Pregnant? You Can Still Travel
Factors Affecting the Decision to Travel
According to the American Congress of Obstetricians and Gynecologists, the safest time for you to travel during pregnancy is during the middle of your pregnancy (weeks 14–28), when you usually feel best and are in least danger of experiencing a spontaneous abortion or premature labor.
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]]>
- Vaginal discharge or bleeding
- Leg cramps
- Increased frequency of urination
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, as well as the quality of medical care available at the destination and during transit.
Guidelines for Traveling
Once you have decided to travel, a number of issues need to be considered prior to departure. For instance, travel with at least one companion. Also, you should know that your level of comfort might be adversely affected by traveling. The following are some guidelines with regard to medical considerations when traveling during your pregnancy.
- 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, ]]>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 very 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.
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.
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:
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. 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 to prevent phlebitis.
- 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 fluids liberally; the low humidity in the aircraft cabin can cause ]]>dehydration]]>.
- Talk to your doctor about anti-nausea medicine if you are you are prone to nausea.
When You Need a Doctor
Signs and symptoms that indicate the need for immediate medical attention are:
- Passing tissue or clots
- Abdominal pain or cramps
- Ruptured membranes or a leakage of fluid from the vagina
- Excessive leg swelling
- 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.)
The Travel Health Kit During Pregnancy
During pregnancy, you may want to add the following items to your usual travel health kit:
- Oral rehydration salt (ORS) packets
- Prenatal vitamins
- Insect repellent containing a low percentage of DEET
- Sunscreen with a high SPF
In your third trimester, you may be advised to carry a blood pressure cuff and urine dipsticks so you can check for protein and glucose in your urine (proteinuria and glucosuria), both of which would require medical attention. Anti-malarial and anti-diarrheal self-treatment medications should be evaluated individually, depending on your trimester, your itinerary, and your health history. Most medications should be avoided, if possible.
American College of Obstetrics and Gynecologists
National Women's Health Information Center
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
The American College of Obstetricians and Gynecologists. Traveling during pregnancy. The American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/publications/patient_education/bp055.cfm. Updated January 2010. Accessed April 29, 2010.
Centers for Disease Control and Prevention. Available at: http://www.cdc.gov.
Last reviewed May 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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