It is important to be aware of a number of factors when travelling while pregnant.


People are now travelling more than ever before - both for pleasure and business. Many women, therefore, need to know where and how they can travel if they are pregnant or planning to become pregnant. In most cases pregnant women can travel safely, even to exotic destinations, but it is important to be aware of a number of factors, particularly relating to insurance, vaccination and medicines. In addition, there are a number of special rules for pregnant women who wish to travel by air. Finally, there is a need to be careful with a number of activities such as diving, hiking and water sports, which make particular demands on a woman's body during pregnancy.

Insurance details
Although a pregnancy that progresses normally is not an illness, it will often mean that the pregnant woman has consulted a doctor or been referred for examination in a hospital within the last two months prior to departure. If this is the case, she might not be covered under the conditions of her travel insurance. As insurance companies vary in their requirements, a pregnant woman is advised to check with her travel agent if she needs a written 'pre-travel health statement' prior to departure. This would usually be provided by her GP.

Medical assistance and maternity care are generally not covered by insurance from the beginning of the ninth month of pregnancy and many airlines will not carry pregnant women after 36 weeks. It is important to first check with the airline before booking.

Vaccinations and medicines
The use of medicines during pregnancy is a complicated and sometimes confusing issue. Often, manufacturers have not undertaken the relevant clinical studies to conclusively state whether a particular medicine is safe to take during pregnancy. Vaccines are no exception. The majority of the manufacturers state that there is insufficient information to recommend the use of their vaccine during pregnancy and advise avoidance. Others say there is a lack of information so their vaccine should be used with caution.

In any situation where a medicine is required during pregnancy, your doctor must weigh up the risks to the unborn foetus against the benefits to the mother. If the benefits outweigh the risks, a doctor will probably prescribe the medicine.

For more specific information about individual vaccines click here.

Most doctors advise pregnant women not to travel to malarious areas. Pregnant women appear to be more attractive to mosquitoes, have decreased general immunity and are prone to more severe disease, affecting both the pregnant women and the foetus. There is also a higher risk of mortality. If a pregnant woman insists on going to a malarious zone the risks of taking chemoprophylactic drugs are much less to the mother and the foetus than those from catching malaria. Concern has been raised about the use of diethyltoluamide (DEET) as an anti-mosquito measure on the skin, but it must be stressed that there is no evidence that it is harmful either to the mother or the foetus. The most dangerous thing a mother can do is to not take preventive measures or avoid precautionary advice. Read more about malaria and pregnancy here.

Chloroquine and paludrine taken by the mother are not regarded as a significant risk to a infant being breast-fed. However, infants will need their own preventive (prophylactic) treatment. Talk to your doctor about suitable medicines and doses.

Travelling by air
Make sure you can also fly back home. Most airlines allow pregnant women to fly up to and including the 36th week, provided the pregnancy has been straightforward. Under IATA guidelines, pregnant women are allowed to fly in weeks 36 to 38 if the flying time does not exceed four hours. However, airlines normally refuse to fly pregnant women who have previously given birth prematurely (pre-term) or have had blood clots in the veins of their legs. It is important to remember that these factors also apply to the journey home, so if you travelled out during the seventh month of pregnancy, there is a risk that you may not be allowed to board the return flight if you are in the eighth or ninth month of your pregnancy at the time of your return journey.

Drink plenty and make sure you are able to move around
The air humidity in the cabins of passenger aircraft is kept at only 8 per cent, and pregnant women should, therefore, drink plenty, particularly on long flights.

Pregnant women run an increased risk of inflammation and blood clots in the veins of the legs and should avoid sitting still for too long. A pregnant woman should therefore have an aisle seat and move around as much as possible - at least 15 minutes every hour. This can also be supplemented with vein pumping exercises. The same naturally also applies to long car and bus journeys.

Some travel sickness medicines can be taken by pregnant women
Pregnant women should, as far as possible, avoid taking drugs, but if they suffer badly from travel sickness, help is available. Cyclizine (Valoid), promethazine (Phenergan), and chlorpheniramine (Piriton) can all be taken during pregnancy. On the other hand, diphenhydramine (Medinex) should be avoided, at least during the first and third trimesters. Always ask the advice of your doctor or pharmacist before taking any medicines in pregnancy.

Wear a seat belt
The wearing of seat belts in both aircraft and cars is recommended for all pregnant women. They should be worn, as far as possible, low over the pelvis. The risk of damage to the mother and unborn child from wearing a seat belt is considered to be less than that of not wearing one.

Special risks in pregnancy

A number of diseases pose a particular risk to a pregnant woman and foetus during pregnancy. Infections that should be avoided occur particularly in the tropics and where the standard of hygiene is poor. Pregnant women are, therefore, recommended only to travel in countries with an adequate standard of hygiene, and not to go trekking or undertake primitive rucksack journeys in less safe destinations.

There is a risk of diarrhoea almost regardless of where you travel. A number of the drugs that can normally be taken to prevent and treat diarrhoea are not recommended for pregnant women. Lomotil can be used with caution, on the advice of a doctor. Loperamide should be avoided completely in pregnancy. Codeine should be avoided in the third trimester and during labour. Rehydration salts such as Dioralyte will prevent dehydration from diarrhoea.

In the last few months of pregnancy it is particularly important to avoid oxygen deficiency and in general pregnant women should not go scuba diving. Take care also with altitudes - see altitude sickness.

Danger signals for pregnant women

If bleeding from the vagina occurs (more than one or two soaked sanitary towels), a doctor should be consulted.

Severe abdominal pain, even without bleeding (particularly during the second, third and fourth months). This could be caused by pregnancy outside the womb.

If increasing bouts of vomiting occur (hyperemesis), a doctor should be consulted.

If subcutaneous (under the skin) accumulation of fluid (oedema) occurs, typically visible at the ankles (swollen feet) and hands/fingers, a doctor should be consulted.

In the case of severe and persistent headaches (perhaps with disturbed vision and vomiting) and any oedema, particularly after the sixth month of pregnancy, a doctor should be consulted immediately. The blood pressure should be checked as well as the urine for the presence of excess protein (the condition of toxaemia of pregnancy).

Severe gastric infections with numerous bouts of vomiting and diarrhoea and perhaps fever and tropical heat can lead to critical loss of fluid and a doctor should be consulted.

If a pregnant woman has felt 'life' in the womb and then suddenly finds that it is strangely calm or quiet over a noticeably long period, she should consult a doctor.

A pregnant woman should consult a doctor if she experiences a watery discharge, spotting or labour pains late in pregnancy.

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