Whether by plane, train, automobile, or even boat, traveling while pregnant involves its own set of challenges and guidelines. But a little advance planning along with some common sense can make all the difference in the world -- anywhere in the world -- when it comes to pregnancy travel.
"It's wrong to say a categorical 'no' when it comes to traveling while pregnant," says Frank A. Chervenak, MD. Chervenak is a professor and chairman of the department of obstetrics and gynecology and the director of maternal-fetal medicine at Weill Medical College of Cornell University in New York City. "You need to individualize each and every situation," he says. For example, "I can imagine a scenario after eight months where travel is permitted."
The bottom line? "Discuss any travel with your doctor and see what he or she thinks," Chervenak says. "If your doctor is concerned, then you should be concerned and really weigh whether the travel is necessary."
"I always tell my patients no travel after 32 weeks, because if she delivers, she won't have me there," says Elizabeth Nye, MD, an obstetrician at Rush Presbyterian St. Luke's Medical Center in Chicago. "She may have to deliver in a strange place with a doctor she has never met."
Pregnancy Travel: Better Safe Than Sorry
There is some general commonsense advice for all women who are traveling while pregnant no matter what transportation route you take or where your destination is:
- Consider buying trip insurance. "You never know what will happen during any pregnancy, and this way you are covered if you have to cancel your trip for any reason," Nye says.
- Schedule a checkup before your vacation so you can get a green light from your doctor.
- Travel with a copy of your prenatal records and copies of any relevant ultrasounds.
- Keep your prenatal vitamins and any other medications you need in your purse in case you get separated from bags.
- Program your obstetrician's number into your cell phone and make sure that your travel companion also has their number handy.
- Get a phone number of a local doctor just in case.
Pregnancy Travel: Up, Up, and Away?
"In general, air travel is OK during the entire pregnancy," says Kenneth Johnson, DO, an associate professor of obstetrics and gynecology at Nova Southeastern University in Fort Lauderdale, Fla. "But common sense dictates that women with complicated pregnancies involving twins, hypertensive disease, severe nausea, placenta previa, preterm labor, and other pregnancy-related complications should not fly." Most airlines do allow pregnant women to fly until about a month before their due dates.
Chervenak agrees: "As long as there are no known complications to pregnancy, traveling on an airplane is reasonable." But he says that "it's important for pregnant women to get up and walk around every hour during flight.
"This is really a good idea for every flier, but in pregnancy it can be even more important to keep your circulation flowing," Chervenak says. Here's why: Pregnancy can cause circulation problems, and flying increases the chance of developing a potentially fatal blood clot. Moving around keeps the blood moving, which helps to prevent the formation of blood clots.
Some people who are prone to blood clots may need special stockings that improve circulation and make it less likely for blood clots to develop, he says.
Choose an aisle seat so you can get up and down without climbing over your neighbor, adds Nye. This will also help you get to the bathroom in a hurry. "We know that pregnant women have to use the bathroom a lot," she says. (This same advice holds if you are taking a bus trip.)
If you are expecting, don't worry about walking through the metal detector at the airport security check, she says. "There is not a lot of radiation coming from these detectors, but if you are at all concerned, request a pat-down instead."
Heavy lifting may cause problems during pregnancy, so schlepping bags from gate to gate is not advisable for women who are traveling while pregnant. "Use porters or suitcases with wheels to try to make pregnancy travel as physically easy as possible," Nye says.
Johnson adds that it's important to drink nonalcoholic, noncaffeinated beverages before, during, and after air travel while pregnant. "Women who do fly should drink extra fluids because air travel tends to be dehydrating," he says. "Extra fluids will also help eliminate Braxton-Hicks 'false labor' pains."
Many airlines no longer supply meals, so it's important for pregnant women to pack their own healthy snacks. "Eat frequent small meals to avoid hypoglycemia and nausea," Johnson says. Importantly, "If you begin to have regular painful contractions, inform the crew early."
Pregnancy Travel: Road Trip
Pregnancy travel by car has some of the same risks and rules as traveling by plane, says Nye.
"The big problem is blood clots," she says. "If you are in a car and driving long distances, get out and walk every few hours," she says. "If you have been diagnosed with a blood clotting disorder, you may need special stockings to increase circulation and decrease your blood clot risk."
Calf exercises can also help keep blood flowing. "Lift your foot up and twirl or wiggle it around for exercise," Nye says.
Be seatbelt savvy. There are nearly 170,000 car crashes involving pregnant women every year, according to the March of Dimes. If you are pregnant, wear both the lap and shoulder belt and buckle the lap strap under your belly and over your hips, she says. Make sure that you rest the shoulder belt between your breasts and off to the side of your belly.
Pregnancy Travel: Cruise Control
Taking a cruise while pregnant may seem like the ultimate in relaxation, but if you have never been on a cruise before, pregnancy is not the ideal time to give it a go, says Nye. Why? Pregnant women tend to be nauseous in general, and seasickness may make this queasiness even worse.
"There are medications that we give for nausea during pregnancy, but is this how you really want to spend a vacation?" she asks.
There are often reports of a stomach virus spreading on cruises, she says, "These can be pretty bad in pregnancy because you are also putting your unborn baby at risk."
Dehydration and electrolyte imbalance can lead to preterm labor, she says. "Drink a lot of water, especially if you have diarrhea or are vomiting," she says. Certain anti-diarrheal medications are safe during pregnancy. Talk to your doctor in advance of your travels.
Pregnancy Travel: Get out the Map
Traveling while pregnant is also contingent on where you are going and at what point in your pregnancy you plan to travel there.
"The end of pregnancy is not the best time to take that African safari," Chervenak says. "It's a good idea not to travel to a Third World or undeveloped country late in your pregnancy because the more pregnant you are, the greater your chances of going into labor, and it's important to have access to good medical care wherever you may be."
"Medical evacuation is tremendously expensive, and if you must go to Nairobi, you need to make sure that these arrangements are made ahead of time," he says.
Pregnancy Travel: Be Prepared
Regardless of how you travel, it's important to have your creature comforts with you such as snack foods and vitamins. This can be even more important when traveling while pregnant. "How prepared you are also depends on where you are traveling to," Chervenak says. "If you are heading to London or Paris, there is likely plenty of good water or snacks available, but if you are going someplace more rural then you have to consider bringing these things with you."
If you are planning to travel to an exotic location, contact the CDC at 800-311-3435 to receive safety information along with the relevant immunization facts.
The American Pregnancy Association recommends protecting your stomach in other countries by drinking bottled water, canned juices, or soft drinks, making sure the milk is pasteurized, and steering clear of fresh fruits and vegetables unless they have been cooked or can be peeled; make certain that all meat and fish has been cooked thoroughly.
"Try to avoid eating in iffy restaurants," Nye adds.