You might think you have travel all figured out — you can pack your carry-on like a pro and have a knack for finding deals on everything from rental cars to train tickets — but add pregnancy into the mix and you could be thrown for a loop. With a literal baby on board, your awareness of things like Zika, long-haul flights, and food poisoning are heightened. You want to get out there, but you also know you need to do it safely.
So, where do you draw the line? What constitutes safe travel and when is it OK to hit the road, skies, and waters? To answer these sensitive questions, we spoke with Pamela Berens, MD, professor of OB-GYN with McGovern Medical School at The University of Texas Health Science Center at Houston, for a dose of expert advice.
When You Should and Shouldn’t Travel
Just because you’re pregnant doesn’t mean you need to hide out in your house for nine months, but it does mean you should keep a few things in mind. “Traveling in the first trimester could be uncomfortable if you are experiencing nausea and vomiting (morning sickness),” Berens noted. On the flip side, she explained, “Traveling during the third trimester may be a bit physically uncomfortable, especially if the trip is long.” In short, your sweet spot in terms of comfort might be the second trimester, although every pregnancy is different. And you should probably stop traveling (at least by air) once you hit 37 weeks.
“Most airlines will allow travel until 37 weeks of pregnancy, but you may need a note from your healthcare provider. Check with the airlines you’ll be traveling with for specifics,” said Berens.
What to Do Before You Go
Before booking a flight or hop aboard a cruise ship, talk to your doctor or midwife. They know you and your pregnancy experience so far and will be able to give you personalized advice on what sort of travel is and isn’t a good idea.
“If you have a complicated pregnancy, speaking with your prenatal provider is even more important. If something happens while you’re traveling, it’s important for the health providers to know the details of your complications and specific plans related to your delivery or any special care needs you might have for your baby,” advised Berens.
Either way, you’ll need to ask yourself a few questions before traveling internationally. “The big consideration here is what would happen if you experienced a complication while traveling to a foreign country. Can you speak the language? How good is the medical care? What insurance coverage do you have while traveling abroad? I have, unfortunately, had patients who delivered a preterm infant in a foreign country. They had to stay there for quite some time until the baby could be discharged and had communication difficulties,” said Berens.
What to Pack
There are plenty of things pregnant women might want to bring along on a trip — from anti-nausea medicine and compression socks to plenty of water and snacks. But one thing many women don’t think about is their prenatal records.
“Always have access to your prenatal records when traveling, just in case,” said Berens. That way, if you end up laboring while you are away from home, the new hospital or doctor will be able to access your history and come prepared. If you’re traveling close to your due date, you’ll also need to bring a note from your healthcare provider. On American Airlines, for example, you must provide a doctor’s certificate stating that you’ve been examined and are fit to fly if your due date is within four weeks of your flight.
What to Watch Out For
If you’re used to eating street food and drinking local water when traveling internationally, you may need to adjust your habits. Berens suggests sticking to bottled water, noting, “It’s very unpleasant to experience a diarrheal food borne illness while pregnant.”
In addition to paying extra attention to food and water, you’ll also need to keep an eye on the health situation in the country you’re visiting. The Zika virus, which is transmitted by mosquitoes, is particularly dangerous to your unborn baby. “In areas of mosquito borne illnesses, wear long sleeves and pants. Keep covered. Use an insect repellent,” said Berens. It’s always a good idea to check for travel advisories before booking your trip.
In addition, all pregnant travelers — domestic and international — will need keep a close eye on their health and bodily functions while traveling. “Notify your care provider for bleeding, change in discharge, increased contractions, or a decrease in your baby’s movements if you are over around 24 weeks of pregnancy,” said Berens.
Flying While Pregnant
Air travel is usually safe for pregnant women, but you won’t want to pop in your headphones and settle in for the duration of your long-haul flight.
“Pregnancy itself causes an increased risk of blood clots. Air travel and prolonged immobility can also increase your risk of blood clots,” said Berens, suggesting that pregnant women “stay well hydrated, move around every few hours, and make sure to keep good circulation in [their] legs.”
Chances are, when you get up to stretch your legs, you’ll also need to use the bathroom. “There is often more pelvic pressure and pressure on your bladder in the third trimester, so you may need to stop and use the restroom more frequently,” said Berens.
Because you’ll be getting up and walking around more than most travelers, The American College of Obstetricians and Gynecologists (ACOG) suggests booking an aisle seat and moving your feet, toes, and legs often. For your comfort, you’ll want to skip carbonated drinks and wear your seat belt low on your hip bones, below your belly.
Traveling by Car or Train While Pregnant
Just like air travel, long-haul road trips and train journeys mean a lot of sitting and not a lot of moving. To avoid problems with blood clots, Berens suggests walking around every few hours.
For road trips, you’ll also want to plan out stops along the way where you can stretch your legs and use the bathroom.
Traveling by Cruise Ship While Pregnant
Many women experience nausea and vomiting in the first trimester of pregnancy, two conditions that might be increased when you hop aboard that luxe cruise. “If you are not familiar with boat or cruise ship travel, you may want to try this first when you are not pregnant. You may need additional medication for nausea and vomiting,” warned Berens.
What to Keep in Mind With COVID-19
COVID-19 has made travel complicated for everyone, but pregnant women are at an increased risk for severe illness. Berens recommends that pregnant women finish their vaccinations before traveling, also adding, “Mask up! Stay six feet apart, and maintain good hand hygiene.”