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Pregnancy and travel

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Pregnancy and travel

Written by Dr Charlie Easmon, specialist adviser in travel medicine

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 you have consulted a doctor or been referred for examination in a hospital within the last two months prior to departure. If this is the case, you might not be covered under the conditions of your travel insurance.

Insurance companies vary in their requirements, so it's advisable to check with your travel agent about whether you need a written 'pre-travel health statement' prior to departure. This would usually be provided by your GP.

Medical assistance and maternity care are generally not covered by insurance from the beginning of the ninth month of pregnancy.

Travelling by air

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, many airlines will not carry pregnant women after 36 weeks - make sure you check with the airline before booking.

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.

These factors also apply to the journey home. 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.

On the plane

The air humidity in the cabins of passenger aircraft is kept at only 8 per cent, so pregnant women should drink plenty, particularly on long flights.

Pregnant women run an increased risk of inflammation and blood clots in veins of the legs and should avoid sitting still for too long.

A pregnant woman should 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 advice also applies to long car and bus journeys.

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.

For pregnant women, the risk of damage from wearing a seat belt is considered to be less than that caused by not wearing one.

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.

Malaria

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. However, 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. Click here to read more about malaria and pregnancy.

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

Travel sickness medicines

Pregnant women should, as far as possible, avoid taking drugs. But if you suffer badly from travel sickness, help is available. Cyclizine and promethazine can be taken during pregnancy, but only on the advice of your doctor.

Always ask the advice of your doctor or pharmacist before taking any medicines in pregnancy.

Medicines for diarrhoea

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.

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