Special considerations for traveling while pregnant

Traveling during pregnancy is normal, and a lot of women do it. But it's important to think about potential problems that could come up during international travel. Also think about how you would get quality healthcare in the countries you are visiting. Get all of the vaccines you need before becoming pregnant instead of waiting to get them during pregnancy.

The American College of Obstetricians and Gynecologists says the safest time for a woman to travel is in the second trimester of her pregnancy, from 14 to 28 weeks. This is the time when you will feel your best. You are also at the lowest risk for spontaneous abortion or premature labor. During the third trimester (28 to 40 weeks), many healthcare providers and midwives advise staying within a 300-mile radius of home because of potential problems such as high blood pressure, phlebitis, and false or preterm labor. Generally, women are not allowed to travel by air after 36 weeks for domestic travel, and after 28 to 35 weeks for international travel. The decision on whether to travel and how far to travel at any time during pregnancy should be a joint decision between you and your healthcare provider or midwife.

For most pregnant women, flying does not pose a risk to the fetus from cosmic radiation. But aircrew and women who often fly may exceed radiation limits.

According to the CDC, pregnant women with the following conditions may be advised against traveling to countries that require pre-travel vaccines. This list may be incomplete. So discuss your health history with your provider or midwife before planning travel:

• History of miscarriage

• Incompetent cervix

• History of ectopic pregnancy

• History of premature labor or premature rupture of membranes

• History of or current placental abnormalities

• Threatened miscarriage or vaginal bleeding during current pregnancy

• Multiple fetuses in current pregnancy

• History of toxemia, high blood pressure, or diabetes with any pregnancy

• History of infertility or trouble getting pregnant

• Pregnancy for the first time over the age of 35 years

• Heart valve disease or congestive heart failure

• History of blood clots

• Severe anemia

• Chronic organ system problems that need to be treated 

You may also be advised against traveling to places that may have hazards. The list below may be incomplete. Talk about your travel plans with your healthcare provider or midwife before planning a trip.

• Places with high altitudes

• Places that have outbreaks of life-threatening food- or insect-borne infections

• Places where malaria is common

• Places where live-virus vaccines are needed or recommended

Healthy tips for traveling while pregnant

Here are tips for traveling while pregnant:

• Try to plan ahead for any problems or emergencies that could come up before you travel. Check that your health insurance is valid while you are abroad. Also check to see whether the plan will cover a newborn, should you deliver while away. You may want to think about getting a supplemental travel and medical evacuation insurance.

• Research medical facilities in your destination. Women in the last trimester of pregnancy should look for places that can manage complications of pregnancy, toxemia, and cesarean sections.

• If you will need prenatal care while you are abroad, arrange for this before you leave. Talk with your healthcare provider or midwife to figure out the best way to handle this.

• Know your blood type and check that blood is screened for HIV and hepatitis B in the areas you will be visiting.

• Check that safe food and beverages, such as bottled water and pasteurized milk, are available at your destinations.

• If flying, ask for an aisle seat at the bulkhead. This gives you the most space and comfort. If morning sickness is a problem, try to arrange travel during a time of day when you generally feel well. Seats over the wing in the midplane region will give you the smoothest ride.

• Try to walk every half-hour during a smooth flight. Flex and extend your ankles often to prevent blood clots in the veins (thrombophlebitis).

• Fasten your seat belt at the pelvis level, below your hips.

• Drink plenty of fluids to stay hydrated. Aircraft cabins have low humidity.

• Try to rest as much as possible while away. Exercise and activity during pregnancy are important. But try not to overdo it.

Special considerations for traveling while breastfeeding

Breastfeeding gives babies the most nutritional start in life. It also gives them vital protection against certain infections. But traveling internationally while nursing can be challenging.

If you are breastfeeding only, you don't have to worry about sterilizing bottles or having clean water. You may get vaccines to protect against disease, depending on where you are traveling. But diseases such as yellow fever, measles, and meningococcal meningitis may be a threat to infants who can't be vaccinated at birth. Discuss this with both your healthcare provider or midwife and your infant's caregiver before you travel.

If you are feeding your baby formula, it's best to use powdered formula made with boiled water. You may also want to carry a supply of prepared infant formula in cans or ready-to-feed bottles for emergencies.

Breastfeeding helps lower the chance of your baby getting traveler's diarrhea. If you get traveler's diarrhea, drink more fluids and continue to nurse your baby.

Watch your eating and sleeping patterns, as well as your stress levels. This will affect your milk output. Drink more fluids. Stay away from alcohol and caffeine, as well as exposure to smoke.