Pregnancy and Travel
The babymoon trend is becoming more popular as soon-to-be parents take that one last pre-baby vacation. It is a chance for a final getaway as a family of two, and an opportunity to relax before the sleepless nights begin.
Travelling when pregnant can be safe but there are special health risks the mama-to-be must consider during planning. Below we’ll outline the steps to planning healthy travel when pregnant.
When to Travel
The best time to travel is generally during the second trimester (14-28 weeks). Pregnancy-related complications are less frequent during this time. Pregnant women are often feeling their best during this period, as morning sickness typically resolves after the first trimester and women tend to have their most energy.
The Pregnancy
Travel during a normal pregnancy is generally safe. Prior to travel your obstetrician or midwife should confirm that the pregnancy is uncomplicated and that there are no contraindications to travel. Travel should be avoided during high-risk pregnancies, history of spontaneous abortions, and expectation of multiple births. There may be other health conditions where it would be advised not to travel. It is important to consult your obstetrician or midwife prior to travel to identify any potential problems. It’s recommended to travel with a copy of your prenatal records, including due date and fitness to travel, as well as your physician or midwife’s contact information.
The Plan
It is important for the pregnant traveller to have a plan in place of where obstetric care will be obtained at the travel destination in the event of an emergency. It is advisable to plan travel to a destination where medical care is equivalent to Canadian standards. Women in their third trimesters should identify a medical facility at the destination that can manage pregnancy complications, delivery, caesarian section, and neonatal care. Immediate care should be sought at the destination for pelvic or abdominal pain, bleeding, rupture of membranes, contractions or preterm labour, symptoms of preeclampsia, vomiting and diarrhea, symptoms of a DVT (deep vein thrombosis), or pulmonary embolism.
Health Insurance
The pregnant traveller should purchase travel health insurance and review the terms of coverage. Some insurance companies will not cover complications of pregnancy or newborns overseas, and some plans have cut-offs for gestation dates, beyond which they will not cover delivery while travelling. It is important to review the policy and purchase supplemental insurance if necessary. It is recommended to purchase evacuation insurance that will cover pregnancy related complications.
The Destination
One of the first things people think about when babymoon planning is where they will go. For ease and simplicity some people may choose to keep it local, such as a weekend getaway to a cabin or a spa. Other people may want to lie on a beach and sip mocktails. When choosing a destination, it’s important to consider disease risk, as some infections acquired during pregnancy can be much more severe, and some medications to prevent or treat infections can be harmful to the fetus.
- Mosquito borne diseases
Zika virus is spread through the bite of an infected mosquito. Infection during pregnancy can cause birth defects, including microcephaly (a smaller than normal brain and head) and other malformations. It is recommended to avoid any non-essential travel to any area where Zika is a risk during pregnancy. This includes many countries in Central and South America, the Caribbean, Mexico, Asia, Africa, and the Pacific Islands. For more information about Zika virus and risk areas visit our blog.
Malaria is also spread by the bite of an infected mosquito. It can pose a risk of severe illness or death to both mother and fetus if infected during pregnancy. If possible, it is best to avoid travel to areas with malaria risk when pregnant. If travel cannot be avoided, an antimalarial medication is recommended. Some antimalarial medications cannot be taken during pregnancy, including Malarone and doxycycline. During a consultation at TravelSafe clinic, your travel health specialist will determine if there is malaria risk at your destination and recommend the safest antimalarial medication to take.
- Food and water borne diseases
Some destinations have higher risk of food and waterborne diseases that can be more severe during pregnancy. Hepatitis A and E during pregnancy can cause premature delivery, fetal complications, or fetal death. Traveller’s diarrhea can more quickly lead to dehydration during pregnancy, and severe diarrhea can lead to shock and premature labour. It is important to follow strict food and water precautions to avoid food and water-borne illnesses, including drinking bottled or boiled water. For more information about food and water safety visit our info page.
- High altitude
There is a lack of research regarding the effects of high altitude during pregnancy. During uncomplicated pregnancies travel up to 2,500m should be safe. Travel to sleeping altitudes above 3,048m should be avoided.
Vaccines
Most inactivated vaccines are generally safe during pregnancy and can be given if there is risk of the disease. Some vaccines are recommended during pregnancy, such as TdaP (tetanus/diphtheria/pertussis) and influenza. Live vaccines are generally contraindicated during pregnancy. During a consultation at TravelSafe clinic we will determine which vaccines are recommended depending on your destination and health history.
Transportation
A seatbelt should be worn when available, including on planes, buses and in cars. The best protection is provided by a shoulder strap worn between the breasts with lap belt worn low across the upper thighs. If only a lap belt is available, it should be worn between the abdomen and pelvis.
- Air Travel
Pregnant women with uncomplicated pregnancies can generally fly up to 36 weeks of pregnancy, and up to 32 weeks with a multiple pregnancy. Some airlines restrict international travel earlier in pregnancy, so it is important to check with the airline and travel with documentation indicating the due date. The plan to travel by air should be discussed with your obstetrician or midwife to ensure you do not have any medical conditions that could be impacted by flying.
General flying discomforts include bloating and gas which can be minimized by reducing consumption of carbonated drinks and gas-producing foods. The immobility on long flights increases the risk of developing a DVT. Pregnant women are at 5-10 times higher risk of a DVT than non-pregnant travellers. Frequent stretching, walking, and isometric leg stretches (e.g. calf raises, toe raises, ankle rolls, and quad stretches), and wearing compression stockings can help to prevent a DVT. An aisle seat can be helpful to promote frequent moving around.
- Cruise Travel
Most cruise lines limit travel to 28 weeks of pregnancy, and some to 24 weeks. It’s recommended to carry a letter from your obstetrician or midwife indicating the due date and fitness to travel. Anti-nausea medication is generally safe during pregnancy and can be helpful to treat motion sickness from the ship’s movements. Talk to your obstetrician or midwife for advice regarding the best anti-nausea medication to take. Use caution when walking on the deck to avoid falls.
What to Pack
In addition to standard items in a medical kit, such as a first aid kit, here are some pregnancy specific items you may want to pack:
- Prenatal vitamins
- Anti-nausea medication (consult your health care provider)
- Acetaminophen/Tylenol (consult your health care provider). Do not take ibuprofen or aspirin during pregnancy.
- Antacids (consult your health care provider). Do not take Pepto-Bismol during pregnancy.
- Hemorrhoid cream
- Compression stockings
- Oral rehydration solution
- Medication for vaginitis or yeast infection (consult your health care provider)
- Sunscreen (SPF 30 or higher)
- Treatment for traveller’s diarrhea (if at risk)
- Antimalarial medication (if at risk)
- Insect repellent with 30% DEET or 20% Icaridin (if at risk of mosquito-borne diseases)
- Blood pressure monitor (during 3rd trimester)
- Urine dipsticks (during 3rd trimester)
There you have it, some basic guidelines to planning healthy travel during pregnancy. For more information or for destination specific advice, make an appointment at TravelSafe Clinic today!
TravelSafe Clinical Educator – Kristin Cain, RN, BSc, MSc(A)
