Pregnancy &
Diving
::
Risk for Women
Divers
::
Menarche
::
Menopause &
Osteoporosis
::
Breast Implants
::
Breast Feeding
::
PMS
::
Postpartum
Diving
::
Gender
Differences
Diving and
Pregnancy
One of the most
frequent
questions people
ask is regarding
scuba diving
while pregnant.
The quick answer
is "Please don't
dive" while
you're pregnant.
We don't have
very good data
showing that
hyperbaric
pressure harms
the fetus, and
in fact, there
are case records
of HBO treatment
of pregnant
mothers with
carbon monoxide
poisoning
without adverse
effect on the
fetus. However,
the fetus does
not have the
protection of
the lungs in
filtering out
the bubbles as
does an adult.
The Russians use
HBO to treat
high risk
pregnancies and
report 54/700
cases of
pulmonary
pathology with
poorly
controlled
studies.
Anecdotal cases
reported:
1. Bangasser
Survey 1978-no
increased
defects
2. Bolton Survey
1980-higher rate
of fetal defects
in 40/109 women
who did not stop
diving, with two
major cardiac
anomalies,
multiple
hemivertebrae,
absent hand, VSD,
coarctation,
pyloric stenosis,
and birthmark.
None in group
who stopped.
3. Turner Case
Report-1982.
Multiple
anomalies in the
fetus of a woman
after 20 dives
in the 15 days
after her LMP.
4. Fife Study
1991. 1037
female divers -
only 1.4% dived
while pregnant.
Studies on
pregnant sheep
are particularly
telling in that
the sheep
placenta is very
similar to that
of the human.
These sheep
studies of DCS
all showed high
rates of fetal
death,
particularly in
the fetuses that
had been
instrumented,
probably due to
the bubbling
that crossed
into the
arterial
circulation via
the patent
foramen ovale.
"The same woman
who will not
drink coffee or
smoke during her
pregnancy will
want to know why
she should not
dive. In this
litiginous
society there is
only one answer
"no diving while
pregnant or even
trying to
conceive".(Dr.
Maida Taylor).
No major studies
prove it unsafe
but the hazards
are there.
Presently, every
HBO treatment
chamber does not
allow female
personnel who
are pregnant to
act as tenders.
Since diving is
an entirely
elective
activity for 99%
of all women
divers, the
obvious choice
would seem to be
not to dive. If
one has been
inadvertently
diving while
early in her
gestation, there
is no good data
which would
justify an
abortion.
--------------------------------------------------------------------------------
Diving in Very
Early Pregnancy
If you are
planning a
perfect holiday
for diving, sun
and you really
want to try and
conceive on the
first three days
of your ten day
holiday, what do
you do about the
possibility of
damaging the
embryo?
Bottom line -
you should
probably go
ahead and
completely enjoy
your dive trip.
The reasons are
multiple. First,
a normal couple,
actively trying
to achieve a
pregnancy,
actually is
successful only
once in three or
four months of
trying to
conceive - so
the odds are
that you won't
get pregnant on
this trip
(although it's
certainly not
unlikely).
Second, the
embryo does not
actually attach
to the wall of
the uterus for
about seven
days, receiving
its nourishment
from fluids
secreted by the
Fallopian tube
and uterus. Even
though
attachment to
the wall of the
uterus occurs
about a week
after ovulation,
it is later in
pregnancy (at
least another
week to ten
days) before
there is any
effective
maternal-placental
blood
circulation. The
major theory for
the cause of
fetal
malformations
associated with
diving concerns
the possibility
of transfer of
intra-vascular
bubbles from
mother to fetus.
As there is no
effective
circulation in
the earliest
stages of
pregnancy we are
considering,
this is possible
cause is not a
concern.
Third, many
thousands of
women have been
diving
unknowingly at
the same early
stage of
pregnancy you
might be in -
there is no
evidence of an
increase in
miscarriages or
other problems
in these women
who have been
diving around
the time of
conception. In
fact, before
pregnant women
were advised not
to dive, several
studies looked
at women who
dived throughout
pregnancy.
Although we no
longer recommend
diving during a
recognized
pregnancy, there
is no solid
scientific data
to prove that
diving is
dangerous to the
fetus.
Finally, the
very early
embryo is still
composed of
cells which have
not yet
undergone
differentiation
- that is, one
cell isn't
destined to be
the heart,
another the left
arm, etc. If any
single cell is
damaged at this
very early stage
of pregnancy,
other cells can
"step in" to
form the needed
structures. Only
later, after
differentiation,
will damage to a
single cell
likely result in
an abnormality.
Martin M.
Quigley, MD
(Certified in
Obstetrics &
Gynecology and
Reproductive
Endocrinology)
Consultant for
Diving Medicine
Online
--------------------------------------------------------------------------------
Return To Diving
After Pregnancy
--Uncomplicated
vaginal delivery
The diver may
return to diving
whenever the
uterus has
returned to
normal size,
when there is
minimal vaginal
discharge and
when the
physician allows
a resumption of
marital
relations. This
period of time
can be variable
and must be
individualized
for the person -
but is usually
anywhere from 4
to six weeks
post-partum.
--Cesarean
section delivery
Resumption of
diving should
await the go
ahead of the
physician. Added
to the factors
above are the
wound strength
of the incision,
the degree of
physical
rehabilitation
of the patient
and whether or
not there is any
blood loss
anemia, which
requires
correction.
Again, a waiting
period of 4-6
weeks would seem
reasonable if
there were no
complications
from the
surgery.
