms of 281 00:13:38,640 --> 00:13:41,480 Dyshotonomia. So dysautonomia refers to 282 00:13:41,480 --> 00:13:44,560 dysfunction of something called the autonomic nervous system. 283 00:13:44,560 --> 00:13:46,760 It controls your blood pressure and your heart rate and it 284 00:13:46,760 --> 00:13:49,040 controls your digestion and so and so on, right. 285 00:13:49,640 --> 00:13:51,840 If you want to read more about steady state training, I do have 286 00:13:51,840 --> 00:13:54,080 an exercise guide on it. Again, I'm not saying 287 00:13:54,080 --> 00:13:56,480 necessarily it's safe for you, please speak with your medical 288 00:13:56,480 --> 00:13:58,360 doctor if needed. But you can find that in the 289 00:13:58,360 --> 00:14:00,960 show notes as well. And the reason for this, of 290 00:14:00,960 --> 00:14:03,840 course is that we have changes in blood volume and the demands 291 00:14:03,840 --> 00:14:06,360 and stresses placed on the cardiovascular system during 292 00:14:06,360 --> 00:14:08,800 pregnancy. In terms of one last 293 00:14:08,800 --> 00:14:12,360 preconception thing, we need to think about potentially issues 294 00:14:12,360 --> 00:14:15,280 with conceiving. So here we're coming to a place 295 00:14:15,280 --> 00:14:18,200 where the research is quite mixed again, but it seems like 296 00:14:18,200 --> 00:14:20,920 there is some research to suggest that hypermobile people 297 00:14:20,920 --> 00:14:24,320 might have issues with getting pregnant Again. 298 00:14:24,320 --> 00:14:26,600 Hopefully more research will be done on this in future to give 299 00:14:26,600 --> 00:14:30,040 us a more conclusive answer. But my gut feeling based on what 300 00:14:30,040 --> 00:14:32,720 I see in my patients is that this is likely due to 301 00:14:32,720 --> 00:14:34,640 undiagnosed polycystic ovarian syndrome. 302 00:14:35,120 --> 00:14:39,320 So polycystic ovarian syndrome is a condition where the person 303 00:14:39,320 --> 00:14:42,240 who's ovulating is not ovulating at regular intervals are not 304 00:14:42,240 --> 00:14:47,600 able to ovulate reliably at all. In some cases they have signs 305 00:14:47,600 --> 00:14:49,640 and features of what's called hercetism. 306 00:14:49,640 --> 00:14:51,720 So they're like growing hair on different parts of their bodies. 307 00:14:52,000 --> 00:14:53,800 They're they're having a lot of things go on. 308 00:14:53,800 --> 00:14:55,480 It's a whole thing. We'll do a PCOS episode. 309 00:14:55,720 --> 00:14:57,760 I've actually kind of done an episode on it. 310 00:14:58,000 --> 00:15:00,240 I did one on period issues, so you might want to go check that 311 00:15:00,240 --> 00:15:03,080 out. Anyways, I think that probably 312 00:15:03,080 --> 00:15:05,280 quite a few of the people who are having issues conceiving are 313 00:15:05,280 --> 00:15:09,720 people who are having issues with undiagnosed PCOS. 314 00:15:09,720 --> 00:15:12,640 So if you're someone in that category, look up the diagnostic 315 00:15:12,640 --> 00:15:16,200 criteria, speak with your healthcare provider, and make 316 00:15:16,200 --> 00:15:18,800 sure that these things aren't being missed. 317 00:15:19,040 --> 00:15:23,160 Something that I'm a fan of as someone who I was told I was too 318 00:15:23,160 --> 00:15:26,560 skinny to have PCOS by the way, which is weird because weight is 319 00:15:26,560 --> 00:15:30,400 nowhere in the diagnostic criteria and I've had 185 day 320 00:15:30,400 --> 00:15:33,440 long cycles. But anyways, something that I 321 00:15:33,440 --> 00:15:36,480 would recommend doing and that I do personally, is called the 322 00:15:36,480 --> 00:15:39,120 symptothermal method. This will only work if you're 323 00:15:39,120 --> 00:15:41,760 not on hormonal birth control, but it's where you basically 324 00:15:41,760 --> 00:15:44,840 track your cycle very, very closely using basal body 325 00:15:44,840 --> 00:15:47,760 temperature and cervical fluid readings. 326 00:15:48,040 --> 00:15:51,040 And this is a cool way to improve your body literacy. 327 00:15:51,400 --> 00:15:53,560 You get to learn like am I ovulating? 328 00:15:53,640 --> 00:15:56,600 When am I ovulating? How long is my luteal phase? 329 00:15:56,600 --> 00:15:59,000 A short luteal phase can be a reason that people really 330 00:15:59,000 --> 00:16:01,760 struggle to maintain a pregnancy, so it will give you a 331 00:16:01,760 --> 00:16:04,080 wealth of information. If you have time and wish to 332 00:16:04,080 --> 00:16:07,480 learn about it, I'll put a resource in the show notes. 333 00:16:07,480 --> 00:16:09,640 Again, this is going to be a long show notes, but I will put 334 00:16:09,640 --> 00:16:13,040 a resource in there for you. It's a 12 page PDF which kind of 335 00:16:13,040 --> 00:16:14,920 outlines all the rules. I'll try and find a couple 336 00:16:14,920 --> 00:16:17,000 studies. Again, this method, when it 337 00:16:17,000 --> 00:16:20,160 comes to identifying ovulation is extremely accurate. 338 00:16:20,320 --> 00:16:25,040 It's accurate like 90% plus, I think 95% plus in terms of 339 00:16:25,040 --> 00:16:28,280 identifying the ovulation and whether or not it's happened and 340 00:16:28,280 --> 00:16:31,800 the fertile window ±3 days. So this is something which may 341 00:16:31,800 --> 00:16:34,400 be for you. I know it's certainly for me, 342 00:16:34,400 --> 00:16:36,360 but just because something's for me doesn't mean it's for you. 343 00:16:37,000 --> 00:16:40,680 Now I think we covered everything pre pregnancy, Let's 344 00:16:40,680 --> 00:16:44,760 talk about pregnancy. So when it comes to pregnancy, I 345 00:16:44,760 --> 00:16:49,440 think it's really important to appreciate that heds certainly 346 00:16:49,640 --> 00:16:52,920 and research suggests that HSD also, although there is a little 347 00:16:52,920 --> 00:16:55,120 bit of controversy here because we can't have anything 348 00:16:55,120 --> 00:16:57,040 hypermobility related without controversy. 349 00:16:57,480 --> 00:17:01,080 But these are autosomal dominant conditions, and with HDS for 350 00:17:01,080 --> 00:17:04,520 certain we can say that it is inherited in an autosomal 351 00:17:04,520 --> 00:17:06,800 dominant pattern. What does this mean? 352 00:17:07,119 --> 00:17:10,599 Autosomal simply means that the gene is not located on the sex 353 00:17:10,599 --> 00:17:12,040 chromosome. So you have different you have a 354 00:17:12,040 --> 00:17:14,520 certain number of chromosomes in your body and there are some 355 00:17:14,520 --> 00:17:17,960 that are particularly for sex, like the X&Y ones. 356 00:17:18,079 --> 00:17:20,880 It's not on those ones okay, it's on one of the other ones. 357 00:17:21,000 --> 00:17:24,880 That's all autosomal means. Dominant means that if one 358 00:17:24,920 --> 00:17:29,520 parent has the gene and their child, they reproduce with 359 00:17:29,520 --> 00:17:30,960 someone else and they have a child. 360 00:17:31,160 --> 00:17:34,400 It means that there's a 50% chance that the child will have 361 00:17:34,400 --> 00:17:37,480 that condition, because if you have one copy of the gene, so 362 00:17:37,480 --> 00:17:41,480 you get 1 gene from the from one parent and you get 1 gene from 363 00:17:41,480 --> 00:17:44,800 the other. If you have that gene, there is 364 00:17:44,800 --> 00:17:47,520 a you will have the condition and there's a 50% chance that 365 00:17:47,520 --> 00:17:50,280 you will get that gene because the affected parent will have 366 00:17:50,320 --> 00:17:54,240 two genes, if that makes sense. So anyways, that is in summary a 367 00:17:54,240 --> 00:17:58,960 very brief explanation of heds genetic inheritance. 368 00:17:59,160 --> 00:18:02,640 Now where this gets complicated is we don't know what gene or 369 00:18:02,640 --> 00:18:04,840 genes cause heds. There is research that's 370 00:18:04,840 --> 00:18:06,600 emerging. It's very, very exciting. 371 00:18:06,880 --> 00:18:09,880 But at the time of filming and recording this, we do not know 372 00:18:10,000 --> 00:18:15,040 what gene or genes cause heds. So in summary, I think the point 373 00:18:15,040 --> 00:18:18,080 that people get confused about is that we can, through studies 374 00:18:18,320 --> 00:18:20,840 identify the inheritance pattern of the condition. 375 00:18:21,080 --> 00:18:23,560 It's what Mandela did with peas back in the day. 376 00:18:23,560 --> 00:18:25,880 You know, are the peas like, I don't know, yellow color or 377 00:18:25,880 --> 00:18:28,600 green color or whatever. And it's what we've done with 378 00:18:28,600 --> 00:18:30,200 HDS. There have been studies that 379 00:18:30,200 --> 00:18:33,400 look at the inheritance patterns of HDS, which have found that 380 00:18:33,400 --> 00:18:37,800 it's autosomal dominant, but we do not know the exact genes and 381 00:18:37,800 --> 00:18:42,320 because of this, it means that you cannot have screening for 382 00:18:42,320 --> 00:18:44,560 HDS and HSD. It is not an option. 383 00:18:44,960 --> 00:18:48,280 Now whether or not you should is an entirely different subject 384 00:18:48,280 --> 00:18:50,640 for an entirely different episode in the distant, distant 385 00:18:50,640 --> 00:18:54,320 future when we feel like doing a super super complex and 386 00:18:54,320 --> 00:18:58,360 controversial topic. But there are there's no genetic 387 00:18:58,360 --> 00:18:59,920 screening if that's something you were curious about. 388 00:18:59,920 --> 00:19:02,960 It does not exist. And I do want to also say there 389 00:19:02,960 --> 00:19:06,840 are a lot of hypermobile people who are awesome and who very 390 00:19:06,840 --> 00:19:10,000 much like being here. So even if that existed, it 391 00:19:10,000 --> 00:19:12,560 might not be something which you would want to do. 392 00:19:13,320 --> 00:19:14,920 And that's all I'm going to say on that for right now. 393 00:19:15,560 --> 00:19:20,560 Anyways, moving on. When it comes to pregnancy 394 00:19:20,560 --> 00:19:25,160 itself, there are some people who will get pregnant, you know, 395 00:19:25,240 --> 00:19:27,920 physically, like in their body, like the kind of old fashioned 396 00:19:27,920 --> 00:19:30,960 way, if we call it that. There's of course also things 397 00:19:30,960 --> 00:19:33,560 like surrogacy or other ways of getting pregnant. 398 00:19:33,560 --> 00:19:34,760 Again, there are ethical issues with that. 399 00:19:34,760 --> 00:19:36,720 There's so many ethical issues with pregnancy. 400 00:19:36,920 --> 00:19:39,240 This is why I was up all night stressing about this episode. 401 00:19:39,240 --> 00:19:42,960 OK, But there is a world of options that you should talk 402 00:19:42,960 --> 00:19:45,360 with your medical doctor about if you are concerned. 403 00:19:45,800 --> 00:19:48,600 But let's say that you're someone who is getting pregnant 404 00:19:48,600 --> 00:19:50,960 yourself. What do you need to think about? 405 00:19:51,440 --> 00:19:53,520 Well, we need to think about a few things. 406 00:19:54,000 --> 00:19:56,400 Firstly, we want to think about the mechanical stressors on the 407 00:19:56,400 --> 00:19:58,840 body. So babies have weight. 408 00:19:58,880 --> 00:20:01,000 There's like the placenta, which is a whole thing enough. 409 00:20:01,000 --> 00:20:03,880 It's in and of itself. There's changes in the mothers, 410 00:20:04,480 --> 00:20:06,520 her musculoskeletal system. There are hormones like 411 00:20:06,520 --> 00:20:08,640 relaxing, which make the tissue a bit stretchier. 412 00:20:08,880 --> 00:20:12,640 So there's a lot going on from a musculoskeletal and a mechanical 413 00:20:12,640 --> 00:20:16,360 perspective. The most common issues which 414 00:20:16,360 --> 00:20:20,240 I've seen in my patients are things like pelvic girdle pain, 415 00:20:20,800 --> 00:20:22,800 so issues with the pubic symphasis, which is a little 416 00:20:22,800 --> 00:20:25,640 joint right in the front of your pelvis, way down low. 417 00:20:26,560 --> 00:20:29,080 There are also issues with things like hip pain and hip 418 00:20:29,080 --> 00:20:33,440 issues and hip dislocations or subluxations, and also with knee 419 00:20:33,440 --> 00:20:35,560 issues as well. I see a lot of knee pain too. 420 00:20:36,040 --> 00:20:40,000 Carpal tunnel syndrome's another big one, and we're seeing issues 421 00:20:40,000 --> 00:20:43,680 because that connective tissue is becoming more stretchy 422 00:20:43,760 --> 00:20:45,840 throughout the pregnancy. That relaxing is affecting it, 423 00:20:45,840 --> 00:20:47,840 and there are other hormones as well, but to keep it simple, 424 00:20:47,840 --> 00:20:49,280 we're just going to talk about relaxing. 425 00:20:49,840 --> 00:20:54,600 There's also the the weight of that baby in the position and 426 00:20:54,600 --> 00:20:57,800 that is changing the the mother's posture. 427 00:20:57,800 --> 00:21:01,160 It's changing how like the load her body has to cope with. 428 00:21:01,200 --> 00:21:04,800 It's it's a lot to carry a child physically just in terms of 429 00:21:04,800 --> 00:21:07,360 terms of literally just like carrying it physically, like 430 00:21:07,360 --> 00:21:13,640 that's a lot of stress as well. We start to see changes in terms 431 00:21:13,640 --> 00:21:17,920 of some of the organs that the, the developing fetus puts 432 00:21:17,920 --> 00:21:20,520 pressure on. So the bladder is a big one. 433 00:21:21,000 --> 00:21:23,760 Of course, a lot of hypermobile people have issues with 434 00:21:23,760 --> 00:21:27,160 incontinence. People report kind of having 435 00:21:27,800 --> 00:21:30,480 peed themselves a little bit, like even even as children or as 436 00:21:30,480 --> 00:21:33,360 teens, because the the bladder is a sack of connective tissue 437 00:21:33,360 --> 00:21:36,640 with a tube of connective tissue that leads to the exit, right. 438 00:21:36,640 --> 00:21:39,560 So we have a connective tissue situation which we're then 439 00:21:39,560 --> 00:21:42,200 putting a baby on top of, which is going to put different 440 00:21:42,200 --> 00:21:45,800 stressors on it. We also have course have issues 441 00:21:45,800 --> 00:21:48,960 with things like reflux. So a lot of people who had 442 00:21:48,960 --> 00:21:51,480 gastroesophageal reflux disease pre pregnancy, they're going to 443 00:21:51,480 --> 00:21:53,600 start to have worsening symptoms potentially. 444 00:21:53,960 --> 00:21:56,000 We also have issues of course with things like morning 445 00:21:56,000 --> 00:21:58,440 sickness as it's called and in cases which are severe 446 00:21:58,560 --> 00:22:01,400 Hypermesis gravidarum. For those of you who don't know, 447 00:22:01,800 --> 00:22:06,160 hypermesis gravidarum or HG is a condition where the mother is 448 00:22:06,160 --> 00:22:08,960 unable to keep food down and basically vomiting profusely. 449 00:22:09,640 --> 00:22:13,240 And that is something which can be very problematic, especially 450 00:22:13,240 --> 00:22:15,800 in someone who's hypermobile, not even just from a nutritional 451 00:22:15,800 --> 00:22:18,600 perspective, but also from a musculoskeletal perspective. 452 00:22:18,880 --> 00:22:21,280 This is something I couldn't really find any research on 453 00:22:21,280 --> 00:22:25,600 online, but I know that being sick, like throwing up, it makes 454 00:22:25,600 --> 00:22:28,840 my ribs hurt, and my expectation is that it would make 455 00:22:29,080 --> 00:22:32,600 hypermobile mother with HGO, it would make her ribs hurt too. 456 00:22:32,600 --> 00:22:37,320 So we have a lot of different considerations there as well. 457 00:22:37,320 --> 00:22:40,480 Of course we have to think about the dysautonomia. 458 00:22:40,480 --> 00:22:43,680 So we mentioned it before. One of the more common or should 459 00:22:43,680 --> 00:22:47,200 I say more well known now forms of dysautonomia is POTS. 460 00:22:47,200 --> 00:22:49,560 So it's postural orthostatic tachycardia syndrome. 461 00:22:49,880 --> 00:22:52,240 There are other kinds of orthostatic intolerance too, 462 00:22:52,240 --> 00:22:56,560 like orthostatic hypotension, but there are people who are 463 00:22:56,560 --> 00:22:58,880 going to have issues with their cardiovascular system. 464 00:22:59,240 --> 00:23:02,800 We then put a baby in there and their blood volume increases. 465 00:23:03,320 --> 00:23:06,280 And the cool thing is, actually for people with POTS, research 466 00:23:06,280 --> 00:23:09,680 does seem to suggest that it's going to be a bit of a benefit 467 00:23:09,680 --> 00:23:11,920 in some ways because they're just going to have a greater 468 00:23:11,920 --> 00:23:14,320 blood volume, which is going to help things function a bit 469 00:23:14,320 --> 00:23:17,320 better for a period of time until of course, they give birth 470 00:23:17,320 --> 00:23:18,520 and then that changes everything. 471 00:23:18,520 --> 00:23:20,760 But there, that doesn't mean that there are people with POTS 472 00:23:20,760 --> 00:23:21,920 who are going to necessarily feel better. 473 00:23:21,920 --> 00:23:25,000 There are people who feel worse. So again, it's a very, very 474 00:23:25,120 --> 00:23:28,600 mixed bag. That being said, the the change 475 00:23:28,600 --> 00:23:30,800 in blood volume means that we need to think about that 476 00:23:30,800 --> 00:23:34,640 cardiovascular system, something which you certainly might want 477 00:23:34,640 --> 00:23:36,000 to speak with your medical doctor about. 478 00:23:36,000 --> 00:23:39,480 I know I would would be wearing compression socks from like day 479 00:23:39,480 --> 00:23:42,320 one. There is an increase in things 480 00:23:42,320 --> 00:23:45,280 like varicose veins in in different places in the lower 481 00:23:45,280 --> 00:23:46,680 extremity and throughout the body. 482 00:23:46,960 --> 00:23:49,880 And I know that I would be wanting to give that external 483 00:23:49,880 --> 00:23:52,960 support to my body should I get pregnant. 484 00:23:53,400 --> 00:23:56,520 So whereas some mums might wait till later long in the pregnancy 485 00:23:56,520 --> 00:23:59,600 to add in compression stockings, I think that for someone who's 486 00:23:59,600 --> 00:24:02,360 hypermobile, it can certainly make sense to make these 487 00:24:02,360 --> 00:24:05,880 interventions earlier and more precisely. 488 00:24:06,880 --> 00:24:08,840 So speak with your medical doctor about that. 489 00:24:09,680 --> 00:24:12,520 In terms of other things as well, I think it's really 490 00:24:12,520 --> 00:24:17,320 important to consider talking about issues early. 491 00:24:17,760 --> 00:24:20,200 The sooner you identify issues and the sooner you speak with 492 00:24:20,200 --> 00:24:22,920 people about them, the more options you have theoretically. 493 00:24:23,480 --> 00:24:27,040 So when we get, you know, we've kind of let's just let's pretend 494 00:24:27,040 --> 00:24:28,120 like we've got through pregnancy. 495 00:24:28,120 --> 00:24:31,160 I haven't really touched on increased risks of bleeding 496 00:24:31,160 --> 00:24:33,200 throughout pregnancy and increased risks of potentially 497 00:24:33,200 --> 00:24:35,840 cervix issues and so on, but those do happen, OK, And I'll 498 00:24:35,840 --> 00:24:39,880 try and put them in a blog post. But when we get to pregnancy, 499 00:24:39,960 --> 00:24:44,920 sorry to labor and delivery itself, OK, we need to make sure 500 00:24:44,920 --> 00:24:48,320 that that patient ideally has thought about what they want and 501 00:24:48,320 --> 00:24:49,880 has spoken with people beforehand. 502 00:24:50,200 --> 00:24:52,160 Now I know there are some people out there who are just going to 503 00:24:52,160 --> 00:24:54,280 be like, you know what, I don't want to even think about it. 504 00:24:54,560 --> 00:24:56,240 I am not going to think about it. 505 00:24:56,240 --> 00:24:57,440 And that's cool. You do you. 506 00:24:57,440 --> 00:25:01,440 OK, but if I had a friend who was hyper mobile, I would be 507 00:25:01,440 --> 00:25:04,560 telling her, like, please speak with your medical doctor about 508 00:25:04,560 --> 00:25:07,720 your concerns, your wishes, things that you're worried about 509 00:25:07,720 --> 00:25:08,360 and so on. Right. 510 00:25:08,360 --> 00:25:11,360 So that this is just like the theme of this episode doesn't 511 00:25:11,360 --> 00:25:13,800 mean you have to do it just means it's what I think is 512 00:25:13,800 --> 00:25:18,640 helpful. So when it comes to labour and 513 00:25:18,640 --> 00:25:21,600 delivery, one thing which we all need to talk about is pain 514 00:25:21,600 --> 00:25:23,880 management. So if you're someone who's 515 00:25:23,880 --> 00:25:25,640 hypermobile, you might have noticed. 516 00:25:25,640 --> 00:25:27,600 I think that's not everyone, because why would it be? 517 00:25:27,600 --> 00:25:29,840 That would be too easy. But you might have noticed that 518 00:25:29,840 --> 00:25:31,920 you have issues with local anaesthetic. 519 00:25:32,160 --> 00:25:34,600 A great example of this is if you're at the dentist. 520 00:25:34,880 --> 00:25:38,400 So some hypermobile people will not respond to numbing 521 00:25:38,400 --> 00:25:41,200 injections at all. Some people will respond a 522 00:25:41,200 --> 00:25:43,800 little bit, but they need more or they need it to be topped up 523 00:25:43,800 --> 00:25:46,240 more regularly. And theoretically, there's a 524 00:25:46,240 --> 00:25:48,440 group as well who will respond fairly normally. 525 00:25:49,280 --> 00:25:52,520 So if you're someone who has had issues with local anaesthetic 526 00:25:52,520 --> 00:25:54,360 previously, and I would say just if you're someone who's 527 00:25:54,360 --> 00:25:58,240 hypermobile regardless, it might be worth talking with your 528 00:25:58,240 --> 00:26:02,680 medical team about things like epidurals and things that like 529 00:26:02,680 --> 00:26:07,320 other forms of local anaesthetic, because they won't 530 00:26:07,320 --> 00:26:10,720 always work or they won't always work in the same way in people 531 00:26:10,720 --> 00:26:12,920 who are hypermobile. Again, I'll try and put all my 532 00:26:12,920 --> 00:26:16,600 research in the show notes, but when it comes to epidurals, if 533 00:26:16,600 --> 00:26:19,160 it was me and I was going in, I was pregnant and I was 534 00:26:19,160 --> 00:26:20,560 approaching, you know, giving birth. 535 00:26:20,880 --> 00:26:23,520 I would want to make sure that I understood all my options and 536 00:26:23,520 --> 00:26:25,960 knew of options other than epidural. 537 00:26:25,960 --> 00:26:28,080 Because I think the person who hasn't thought about pregnancy 538 00:26:28,080 --> 00:26:31,040 as much as I have, perhaps they think, oh don't worry, if I'm in 539 00:26:31,040 --> 00:26:34,080 too much pain, I'll get an epidural and it will work and 540 00:26:34,080 --> 00:26:36,720 it's not that simple, especially right from about people. 541 00:26:37,280 --> 00:26:40,480 Now I would also want be wanting to think about things like 542 00:26:40,840 --> 00:26:43,960 nitrous oxide gas that's available to pregnant mothers in 543 00:26:43,960 --> 00:26:49,040 the the UK. It's something again where right 544 00:26:49,040 --> 00:26:51,400 now in the uki, don't know if you saw this in the in the news. 545 00:26:51,400 --> 00:26:52,920 I think the Guardian did an article on this. 546 00:26:53,160 --> 00:26:58,120 But there is a shortage of nitrous oxide because they found 547 00:26:58,120 --> 00:27:00,840 that on some of the hospital wards that have poor ventilation 548 00:27:00,840 --> 00:27:03,760 in the UK, which is more common than you would think that the 549 00:27:03,760 --> 00:27:06,760 midwives and other staff on those wards were breathing in 550 00:27:06,760 --> 00:27:09,760 too much of this nitrous oxide or whatever they call it, like 551 00:27:09,920 --> 00:27:12,320 gas air, I think they call it here anyways. 552 00:27:12,320 --> 00:27:15,320 They're breathing in too much of that and it was causing them to 553 00:27:15,320 --> 00:27:18,680 potentially have issues with B, vitamin malabsorption and other 554 00:27:18,680 --> 00:27:21,800 things. So they have now stopped making 555 00:27:21,800 --> 00:27:25,600 available nitrous oxide on in some hospitals entirely. 556 00:27:25,600 --> 00:27:28,320 So if that was a pain management option that a person who was 557 00:27:28,320 --> 00:27:31,440 going to give birth was relying on, they might be surprised to 558 00:27:31,520 --> 00:27:33,520 to go give birth and not have that there. 559 00:27:33,920 --> 00:27:36,520 So it might help if you like even look at the hospitals which 560 00:27:36,520 --> 00:27:39,320 are an option to you or call them or try and contact them 561 00:27:39,520 --> 00:27:43,000 just to know what the menu of pain management options is. 562 00:27:43,000 --> 00:27:45,640 And yeah, I just want to say to the the gas air or whatever they 563 00:27:45,640 --> 00:27:47,640 call it here it's a mixture basically of nitrous oxide and 564 00:27:47,640 --> 00:27:49,800 oxygen and you get a little mask and the patient can self 565 00:27:49,800 --> 00:27:53,520 administer it. And I think even if it doesn't 566 00:27:53,920 --> 00:27:56,320 provide, obviously it doesn't provide the same level of pain 567 00:27:56,320 --> 00:27:59,960 relief as other interventions. It's something which can help 568 00:27:59,960 --> 00:28:02,600 and which I think people, especially in the UK, where I I 569 00:28:02,600 --> 00:28:05,480 know it is quite a common option, they go into their 570 00:28:05,480 --> 00:28:08,400 delivery thinking that they will have that to rely on and to not 571 00:28:08,400 --> 00:28:10,280 have that, there would be quite a shock. 572 00:28:11,040 --> 00:28:14,240 Now, in terms of other things that you might want your health 573 00:28:14,240 --> 00:28:17,760 team to be aware of or whoever's helping you to give birth to 574 00:28:17,760 --> 00:28:21,880 this, in fact, this baby, you would want them to probably be 575 00:28:21,880 --> 00:28:24,760 aware of some of the issues surrounding episiotomy and 576 00:28:24,760 --> 00:28:27,640 hypermobility. So episiotomy refers to 577 00:28:27,640 --> 00:28:31,320 incisions that are made to help with the vaginal delivery of the 578 00:28:31,320 --> 00:28:33,160 baby. There are different types of 579 00:28:33,160 --> 00:28:35,120 episiotomy. Is there somewhere they go kind 580 00:28:35,120 --> 00:28:38,120 of forward back there, somewhere they go more out to the side. 581 00:28:38,920 --> 00:28:41,520 Based on my research, I know that I certainly would want to 582 00:28:41,520 --> 00:28:44,400 avoid a forward and back one, but even the ones that go out to 583 00:28:44,400 --> 00:28:47,360 the side because of how they affect the thigh can have huge 584 00:28:47,360 --> 00:28:51,000 problems. There is some, I think there was 585 00:28:51,000 --> 00:28:53,560 1 research paper that suggested that some patients would 586 00:28:53,560 --> 00:28:56,840 actually have better outcomes from AC section than an 587 00:28:56,840 --> 00:29:00,960 episiotomy just simply because of the risk of prolapse long 588 00:29:00,960 --> 00:29:03,120 term. So this is a talk and this is 589 00:29:03,120 --> 00:29:04,600 like the thing. I don't even know how this would 590 00:29:04,600 --> 00:29:08,000 happen because a lot of people who are hypermobile, they don't 591 00:29:08,000 --> 00:29:10,240 have a diagnosis, they don't have this team. 592 00:29:10,440 --> 00:29:13,280 I I watched this lecture this morning and there was like this 593 00:29:13,280 --> 00:29:16,080 at the the last slide was like find your healthcare team and 594 00:29:16,080 --> 00:29:18,000 talk to them. They don't have a team. 595 00:29:18,000 --> 00:29:20,240 They're just getting whoever's at the hospital on the day. 596 00:29:20,640 --> 00:29:23,880 So I don't know how this would actually work but what I would 597 00:29:23,880 --> 00:29:26,680 do maybe is bring a little like a folder with me. 598 00:29:28,600 --> 00:29:31,920 Like what I would do maybe is bring a little folder with me 599 00:29:31,920 --> 00:29:36,680 and I would be like, here's what I would like you to know, person 600 00:29:36,680 --> 00:29:41,160 who is here and helping me hopefully safely deliver my my 601 00:29:41,160 --> 00:29:43,520 baby. But I would want them to 602 00:29:43,520 --> 00:29:47,360 understand that I am extremely concerned about risk of prolapse 603 00:29:47,360 --> 00:29:50,960 following an episiotomy because of hyperbolic connective tissue. 604 00:29:50,960 --> 00:29:53,160 It basically means that wounds don't heal as well as they 605 00:29:53,160 --> 00:29:55,600 should sometimes. And people, even if they haven't 606 00:29:55,720 --> 00:29:58,600 given birth vaginally, they are at risk of having things like 607 00:29:58,600 --> 00:30:01,600 prolapse, which is the medical term for organs moving 608 00:30:01,600 --> 00:30:04,280 downwards, rectal prolapse, uterine prolapse, vaginal 609 00:30:04,280 --> 00:30:06,080 prolapse. Things move down when you do not 610 00:30:06,080 --> 00:30:08,920 want them to move down. So I would really want the 611 00:30:08,920 --> 00:30:12,720 person who is helping me deliver my baby to know that I'm very 612 00:30:12,720 --> 00:30:16,080 sensitive about my pelvic floor. On that note, going back to what 613 00:30:16,080 --> 00:30:18,240 we said earlier about prehab, you could also like look for 614 00:30:18,240 --> 00:30:21,080 some pelvic floor physiotherapy. I think that's a great thing to 615 00:30:21,080 --> 00:30:23,560 do. But again, it's all up to you. 616 00:30:23,560 --> 00:30:25,200 It's your pregnancy and your body. 617 00:30:25,560 --> 00:30:29,240 Now. I would also want them to be 618 00:30:29,240 --> 00:30:32,040 aware about moving my body around. 619 00:30:32,040 --> 00:30:35,520 I had a patient the other week tell me that her thought she was 620 00:30:35,520 --> 00:30:38,200 lying down on her back, kind of in a reclined position on her 621 00:30:38,200 --> 00:30:41,400 back giving birth to her baby. And the person who was there, 622 00:30:41,400 --> 00:30:43,320 the the midwife or I don't know if it was a medical doctor or 623 00:30:43,320 --> 00:30:45,280 whatever they like yanked back on her leg. 624 00:30:45,960 --> 00:30:48,560 I would not want someone doing that to my legs. 625 00:30:48,560 --> 00:30:52,480 So I don't know if I'd be the the favorite patient ever or the 626 00:30:52,480 --> 00:30:56,520 least favorite patient, but I would just want my partner 627 00:30:56,520 --> 00:30:59,360 there. Or like I would just have a a 628 00:30:59,360 --> 00:31:04,400 big document with me explaining like do not aggressively move my 629 00:31:04,400 --> 00:31:07,400 joints. Listen to me if I tell you 630 00:31:07,400 --> 00:31:10,640 something, if I tell you I'm in pain and I can feel something, 631 00:31:10,840 --> 00:31:15,240 it doesn't mean it's in my head. It means that the pain relief 632 00:31:15,240 --> 00:31:18,120 you've given me has not worked because hyper mobile connective 633 00:31:18,120 --> 00:31:20,760 tissue people problems. So please listen to me. 634 00:31:20,760 --> 00:31:24,640 I think the the big thing here is just patience being listened 635 00:31:24,640 --> 00:31:26,680 to. That's what will save lives and 636 00:31:26,680 --> 00:31:29,000 that's what will make everyone's pregnancy experience better. 637 00:31:29,800 --> 00:31:32,640 But anyways, carrying on, I would want to think about 638 00:31:32,640 --> 00:31:35,960 different positions. So I'd be very aware that 639 00:31:36,200 --> 00:31:38,640 positions that work for other people might not work for me. 640 00:31:39,000 --> 00:31:41,400 I would also be aware of the fact that there's an increased 641 00:31:41,400 --> 00:31:43,640 risk of what's called precipitous birth or I think 642 00:31:43,640 --> 00:31:47,000 it's precipitous labor actually. But basically what this means is 643 00:31:47,000 --> 00:31:50,360 that from the onset of contractions to baby, like being 644 00:31:50,360 --> 00:31:54,160 born is 3 to 5 hours, which is a short window and it can really I 645 00:31:54,160 --> 00:31:56,320 think catch a lot of healthcare professionals off guard. 646 00:31:56,760 --> 00:31:59,920 So knowing also that my mom had that happen with two 647 00:32:00,000 --> 00:32:03,520 pregnancies, I would want my healthcare team to know, you 648 00:32:03,520 --> 00:32:06,680 know, it might look like it's going slow, it's it's often kind 649 00:32:06,680 --> 00:32:09,680 of like a slow progression of the the pre, you know, pre 650 00:32:09,680 --> 00:32:12,840 actual contraction stuff. But I would say like once we get 651 00:32:12,840 --> 00:32:14,720 there, it might go very, very fast. 652 00:32:14,720 --> 00:32:17,880 Please, please be aware of that as well. 653 00:32:18,600 --> 00:32:22,880 It might affect things like making sure that you are 654 00:32:22,880 --> 00:32:25,680 prepared for a home birth. Not that I'm advocating that, 655 00:32:25,840 --> 00:32:27,760 but just in case it happens. And this is one of the 656 00:32:27,760 --> 00:32:30,080 suggestions, actually, I think I saw it in the British Journal of 657 00:32:30,080 --> 00:32:32,200 Midwifery. But they were saying, you know, 658 00:32:32,200 --> 00:32:36,200 just having a partner or, you know, yourself being prepared 659 00:32:36,200 --> 00:32:38,440 for, like what a home birth might entail. 660 00:32:38,760 --> 00:32:41,680 It just takes away a bit of the risk, right? 661 00:32:41,680 --> 00:32:45,080 A prepared home birth is better than a not prepared home birth. 662 00:32:45,560 --> 00:32:48,120 So if you can make sure that you have some of the sterile stuff 663 00:32:48,120 --> 00:32:50,840 required to make sure that if you're in that situation that 664 00:32:50,840 --> 00:32:54,480 you could manage that can just take a one stress, one worry 665 00:32:54,480 --> 00:32:56,080 that you have and just decrease it. 666 00:32:56,600 --> 00:32:58,920 A lot of this at the end of the day is looking at risk 667 00:32:59,000 --> 00:33:01,680 management and potential benefit, kind of like a risk 668 00:33:01,680 --> 00:33:04,960 benefit analysis and learning about a home birth is something 669 00:33:04,960 --> 00:33:08,240 which it's not going to hurt you and it might help you. 670 00:33:08,600 --> 00:33:12,680 So that's the kind of thing that I would do personally when it 671 00:33:12,680 --> 00:33:16,880 comes as well to baby actually being delivered and coming out, 672 00:33:16,880 --> 00:33:19,920 there is an increased risk in people who are hyper mobile of 673 00:33:19,920 --> 00:33:22,280 baby not being positioned in the right way. 674 00:33:22,280 --> 00:33:25,120 So we have to remember giving birth is not just a one person 675 00:33:25,120 --> 00:33:28,240 thing, it's a two person thing. There's the mom and the baby. 676 00:33:29,280 --> 00:33:31,080 So, and again, when I say mom, I want to just stress, I didn't 677 00:33:31,080 --> 00:33:32,480 say this earlier. I'm including everyone. 678 00:33:32,840 --> 00:33:35,560 Anyone can be a mom. I don't care like what your 679 00:33:35,560 --> 00:33:38,040 gender identity is, or if you don't even identify as a gender, 680 00:33:38,040 --> 00:33:41,720 like anyone who is giving birth. This applies to you. 681 00:33:41,720 --> 00:33:48,640 OK, but the person who's giving birth, they might have the baby, 682 00:33:48,640 --> 00:33:52,160 which is just not cooperating. There's a 50% chance their baby 683 00:33:52,160 --> 00:33:54,240 is hypermobile. I don't know if studies have 684 00:33:54,240 --> 00:33:56,440 actually been done looking. It'll be really hard to do 685 00:33:56,440 --> 00:33:58,640 because how do we know? Like in utero, if the baby's 686 00:33:58,640 --> 00:34:00,240 hypermobile or not? They'd have to almost be like 687 00:34:00,240 --> 00:34:04,120 retrospective studies. But the the baby might just not 688 00:34:04,120 --> 00:34:06,960 be playing ball. It might be in a really annoying 689 00:34:06,960 --> 00:34:08,880 position and that might be a thing. 690 00:34:08,880 --> 00:34:12,000 Even if the mum is doing great, baby can cause problems. 691 00:34:12,000 --> 00:34:14,639 So This is why pregnancy is such a complicated and stressful 692 00:34:14,639 --> 00:34:17,719 thing because it's not just a one person situation, it's a 2 693 00:34:17,880 --> 00:34:22,480 two person situation right now. Being aware that baby might be 694 00:34:22,520 --> 00:34:25,679 positioned not as well I think helps patients prepare too for 695 00:34:25,679 --> 00:34:28,000 the reality that they might not get the birth experience that 696 00:34:28,000 --> 00:34:30,320 they want. They might have to have AC 697 00:34:30,320 --> 00:34:32,760 section right or they they're need, they might not get the 698 00:34:32,760 --> 00:34:36,040 water birth or whatever that they were hoping for because of 699 00:34:36,040 --> 00:34:39,080 the baby at the end of the day. So just having that expectation 700 00:34:39,080 --> 00:34:42,600 management in mind and again this all of this stuff goes back 701 00:34:42,600 --> 00:34:45,679 to basic things we talked about being listened to earlier and 702 00:34:45,679 --> 00:34:48,040 believed we're now going to talk about informed consent. 703 00:34:48,400 --> 00:34:52,440 Like literally if people just have their risks and benefits 704 00:34:52,440 --> 00:34:55,239 explained to them. It's the the gold standard for 705 00:34:55,239 --> 00:34:57,760 informed consent is called a brand statement, Benefits, 706 00:34:57,760 --> 00:35:00,800 risks, alternatives and nothing. So what are the benefits of 707 00:35:01,080 --> 00:35:03,440 giving birth vaginally? What are the risks for this 708 00:35:03,440 --> 00:35:04,640 patient of giving birth vaginally? 709 00:35:04,640 --> 00:35:06,680 What are the alternatives? Could they have a C-section or 710 00:35:06,680 --> 00:35:09,560 do something else? And what happens if we do 711 00:35:09,560 --> 00:35:11,400 nothing? You don't have a choice to do 712 00:35:11,400 --> 00:35:12,360 nothing when they're giving birth. 713 00:35:12,360 --> 00:35:14,600 But you know what I mean? Like, we could just, if it's a 714 00:35:14,600 --> 00:35:16,880 shoulder injury, what happens if they don't have any treatment at 715 00:35:16,880 --> 00:35:18,040 all? We just leave them and do 716 00:35:18,040 --> 00:35:20,720 nothing at all, right? Like a brand statement. 717 00:35:20,720 --> 00:35:22,120 We just need more brand statements. 718 00:35:22,120 --> 00:35:23,280 That's all we need in this world. 719 00:35:23,440 --> 00:35:27,360 Not not all, but it will be a good start anyways when it comes 720 00:35:27,360 --> 00:35:31,280 to people actually giving birth. We talked a bit about baby 721 00:35:31,280 --> 00:35:34,880 positioning problems, but we also need to talk a little bit 722 00:35:34,880 --> 00:35:36,760 about the actual tissue down there. 723 00:35:37,480 --> 00:35:42,520 So there does seem to be this increased risk of precipitous 724 00:35:42,680 --> 00:35:45,000 labor leading to really, really fast births. 725 00:35:45,440 --> 00:35:49,480 But there does also seem to be so there's an increased risk 726 00:35:49,480 --> 00:35:52,120 with episiotomy. So when an episiotomy is made, 727 00:35:52,120 --> 00:35:54,520 that incision, again theoretically is made to help 728 00:35:54,520 --> 00:35:57,920 deliver baby. I think that if it was me giving 729 00:35:57,920 --> 00:36:01,840 birth, certainly I would want to be allowed within safe, always 730 00:36:01,840 --> 00:36:03,360 being safe, right? But I'd want to be allowed to 731 00:36:03,360 --> 00:36:06,320 give birth to that baby slowly and in a controlled way. 732 00:36:06,320 --> 00:36:10,200 And I would really want to have good support and coaching on 733 00:36:10,360 --> 00:36:13,520 like not pushing too fast and trying to avoid pelvic tears. 734 00:36:14,000 --> 00:36:16,000 Like other than healthy baby, healthy mom. 735 00:36:16,000 --> 00:36:19,280 My, my second biggest goal would be not tearing the pelvic floor 736 00:36:19,360 --> 00:36:20,520 because that would be really helpful. 737 00:36:21,480 --> 00:36:24,440 But yeah, physiotomies and awareness of tearing and not 738 00:36:24,440 --> 00:36:27,000 pushing too fast. I think that's a really, really 739 00:36:27,000 --> 00:36:30,000 important thing to make sure every hypermobile person is 740 00:36:30,000 --> 00:36:35,720 aware of as well. When it comes to medication, 741 00:36:35,720 --> 00:36:38,520 both during labor and delivery and any kind of, you know, 742 00:36:38,520 --> 00:36:41,360 drugs, people are being given or taken or pain management as well 743 00:36:41,360 --> 00:36:43,160 as throughout the pregnancy. I should have said this earlier, 744 00:36:43,480 --> 00:36:45,680 people need to talk to their medical doctors because they 745 00:36:45,720 --> 00:36:48,960 might need a medication to help manage their symptoms that maybe 746 00:36:48,960 --> 00:36:51,680 hasn't been studied as much as would be ideal, but we need to 747 00:36:51,680 --> 00:36:53,920 think of what's safe and appropriate for that patient. 748 00:36:53,920 --> 00:36:56,800 And again, we don't have the studies on pregnancy that we 749 00:36:56,800 --> 00:36:59,800 need because researchers don't like studying on people who are 750 00:36:59,800 --> 00:37:04,400 pregnant because there's a risk of course of potential harm 751 00:37:04,400 --> 00:37:06,840 depending on how the study is structured and and how it's 752 00:37:06,840 --> 00:37:09,120 actually carried out. So it's something that we've 753 00:37:09,120 --> 00:37:10,800 shield away from for way too long. 754 00:37:10,800 --> 00:37:13,080 There are books written on this and it's something that 755 00:37:13,080 --> 00:37:15,720 hopefully will is changing and hopefully will continue to 756 00:37:15,720 --> 00:37:19,080 change in future. But for now it really does come 757 00:37:19,080 --> 00:37:22,200 down to risk management and looking at the risk benefit 758 00:37:22,200 --> 00:37:24,880 ratio by that patient's medical doctor at the end of the day. 759 00:37:25,720 --> 00:37:31,080 Now in terms of AC section, I think again it's really 760 00:37:31,080 --> 00:37:35,040 important to be aware of the benefits. 761 00:37:35,040 --> 00:37:38,400 In some instances here we've had the phrase for a while. 762 00:37:38,400 --> 00:37:41,160 I think like breast is best and I I hate this, this is best is 763 00:37:41,160 --> 00:37:43,200 this or worst. Whatever is best for the patient 764 00:37:43,200 --> 00:37:46,200 is what's best for the patient. If you're a hypermobile person 765 00:37:46,200 --> 00:37:49,080 and AC section is best for you, that's cool, that's good, that's 766 00:37:49,080 --> 00:37:50,360 great. I'm happy you have good 767 00:37:50,360 --> 00:37:52,120 healthcare. If you're a hypermobile person 768 00:37:52,120 --> 00:37:54,320 and you feel like a vaginal birth is best for you, again 769 00:37:54,320 --> 00:37:56,720 that's great in terms of the guidance. 770 00:37:57,200 --> 00:38:00,360 Research does suggest, and guidance does suggest that there 771 00:38:00,520 --> 00:38:03,440 unless there is a clear reason why someone with HTTS should not 772 00:38:03,440 --> 00:38:06,520 give birth vaginally, then that should be ideally probably the 773 00:38:06,520 --> 00:38:09,000 best option. But again, every single 774 00:38:09,000 --> 00:38:14,520 patient's different now when it comes to the postpartum period. 775 00:38:14,960 --> 00:38:19,440 This is a very, very problematic situation because we have 776 00:38:19,440 --> 00:38:23,160 someone who not only has all of the chronic health issues they 777 00:38:23,160 --> 00:38:26,600 had before, they have them being exacerbated or them being 778 00:38:26,600 --> 00:38:31,000 complicated by the postpartum hormonal chaos, mechanical 779 00:38:31,000 --> 00:38:32,640 chaos. Like there's a sudden change in 780 00:38:32,640 --> 00:38:37,040 your body and the stresses of a newborn, which I don't know 781 00:38:37,040 --> 00:38:39,080 personally, but I've heard they don't sleep so well at the 782 00:38:39,080 --> 00:38:43,800 beginning and that they need to be fed very often anyways. 783 00:38:43,800 --> 00:38:46,240 You have a baby to care for. Theoretically, if you've made 784 00:38:46,240 --> 00:38:47,880 this through, made it through this. 785 00:38:48,320 --> 00:38:51,520 If you have family members, you can reach out to your friends or 786 00:38:51,520 --> 00:38:53,640 community or whatever, like do that. 787 00:38:53,640 --> 00:38:55,600 I think that a lot of hypermobile people, because 788 00:38:55,600 --> 00:38:58,400 they've had to struggle for so long, I think they almost hold 789 00:38:58,400 --> 00:39:00,040 back or they're shy to ask for help. 790 00:39:00,280 --> 00:39:03,800 Like ask for that help because you probably have people who 791 00:39:03,800 --> 00:39:05,240 care about you more than you think. 792 00:39:05,360 --> 00:39:08,880 So reach out, even if it's just people like helping with some 793 00:39:08,880 --> 00:39:11,000 food prep or maybe helping with some cleaning. 794 00:39:11,000 --> 00:39:15,560 Like I think that we see a lot of kind of hyper independence 795 00:39:15,560 --> 00:39:17,640 part, maybe because of a neurodivergent component of all 796 00:39:17,640 --> 00:39:20,080 this stuff. But reach out to your support 797 00:39:20,080 --> 00:39:21,880 network even if you think you don't have one. 798 00:39:21,880 --> 00:39:26,560 You might be surprised as well. We see a lot of issues with 799 00:39:27,200 --> 00:39:29,680 dismissal of muscle and joint pain. 800 00:39:30,160 --> 00:39:33,520 I cannot tell you how many patients I've had see me who 801 00:39:33,520 --> 00:39:35,520 it's like years after their last pregnancy. 802 00:39:35,520 --> 00:39:37,720 And they tell me, oh, I developed plantar fasciitis 803 00:39:37,720 --> 00:39:40,520 during the pregnancy and postpartum, but the medical 804 00:39:40,520 --> 00:39:43,360 doctor told me it was just normal and it would go away. 805 00:39:43,720 --> 00:39:46,920 And now that it's been 2 years, they say that it's chronic and I 806 00:39:46,920 --> 00:39:49,960 have pain just because I'm like, old and now I have to live with 807 00:39:49,960 --> 00:39:52,080 it or whatever. That's ridiculous, right? 808 00:39:52,080 --> 00:39:55,320 Like, we need to look at musculoskeletal injuries 809 00:39:55,440 --> 00:39:58,360 appropriately. We need to stop just accepting 810 00:39:58,520 --> 00:40:01,680 that someone who's given birth is necessarily going to have 811 00:40:02,920 --> 00:40:04,760 pain that is not treatable, right? 812 00:40:04,760 --> 00:40:06,920 We need, we need to take these injuries really seriously. 813 00:40:07,440 --> 00:40:09,400 So I think that that's something I really want to emphasize is if 814 00:40:09,400 --> 00:40:12,320 you're someone who is looking to a pregnancy in the future and 815 00:40:12,320 --> 00:40:14,480 thinking about the postpartum period, or you're someone who's 816 00:40:14,480 --> 00:40:16,400 listening to this, who is postpartum? 817 00:40:16,680 --> 00:40:19,720 Your body still matters, your health still matters. 818 00:40:19,920 --> 00:40:23,440 And ideally you will be able to access healthcare providers who 819 00:40:23,440 --> 00:40:25,120 will actually help you with this. 820 00:40:25,120 --> 00:40:29,880 OK, so don't live with pain if don't live with excessive pain 821 00:40:29,880 --> 00:40:31,840 if you don't have to. I know that part of having HDS 822 00:40:31,840 --> 00:40:35,440 and HSD is chronic pain, but we want to try and just minimize it 823 00:40:35,440 --> 00:40:39,320 as much as we can right? As well I think we really need 824 00:40:39,320 --> 00:40:44,600 to appreciate the psychological changes and and stressors which 825 00:40:44,600 --> 00:40:47,120 can happen. Postpartum depression is real 826 00:40:47,120 --> 00:40:49,600 and scary and there are other psychological conditions which 827 00:40:49,600 --> 00:40:53,800 can occur and research does suggest I believe that people 828 00:40:53,800 --> 00:40:57,680 who have Heds and HSD are at a greater risk of having issues 829 00:40:57,880 --> 00:41:01,280 like postpartum depression. So again, you might find it 830 00:41:01,280 --> 00:41:04,800 helpful to if you can afford it or if you can manage it through 831 00:41:04,800 --> 00:41:08,480 a healthcare plan that you have. Schedule things like therapy in 832 00:41:08,480 --> 00:41:10,720 advance. I know if I was giving birth 833 00:41:10,960 --> 00:41:14,400 because I don't have my mom around, like I I just get sad at 834 00:41:14,400 --> 00:41:17,200 the idea of it, right? So I know that I'm someone who 835 00:41:17,200 --> 00:41:20,480 probably would be high risk for postpartum depression and I 836 00:41:20,480 --> 00:41:24,720 would be wanting the support of a mental health worker, probably 837 00:41:24,920 --> 00:41:27,440 maybe pre pregnancy, certainly during the pregnancy and 838 00:41:27,440 --> 00:41:31,080 absolutely after the pregnancy. So try to anticipate those 839 00:41:31,080 --> 00:41:32,640 issues. If you can't do it on your own, 840 00:41:32,640 --> 00:41:34,200 try and work with someone who can help you. 841 00:41:34,640 --> 00:41:37,800 But anticipating issues or vulnerabilities like that they 842 00:41:37,800 --> 00:41:41,000 are, they can help you really have positive outcomes where 843 00:41:41,000 --> 00:41:43,600 otherwise we might be going down a path where we start to have 844 00:41:43,600 --> 00:41:45,560 some negative outcomes and some harm happened to that 845 00:41:45,560 --> 00:41:48,040 individual. So think about you, think what 846 00:41:48,040 --> 00:41:49,960 you're worried about and appreciate there might be a 847 00:41:49,960 --> 00:41:53,800 reason why you're worried about it and why you're stressed as 848 00:41:53,800 --> 00:41:55,920 well in terms of postpartum issues. 849 00:41:56,080 --> 00:41:58,840 Breastfeeding. Again, nothing is. 850 00:41:59,080 --> 00:42:01,560 As I like to say, Nothing is good, nothing is bad, and 851 00:42:01,560 --> 00:42:04,800 everything's complicated. So if you are someone who is 852 00:42:04,800 --> 00:42:07,560 struggling to breastfeed, again, breastfeeding is quite a complex 853 00:42:07,560 --> 00:42:09,520 thing. It requires the person with the 854 00:42:09,520 --> 00:42:12,080 breast to be doing something, the person with the baby, like 855 00:42:12,080 --> 00:42:14,560 sorry, the baby to be doing things, and latching. 856 00:42:14,560 --> 00:42:16,800 There's a whole bunch of complications that can occur. 857 00:42:17,200 --> 00:42:19,080 There are things like tongue ties, which again, I don't think 858 00:42:19,080 --> 00:42:21,120 we have research on the prevalence of tongue ties. 859 00:42:21,120 --> 00:42:24,240 And people with HDS and HSDI do wonder if it could be higher 860 00:42:24,240 --> 00:42:25,320 though. But who knows. 861 00:42:25,640 --> 00:42:30,280 But anyways, it's a whole thing. If you can find a magical heds 862 00:42:30,280 --> 00:42:32,600 lactation consultant specialist, please let me know. 863 00:42:32,840 --> 00:42:36,040 I will send them many patients, but I might see that myself one 864 00:42:36,040 --> 00:42:37,680 day. But when it comes to 865 00:42:37,680 --> 00:42:40,040 breastfeeding, it's very challenging mechanically. 866 00:42:40,760 --> 00:42:42,600 You want to make sure you're in the confused position. 867 00:42:42,600 --> 00:42:45,520 Possible you want to make sure you're supported, prop up the 868 00:42:45,520 --> 00:42:48,520 tissues that you can, get all the pillows, all the supports, 869 00:42:48,760 --> 00:42:51,480 and try to make sure that your body is not being hurt as you 870 00:42:51,480 --> 00:42:53,720 feed your baby. But if you can't breastfeed, 871 00:42:54,240 --> 00:42:56,040 that is why we have bottle feeding. 872 00:42:56,320 --> 00:42:59,080 So again, find the option that's right for you. 873 00:42:59,080 --> 00:43:02,760 And ideally you would certainly have that magical support team 874 00:43:02,760 --> 00:43:05,800 which all of the presentations that I've seen talk about but 875 00:43:05,800 --> 00:43:08,240 yet I don't hear about from most of my patients. 876 00:43:08,800 --> 00:43:12,840 One last thing I I want to say actually briefly, I think just 877 00:43:12,840 --> 00:43:15,520 about this whole thing, if we kind of look at what we've 878 00:43:15,520 --> 00:43:18,000 talked about today is almost, it's almost like having a plan, 879 00:43:18,000 --> 00:43:19,040 right? But it's not just even like a 880 00:43:19,040 --> 00:43:22,240 birth plan. It's like a a pregnancy, birth 881 00:43:22,240 --> 00:43:25,200 and postpartum plan. There's a lot of some 882 00:43:25,200 --> 00:43:27,680 controversy, I should say, around planning. 883 00:43:27,920 --> 00:43:31,120 Some people say that, like, if they saw me or if they were 884 00:43:31,120 --> 00:43:33,480 thinking, you know, looking at how I think if I told my medical 885 00:43:33,480 --> 00:43:36,760 doctor, like, yeah, I have like a a pregnancy plan, a labor and 886 00:43:36,760 --> 00:43:39,040 delivery plan, a postpartum plan to be like, oh, this patients 887 00:43:39,040 --> 00:43:40,200 anxious. They're overthinking. 888 00:43:40,200 --> 00:43:43,040 They're catastrophizing. I disagree with them. 889 00:43:43,280 --> 00:43:46,160 I think that I'm being thoughtful and that I'm 890 00:43:46,440 --> 00:43:49,560 anticipating problems or concerns that I have and that 891 00:43:49,560 --> 00:43:52,920 I'm really trying to find solutions and treatment 892 00:43:52,920 --> 00:43:55,360 strategies to those. So I think there's so much of 893 00:43:55,440 --> 00:43:59,200 putting patients down. And if you're someone who finds 894 00:43:59,200 --> 00:44:01,600 thinking about things beneficial, maybe you're someone 895 00:44:01,600 --> 00:44:04,080 like me who's been an overthinker your whole life. 896 00:44:04,560 --> 00:44:07,480 This can be a really good opportunity for you to look at 897 00:44:07,480 --> 00:44:11,560 and assess and identify your options and find what works for 898 00:44:11,560 --> 00:44:13,720 you. And if you have a medical team 899 00:44:13,720 --> 00:44:16,480 that's telling you, oh you worry too much, stop stressing, blah 900 00:44:16,480 --> 00:44:19,000 blah blah. They're probably not like the 901 00:44:19,000 --> 00:44:21,640 best healthcare providers, and if you can find different 902 00:44:21,640 --> 00:44:25,360 healthcare providers, do that. If you can't, then you just try 903 00:44:25,360 --> 00:44:27,400 to make it work. But I think that at the end of 904 00:44:27,400 --> 00:44:31,320 the day thinking about these things can help to prevent harm. 905 00:44:31,320 --> 00:44:33,880 Like for example using a personal story. 906 00:44:34,360 --> 00:44:37,200 I used to be very keen on the idea of a home birth. 907 00:44:37,400 --> 00:44:41,400 I I was like, I think they call it crunchy, but like I was at 908 00:44:41,400 --> 00:44:43,920 back in the day like a very much that way. 909 00:44:43,920 --> 00:44:45,760 We're talking like a decade plus ago, right. 910 00:44:46,040 --> 00:44:48,040 And I used to think like, oh, I would not want to go to a 911 00:44:48,040 --> 00:44:51,080 hospital for a a birthright. I want to do it at home with 912 00:44:51,080 --> 00:44:53,800 like, whatever, right. Not saying home births are bad. 913 00:44:53,800 --> 00:44:57,040 You can again there are awesome midwife support services in some 914 00:44:57,040 --> 00:44:59,920 parts of the UK You do what's right for you. 915 00:45:00,120 --> 00:45:01,800 That's the whole point of this episode. 916 00:45:01,800 --> 00:45:06,040 But speaking about myself, when I learned more about, for 917 00:45:06,040 --> 00:45:11,360 example, the risk of things like hemorrhage, like put, you know, 918 00:45:11,360 --> 00:45:13,320 after the baby's been born, you have to the whole placenta 919 00:45:13,320 --> 00:45:15,640 delivery thing. When I've learned about how fast 920 00:45:15,640 --> 00:45:18,200 hemorrhage can happen and how quick and how scary and life 921 00:45:18,200 --> 00:45:20,760 threatening it can be, that was something which made me say, you 922 00:45:20,760 --> 00:45:22,640 know what? I want to give birth in a 923 00:45:22,640 --> 00:45:25,440 hospital if I ever have a baby. When I learned about the fact 924 00:45:25,440 --> 00:45:28,240 that things like placenta accreta, which is a condition 925 00:45:28,240 --> 00:45:30,840 where the placenta doesn't form quite how it should, which can 926 00:45:30,840 --> 00:45:33,120 affect again we can have bleeding issues from now which 927 00:45:33,120 --> 00:45:35,520 are very scary and in some instances is life threatening. 928 00:45:35,760 --> 00:45:38,280 When I learned about that, I was like, you know what, I 929 00:45:38,280 --> 00:45:40,480 definitely want to give birth in a hospital. 930 00:45:40,480 --> 00:45:43,560 It has some facilities for these kinds of emergencies, just 931 00:45:43,560 --> 00:45:46,640 because for me I couldn't stomach that risk. 932 00:45:46,720 --> 00:45:50,880 Some people will be more OK with stomaching that risk, but for 933 00:45:50,880 --> 00:45:52,520 me, I wouldn't feel safe with it. 934 00:45:52,800 --> 00:45:55,720 I know that I used to not want even to have an IV placed. 935 00:45:55,720 --> 00:46:00,320 I hate needles and I hate the thing I hate most is Ivs because 936 00:46:00,320 --> 00:46:02,200 they're like inside and outside the body. 937 00:46:02,200 --> 00:46:04,360 At the same time, I I do not like them. 938 00:46:04,360 --> 00:46:06,400 I've had surgeries. I am not a fan of Ivs. 939 00:46:06,400 --> 00:46:10,120 But again, after reading all this, and after, like, listening 940 00:46:10,120 --> 00:46:13,040 to nurses who've talked about how hard it is to place an IV 941 00:46:13,400 --> 00:46:16,760 when a patient is hemorrhaging and has lost a lot of fluid, you 942 00:46:16,760 --> 00:46:19,400 know what? I'd rather have the IV there. 943 00:46:19,920 --> 00:46:23,440 So it's something which the more you learn, you might be 944 00:46:23,440 --> 00:46:25,720 surprised how much your views change. 945 00:46:25,720 --> 00:46:30,080 So as always, my recommendation to you is to keep learning, to 946 00:46:30,080 --> 00:46:32,920 keep asking questions. I hope you've learned something 947 00:46:32,920 --> 00:46:35,400 from today's episode. And I hope that most of all, you 948 00:46:35,400 --> 00:46:37,360 feel like you're not alone in all this, because you're not 949 00:46:37,360 --> 00:46:40,120 alone. And I hope that one day we will 950 00:46:40,120 --> 00:46:42,920 have more answers and more research and more guidance. 951 00:46:43,160 --> 00:46:47,480 But for now, literally just finding healthcare providers and 952 00:46:47,480 --> 00:46:51,720 medical doctors, if possible, who will listen to you and who 953 00:46:51,720 --> 00:46:54,200 don't care if you, you know, for that, for some patients, I think 954 00:46:54,200 --> 00:46:56,040 they get so scared because they don't have a diagnosis. 955 00:46:56,400 --> 00:46:59,360 I like to imagine like Jen Hamilton, I don't know if you've 956 00:46:59,360 --> 00:47:03,600 seen her on TikTok, but she's a labor and delivery nurse. 957 00:47:03,600 --> 00:47:06,520 And I like to think that if I came up to Jen Hamilton and I 958 00:47:06,520 --> 00:47:08,760 was pregnant and going to give birth and I was like, hey Jen, 959 00:47:09,080 --> 00:47:11,880 you know what? I don't have an heds diagnosis, 960 00:47:12,240 --> 00:47:15,680 but I'm hyper mobile and we have all these issues and I'm a bit 961 00:47:15,680 --> 00:47:17,000 worried about this, this and this. 962 00:47:17,000 --> 00:47:19,760 And research suggests that I might be at risk of having these 963 00:47:19,760 --> 00:47:21,560 issues. And there's a chance that you 964 00:47:21,560 --> 00:47:24,920 might have me have some pain, pain relief, intervention and it 965 00:47:24,920 --> 00:47:26,960 might not work on me and I might still feel pain. 966 00:47:26,960 --> 00:47:29,800 And I'm scared of like, you know, feeling you stitch me up 967 00:47:29,800 --> 00:47:33,640 potentially and feeling that can you please just listen to me and 968 00:47:33,640 --> 00:47:37,520 trust me as your patient? And I like to think that someone 969 00:47:37,520 --> 00:47:40,080 like if we say like Jen Hamilton would be like the ideal labor 970 00:47:40,080 --> 00:47:42,280 and delivery nurse. I like to think that Jen would 971 00:47:42,280 --> 00:47:44,640 be like, you know what, Alex, I hear you. 972 00:47:44,800 --> 00:47:47,400 Thanks for telling me all that. I'm going to try and incorporate 973 00:47:47,480 --> 00:47:51,200 incorporate that into your care because you're my patient. 974 00:47:51,200 --> 00:47:54,040 And of course I hear you and I trust you and I see you and I 975 00:47:54,040 --> 00:47:56,560 care about you. So that's what we want. 976 00:47:56,560 --> 00:47:59,240 It doesn't always happen, but let's keep trying to make it 977 00:47:59,240 --> 00:48:01,320 happen, shall we? Anyways, hope you've enjoyed 978 00:48:01,320 --> 00:48:03,600 today's episode and I'll see you next time.