Travel Reference
In-Depth Information
No specific treatment can be given in a wilderness situation. The bleeding is rarely severe
enough to create blood loss problems. If a hemorrhage of massive proportions does occur,
packing the vagina with tampons, gauze, or anything available may help slow the bleed-
ingduringevacuation, althoughcomplete controlofbleedingbysuchmeansprobablycan-
not be obtained. Such problems must be exceedingly rare; exercise helps control abnormal
bleeding for many women.
Pregnancy
Pregnancy, at least in its early stages, does not necessarily require curtailment of a wo-
man's customary activities, but some precautions should be observed during wilderness
activities. Of all pregnancies, 15 to 20 percent terminate in spontaneous abortions, most of
which occur during the first three months of pregnancy. Occasionally such abortions are
associated with severe bleeding that cannot be stopped without hospital facilities. A wo-
man in this stage of pregnancy should probably not enter an area so remote that evacuation
within twelve hours could not be readily accomplished.
During the last three months of pregnancy, the enlarged uterus and the baby it contains
oftencauseproblemswithbalance.Activitiesthatrequirebalancewouldbedifficult.Afall
could injure the mother, baby, or both, even though such falls would not injure a woman
who was not pregnant. Premature labor, whether caused by a fall or occurring spontan-
eously,could result in the birth—in less than optimal circumstances—of a small, immature
baby who could not survive without the facilities available in a hospital.
Occasionally pregnancy creates oraggravates other medical problems, such as diabetes,
hypertension, or cardiac disease. The mother should consult her physician for any special
care such problems would require on a wilderness outing.
(Thespecificproblemofaltitudeandpregnancyisdiscussedin
Chapter25:Altitudeand
Contraceptives
One aspect of pregnancy, its prevention, does have implications for high-altitude activ-
ities. Oral contraceptives cause a very slight increase in the incidence of deep vein throm-
bosesandpulmonaryembolism.Highaltitudesalsopredisposetothedevelopmentofthese
Trekkers who stay at moderate altitudes do not have a demonstrable increase in the incid-
ence of such conditions unless they are smokers. However, female climbers taking part in
expeditions requiring a prolonged stay at altitudes above 18,000 feet (5500 m) should con-
sider discontinuing oral contraceptives or switching to a preparation that does not contain
estrogen several months in advance.
MALE GENITAL PROBLEMS
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