This article first appeared in the December/January 2016 issue of Your Pregnancy magazine.
Before you jet off anywhere, you need to have had an ultrasound to check your due date and confirm you’re having a normal pregnancy. That’s according to Dr Peter Vincent, medical adviser to Netcare Travel Clinics, who says flying while pregnant is either not advised or completely ruled out in high-risk pregnancies.
In normal (low-risk) pregnancies there’s generally no restriction on domestic or international air travel from 23-36 weeks. If you’re carrying multiples, the cut-off is 32 weeks. All airlines have different policies on travel during pregnancy, so you do need to check with the airline directly.
“Remember too that the cut-off date usually includes the return date of travel,” says Lucinda Tyler, Club Travel product manager. “So you need to calculate how many weeks pregnant you’ll be when you fly back.”
Many airlines require a doctor’s letter confirming you’re fit to fly only in the third trimester, but Lucinda recommends taking a doctor’s letter along in the first and second trimesters just in case. “It’s also a good idea to travel with your prenatal records, doctor or healthcare provider’s contact details and health and/or travel insurance details,” she advises.
- Also see: Taking your bump on the road
Safety by trimester
Even if the airline allows you to fly, should you? Dr Vincent advises against non-essential travel during the first trimester. Not only will flying make symptoms such as morning sickness and fatigue worse, he says, “It’s also a time when your body is adapting to hormone changes and the most likely period to suffer a miscarriage.”
The second trimester is a much better time to board that plane. “This is the safest time for a pregnant women to travel, particularly the 18-24 week period,” he explains.
He advises only flying during the third trimester if you’re comfortable and have been given the all clear by your doctor, even if you’re well within the 36-week cut off period.
Comfort and safety tips
Deep-vein thrombosis is a risk when flying while pregnant. “It’s said to be 5 to 10 times higher than in non-pregnant women,” confirms Peter. He recommends taking preventative measures such as frequent stretching, walking and leg exercises, as well as wearing graduated compression stockings.
“Keep compression stockings on and keep leg exercises up for at least 48 hours after a flight longer than 8 hours.” Blood thinners to ward off thrombosis are not recommended, unless prescribed by your gynae/obstetrician.
Other tips for staying comfortable when flying with a bump include wearing loose clothing and comfortable shoes, booking an aisle seat close to the toilets, not drinking fizzy drinks before or during the flight (the gas will expand in the pressurised cabin), and avoiding all drinks with caffeine (including teas, coffees and soft drinks).
- Also see: Travel first aid kit
Like flying, long car drives or bus rides aren’t recommended during the first trimester and should be taken with caution during the third. The second trimester is when you want to be packing the padkos.
Peter says it’s important to stop and walk around every two hours, as there’s a risk of deep vein thrombosis with long drives. “Also do leg and ankle movements while sitting and wear graduated compression stockings.”
A seatbelt is an absolute must. “A diagonal shoulder strap with a lap belt provides the best protection,” says Peter. “The shoulder belt should be worn between the breasts with the lap belt low across the upper thighs. When only a lap belt is available, it should be worn low between the abdomen and pelvis.”
Most international cruise lines allow pregnant women on board up until 28 weeks, but also require a doctor’s letter saying they’re fit to cruise. Allan Foggitt, marketing and sales director for MSC Starlight Cruises, which operates cruises locally, says they only allow pregnant women on board if they “do not reach or exceed the 24th week of pregnancy during the trip”.
A doctor’s letter is also recommended. Peter warns that pregnant women may struggle more with motion sickness on cruises. A good remedy is to add ginger powder to your food or drink. Vitamin B6 tablets should also help.
If the seasickness is severe (constant nausea and vomiting that’s not responding to the other remedies), he says it’s safe for pregnant women to take seasickness medications Cinnarizine or Cyclizine, but always check with your doctor first.
Having a good travel insurance policy is essential, especially if you’re travelling out of South Africa. “A travel insurance policy will give you peace of mind should you go into early labour and need hospitalisation, and/or repatriation, or experience any other unforeseen complication as a result of your pregnancy,” explains Simmy Micheli, sales and marketing manager for Travel Insurance Consultants.
Bear in mind that the standard “free” travel insurance that comes with your credit card is often not sufficient to cover these costs outside of South African borders, and you may need to buy a top-up policy or even a separate policy altogether.
Here’s the most important thing you need to know: even if an airline allows you to fly up to 36 weeks, travel insurers will only insure you for pregnancy-related medical claims up to 15 weeks before your due date.
“Most travel insurance products in South Africa will only cover any unforeseen complications of a normal pregnancy up to the end of your 25th week of pregnancy,” confirms Simmy. She emphasises “normal” because if your pregnancy is high risk in any way, most travel insurers won’t pay pregnancy related claims.
“If your doctor says you shouldn’t be flying, then don’t,” warns Simmy. “Insurers won’t pay claims if you’ve travelled against medical advice.”
- Also see: Get ready for family travel
Travel medication and vaccinations
If you’re planning a trip in advance, it’s preferable to have any vaccinations you may need before you’re pregnant. But make sure your timing is right, says Dr Vincent, as it’s recommended you don’t try to conceive for 28 days after receiving live vaccines such as yellow fever, MMR or varicella. If there was no planning (for the trip or the pregnancy!), always consult your doctor or a travel clinic about which vaccinations may be needed and which are safe for pregnancy.
Travelling to malaria areas while pregnant should be avoided completely, according to the American Center for Disease Control, as pregnant women are more likely to develop very serious malaria, which can be rapidly fatal if not treated early, should they become infected. Malaria can cause severe birth defects in unborn babies, or death.
If travel to a malaria area is absolutely essential, certain malarial medications are allowed, but should only be taken under your doctor’s strict supervision.
Play it safe
You don’t have to spend your entire holiday on a shaded sun lounger (unless you want to); there are plenty of activities that are perfectly safe for pregnant women. “Pregnant travellers should be advised against doing vigorous physical activity and activities where there’s a risk of contact with the abdomen or falling,” says Dr Vincent.
Swimming and snorkelling are perfectly safe, but waterskiing, where there’s a risk of falls and/or injecting water up the birth canal, are not. Scuba diving isn’t allowed because there’s a risk of foetal gas embolism (potentially fatal).
Walking and gentle jogging is fine. Dr Vincent warns against riding bicycles, motorcycles or animals though, as there’s a “risk of falls that could cause trauma to the abdomen”.
Skiing and snowboarding is off the itinerary because of the risk of falling. In fact, Dr Vincent says it’s not a good idea to be on very high slopes at all: “Pregnant women should avoid activities at high altitude and avoid sleeping at altitudes above 12 000 feet.”
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