UAB Medicine

February 26, 2012

Traveling and pregnant? Follow guidelines, use good judgment

Pregnant Travel

Pregnancy changes a woman’s body and her routine, but those who travel regularly or have a get-away on the calendar should be reasonably safe and comfortable — with a few physician-recommended modifications.

“First, I tell my patients the best time to travel is the second trimester, after the first 14 weeks,” saysUniversity of Alabama at Birmingham OBGYN Cheré Stewart, M.D. “Common pregnancy emergencies usually happen early or late in pregnancy. Pregnant women feel better during this time as well. Morning sickness is usually gone and their energy has returned, while in the third trimester it can be more difficult and uncomfortable to travel.”

Stewart says women planning international travel should keep a couple things in mind:

  • Review your vaccination history with your physician and decide if your destination requires vaccinations you cannot receive.

“There are certain vaccinations that are safe to get before traveling abroad and there are others that we don’t recommend until after pregnancy,” Stewart says. “For example, hepatitis B vaccines are safe during pregnancy for women traveling to developing countries. The Tdap vaccine — the tetanus, diphtheria and pertussis vaccine — also is safe during all trimesters. Unfortunately, the varicella vaccine for chicken pox and the MMR vaccine for measles, mumps and rubella cannot be administered during pregnancy.”

  • Be careful what you eat and drink.

“We often see food-borne illnesses that can make any traveler sick, but this is of more concern in pregnant women,” Stewart says. “Traveler’s diarrhea is very common. Stay away from tap water and ice in developing nations unless the water has been boiled. Avoid fresh fruits and vegetables unless cooked. Do not eat raw or undercooked meat or fish. Pregnant women also have to be careful with unpasteurized foods. Often cheeses and milks are unpasteurized in other countries and can contain listeria, which can be transmitted to the baby. Listeria can cause miscarriage, premature delivery and infections in newborns.”

Other travel considerations, Stewart says:

  • Reconsider travel at 36 weeks and after.

“At 36 weeks, most airlines will not allow you to travel, and the cutoff is sometimes earlier for international flights,” she says. “The same is true with cruise lines. In general, we recommend that you not travel as your due date approaches. If absolutely necessary, then please carry a copy of your prenatal record. Another consideration is insurance coverage for out of network delivery.  If traveling late in pregnancy, check with your insurance provider to make sure you are covered.”

  • Traveling with pregnancy complications is not advised.

“We limit travel for some women because they have conditions that place their pregnancy at high risk, such as twins or medical conditions that complicate the pregnancy. Pregnant patients who should avoid travel include those with abnormal placental location, history of preterm labor and bleeding in the third trimester,” Stewart says.

  • Radiation exposure for frequent travelers adds up.

“The exposure to radiation while going through airport security is similar to that of a cell phone conversation,” Stewart says. “And cosmic radiation at high altitudes does not cause problems for the occasional traveler. But for frequent travelers, like flight attendants and pilots, there is radiation exposure for prolonged flights. Any flight greater than 8 hours has about the exposure of a chest x-ray. In patients that are going to be traveling quite often, that is something to consider.”

  • Move around frequently to avoid blood clots.

“I always have patients do leg or calf exercises on the plane or walk along the aisles to prevent deep vein thrombosis,” Stewart says. “For my car travelers, I tell them to make frequent stops every one to two hours and get out of the car and walk around.”

Stewart adds that in addition to following guidelines and physician instructions, women should listen to their own bodies in order to play it safe for them and their babies.

“Your body knows when it’s tired, when you need to eat and when you need to drink,” Stewart says. “Using one’s own good judgment combined with your doctor’s recommendations will go a long way to keep you and your baby healthy on your next trip.”

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