pregnancy and altitude.

Wife is 20 weeks pregnant and I'm wondering if anyone has any experience at altitude during pregnancy?  We are looking for things to do in mid april and she is pushing to do some snow climbs to some 13,000 foot peaks in colorado.  

Even at this stage I know she can physically handle it as we just got back the other day from doing several multi pitch ice routes.  She is still climbing well and did well in the deep snow on the approaches.  

Normally she does well at altitude, she is my main partner for alpine objectives.  She is pushing to do the trip but I'm slightly concerned, and am wondering if something lower elevation would be safer.  

My main concern is what the risks are to the kid? 

1). Talk to your ob/gyn

2). Ignore your doc and go for it.  My wife and I skied the oeztal and other objectives when she was 7 months preggers.  Living at altitude isn't a great idea but forays seem fine.  I've guided multiple knocked up ladies at altitude and the consensus seems to be watch pulse rate and O2sat, don't push to exhaustion, have a definitive coms/evac plan, and other normal common sense.

Dude you should to talk to your obstetrician. I would take 0.0% of advice from this forum. Just because someone else's wife did OK or didn't has no relevance your wife.

Personally I think your concerns are well founded.

Brian Shaffer wrote:

Dude you should to talk to your obstetrician. I would take 0.0% of advice from this forum. Just because someone else's wife did OK or didn't has no relevance your wife.

Personally I think your concerns are well founded.

Bingo!

Yeah, live in fear like the rest of the worms.  Cage your wife and ignore her opinions.  U!S!A!

We do plan to ask when she goes in for her next appointment.  

She also asked about rock climbing however which wasn't very helpful as the OB didn't really understand that there was any difference between toprope craiging and free soloing big walls :)   Doc said no to rock climbing at first at first which she took at face value.  When she gave me the doc's answer I urged her to explain what she was really doing.  Doc said didn't realize we were using ropes to prevent falls and she was good to go.  

I figured this was an April fools joke.............If it's not a joke don't risk the baby or your wife's lives. If it is a joke it's starting to get creepy. You should have yelled April fools! by now. JB

There are tens of thousands if not hundreds of thousands of people in the world that reproduce and live at 12,000+ feet. https://en.wikipedia.org/wiki/Puno for example. 

But living at 2,000 feet and travelling to 13,000 is a whole different story. I would consult a doctor.

Tylerpratt wrote:

There are tens of thousands if not hundreds of thousands of people in the world that reproduce and live at 12,000+ feet. https://en.wikipedia.org/wiki/Puno for example. 

But living at 2,000 feet and travelling to 13,000 is a whole different story. I would consult a doctor.

THIS.  Though average doctor wouldn't have answers to this type of question, but would very likely err on the side of caution.

I backcountry skied until I was 9 months pregnant, up to almost 12,000 feet in the Tetons sometimes. However, I live in Jackson above 6,000 feet.   A LOT of people have questions about what type of exercise is safe during pregnancy, and the best resource I've found is "Exercising through Pregnancy" by James Clapp.  His book presents the results of scientific studies involving pregnant women and exercise. He finds that the most important measure is perceived exertion, not heart rate, since heart rate naturally is elevated during pregnancy. If you are exhausted the next day, and next day, then you overdid it.  I learned this the hard way!

First question: Where do you live? I felt well-acclimatized to altitude because I live relatively high and was hiking to elevation 3-4 times a week (first baby - spoiled!). I'm not sure if it would take your wife longer to acclimatize if you are coming from a low elevation, but another thing to consider is that pregnant women have 50% more blood volume, and therefore more red blood cells, by ~ the second trimester.

Next question: When is your trip?  I felt fabulous during my second trimester and didn't notice a big difference in my strength or endurance. But by the third trimester I was definitely having to scale back...

Finally, I discussed all of this with by OBGYN and she was psyched that I was exercising and encouraged me to keep getting out as long as I felt good.  I think this is pretty common for people having a healthy, complication-free pregnancy. I even asked about having the tranceiver next to my stomach for hours and she thought that was fine.

I think it's great that your wife is still feeling great and adventurous!  Not all women are this lucky. So definitely take advantage of it. :)

Oh and last thing - no falling! I was terrified of getting caught in even a small slough every time I skied and was super cautious. 

Edit - Just re-read your post and saw you're leaving mid-April.  If you're wife feels good now, she'll probably feel good then.  Remember, she's the best gauge of how she feels and what she perceives she can do.

Hypoxia is definitely to be avoided in pregnancy. However low maternal blood oxygen might be,fetal blood oxygen is lower. This is why asthma in pregnancy is such a big deal.

However, at that altitude (or at sea level!) I'd be much more worried about a fall. Great that these other folks got away with it, but a fairly minor tumble could result in a placental abruption. Totally not worth the risk in my opinion.  

I'll also respond to the people saying that pregnant women who exercise at altitude risk hypoxia and the health of their baby.  If you're not out of breath, then you and your baby are fine.  They key is to slow your pace so that you can carry a conversation.  If you are acclimatized and fit, this is totally doable.  I know about a bazillion women who exercised hard during pregnancy, and they all had healthy, happy babies.  What's good for mom is good for baby.

wisam wrote:

We do plan to ask when she goes in for her next appointment.  

She also asked about rock climbing however which wasn't very helpful as the OB didn't really understand that there was any difference between toprope craiging and free soloing big walls :)   Doc said no to rock climbing at first at first which she took at face value.  When she gave me the doc's answer I urged her to explain what she was really doing.  Doc said didn't realize we were using ropes to prevent falls and she was good to go.  

Your wife might want to consider switching doctors. 

My first OB wasn't much of an athlete and therefore warned me off most physical activity beyond pregnancy-designed yoga and swimming. I asked around and found an OB that was helping a friend of a friend stay fit for triathlons while pregnant. An OB that is an athlete or regularly cares for athletes can make a big difference in managing physical activity throughout pregnancy. I switched, and instead of advice with no real context or understanding, I got tips on how to avoid/manage injury from progesterone causing a laxity or loosening of my ligaments and joints. She also talked to me about how to identify Diastasis recti, and what to do if I start to see signs. We even discussed when would be the best time to switch from the standard harness to a full-body based on position of the baby.

Doctors should be saying more than "good to go." They should help you figure out how best to go. My doctor helped me climb right up until arrival day for both of my kids. I believe it was keeping up with climbing and remaining injury free that made my pregnancies feel easy and kept me happy throughout. I wish you and your lady the best, no matter your course of action.

If she ever wants a climbing mom to talk to, tell her to shoot me a message.

Alison Osius climbed up to 5.11 until she was about 7 months. Her big complaint was being unable to see her feet.

kenr wrote:

A key response of adult humans to moderate altitudes is that their blood becomes more alkaline (higher pH) because of the exchange of carbonic acid with reduced CO2 pressure in the atmosphere. Which is a key cause of AMS syndrome (because variation in pH is significant for some biochemical reactions, so it has different effects (some of them neural/mental?) on different people.

Part of the acclimatization response is that the body gets better at buffering the pH.

So something to explore . . . If there's evidence or theory that the fetus is likely to have greater or lesser tolerance to a (temporarily) higher-pH blood supply.

Ken

P.S. If you're into evidence-based medicine, seems unlikely to me that any serious careful studies have been done with randomly-assigned samples of pregnant women at 11000-14500 ft altitude. My experience is that when faced with lack of scientific evidence, a significant percentage of medical professionals just guess an answer - (perhaps thinking that most patients like to get an "answer", without any confusion about the paucity of the statistical evidence). Would not be surprising if such answers tended toward very conservative.
. . . (of course if the answer is about a fetus around which I am betting the next twenty years of my life, perhaps "very conservative" is just what I want).

Get a pulse oximeter and ask a doctor was a healthy saturation level is during pregnancy.

Its pretty commonly known that hypoxia in adults is bad for cell regeneration and cognition. I'd imagine that this goes double for unborn children. Looking at elevations or climbing difficulties is probably useless as it's different for everybody. 

kenr wrote:

A key response of adult humans to moderate altitudes is that their blood becomes more alkaline (higher pH) ...  Which is a key cause of AMS syndrome...

AMS is a genetic disorder that predisposes one to amore alkaline pH - there is no increased risk of your child developing it no matter what the serum pH.  Of course pH has an effect on epigenetic regulation, post-translational modifications, and protein interactions, which all have far-reaching effects, but AMS is not caused by high pH.

I looked into the adaptive mechanisms of O2 carrying capacity of the fetus and found that not only do fetal hemoglobin have a greater affinity for O2 (so that it can take it from the maternal blood) but the fetus also has quite the buffered range of acceptable environmental oxygen levels.  So, in the short term, and at the relatively low "high-altitudes" you'll find in Colorado, your wife and your baby will be fine.  From the dozens of articles available on the subject, the only risks incurred by chronic high-altitude exposure are maternal hypertension and a modest increased risk for preeclampsia, but then again these associations were drawn from populations living at 10000 feet, so those results could hardly even be extrapolated to your situation.

I'd recommend getting into the subject in pubmed and google scholar before your Ob visit, otherwise they might just spew what their best guess is and hope the answer's good enough for you.  Watch out for altitude sickness and be careful and you'll be good to go!

Safe Climbing!

Optimistic wrote:

Hypoxia is definitely to be avoided in pregnancy. However low maternal blood oxygen might be,fetal blood oxygen is lower. This is why asthma in pregnancy is such a big deal.

However, at that altitude (or at sea level!) I'd be much more worried about a fall. Great that these other folks got away with it, but a fairly minor tumble could result in a placental abruption. Totally not worth the risk in my opinion.  

To clarify I do think that climbing on TR is completely fine all the way through assuming that the harness issues can be worked out. It's the mountaineering/snow climbing mentioned in the original post that worries me, seems like there's much more significant fall risk there.

Brian Shaffer wrote:

Dude you should to talk to your obstetrician. I would take 0.0% of advice from this forum. 

So she shouldn't go see her obstetrician?