Pregnant? You Can Still Travel

Possible Problems

Problems that may arise include:

• Preterm labor and delivery while travelling
• False premature labor
• 3rd trimester bleeding
• Deep vein thrombosis and pulmonary embolus
• Phlebitis (inflammation of veins, often in the legs)
• High blood pressure and pre-eclampsia
• Fatigue
• Heartburn
• Indigestion
• Constipation
• Vaginal discharge or bleeding
• Leg cramps
• Increased frequency of urination
• Hemorrhoids

Regardless of the stage of your pregnancy, consult with your heath care provider before making any travel decisions. Important considerations include the potential problems associated with international travel, as well as the quality of medical care available at the destination and during transit.

Before Departure

• Make sure that your health insurance is valid while abroad and during pregnancy, and that the policy covers a newborn, in case you deliver during the trip. Also, a supplemental travel insurance policy and a prepaid medical evacuation insurance policy should be obtained, though most might not cover pregnancy-related problems.
• Check medical facilities at your destination. If you're in the last trimester, medical facilities should be able to manage complications of pregnancy, toxemia, and cesarean sections.
• Determine if prenatal care will be required abroad and, if so, who will provide it. Also, make sure prenatal visits requiring specific timing are not missed.
• Find out if blood is screened for human immunodeficiency virus (HIV) and hepatitis B at your destination. And be sure you know your own blood type as well as those of your companions.

Traveling by Car

Motor vehicle accidents are a major cause of morbidity and mortality for pregnant women. Fasten safety belts at the pelvic area. Lap and shoulder restraints are best; in most accidents, the fetus recovers quickly from the safety belt pressure. However, even after seemingly blunt, mild trauma, consult your doctor.

Stop frequently and get out of the car to walk—this will prevent the formation of blood clots in your legs.

Air Travel

Commercial air travel poses no special risks to a healthy pregnant woman or her fetus. Some conditions related to pregnancy do raise flying concerns, though. These include:

• Severe anemia (hemoglobin, 0.5 grams per deciliter [g/dL])
• Sickle-cell disease or trait
• History of thrombophlebitis
• Placental problems

If you have any of these conditions, check with your doctor before flying. In some cases, supplemental oxygen can be ordered in advance.

Each airline has policies regarding pregnancy and flying. When booking your flight, check with the airline; some require that you complete certain medical forms before traveling. Domestic travel is usually allowed until your 36th week of gestation, and international travel may be permitted until the 32nd week. You should always carry documentation stating your expected date of delivery.

An aisle seat at the bulkhead will provide the most space and comfort, but a seat over the wing in the midplane region will give the smoothest ride. Other important guidelines during air travel include:

• Walk every half hour during a smooth flight
• Flex and extend your ankles frequently to prevent phlebitis
• Keep the safety belt fastened at the pelvic level at all times when you are sitting
• Drink fluids liberally; the low humidity in the aircraft cabin can cause dehydration

When You Need a Doctor

Signs and symptoms that indicate the need for immediate medical attention are:

• Bleeding
• Passing tissue or clots
• Abdominal pain or cramps
• Contractions
• Ruptured membranes
• Excessive leg swelling
• Headaches
• Visual problems

Hepatitis E (HEV), which cannot be prevented by a vaccine, can be especially problematic for pregnant women. Other types of hepatitis such as A, B, and C are also more prevalent in underdeveloped countries. Vaccines are available for Hepatitis A and B, but not for C. Hepatitis A is spread through food and water, while B and C are spread through contaminated needles or blood products, or from sex. Get advice from your doctor on which vaccines you should get and how to avoid potentially contaminated water and food. (Note: Hepatitis vaccines are indicated during pregnancy only if clearly needed after consulting with a doctor.)