Abstract
When Aneema Van Groenou asked me to write a book jacket quote for The Active Woman's Guide to Pregnancy, I was flattered. One of the joys of being a teacher is watching young authors blossom as writers, particularly when their topic is important and enthusiasm is infectious. Another great feeling is uncovering a new niche in wilderness medicine. Women's health has only recently been appropriately emphasized, so advice for pregnant women lags behind offerings for other special interest groups. With this guide, active women are encouraged and counseled to get outdoors and make the most of it.
As much as any other group, pregnant women are the recipients of varying recommendations about activities, diet, drug use, and travel. Much of what is written is anecdotal. So, it is high time to offer some reasons for our guidance. This book stays within bounds and is conservative in its content and recommendations. For a first effort, that is the correct approach. It is an ambitious undertaking. With the portions that have been well done come some sections in need of improvement. The overall product is worth the effort. I anticipate that the author will receive a fair amount of feedback that will be taken into consideration for the next edition.
The structure of topics is to enumerate the benefits of staying active then to briefly discuss health concerns by trimester of pregnancy, elucidate outdoor gear for pregnancy, move on to first aid, and then enter the major part of the book. This deals with exercise, staying active (activity by activity), and is followed by a brief concluding section on resuming activities postpartum.
In my reading of the book, I observed the following. The section on staying active is excellent. This should be read by every pregnant woman to assist her in deciding about physical activities during pregnancy. I would imagine that given the choice, most women would choose to be physically active, and this reinforces it. There is not a definitive discussion about how to initiate exercise during pregnancy if you have lived a sedentary life up to the point of conception. Also, there is no mention of immunizations during pregnancy for foreign travel, which is a likely possibility for certain outdoor adventures. When outdoor gear is listed, clothing designed to block ultraviolet (UV) radiation would be important to note. The later mention of a t-shirt to protect your back from blisters does not offer any advice about the transmittal of UV radiation through wet, white cotton. Because there is no real discussion about the day-to-day operations of backpacking, camping, or trekking, the lists of “Outdoor Essentials” and “Emergency Survival Kit” seem superfluous. What is the reason to carry tea bags? I presume to squelch bleeding from a tooth socket, but it is never explained. Because this book is neither a comprehensive guide to outdoor activities nor a field medical guide, it might be better in the future to expand the contents that are unique to pregnant women and to focus more on the specifics of essential topics, rather than cover the waterfront in a superficial manner. For instance, in the discussion on insect repellents, why not describe how to impregnate clothing with repellents? For the prevention of motion sickness, why not mention the Relief Band device, which is a nonpharmacological approach? I also have a few quibbles with assertions such as “reactions to (marine) stings may be more pronounced during pregnancy,” and advice like the need to cool down after snorkeling while still in the water.
The section on stretching is a nice touch and applies to everyone, not just pregnant individuals. In this sort of writing, which is common sense and practical, the author shines. The activities sections, which include gardening, walking, running, biking, in-line skating, hiking, camping, mountain biking, rock climbing, mountaineering, horseback riding, swimming, snorkeling, scuba diving, paddling, boating, windsurfing, surfing, waterskiing, downhill skiing, snowboarding, cross-country skiing, and snowshoeing are neatly done. Herein lies the real value of the book. For both pregnant consumers and medical practitioners alike, we gain comfort with activities that are safe and accept prohibitions against activities that are not (such as scuba diving and waterskiing). This large section is followed by an equally useful and excellent discussion of recovering and resuming activity, including exercise and breastfeeding, resuming activity after delivery, and postpartum toning exercises.
A written announcement from the publisher that accompanied my copy states that “there may be only one woman physician trained in obstetrics and wilderness health who can write on the subject of how to plan for and stay safe…” I know a great many phenomenal women clinicians, explorers, researchers, and authors of wilderness medicine. The publisher's announcement raised the eyebrows of a few women who are simultaneously accomplished health care providers, mothers, extremely active in the outdoors, and knowledgeable about wilderness medicine. Fortunately, I know that Dr Van Groenou appreciates the enormous amount of excellent work being done by her peers, so what is written on the back cover of the book is fairly stated.
The Active Woman's Guide to Pregnancy is important reading for pregnant women who seek to remain physically active during their pregnancies. It is practical and encouraging in promoting exercise and outdoor activities. It is not a first aid or medical book, nor is it a complete guide to pregnancy. It should be used as a prescription for exercise and healthy outdoor activities by women who are able to find the time to maintain these important pursuits during a time of enormous responsibility and concern associated with the gestation and birth of a newborn child.