When Traveling during pregnancy: safe and risky trimesters
Interviewer: Dr Jennifer Feige is an obstetrician-gynecologist at University of Utah Health. If you have a pregnant patient who is considering or has planned a trip, what kind of advice do you usually give her?
Dr. Feige: I generally break it down into three different categories. So first of all, “when” during pregnancy do they travel? “Where” are they going? And then finally “how” do they get to their destination?
To begin with, when we talk about when to travel during pregnancy, although there are no contraindications to traveling during a trimester, more often than not, if something were to happen during a pregnancy, it would would produce during the first and/or third trimester. The ideal time to travel would therefore be during the second trimester, between 14 and 28 weeks of gestational age. The first trimester carries risks of miscarriage, vaginal bleeding as well as cramping, then the third trimester, as one gets closer to term, again there are increased risks of not only bleeding and/or or leakage of fluid, but also early pregnancy. work and having a baby. It's always best to be at home closer to a hospital and your known obstetrician/gynecologist, as well as to have records before giving birth on the road.
Interviewer: So you would recommend, if you were really worried, that the second trimester is about the best, but like you said before, it's okay for the first or third as well.
Dr. Feige: Exactly. The only contraindication that appears is that some airlines have a strict policy of not traveling once your stay is over, so after 37 weeks, but otherwise there is no strict contraindication.
Interviewer: And why?
Dr. Feige: Again, there's just the risk of giving birth when you're in the air: your water breaks, you bleed, you contract, and then a baby is born.
Interviewer: Okay, yeah, it's just an added inconvenience that they would have to deal with that.
Dr. Feige: Yeah, emergency landing of the flight, putting other passengers in danger.
Interviewer: Yeah, sure, okay, that's fair enough.
Dr. Feige: And perhaps not having the team ready to care for a newborn if, for some reason, there was another complication.
Or Traveling While Pregnant: Destination Considerations
Interviewer: Alright, so that covers the “when” component. What about the second element, which is “where”?
Dr. Feige: Where nowadays many people prefer more exotic trips, which is very romantic. We basically break it down by whether you're traveling to a developed country and/or a developing country. Developed countries have fewer risks. Growing comes with more risk because you have to think about where your water comes from and food preparation. But as long as you are in a developed country, the risks are minimal.
The exception to this, of course, is that we have all heard of the Zika virus, particularly in South America, Central America, and then parts of North America. Zika is a conversation in its own right. But if for any reason you need to travel to Zika-affected areas, we (a) generally discourage it, (b) if you choose to travel there, use protection. This means covering your extremities, sleeping under mosquito nets to avoid mosquitoes, and using DEET to specifically prevent any bites.
If for some reason you and your partner are traveling there and your partner becomes infected, we also encourage condom use every six months, as the virus can also be transmitted during sexual intercourse. We offer testing if you are in one of the Zika-prone areas. Here at the University of Utah, we can screen for that.
Other contraindications or other things to consider when we're talking about developing countries, as I alluded to, were where the water comes from. If it is not bottled water, we recommend boiling the water for at least one minute before consuming it. This includes brushing your teeth with bottled water and any type of ingestion, as water may carry risks of bacteria or viruses. We mainly think of hepatitis A when traveling to developing countries. Plus, we're also talking about washing your fruits and vegetables, making sure you know how they're prepared, and making sure things are cooked properly, just again to decrease your risk of viral or bacterial contamination.
Interviewer: So wash those fruits and vegetables if you are in an area. . .
Dr. Feige: In your clean water with your soap.
Interviewer: OK, your bottled water.
Dr. Feige: Yes.
Interviewer: I just want to check this.
Dr. Feige: Do not pour it down the sink. The only other thing we talk about even when traveling to developed countries is pasteurization. There is a bacteria called Listeria that is found even here in the United States. You always want to check that all your cheeses are specifically pasteurized, without eating cold cuts that have sat out for a long time, or any mayonnaise type dishes that have been sitting on the counter for an extended period of time.
Interviewer: Okay, so maybe a trip to France and those exotic cheeses you might want to avoid if they're not pasteurized.
Dr. Feige: Make sure they are pasteurized, exactly.
How Traveling during pregnancy: travel methods
Interviewer: All right. We've covered the when and the where. The “how” do you achieve this? What are the concerns?
Dr. Feige: We will focus on road trips, plane trips, then finally boat trips and/or this cruise.
Traveling by car
In reality, when it comes to car travel, there is no need to worry too much. If you obviously spend an extended period of time, more than five hours in the car, if you make a gas stop, we encourage you to get out, stretch your legs and move around.
Traveling by plane
This also translates to air transport. Many people are concerned about DVT that can occur outside of pregnancy. However, the physiology of pregnancy also increases this risk. We generally recommend wearing compression stockings on flights, walking around frequently, staying well hydrated and wearing loose clothing just to promote general circulation.
Another question that often comes up when talking about air travel is radiation exposure. They've done a lot of studies on this, and the FAA actually has a tool to assess your overall exposure to cosmic radiation. Even with the longest flights, they expect you to only get about 15% of your maximum dose. Obviously, flight attendants or people who are frequently in the air would be an exception here and could use the FAA tool to help them.
Traveling by sea
Finally, the other trip we're talking about is a cruise and/or being on a boat. Things to consider when traveling by sea and air are always antiemetic. Obviously, nausea and vomiting are quite common in early pregnancy. You always want to have your medications with you. More specifically on cruises, there has been an association with norovirus which is found on some cruise lines. It causes nausea, vomiting and diarrhea and obviously can disrupt a pregnancy, make you feel unwell and can have long-term effects. If for some reason there was an outbreak on your cruise ship, they would notify you and you would definitely want to notify your OB/GYN.
Cancellations, comfort and documentation
Interviewer: Have you ever had patients who actually canceled cruises or . . .
Dr. Feige: Absolutely.
Interviewer: . . . trips canceled due to pregnancy?
Dr. Feige: Yeah. This is a pretty common question where we have to fill out a letter saying yes, you are indeed pregnant. This also happens quite often during ski season, you need a letter from us proving you are pregnant in order to get a refund.
Interviewer: I got you, I got you. Do you have any other final thoughts on this? I think you covered it very well. It seems that there are some very practical health issues. It seems like there are a lot of comfort issues as well.
Dr. Feige: Yeah. Again, overall it is safe to travel while pregnant. Once your term is over, we encourage you to stay close to home, your hospital, and your obstetrician/gynecologist. But otherwise, I think it's great to get out and explore.
updated: November 29, 2024
originally published: June 1, 2017
