Hi,
My name is Katranitsa Lamprini and I love to dive! As a woman I would like to know what are the risks of diving during pregnancy and what might happen if I dive at the first 2-3 months of the pregnancy. Could something happen to the baby or are there risks for the mother? I have been asking dive instructors about this but they could not give me a definite answer. Thanks in advance!!

Dear Katranitsa,
The agreed upon medical opinion among dive medical specialists, is that diving during pregnancy is not allowed. If you dove and did not know that you were pregnant, there is no reason to panic. We would advise that you should consult with your gynaecologist/obstetrician and inform him. Someone asked me in panic if she should terminate the pregnancy and the answer is definitely NO!

In the 70’s and early 80’s we were not as strict as we are nowadays. Some of the leading diving literature, actually a diving manual, gave the advice, that if the pregnant diver wants to dive, she had to make sure that it was in the first trimester, that she dives only under favourable conditions, i.e. in warm waters, no currents, easy entry and exit and not exceed 33’ (10 msw) depth! Two entities are considered when discussing this subject: the foetus and the mother.

Experiments on humans are scant for obvious reasons and scientists relied on animal experiments in addition to questionnaires to mothers that continued diving after they got pregnant out of ignorance or not knowing that they were pregnant. They showed that the foetus could sustain damage caused by higher concentrations of Nitrogen and possible bubble formation. The direct and long term effects of higher partial pressures of Oxygen to the fetus are not clearly known. Furthermore, the foetal circulation is a more or less independent one and the passage of abnormal concentrations of gases through it, could represent a challenge to that system. There is also very recent studies indicating a shift of extra cellular fluids following the dive and that may also interfere with the foetal circulation.
The first 3 months or first trimester is definitely very crucial in the embryonic development and any interruption of the developmental process could have dire consequences or lead to abnormalities or an abortion. Other than the mechanical obstructive direct effects of bubbles, we need to consider the biochemical effects caused by mediators released from the endothelium (inner wall) of the blood vessels when bubbles bombard it. Cold, due to unplanned prolonged immersion is also a factor and can adversely affect a pregnancy.
As to the mother, several questions need to be carefully considered. With the morning sickness and the hormonal changes taking place, would she be physically fit to go diving? And what if she has to vomit under the water? Even the normal ear and sinus equalization could be affected, as pregnancy usually results in some water retention leading among other things to nose and ear stuffiness. Another aspect that complicates the matter, is what if the mother has a diving accident and needs to be treated in the recompression chamber? The effects of such a treatment would also have harmful effect on the foetus.

So, in conclusion: enjoy every minute of your pregnancy, give birth and then return to diving. If the delivery was a normal vaginal one without complications, we recommend a minimum of 4 weeks and if it was a caesarean section, the minimum of 8 weeks to allow for wound healing. Before returning to diving, the general physical fitness should be tested. A gradual approach will allow you to regain your pre-pregnancy stamina.

SAFE DIVING!
Dr. Adel Taher & Dr. Ahmed Sakr: your diving docs

If you have any medical queries please let us know at jochen@redseacollege.com. The most interesting one will be discussed in our next issue. 24 hr Emergency Hotline +20 (12) 212 42 92 – Email: hyper_med_center@sinainet.com.eg

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