Pregnancy Uncut

Few people can genuinely claim to have changed the course of healthcare but Caroline de Costa could do just that. Not that she would, for her - pioneering change and fighting for women's rights in healthcare is just part of the all-encompassing job of an obstetrician. With a career spanning decades, Caroline has been on the frontline of ensuring women have active choice over their reproductive health, from fighting for abortion rights in Ireland early in her career, to pioneering access to medical abortion services in Australia. Those rights are still under attack and so to take inspiration from Caroline's work is particularly galvanising. Join Kara in this fascinating conversation with Caroline, the first female professor of Obstetrics in Australia, author and trailblazer.

In our final episode for season 6, Kara talks to Dr. Imogen Hines about Induction of labour, specifically planned induction and the surprising reaction it can prompt. As an orthopedic doctor, Imogen was no stranger to research and so when she found out she was pregnant she didn't hesitate to put that to the test researching the birth that was going to be best for her and her baby. Based on her findings and on her personal situation she decided to book for a planned induction at 39 weeks. As a public figure, Imogen was expecting to hear multiple opinions on her decision but she did not anticipate the level of negative comments, even vitriol, that would come her way As well as speaking openly of her own experience, Imogen and Kara discuss induction at length including the ongoing impact of the Arrive trial and being pregnant when everyone seems to have an opinion on your choices. She also shares fascinating insight on the ongoing gender inequity in surgical training and how women continue to be pushed out by unnecessary structural barriers.

In this episode we are thrilled to welcome back to the podcast, Amy Dawes - co-founder and CEO of the Australasian Birth Trauma Association to talk with Kara about informed consent. This was the theme of this year's birth trauma awareness week and Kara and Amy do a deep dive on just why it is so important. When Amy was last on the podcast she spoke openly about her personal journey of birth trauma and living with levator avulsion. Now, some years on we welcome her candor as she talks about her own life and the directions it is now taking her. This is a fantastic and important conversation that covers many aspects of why informed consent in healthcare is the cornerstone of supporting and caring for women through pregnancy, labour and birth.

Hayley is a qualified trauma counsellor and mum of two. With her education and expertise she felt well equipped to manage her own trauma from sexual assault, particularly when her first birth was straightforward. Going into her second Hayley felt prepared and excited. However, in the midst of her labour and birth she found herself disassociating and unable to reach anyone who would be able to help her. Bravely sharing her raw yet insightful story, Hayley teaches us how past trauma can impact pregnancy, labour and birth. Alex and Hayley discuss her personal experience of birth after sexual assault but also discuss more broadly the things that healthcare providers can be doing to provide true trauma-informed care to victim survivors. Tune in to this valuable episode now by listening to Season 7 episode 8 at pregnancyuncut.com, spotify or wherever you get your podcasts. We encourage you to please reach out if you, or someone you know, need support Sexual assault support services | Sexual assault (reachout.com)

Family is everything to Renee. At 95, she is a living legend, and our oldest guest on Pregnancy Uncut. Renee' s memory is impressively sharp and despite her age, her experiences of her five births remain vivid and profound. Renee now has three grown up children, but she also has two children no longer earthside: she is a survivor of her time, to say the least. Renee is one of ten (10!!) and grew up in a time where resilience reigned and preventable deaths were part of life. She's lived through a world war, and lost siblings to vaccine preventable disease. Perinatal loss was considered a mishap, at least to some, rarely acknowledged and never discussed or supported. Her most profound and lasting memories as a young mother are of her still born baby, and subsequent death of another baby, at just a few days old. Sounds and the kind of maternity care she received have never left her. Renee generously shares her story, and reflects on how much maternity has changed in the last 100 years and how birth experiences imprint on mothers. She is a living testament to the lasting and deep impact of loss, and the strength and resilience of a generation. Join Alex as she talks to Renee about family, bereavement and the changes that she has seen across nearly a century.

When his partner Maddy went into labour with their second child, Matt was excited to meet the new addition to their family, but a cord prolapse leading to emergency surgery, saw him instead, alone in a waiting room looking at the seemingly motionless hands of a clock. When Baby Wren was born, she required intensive breathing support, and soon afterwards Matt and Maddy had to make the impossible decision to palliate or transfer her to Melbourne to see if specialist help could save her. Wren spent 8 days in the Royal Children’s hospital in Melbourne and underwent cooling. Despite receiving the devastating news that she would not be able to live without a ventilator, Matt describes them as some of the most treasured days of his life, and the special memories they created that captured her last moments. In his grief and trauma, Matt has been mobilised to bring about change. He is an incredible advocate for bereaved parents, creating spaces where they, especially the Dads, have the support and resources they need to support themselves and their families. Join Matt as he talks to Alex about the heartbreaking and precious short life of baby Wren, and how they navigated pregnancy and birth after birth trauma and loss.

After a complex fertility journey and a birth and post-partum overshadowed by Covid, Isla was hopeful that she was through the complexity and her journey to her next baby would be more straightforward. At first, this seemed to be the case - as Isla naturally fell pregnant with second baby Freddie. Everything seemed to be going well when Isla discovered a lump on her breast. Thinking it was likely nothing, possibly mastitis or something connected to the changes of her body in pregnancy, Isla couldn't get rid of the nagging feeling that something wasn't quite right. She persued it further and, after being sent for scans, was told that her hunch had been right - she had aggressive Stage four breast cancer. Only 33 weeks pregnant at the time, Isla suddenly had to make all kinds of hugely difficult decisions, not just about what was right for her, but also what was the best thing for her baby and she had to do so fast. Isla speaks of the enormous support she found in community groups, two of which can be found here: Cancer Chicks. https://www.instagram.com/cancerchicksau?igsh=dHMzNHFvNTdjeDd2 Pregnancy With Cancer Support Group. (Note, this is a private group and you must ask to join) https://www.facebook.com/groups/168089259921374/?ref=share&mibextid=NSMWBT

When Candice took her baby boy Emmett home from hospital he had twice failed the standard hearing tests. However, no one seemed too concerned, her pregnancy had been uncomplicated and everything seemed well. However an outpatient audiology consult that should have taken a couple of hours, lasted nearly a full day and maternal instinct started tingling. At the end of that day she was told that Emmett had permanent hearing loss on one side and they were referred for further testing and consultation. Congenital CMV was listed as one possible cause and there followed a whirlwind of appointments and tests to arrange to determine exactly what might have caused the hearing loss. Candice and Isaac had never heard of CMV and they took to google, quickly heading down a whirlwind of their own. The symptoms of CMV vary wildly, are often difficult to diagnose and may only present later in life. Testing confirmed that Emmett had CMV and the next few months were absorbed by days of testing and appointments. Emmett is now a happy boy, developing and learning well - navigating around his hearing loss and Candice is confident that with their support, he will be able to take on the world. With the benefit of hindsight, Candice reflects that there is little she could have done differently, with the precautions to prevent CMV being virtually impossible when living with a toddler and the prevalence of infection being so high. This episode includes a bonus mini-discussion of the complexities of CMV following Kara's interview with Candice.

In this episode we side-step from our usual content to hear the considered insights of Dr. Nisha Khot. Nisha grew up, studied and practiced to become a consultant obstetrician and gynaecologist in India - where 'a feminist was born'. After further training and working in the UK she landed on Australian shores, practising and training the next generation of O&G specialists, many (including our co-host Kara) are all the better for it. Working as a consultant, Nisha realised that the injustices she was seeing were not going to be fixed by a magical ‘someone’ and so took it upon herself to do something about it. As a fierce advocate of equity in healthcare and medicine, she is now the Vice-President of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), and is committed to ensuring the future of the profession has women at its very core . Join Dr Kara and Dr Nisha as they explore topics close to their hearts and to their practice: the value of diversity, and importance of informed decision-making, and advocacy for gender equity in healthcare.

Pip had always seen herself having a family and as a driven and organised obstetrician she had clear expectations about how, and when, that might happen. But rarely do fertility journeys unfold as we expect. After an initial miscarriage that instantly her interactions and understanding of the women in her care, she found herself on an IVF journey that would bring heartbreak, complications, twists and turns that she could never have predicted. Now a mum of four, the family picture belies the journey that Pip and her husband went on to get there. She talks to us about how that journey has shaped every aspect of her, not just as a person but as a doctor as well. Pip’s open and moving conversation with Kara shows how what we see of a person is often only the tip of the iceburg of who they are and the experiences they have had. We carry all our pregnancy experiences in our hearts, those visible to all and those hidden to the outside world.

Following the birth of her first child, Violet, Kirsty experienced a large post partum haemorrhage, which required a hysterectomy to save her life. This would seem to spell an end to her fertility journey and Kirsty, who had always imagined more children, began conversations around surrogacy. However, she couldn't get rid of the nagging feeling that she desperately wanted to carry another child herself. Still deep in postpartum, Kirsty began a journey of discovery about uterine transplant - a surgery not yet performed in Australia but gaining momentum elsewhere in the world. Stumbling across a website for a clinical trial in Australia, Kirsty fired off a chance email that would change her trajectory completely and see her become the first woman in Australia to undergo the surgery and successfully receive her mother's uterus. She subsequently became pregnant and her son Henry grew and flourished in the same womb in which she herself had developed years before. Kirsty speaks of the science which saved her childbearing dreams and has already been replicated for others in Australia as momentum continues to grow for women's fertility choices.

Alexandra had always imagined being a mum, but the onset of baby hunger in her late 30s, while a long term relationship with a man who didn’t share her dream, led to a change in direction. After moving back in with her parents, a series of bad dates, time began to outrun her reproductive age, so Alexandra made the pragmatic decision to go it alone using donor sperm. What followed was a journey of discovery; leading her family through their unease and grief of an expected path, encountering strangers and health professionals quick to share opinions and assumptions. Alexandra surrounded herself with a community of people who understood and supported her, and in her memoir shares her experience of pregnancy, birth and parenting baby Quinn. Alexandra's book, Inconceivable, is a beautiful, raw, honest, and at times hilarious journey into solo motherhood, one becoming ever more prevalent amongst Australian women.

Nine years on from a traumatic birth that led to a fourth degree tear, Verity still finds herself wondering if there is more she could have done; asked a different person, articulated herself differently, said the magic words that would have got her the help she so desperately needed. The reality however, is that she pushed and pushed and pushed. Went down every avenue, was articulate in her concerns, her needs and her emotional vulnerability. Had it not been for her mother and a GP who finally listened, Verity believes her story could have had a disastrous ending. In her conversation with us, Verity is open and honest about her birth, her fourth degree tear, subsequent surgery and the toll that took, and continues to take, on her physical and emotional health. She believes that this transparency is crucial, not just for her healing but for others in her position, and there are many. With so much secrecy and misunderstanding still surrounding severe tears, many woman still feel ashamed to talk openly about the reality of living a changed life as a result. Verity speaks eloquently about this, her personal experience, her fear at falling pregnant a second time and her belief that the impact of her trauma will continue through the generations. Yet at the time, not one person even mentioned the phrase 'birth trauma'.

Married to a busy farmer and working as a midwife at their nearest hospital, Marnie’s dream was always to have her family born and bred close to home. She was just 19 weeks pregnant with her second baby, when her rural GP obstetrician found that baby's heartbeat was around half what it should have been, and diagnosed fetal heart block - a rare condition that would shape the pregnancy, birth, and first months of baby Amelia's life. What followed was the opposite of what Marnie had envisaged, with hours and hours of driving to multiple appointments, days of intense monitoring and months of uncertainty, all far from home. Impacting the whole family - Marnie is so proud of her partner Pete as he worked all hours of the day, every day, keeping the farm running; and her son Jack who quickly had to get used to spending a lot of time away from his home and his parents, something he had never done before. Marnie shares with us her incredible story of a rural family under pressure, out of their environment, in a pandemic; and of the pacemaker that finally turned Amelia's life around.

Heidi is mother to three children but her firstborn, Harry, was stillborn at 38 weeks after a seemingly straightforward pregnancy. The delivery of that news, that no expectant parent should ever hear, was done in a way that lacked the care and compassion it warranted and that memory continues to loom large. Returning home, Heidi and her family were lucky to be surrounded by love and support but there were still moments where she felt isolated and alone. That unique and difficult insight is one that guides her as she supports other families and educates health workers in her role as a Bereavement Support Worker for the Red Nose Foundation, a position that she was offered after sharing Harry's story in a campaign around Stillbirth Australia. In this episode, Heidi shares her story of Harry - how he remains a large presence in her and her family's lives and how her work with Red Nose is such an important part of the slowly improving approach to supporting families through stillbirth and pregnancy loss.

An accomplished writer, musician, journalist, broadcaster and climate activist, Sian Prior has led a fulfilling life. However, she has always felt a chasm where her child should have been and it is only recently that she has given herself the space and compassion to acknowledge the grief that has been with her throughout much of her adult life as a result The grief connected to Sian's journey of infertility and recurrent miscarriage carries its own weight, but has been further exacerbated by having to navigate her way in a society that places judgment and labels on those in her position without consideration for circumstance. Feeling that there is not enough open conversation and empathy around the complexities of being a woman without children, Sian has bravely bared her soul in her new book 'Childless' in the hope at going some way to breaking the silence. We are so glad to have the opportunity to have this important conversation on Pregnancy Uncut.

Claudine had been having a normal second pregnancy but when her 20 week scan showed abnormalities and she received the heartbreaking news that her baby, Sophie had severe Spina Bifida, her and her husband had two weeks to make the hardest decision of any parent. Soon after, Claudine fell pregnant for a third time and took every recommended precaution but again, this time at 18 weeks, she received the same devastating news of Spina Bifida with baby Willow already showing signs of multiple complications. Claudine and her family once again had to say goodbye. Feeling strongly that their family was still not complete and that their daughter Eliza should have a sibling, Claudine and Dave gathered the courage to try again but their 16 week scan revealed that despite all odds this baby too had Spina Bifida. This time, however, them receiving this news coincided with the first intra-uterine surgery being performed in Australia and suddenly they were faced with possibility. Claudine shares her incredible story of the heartbreak, hope and groundbreaking science that has created and shaped her family.

Following years of masking and unanswered questions, Annie was finally diagnosed Autistic and ADHD when she was in her late 20s, a delayed trajectory that is not uncommon in women on the spectrum. Annie has also faced several challenges including a history of sexual assault, PTSD, Ehlers Danlos syndrome, and complex mental health (including an eating disorder) . In this episode of Pregnancy Uncut, Annie shares her experience of navigating pregnancy and birth as a neurodivergent woman. She shares how important it is for maternity care providers to understand and embrace the unique care considerations for Autistic individuals, from information sharing, planning and communication, to sensitivity to touch, light, and noise in the birthing space. Thank you Annie for sharing your important story with us at Pregnancy Uncut.

Kim and July met at an all-girls school. But when deciding to embark on a relationship, Kim had one important consideration; he identified as male, and wished to take the necessary steps for him to affirm his gender identity as a transgender man. Several years later, Kim’s wife July faced a heart-breaking IVF journey and was unable to conceive. Faced with the possibility of never having the family they longed for, Kim made the difficult decision to pause his hormone therapy, and carry the pregnancy himself. Kim shares the challenges of accessing fertility and pregnancy care as a man, and the systemic barriers that exist to feeling welcome and accepted in this highly gendered space.

Portia has, in her own words, always lived in a larger body. Even when she adopted excessive and almost disordered eating and exercise habits, her body mass index (BMI) remained in the ‘‘overweight’ category. As a doctor working in general practice, Portia understood the significant shortfalls of the BMI as a measurement, and the poor correlation of weight as an independent marker of overall health. Portia is one of a growing group of medical professions in Australia practising HAES-aligned care (Health at Every Size). However when Portia discovered that she has endometriosis and would require medical assistance to conceive, she encountered a world of fertility medicine that she believes viewed her as merely as a number on a set of scales, rather than as a whole person. Portia shares her story of being denied access to fertility treatment based purely on her BMI, and the frustration, guilt, and shame that these interactions caused. Portia describes how weight bias in medicine causes harm both on a personal and systemic level, and shares how her personal story provides hope for improvement and change.