Podcast Episode #81

6 Week Check - What to expect: Dr Miranda Bradley from Thrive Perinatal

What to expect from a 6 week or postnatal check?

The postnatal or 6 week check is really important for both mum and bubs after the birth.

In the episode with Dr Miranda Bradley – a GP, mum of three, and founder of Thrive Perinatal, we discuss:

What is a 6 week check?
What does a 6 week check involve?
Why is the 6 week check so important for a mum (+/- partner) and bubs?

Dr Miranda Bradley takes us through a few things that she checks over with both mums and bub, including discussion about:

Breastfeeding
Baby growth / development
Contraception options
Vaccination options
Hip dysplasia
Mental health

This is a brilliant episode with Dr Miranda Bradley who is a mum of three and General Practitioner working exclusively in perinatal health. She is founder of Thrive Perinatal, a unique GP medical service providing care to future, expectant and new mums and babies in Melbourne.

Thrive Perinatal is Miranda’s vision to provide a different and more comprehensive perinatal GP service. A “one stop shop” where she can provide more time with future and new mums, to help with womens’ physical and mental health, assist with fertility or pregnancy concerns, baby health concerns, breastfeeding, parenting skills or any other perinatal issues.

I trust you will find this episode really informative. Sit back, relax and enjoy!

Episode Links

Melbourne Vaccine Education Centre: https://mvec.mcri.edu.au/
Thrive Perinatal Website: https://www.thriveperinatal.com/
Thrive Perinatal Instagram: @thriveperinatal

Links to previous podcast episodes discussed:
Paediatric physio: https://www.fitnestmama.com/podcast/how-do-i-know-if-my-baby-is-reaching-milestones/
Baby wearing: https://www.fitnestmama.com/podcast/the-magic-of-babywearing/

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6 Week Check - What to expect with Dr Miranda Bradley

Transcription

DISCLAIMER:

Please note that this transcription was completed with computer voice recognition software. Quite often unanticipated grammatical, syntax, homophones, and other interpretive errors are inadvertently transcribed by the computer software. Please disregard these errors. Please excuse any errors that have escaped final proofreading.

INTRODUCTION

If you are pregnant or you’ve recently had a baby, this podcast is for you. I am your host, Kath Baquie. A physiotherapist working in women’s health and mum of three. Join me each week as we dive into all things pregnancy care, childbirth and postnatal recovery. Helping you have a wonderful pregnancy and after birth experience. And don’t forget to hit subscribe so you don’t miss any episode.

KATH BAQUIE

Well, hello there. It’s great to have you here for another episode of the FitNest Mama Podcast. In this episode today, we are discussing the 6 Week Check After Having A Baby. This is a brilliant episode with Dr. Miranda Bradley, who is a mum of three and General Practitioner (GP) working exclusively in perinatal health. Dr. Bradley is the founder of Thrive Perinatal. A unique GP medical service providing care to future expectant and new mums and babies in Melbourne. Thrive Perinatal is Miranda’s vision to provide a different and more comprehensive perinatal GP service, a one stop shop, where she can provide more time with future and new mums to help with women’s physical and mental health. Assist with fertility or pregnancy concerns, baby health concerns breastfeeding parenting skills or any other perinatal issues.

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In this episode today, we discuss what a 6-week check is and what it involves. Dr. Miranda Bradley also discusses why is the six week check so important for mums and partner as well as your new baby. Dr. Miranda Bradley talks us through a few of the things that she comprehensively checks over with both mums and bubs including discussion about breastfeeding baby growth and development contraception options, vaccination options, hip dysplasia, mental health and more. So if you’re pregnant, or you’re about to have a 6-week postnatal check, this episode is for you.

Before I do dive in, I do just want to let you know coming up very soon. If you are listening to this in the few days after this has been released, there is a live 3-day Postnatal Workshop which is on again. It hasn’t been held for six months. But kicking off Monday, second of May, come and join us it’s fun, it’s interactive, and it will leave you feeling more confident and empowered about the steps to take to help you get back into fitness post birth. In these three days, we will cover pelvic floor readiness to how to know if your pelvic floor and core is ready, body strength stability. And we’re going to talk about a step by step plan to help you know exactly the next steps you need to move forwards in your postnatal recovery. It’s free, it’s live and I am here to support you during these three days. So head to fitnestmama.com/free for the link. And the link is also in the show notes. And if you’re listening to this in few months from now, still go and check out the link because there will be a waitlist, which you can pop your name on so that you find out when it is next on.

All right. Let’s dive into this episode.

So Miranda, thank you so much for joining me today on the Fitness mama podcast. It’s great to talk to you all about the 6-week check-up. So thank you.

DR. MIRANDA BRADLEY

Thank you for having me. It’s a pleasure to be here chatting to you today.

KATH BAQUIE

Fantastic! So could you just give the listeners a quick little introduction. Who you are? Why you do what you do like what made you start Thrive Perinatal? Would love to hear about it.

DR. MIRANDA BRADLEY

Right. Well I’m a GP. I have a special interest in women’s health. I guess I’ve always even through medical school and through all my hospital jobs being drawn to looking after mums, babies anything pregnancy related. It’s what I love and what I’m passionate about. Thrive Perinatal. So Thrive Perinatal is really me fulfilling my vision and dream to be able to provide better, more comprehensive care to mums and babies. Working as a GP, I so often will have mums come in, in especially those first six weeks after birth. And everything would just be falling apart. I mean, many women things don’t fall apart. But for many women, they do and they’d come in for their 15-minute appointment and I just couldn’t even scratch the surface of trying to help them fill their shoes. So it had been an idea bubbling away for several years that I just really want to go into these women’s homes and do home visits, spend an hour, an hours and a half with them and try and help sort out everything bit of a one stop shop. So this was something that I’ve just had on the back burner for a while and being I’ve got three kids of my own I’m working never really had time to, to think any more about this. And then COVID hit and I being a general practitioner working in the Melbourne CBD, suddenly it was a ghost town and I had a little bit more time on my hands for a period of time to think about, well, maybe I can make this vision a reality. So I started looking into how I would go about that, because it’s not really a service that existed before GPs service specifically for mums and babies during this time. So, so I had to figure out whether it was viable. And then I went ahead and did it. So I guess it started off as a home visit service, then with COVID, then introduced telehealth, which suddenly made it a whole lot more accessible to be able to not just do home visits, but video telehealth, which is fantastic for new mums who are stuck at home with their babies. And now I’ve extended that into face to face appointments. So yeah.

KATH BAQUIE

It’s amazing. And I still distinctly remember my six-week check-up with my first baby and being in and out. And they said, yeah, everything’s going really well. That’s great. We’ll see you in your next pregnant. But a bit of a jaw dropping moment, like my whole life is turned upside down. My body feels different. What do I do with this baby? And I remember going back onto the street and thinking oh my god, help. So fantastic. So let’s start with start, why do women need a six-week check-up?

DR. MIRANDA BRADLEY

Right, well, 6-week check-up is, well, first of all, what is a 6-week check-up? It’s essentially to a routine medical review usually done by GP. Why do women need it? Well, it’s a six-week check-up for me is not just for women, but for their baby as well. So we’re sort of talking about the mum and for baby. What do they need it I think? it’s really just a formal review, but not just a physical review of mum and baby. But an emotional review, touching base with mum, especially checking in on the mental health side of things and emotional side of things. But, but also social sort of examination as well, making sure that, you know, seeing how they’re coping how they’re getting on and providing that extra support.

KATH BAQUIE

Yeah, okay, so it sounds like it’s quite involved. Let’s break it down. So when it comes to the baby, at the six week check, What are some of the things you might examine with the baby or talk about?

DR. MIRANDA BRADLEY

Sure. All right, so, well, I might backtrack one step and say that when I do a six week check, I encourage mum to bring in their baby health book and also a list of any questions or concerns. So often mum will have mum or both parents, to be honest, it’s lovely to have that there as well. Have them bring in any list of any issues concerns that they might have about their baby. So I do like to find out, look through the birth history, and ask them to bring in their medical discharge summary from the hospital too, because that has a whole lot of information about mum and baby on it that can give me a bit of a background, whether there were any issues or concerns. So with the baby, if I start with that, I would I like to know a bit of the history first. So I like to know whether there are any issues during the pregnancy, whether there are any issues with baby during birth in recovery was baby did baby need any resuscitation? Do they need to go to special care nursery for a period of time? So that really gives me that background and we often will have a chat about these things going through mums concerns, but the examination I guess is probably the last part of what I would do after getting a little information.

KATH BAQUIE

So much to cover.

DR. MIRANDA BRADLEY

Very. Very. It goes on forever.

KATH BAQUIE

Yeah, absolutely. I know that in Australia, there’s the maternal child health nurse check-ups, and they also look at a lot of baby stuff. Is there anything you would do in addition or separate to that?

DR. MIRANDA BRADLEY

I think a lot of what we do and as healthcare workers were trained for, sort of similar, but I guess we do have that extra medical side of the examination. I mean, I will generally apart from well, maybe if I take you through what an examination involves when I do it. First of all, just generally looking at the baby, seeing if there’s anything that looks unusual or different. Looking at their skin, seeing if they’re jaundice, they could be bright yellow. We check their eyes. We screen for congenital cataracts. I will always check a baby’s mouth. Look for oral thrush. Check for check their palate look if there’s any obvious tongue tie, things like that. And basically it’s top to toe work my way down. So next, I’d move on to listening to their heart and heart and lungs, making sure there’s no signs of any sort of cardiac problems, feel their tummy, checking the hips is a big one. And mums will parent will see that as health professionals were always checking their baby’s hips because we’re screening for a hip dysplasia condition which is really important and very important not to miss. Checking the baby’s skin for any rashes. Newborn rashes, especially those first six weeks are incredibly common. Most of them are benign and nothing to worry about. But every now and then there can be ones that we do need to be looking into further so. And then there’s a neurological examination. So apart from just the physical side of things, we’re looking to see, is this baby developing normal. Are they meeting their milestones? Are they moving all limbs equally? Could there be any signs that there’s anything else going on? We checked baby’s reflexes as well. And yeah, it’s, it’s really as a comprehensive sort of examination top to toe.

KATH BAQUIE

Yeah, brilliant. So that could take the whole session in itself, couldn’t it? Without even getting to the mom’s side of things.

DR. MIRANDA BRADLEY

And that’s why another reason I’ve chosen to do what I’m doing with Thrive Perinatal, because you can’t do this in a 15-minute appointment.

KATH BAQUIE

Yeah, absolutely.

DR. MIRANDA BRADLEY

In my six week checks, I would always, if I had the opportunity, and I was caring for women during pregnancy as well, I would say please, book an hour. 30 minutes for mum, 30 minutes for baby. If we don’t use the time, that’s fine. But at least we’ve got the time if we need it.

KATH BAQUIE

Yeah. And I just love that. I think that’s why I wanted to get you on the podcast today. Because I just think this is so special. And for mums to know that this sort of service does exist, and they just don’t need to be in and out within a 10 to 15-minute appointment is really important. Okay, so let’s move. Is there anything else you want us to talk about baby?

DR. MIRANDA BRADLEY

I guess, yeah, if I get time I do like to be able to cover, I’ll talk a little bit about what to look out for if you’re worried about baby, because suddenly, you know, mum and dad become mum and dads, and they’ve got this baby to care for and they don’t know, what’s normal? What isn’t normal? When to go to the GP? When to go to the emergency department? What’s important and what isn’t? So if we get time, then I’d like to cover that. And also vaccine counselling. There’s a lot of discussing, well, discussing the routine. Vaccinations that are available, but there are also additional vaccines. And I do like to cover that as well. And so make sure that parents are informed that there are extra additional vaccines that they can get which they pay for privately, that can help protect bub.

KATH BAQUIE

Okay, could you run through a few of those?

DR. MIRANDA BRADLEY

Okay.

KATH BAQUIE

I still put you on the spot.

DR. MIRANDA BRADLEY

So I guess the extra additional ones, you might have heard of meningococcal vaccines. There’s several different strains of meningococcal virus, which is a bacterial infection that’s extremely rare, but really quite dangerous and potentially lethal to infants. There are vaccines that can help protect against that. In particular, there’s two different ones. So there’s one called the B strain, and there’s a vaccine called Bexsero. And there’s another one which is given when the baby is 12 months old, but this can be given as early as six weeks. And it’s a fourth factor for anyone. So it’s a CWY strain, and that goes by different brand names, Nimenrix and Bexs. So there’s the two different meningococcal vaccines that that can be given.

KATH BAQUIE

And I’m sure a question on everyone’s mind is, are there any potential negative effects with that vaccine?

DR. MIRANDA BRADLEY

Oh, vaccination such a topical at the moment, isn’t it?

KATH BAQUIE

Sorry, we weren’t going to get on to vaccination. But here we are.

DR. MIRANDA BRADLEY

Yeah. It could be an hours of hours of discussion about vaccines.

KATH BAQUIE

Or any links that you could recommend mums if they want to learn more about this, perhaps have you got any links that we could link in the show notes?

DR. MIRANDA BRADLEY

MVEC. M-V-E-C. If you type that into Google has really good information. It’s a government website. There can give you a pros and cons. I mean, essentially, if I break it down in a nutshell, I’m very pro vaccination, if there’s anything I could possibly do to protect my children against any, any potentially deadly diseases, I would do it my three children are all vaccine fully vaccinated. As I tell my patients, their vaccs up to their eyeballs, and I’ve got that feel comfortable knowing that if that I’ve done everything I can to protect them.

KATH BAQUIE

Yup. Okay.

DR. MIRANDA BRADLEY

But in summary, the vaccines, any side effects are extremely rare. The Bexsero vaccine, which is the meningococcal Bvaccine, does have a higher rate of babies a bit more irritable or potentially having a fever. So it’s recommended that they get a dose of baby panic paracetamol 30 minutes before the vaccine. That’s the only vaccine we do that for. But on the whole, you know, if you can protect your child against meningococcal disease, I think it’s well worth it.

KATH BAQUIE

Yeah, absolutely. And I remember, do you have to go back for a few boosters of that?

DR. MIRANDA BRADLEY

Yes. Correct. So not just one.

KATH BAQUIE

Yeah. So I actually found that one really, yeah, I found that personally hard to keep track of because especially when it got to my third child, cause it’s not part of the normal vaccination record, so to speak. And I had to personally sort of follow up on that with my GP and I think that by the time it got to my third, I’m sure she got it but in the end.

DR. MIRANDA BRADLEY

Yeah, you get that in the end.

KATH BAQUIE

And then I remember that being a struggle to stay on top of what I needed or what the options were.

DR. MIRANDA BRADLEY

Yeah, so the younger the child, the more vaccines they need, because their immune system is immature. They need boosters. That’s why they routine vaccines are given at two months, four months, six months and 12 months. So they need these boosters. And the same goes for the meningococcal vaccines as well. With the timing, I often at the six week check if they’re, the parents are keen to get these meningococcal vaccines, they can fit in quite nicely with the same intervals as your other vaccines, or even some parents want to have a little think about it. In which case, I say, Well, you could get them done at the four month vaccines and the booster at the six month vaccines, and then the final one at 12 months. So the four 6-12 months fits in quite nicely with these meningococcal vaccines.

KATH BAQUIE

Okay, that’s great. So what we’ll do, can you just say that would say that one more time?

DR. MIRANDA BRADLEY

M-V-E-C. MVEC

KATH BAQUIE

And I’ll link that in the show notes, ladies. So just have a look in the podcast and you should see it. Thank you. So that’s great. So you can check that out whether or not. Yeah, go for it.

DR. MIRANDA BRADLEY

As you say there are other additional optional extras as well. But usually when they’re a little bit older, but they include I’ll just list them so that we’ve been complete here. Flu influenza vaccine can be given after six months. A chicken pox booster vaccine can be given after the child is 18 months and I really love parents to know this because it is recommended that chicken pox vaccine is given with a booster shot. But the government here in Victoria only fund one vaccine not 2. So after the about from a month after they’ve had their chickenpox vaccine, when they’re 18 months old, you can get them their booster, and it brings their immunity up from about 85 to about 97%.

KATH BAQUIE

Okay, amazing. Thank you for running through because I know vaccinations can be a bit complicated, bit daunting. It’s a lot of information suddenly. So thank you for giving us that information, those resources. That’s great.

DR. MIRANDA BRADLEY

That’s okay. And it’s a lot of vaccines to give to one child at one time, and a lot of parents struggle with that. But it is perfectly safe to be given all at once. And I think it’s just that knowledge that they’re protected, I think is really important.

KATH BAQUIE

Absolutely. Okay, on that note, with COVID vaccination, how early can you give that for babies?

DR. MIRANDA BRADLEY

That is currently not licensed in babies. It is licensed for over five year olds.

KATH BAQUIE

Of course, I know that my four year olds.

DR. MIRANDA BRADLEY

No. Not there yet. Yeah. And I don’t think it’s going to be anytime soon. They really don’t think it’s particularly effective in that young age group. And, again, it’s weighing up risks and benefits. So children and babies and infants really, they’re doing pretty well. If they get COVID. There, it’s very rare that they’re going to get really sick, so.

KATH BAQUIE

Yeah. Okay. Moving on. So we’ve talked quite a lot about baby. About vaccinations. One question I did, have you talked about checking the hips and I know that’s something that gets checked a lot with maternal child health nurses.

DR. MIRANDA BRADLEY

Yes.

KATH BAQUIE

Is hip dysplasia something that can be checked a lot when they’re young, and then it sorts of becomes more apparent as the baby grows? Is that why we have so many checks for the hip dysplasia or is it just really important, we don’t miss it?

DR. MIRANDA BRADLEY

I think it’s really important, we don’t miss it. Hip dysplasia is essentially where a hip joint is a ball and socket joint, the socket is quite shallow and the hip can move around in in worst case, some baby’s hips are actually dislocated at birth. It’s something that we can treat 100% successfully. And parents may have seen babies in a little hip brace where their hips where their legs are sort of out in froggy position called Spiker, or Pavlik harness, and being able to detect any issues with this formation of the hip at a young age is crucial because if, if anything is found, if this hip socket is found to be shallow, and or there’s any concerns at all, we can by using this by referring on and having a harnessed popped on, they can avoid getting hip arthritis in their 20s or, you know in for ones that have been missing. in times gone past, adults might be needing hip replacements in their 20s. And that’s just such an important thing. So we always check hips, we look at creases, I get many referrals from maternal child health nurses sending in babies, to me because they’ve noticed that the creases on their thighs, those cute little creases in their chunky little thighs are uneven. And sometimes that can suggest as an issue, not always, of course, but if there’s ever any doubt I refer on for an ultrasound, and an ultrasound. There’s no radiation involved. It’s completely safe. And I always, on the side of caution with hips.

KATH BAQUIE

And you need to have a GP referral for an ultrasound. Is that correct?

DR. MIRANDA BRADLEY

That’s correct. Yes. Yeah.

KATH BAQUIE

Thanks for clarifying that. And for anyone listening is interested in learning more about hip dysplasia. We have had a relatively recent episode with a paediatric physiotherapist who talks about it a bit as well. And there’s even some information, we’ve got an episode on wearing on baby slings, baby wearing, and she talks about the different slings that are recommended to help support the hips. Is there anything new? It’s all linked that in the show notes too. Have you got anything to say about slings and those harnesses?

DR. MIRANDA BRADLEY

I think. I think the important thing with bub is that they need to be able to get their little legs into froggy position. And there’s, you know, swaddling your baby, it’s important to know that if you swaddle them tightly, their hips still need to be able to move around because if they’re lying in a straight position with legs straight out there, it’s not the position that favours this improving the hip joint formation.

KATH BAQUIE

I always used to joke with my husband because I am, I was always a shocking swaddler. You know how some mums really have the neck and their babies beautifully swaddled up as a joke, because within 10 minutes, my baby was loose. But I always said that’s great for their hips.

DR. MIRANDA BRADLEY

Exactly. Oh, it was a Velcro swaddler mom, I gave up on them on the muslin cloths and into the into the little Velcro things at the time. So but then with their legs free so that that was my children were born in Singapore so well. So that was you sort of get use what’s available. Depending on where you are at the time.

KATH BAQUIE

I haven’t heard of the Velcro swaddles. Are they still around?

DR. MIRANDA BRADLEY

It was really just a little cloth, cloth swaddle but you’d sort of stick it around the front over the arms when there’s a little bit of Velcro. So I don’t think that’s my term for it.

KATH BAQUIE

Okay, let’s move on to mum. Can we move on to mum?

DR. MIRANDA BRADLEY

Absolutely. Let’s move on to mum. So, mum, I always like to find out how they going and debriefing a bit about their birth, somebody fell through. Other women don’t sail through. And people I think can underestimate the trauma that women can experience. Doesn’t matter what happened, they can be struggles with that. I remember, just one of the women, one of my patients comes to mind who her labour was so quick, she delivered within an hour and a half her first child and it was just completely different to what she anticipated and what she thought it was going to be. And it just something like that can really throw you and can become a struggle and so I think debriefing, I do like to spend some time and finding out how it went and their feelings about how it all went.

KATH BAQUIE

So great to hear. Because I think that something that can’t be underestimated the power of debriefing, especially with a medical professional, it’s that much different I think to debriefing with the family, which is just family or friend, which is still important. But we have this exact conversation with Helen Nightingale talking about birth trauma and debriefing. So I’ll link that in the show notes too.

DR. MIRANDA BRADLEY

Yeah, good, good. Please do. It’s so important. I guess I’ll then move on to what if they have any concerns, and often they will often there’ll be a long list again, which is why I like long appointments. But the sorts of things that women experienced after birth, you know, issues with, with pain recovery from severe infection, or their perineal pain from vaginal birth bladder function, and that comes certainly like to ask that whether they’re having any leakage, incontinence, any issues, and that’s where people like yourself come in, I will always ask whether they’ve seen a pelvic floor physiotherapist, because I think it’s a really important and good idea to get that expertise. Current baby feeding really likes to take good history to see how things are going whether they’ve chosen to bottle feed breastfeed. So many women think that they’re going to be able to breastfeed or certainly hope to breastfeed and things just don’t turn out the way they had hoped. So I’d like to spend a bit invariably spend a lot of time talking about feeding, and I have a special interest in breastfeeding medicine. So I do like to help them with those issues as well. Contraception. Oh sorry?

KATH BAQUIE

Oh, well, going back to the breastfeeding

DR. MIRANDA BRADLEY

Yes.

KATH BAQUIE

Can you help with things such as? Do you talk more about like the attachment or timing? Do you look for tongue tie? Like, what sort of things you help?

DR. MIRANDA BRADLEY

All of the above. Yeah, yeah. So I’ve done upskilling in breastfeeding medicine. So a lot of my consults are just mum and baby breastfeeding consultations, but I guess because I’ve got that medical background. You know, if they’ve got mastitis, then I can give them their antibiotics for them or status. It’s it’s really a bit of a one stop shop where I can try to deal with everything. Yeah. Contraception. Often I know we have a bit of a laugh about it, because it’s six weeks. There’s a lot of women who don’t need the contraception at that stage just yet and for the foreseeable future. There are other women who jumped back into being sexually active and it’s really important to know that breastfeeding, it’s a very good form of contraception, but it’s not 100%. So we like to, I like to discuss options that are available for that.

KATH BAQUIE

Could you run through the top three? I guess most popular forms of contraception after having a baby?

DR. MIRANDA BRADLEY

Yep, sure. Well, the easiest one that many women choose is just to use condoms with a lot of lube. And a lot of women aren’t ready to start taking anything hormonal at that point. That’s a personal choice. So that would be you know, one of the three. The Mirena is a fantastic form of contraception to space between babies. The Mirena is the entry uterine device, or used to be known as a coil. It’s a device that is popped in, I don’t do them. But there are other practitioners who do your gynaecologist can pop them in or family planning Victoria, the other people to approach to have a Mirena put in, and it’s a fit and forget type of contraception. So if we compare that to the third option I was going to mention which is the mini pill, or even the standard pill that it used to be the advice that you can’t be on the normal contraceptive combined pill after birth, because it interferes with milk supply, these guidelines have changed, depending on the individual as to whether I’ll prescribe it or not, because I still like to be a little bit conservative with that. But going back on the pill, certainly an option. Problem is when you have a new baby, trying to remember to take a pill at a certain time every day becomes really hard. And it’s the last thing on the agenda really, when for sleep deprived mum. So I think if people ask, what would I recommend, and if the Mirena is certainly at the top of the list.

KATH BAQUIE

And out of interest, why would you, because I know there’s copper, the copper IUD? When would you use the Mirena over the copper IUD? And what’s the difference?

DR. MIRANDA BRADLEY

I would use the Mirena almost every time over a copper IUD. Mirena has a very low dose of progesterone hormone on it. So what that does is that it actually thins the lining of the womb, so that it reduces menstrual bleeding. Now, when women are breastfeeding, they’re often not bleeding anyway. So it’s a really good time to start that. Copper IUDs have their role in women who don’t want the hormones on the device. But in saying that progesterone is at such a lower level lower than when you take the oral pill as well, that it really has very little hormonal effect. Copper IUDs main side effects of increased period pain and also heavy bleeding. So it’s just not as commonly used anymore. In fact, it’s really quite rarely used.

KATH BAQUIE

Interesting, okay. Now I want to backtrack as well, because you mentioned lubric condoms with lots of lubricant. And I just want to add my little two pennies worth 2. Because sometimes six can be uncomfortable of having a baby. And when you’re breastfeeding, as we know there’s your body’s very low oestrogen and that can cause vaginal dryness. So big tip for anyone who’s thinking they’re ready to get back into having sex, lubricant. Lots of lubricant, because lubricant, yeah, for vaginal dryness, just to help reduce, well, help comfort levels, really.

DR. MIRANDA BRADLEY

That’s right, and there’s lots of different types of lubricant that you can experiment with as well that can make a difference. And then if there’s still problems, I do like women to know that the vaginal oestrogen is an option as well, if you GPs happy to prescribe that. And I do think it’s under prescribed is very low option into the body. It’s a lot lower dose than you’ve been taking the contraceptive pill, but it can make a massive difference down below to comfort having any urinary symptoms or pelvic flourishes that that’s when pelvic floor physiotherapist like yourself come in. Because you’re you guys are really good at having a good look down there much more. I mean, you do that all day. So, you know, I like to refer on to good pelvic floor physio.

KATH BAQUIE

Yeah. And we’re often referring back to the GP for them to discuss with oestrogen. Yeah, for the estrogen because if there’s like prolapse that it’s there’s been some great research to show topical estrogen can really help to improve those symptoms. So lots of reasons why topical estrogen might be effective. So yeah, music to my ears to hear. That’s great.

DR. MIRANDA BRADLEY

And especially for breastfeeding mums, because it’s a breastfeeding really does drop these levels of estrogen. They plummet and women can get all sorts of funny little symptoms, but that’s certainly one of the most common is vaginal dryness.

KATH BAQUIE

Yeah, and if we think about the two times in our life, when we’re more likely to have pelvic floor issues, there’s a spike around having a baby. And then there’s a spike around pre post menopause. And both those times if we think our body is lacking estrogen, and correct me at any stage around of it. But the vaginal dryness set also if we can think about a nice plump tissue, like a nice, what’s another word for it, but low estrogen can thin out tissues and make them less plump. And that’s when symptoms of leaking and prolapse and painful sex and that sort of thing might become more prevalent. So that’s where the topical estrogen is really local to that area as Miranda said, so yeah, and ican be fantastic.

DR. MIRANDA BRADLEY

And I think it’s interesting when I will examine a woman or do a pelvic examination before estrogen, and then even two weeks after estrogen, the whole appearance down below looks, as you say plump, healthy, moist, lubricated, and you just know women are going to be a lot more comfortable.

KATH BAQUIE

Yeah, fantastic. Okay, good to know, where were we? So we’ve talked about mum, we’ve talked about her the mental health side of things debriefing, we’ve talked about contraception, breastfeeding.

DR. MIRANDA BRADLEY

That’s right. Examinations, sometimes I will examine women or have a look at the perineum. It’s not every time though it really does depend on the individual. Some mums have breezed through have no issues, no concerns, but there’s a lot of women who might have had a tear or an episiotomy, or they just want to know that everything’s healing nicely, and I might check their searches and have a look down below. Or another common thing is women might have an unusual, unusual discharge, or a little bit of bleeding that’s going on for a bit a little bit longer than expected, in which case, I might do a pelvic examination, take a swab. Sometimes I’ll do a sparkle screening tests as well used to be known as pap smear if they do, but not for everybody.

KATH BAQUIE

Yeah. Okay. Good to know. Do you find any common things of topics that mums want to discuss at the six-week mark? Like what would be the biggest couple of things that are really prevalent to a new mum? Would it be the birth, the debriefing from the birth? Would it be difficulties breastfeeding, like, what would you say the biggest challenges a mum might be facing in this time? And I know, it’s probably a really hard question to answer.

DR. MIRANDA BRADLEY

Yeah, look, I guess the most common one would probably be feeding issues and breastfeeding issues. And not I guess, not feeling that they’re having problems actually, with their lash with their feeding with their nipples with nipple damage. But then there can be knock on effects from that too, such as things like blocked ducts, mastitis, so I do see a lot of that. And then there’ll be those women who have an amazing journey with their breastfeeding, no issues whatsoever, but they aren’t coping emotionally, I suppose. Because suddenly they’ve been it’s just been them and their partner. And then overnight, they’ve become a parent, they’ve got this new baby, their relationships change with their partner, they’re sleep deprived, they’re emotional, they’ve got the hormones raging, and lack of often lack of support, and at six weeks, that’s probably the time when a lot of the dads go back to work. So I have a lot of women who have that fear and trepidation, that what’s going to happen now, because suddenly, it’s just going to be me at home. So I do spend, I do a lot of perinatal mental health, I guess, I’m trying to help women manage this, sort of normalize it a bit for them, but also give them that support referral, if needed to.

KATH BAQUIE

And when you say referral, referral to what sort of services?

DR. MIRANDA BRADLEY

It depends on what’s going on. I mean, a lot of the time, women can feel a whole lot better after just knowing that what they’re feeling is normal. And when I say normal, I’m not minimizing it at all, I’m really just them knowing that it’s okay to have these feelings of, of fear, guilt, sadness, you know, all of the things that go with it. So sometimes they won’t need any referral at all. There’s a lot of online mental health resources as well. And so I’ll often point them in the direction of that. And if I’m in a good you ask about online resources, the head to help website has is a government website that can show you all the resources that are out there. So that’s a good starting point. Or you can have a look at my Thrive Perinatal Insta feed. And I’ve got a link there on one of my tiles with a few of the main ones there too.

KATH BAQUIE

Fantastic.

DR. MIRANDA BRADLEY

And then referral to psychologists obviously, or other specialized mental health therapist, psychiatrist, whatever is required really?

KATH BAQUIE

Yeah. Okay, so that’s great to know, a lot of support available. So a really good first support to call is your GP. To talk through those issues and concerns. So to wrap this up, if there’s a pregnant mum listening today, or any final words of wisdom to her, or any bits of advice you’d part with?

DR. MIRANDA BRADLEY

Well, I guess because the topic of today’s 6-week Check, then I think it’s a really good idea to book a six week check. A lot of people have never heard of this concept, or it might it’s usually mentioned at the hospital on discharge, go see your doctor at six weeks, but a lot of women forget this in the moment. So I do think it’s nice to finalize it and book an appointment for you and for your baby. Now, women who have a baby in the private system often have their six week check with their private obstetrician, but it’s important still, I feel, to have baby checks. If they have had paediatrician, do a six week check fine. Otherwise book a time with your GP. And maybe ask if you can book a little bit longer appointment to and finding that GP who’s got an interest and experience in mums and babies, I think it’s really important because you might have a bit of a different experience.

KATH BAQUIE

Right advice? Thank you.

DR. MIRANDA BRADLEY

Oh, can I add something there? Yeah, don’t wait for six weeks. If you’ve got any concerns, the six-week mark is not, you know, it’s not suddenly like, yes, we’re going to detect everything in six weeks, it’s really just picked out as a time, as suggested time, that’s good to touch base with the doctor. I like women to have a two to three week check, honestly. We can do a lot of this at a two to three week check. Because the earlier we get out onto these things, the better. Trying to nip things in the bud is really important physical and mental health. So if you’ve got any concerns, don’t wait to get checked. Get seen earlier.

KATH BAQUIE

Fantastic. And on the flip side, if you feel if suddenly realize your eight weeks and time has passed, it’s not too late either.

DR. MIRANDA BRADLEY

Absolutely. Absolutely. And it’s an opportunity. I didn’t mention in the baby check. I do like to measure baby, weight baby, check their growth patterns as well. And just make sure that everything’s tracking nicely, whether it’s six weeks or eight weeks. If you’re tying the six week check in with vaccinations, it needs to be at least six weeks because the vaccines must be given from six, eight weeks onwards. But it depends on where you’re going and who you signed for your check as to whether you’re doing that on the same day, or you can have an appointment first and vaccines on another date.

KATH BAQUIE

And I just want to chime in there as a mum, knowing that thinking, okay, there’s nothing wrong with my baby, but then just going in having a professional opinion someone to say everything’s going really well, your baby’s developing really well. Even if you thought that, I’ve personally always find that a big relief and almost like a confidence builder. It’s like yeah, you know, doing well, even. So, just that verification, I think there’s a lot of power to that.

DR. MIRANDA BRADLEY

Absolutely. And I think often new mums, that you know, it’s a hard slog, and no one’s really telling them that they’re doing a good job. And I like to tell mums, they’re doing a good job.

KATH BAQUIE

Beautiful. On that note, where can mums listening find you, Miranda?

DR. MIRANDA BRADLEY

Right. Well, I practice in Melbourne. I am now offering face to face appointments in Armadale on High Street, but I also do telehealth, video telehealth appointments as well. So people can be you know, it’s a lot more flexible people to get that advice. I mean nothing beats being face to face but telehealth is still a really great tool. My website is www.thriveperinatal.com and I have an Instagram feed, @thriveperinatal. I also have my @drmirandabradley Insta, which is more of a personal one because I’m running with a few interesting photographs because that’s one of my hobbies. But you can check out both if you like and I’m most happy to answer any queries by email. My Thrive perinatal businesses is really just me. I’m doing my own admin at this point in time. So if you send me an email, it will be me replying to you so and I’m quite happy to answer any queries.

KATH BAQUIE

Beautiful. Well, I’ll put all those links in the show notes. Thank you so much for your time today. I really do appreciate. That was really informative and hopefully reassuring. For mums who are heading into the six week check. So thank you.

DR. MIRANDA BRADLEY

Thanks for having me. It’s really nice to chat.

KATH BAQUIE

Beautiful things. We’ll catch you soon. And before I sign off, remember my team and I will be putting together the show notes for this episode with all the links that Dr. Miranda Bradley talked about. At www.fitnestmama.com/podcast and don’t forget, if you want to come and join us inside the Postnatal Workshop, head to fitnestmama.com for all the details. That’s it ladies have a fabulous day and I look forward to you joining me next week for another episode of the FitNest Mama Podcast.

Thanks for listening to the FitNest Mama Podcast brought to you by the FitNest Mama Freebies found at www.fitnestmama.com/free. So please take a few seconds to leave a review, subscribe so you don’t miss an episode. And be sure to take a screenshot of this podcast, upload it to your social media and tag me, @fitnestmama so I can give you a shout out too. Until next time. Remember, an active pregnancy, confident childbirth, and strong postnatal recovery is something that you deserve. Remember our disclaimer, materials and contents in this podcast are intended as general information only and shouldn’t substitute any medical advice, diagnosis or treatment. I’ll see you soon!

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