Traveling Pregnant

Travel during pregnancy

A healthy woman with an uncomplicated pregnancy may be safe to travel to most destinations. However, it may be wiser to change or postpone your travel plans if your destination puts you at risk for diseases such as malaria or yellow fever. According to the American College of Obstetrics and Gynecology, the safest time for a pregnant woman to travel is during her second trimester (14-26 weeks). This is the time that a pregnant woman usually feels best and is in the least danger of miscarriage or premature labor.

If you are pregnant

• Consult with your doctor or midwife before making any travel decisions. In general, the greatest risk to travel in pregnancy is being far away from your medical team if symptoms develop or complications arise. In addition, in remote areas, healthcare services may not be up to the hygienic or technologic standards you are used to in the U.S.
• Consider carrying a copy of your prenatal chart with you when you travel.
• Schedule an appointment with a Travel Clinics of America physician well in advance to discuss recommendations for travel vaccinations. Certain vaccines such as influenza, tetanus, and pertussis are considered safe during pregnancy. Others, such as chickenpox, measles, and rubella, are live vaccines and should be avoided.

Zika virus

There is no vaccine or medicine for Zika. Prevention is key. Zika virus is very rarely fatal, and once a person has been infected with Zika, they are likely to be protected from future infections.

Why Zika is risky for some people

Zika infection during pregnancy can cause a birth defect of the brain called microcephaly and other severe brain defects. It is also linked to other problems, such as miscarriage, stillbirth, and other birth defects. There have also been increased reports of Guillain-Barré syndrome, an uncommon sickness of the nervous system, in areas affected by Zika. If you are pregnant or planning to become pregnant before your international travel, speak to your travel medicine specialist for guidance.

How to prevent Zika

There is no vaccine to prevent Zika. The best way to prevent diseases spread by mosquitoes is to protect yourself and your family from mosquito bites.

Malaria and pregnancy

It is best to avoid malaria-endemic areas while you are pregnant, since malaria during pregnancy is a high-risk disease for both the mother and her unborn baby. If you do travel to malaria risk areas while pregnant, discuss with your physicians which medications are best for you, as many of the anti-malarial drugs are contraindicated during pregnancy. Follow these precautions to reduce exposure:

1. Stay indoors between dusk and dawn when malaria-carrying mosquitoes are most active.
2. When outdoors, wear protective clothing pre-treated with permethrin.
3. Apply mosquito repellants containing DEET (30-50%) to exposed skin avoiding eyes, lips, and open cuts. Wash off with soap and water when back indoors. DEET is considered safe to use during pregnancy.
4. Use permethrin-treated mosquito netting over beds where needed.

Traveler’s diarrhea and pregnancy

Traveler’s diarrhea, with its risk of dehydration, is a serious concern for a pregnant traveler.

• If you develop diarrhea while traveling, use rehydrating salts dissolved in safe water to prevent dehydration.
• Your travel physician can advise you on antibiotic and anti-diarrheal medications.

Safety advice

• Medications
  1. Bring extra medication to cover unexpected trip delays. The quality of medications available overseas may not meet US standards.
  2. Pack all medications and supplies in your carry-on luggage.
  3. Bring copies of your prescriptions.
  4. Only take medications approved by your physician.

   

• Medical care abroad
  1. Bring a first aid kit containing medications approved by your doctor for use during pregnancy.
  2. Join the International Association for Medical Assistance to Travellers (IAMAT) for a list of English speaking doctors, clinics, and hospitals. Membership is free.
  3. Evaluate your U.S. medical insurance policy coverage. Verify that it covers emergency evacuation. Purchase supplemental medical insurance if necessary.
• Flying and Pregnancy
  1. Commercial air travel poses no special risks to a healthy pregnant woman or her baby. Lowered cabin air pressure, airport metal detectors, and cosmic radiation during routine flights will not harm you or your baby.
  2. All airlines have policies regarding pregnancy and flying. Check with the airline before booking a flight. Some airlines may require a physician’s written permission to travel.
  3. Request bulkhead or an aisle seat to give you more space.
  4. Pregnant women are more susceptible to blood clots. Walk every half hour during flight and flex your ankles frequently to prevent Deep Vein Thrombosis (DVT).
  5. Fasten the safety belt under your abdomen across the top of your thighs.
  6. Drink plenty of fluids. Low humidity in the cabin increases the risk of dehydration.