Travelling during pregnancy
With women leading busier lives, travel during pregnancy is quite common - be it for work, a best friend's destination wedding or a 'baby-moon'.
There are a number of factors important for pregnant women to consider before they pack their bags.
Travel vaccinations
Many destinations, particularly in the developing world require travel vaccinations. Some vaccines (hepatitis A, hepatitis B, tetanus, diphtheria and pertussis) are safe and recommended for pregnant women who are travelling to places where they are at risk. However, the majority of live-virus vaccines (yellow fever, oral polio, oral typhoid) are not recommended for pregnant women as they are not considered safe for the unborn child. Pregnant women should discuss their travel destinations with their doctor to determine what vaccines might be suitable.
Airline policies
Airlines have restrictions for pregnant women based on:
- Week of pregnancy
- Single or multiple pregnancy
- Length of flight; and
- If there are any existing pregnancy complications.
Many airlines require a certificate or letter from a registered medical practitioner/midwife if you are 28 weeks or more pregnant. The certificate/letter confirms the estimated date of delivery and that there are no complications with the pregnancy.
Pregnant women have a higher risk of developing deep vein thrombosis (DVT) while flying. Women can reduce their risk by drinking plenty of water during the flight, using foot rests if available and doing in-flight exercises. Compression stockings may be recommended for longer flights.
Travel insurance
Having adequate travel and health insurance in place before departure is vital. Many policies consider pregnancy a pre-existing condition and will not provide cover for pregnancy-related complications. While others provide cover only until a certain week of the pregnancy. Policies that do cover unexpected complications in pregnancy may not cover childbirth or any medical care of the unborn baby. If a woman gave birth prematurely, for example, the birthing expenses and care of the newborn would not be covered, which could be extremely costly.
Eating and drinking
Pregnant women are more vulnerable to contracting food and water-borne illnesses during pregnancy. They need to take extra care with what they eat and drink.
Precautions include only drinking bottled water or boiled and cooled water, using bottled water to brush teeth, avoiding ice in drinks and avoiding salads and uncooked fruit and vegetables. If a pregnant women develops travellers' diarrhoea, she should see a doctor as soon as possible as the associated dehydration can be harmful to the baby. Also, many of the common diarrhoea relief medications are not considered safe to take during pregnancy.
Mosquito-borne diseases (Malaria, Zika Virus)
As with food and water-borne illnesses, pregnant women are also more susceptible to contracting mosquito-borne diseases. It appears that mosquitoes are more attracted to pregnant women and pregnancy reduces a woman's immunity to the diseases. Malaria increases a pregnant woman's risk of miscarriage, stillbirth and premature birth, and the Zika Virus has been linked to birth defects.
Women should discuss the risk of malaria at their travel destination with their doctor and whether anti-malarial medications are required. Not all anti-malarial medications are recommended for use by pregnant women.
The past year, pregnant women and those actively seeking to become pregnant have been advised to consider postponing travel to areas where the Zika virus is being transmitted (see here). Women should discuss any travel plans with their doctor.
Local medical care standards
In many developing countries or even the more remote regions of Australia, the medical facilities will not be the same as those in a developed country or a metropolitan city. If a pregnancy complication occurs there may be limited support at the local hospital. Women should ask their doctor about where to go to if they require medical assistance for each destination in their travel itinerary.