Possible Problems

Problems that may arise during travel include:

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

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

Before Departure

• Make sure that your health insurance is valid 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, pre-eclampsia, 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. Either bring records about your prenatal care or be familiar with the information.
• 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.
• Talk to your doctor about getting vaccines appropriate for the time of year and location of travel.
• If you will be at risk of contracting tuberculosis at your destination, receive skin testing before and after travel.
• Get advice from your doctor on how to avoid potentially contaminated water and food.
• Be aware of any other disease that you may be at high risk of getting at the destination, such as malaria. If you need preventitive medications, make sure you tell your doctor you are pregnant.

Traveling by Car

Motor vehicle accidents are a major cause of morbidity and mortality for pregnant women. Fasten safety belts at the pelvic area, below your belly. 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. Try to limit being in the car to no more than 5-6 hours a day. Stop frequently and get out of the car to walk—this will prevent the formation of blood clots in your legs.

Air Travel    TOP

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
• 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 airlines 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 32-35th week. Check with the airline for specific cut-off times for when you can travel. 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.
• Keep the safety belt fastened at the pelvic level at all times when you are sitting.
• Do not drink carbonated drinks or eat foods that cause gas before your flight.
• Drink plenty of fluids; the low humidity in the aircraft cabin can cause dehydration.
• Talk to your doctor about anti-nausea medication if you are you are prone to nausea.

When You Need a Doctor    TOP

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

• Bleeding
• Passing tissue or clots
• Abdominal pain or cramps
• Contractions
• Ruptured membranes or a leakage of fluid from the vagina
• Excessive leg swelling
• Headaches
• Visual problems