November 22, 2017
14 Tips for Traveling While Pregnant

14 Tips for Traveling While Pregnant

by Jeanine Barone  

If you’re pregnant, you know that the birth of your baby will turn your life upside down. That’s why it’s good to savor intimacy with your partner while you are pregnant, unencumbered by the new set of family pressures and concerns. Consider taking a “babymoon,” as the pre-baby vacation is often called, to enjoy your last bout of freedom as a couple.

But while a relaxing trip may sound idyllic, traveling while pregnant carries its own set of health concerns. The Zika virus epidemic in the Caribbean and Latin America is just one risk to a pregnant woman and her developing fetus. Here is what you need to know in order to protect your health and that of your baby.

1. Get vaccines if advised

If you are pregnant and intend to travel internationally, ask a doctor who has expertise in travel medicine about vaccinations you may need. Do this at least one or two months before you leave. Bring your itinerary and your history of vaccinations. Also discuss your travel plans with your obstetrician, who should consult with your travel medicine doctor. Carry along the contact information for your doctors and ask them to supply the names of high-quality medical facilities at your destinations in case you require medical care.

Pregnant women should not receive live-virus vaccines (referred to as live-attenuated vaccines), which include the shot for measles, mumps, and rubella (yellow fever vaccine may be used if the benefits outweigh the risks). That’s because of theoretical concerns that the weakened virus could infect the fetus. If you are not yet pregnant but planning to be, it’s advised to wait four weeks after getting a live vaccination before trying to conceive. The safety of certain other vaccines, including typhoid and Japanese encephalitis, for pregnant women isn't clear—another reason it's important to consult a travel medicine doctor.

2. Book an aisle seat

Pregnant women are at increased risk for the formation of blood clots, especially in the veins of the leg, when they sit for long hours. The enlarged uterus puts pressure on major blood vessels, and changes in hormones influence blood’s tendency to clot. Blood clots in the leg and pelvic area are called deep vein thrombosis (DVT) and can pose serious risks to the woman and developing fetus. To reduce the risk of DVT, book an aisle seat on the plane, train, or bus so you can easily get up to walk the aisle every half hour or so. You can also do leg-ankle exercises while in your seat. And when you’re traveling by car, make frequent stops at rest areas to take a walking break.

In addition, you may develop swelling (edema) in your legs and feet from sitting for long hours. So wear loose clothing and comfortable, loose-fitting shoes.

3. Check for any travel restrictions

Check with your airline about possible restrictions on travel during pregnancy. Some airlines restrict travel during the last month of pregnancy. International flights often have earlier cutoff points. Some cruise lines also have restrictions about pregnancy, sometimes after 24 to 28 weeks, and may require a doctor’s note saying it’s safe for you to travel.

Any pregnant woman with a medical condition that could be worsened by flying or that may necessitate emergency care should avoid flying. These conditions include women carrying twins, a history of preterm delivery, vaginal bleeding, problems with the cervix, uterine contractions that might lead to early delivery, severe anemia, chronic hypertension, and diabetes during pregnancy (gestational diabetes).

Most airline cabins are pressurized to 6,000 to 8,000 feet above sea level. That means there is less oxygen to breathe than at sea level. This isn’t a problem if you are healthy and have a normal pregnancy. But if you have a condition such as heart disease, severe anemia, or sickle cell disease, it could create a problem for the fetus. So check with your doctor.

4. Put together a special first-aid kit

Put together a first-aid kit that includes not just the usual items for cuts and bruises or bites and stings, but also your prenatal vitamins and any other medications you may be prescribed. For instance, your doctor may recommend a vaginal cream or suppository to treat yeast infections, which many pregnant women develop. Many pregnant women also experience heartburn, so pack a simple antacid like Tums or Rolaids. If you’ve developed hemorrhoids, which frequently occur with pregnancy, include pre-moistened wipes (such as Balneol or the generic equivalent) and whatever topical treatments you’ve found useful, such as witch hazel pads. Make sure you pack your first-aid kit in your carry-on bag in case your checked luggage is delayed or lost.

5. Ask about safe medications

Ask your doctor about which medicines you can safely take while pregnant, as well as safe herbal or dietary supplements. Ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin should be avoided; they can impact the fetus’s heart and increase the risk of placental abruption, a serious complication in which the placenta separates from the wall of the uterus before birth. Other drugs to avoid are certain antihistamines—common in allergy medicines—as well as decongestants such as brompheniramine, chlorpheniramine, phenylephrine, and pseudoephedrine.

6. Prepare for motion sickness

Motion sickness is common when traveling by boat, plane, bus, and car. The CDC recommends several simple non-drug strategies to prevent or treat motion sickness, including lying on your back with your eyes closed or sitting and gazing at the distant horizon. Distracting stimuli are worth a try, including sniffing lavender or mint scents, sucking on ginger-flavored lozenges, or listening to music. You may want to consider wearing a small watch-like device, ReliefBand, which uses a mild electric shock to stimulate an acupressure point on the inside of your wrist, providing an anti-nausea effect. This battery-powered device is expensive ($90), but some people swear by it. Other non-drug strategies that health professionals recommend include deep, slow breathing; holding your head very still; and eating only bland food.

7. Avoid risky foods

A woman’s immune system changes with pregnancy, making it harder for her to fight off infections, including microbes that cause foodborne illnesses. Among the diseases spread by food or water, hepatitis A and E are serious risks. Hepatitis A can increase the risk of premature delivery or placental abruption. Hepatitis E can cause fetal complications and can threaten the life of a pregnant woman. These viruses can spread in raw food and contaminated drinking water.

Pregnant women should drink water only from sealed bottles, or take an ultraviolet light water sterilizer on their trip that’s safe, effective, and easy to use. Also avoid any raw food—even sushi. To prevent listeriosis, don’t eat unpasteurized cheeses. And avoid undercooked meats, which carry a risk of toxoplasmosis (a dangerous parasitic disease). For more tips, see 8 Ways to Avoid Foodborne Illness When Traveling.

8. Take antibiotics on your trip

Diarrhea and vomiting are common symptoms of foodborne illness. Azithromycin, an antibiotic for traveler’s diarrhea, can be prescribed to pregnant women, although most women can recover within a few days without antibiotics. Imodium, a common anti-diarrhea medicine, can also be taken by pregnant women and should be carried in your first-aid kit. If you get traveler’s diarrhea, be sure to drink plenty of fluids to prevent dehydration. Bottled water, flat soft drinks, or sports drinks, will help. Or carry a powdered hydration mix with you—it can be purchased online, in pharmacies, or in large sporting goods stores—and mix it with bottled water.

9. Play it safe

Pregnant women should avoid activities that increase the risk of falling or involve vigorous, jarring movements. That includes wind surfing, water skiing, horseback riding, jet skiing, water slides and amusement park rides, and mountain biking. Also it’s best to avoid hot tubs, steam rooms, and saunas because of the high heat and the reduced ability of the body to effectively cool itself during pregnancy. In addition, while swimming and snorkeling are fine, most experts advise avoiding scuba diving. During decompression, a pregnant diver may be at an increased risk for an air bubble (called a gas embolism) forming in a blood vessel, which can be life threatening if it forms in the bloodstream of the fetus.

10. Stay cool

When pregnant, a woman’s body can’t regulate core temperature as well. Becoming overheated can lead to risky drops in blood pressure, fainting, and potential harm to the fetus. Be sure to book accommodations that have air conditioning, and minimize activities in the heat. If you’re hot, take a cool bath or shower. Be sure to drink fluids before you become thirsty. Dehydration for any reason is a concern for pregnant women, as it can affect blood flow and the amniotic fluid surrounding the fetus.

11. Limit sun exposure

Changing hormones and a genetic predisposition cause some pregnant women to develop a hyperpigmentation with clusters of brownish spots on their face, called melasma. Melasma is aggravated by exposure to the sun. So keep your direct sun exposure to a minimum, wear a broad-spectrum sunscreen with SPF of at least 30, and apply it liberally and often.

12. Avoid high altitude

Healthy pregnant women should avoid traveling more than 12,000 feet above sea level, because there is less oxygen to breath at high altitude. The developing fetus depends on the mother’s supply for its oxygen. Women with a high-risk pregnancy, or who are in late pregnancy, should avoid altitudes greater than 8,200 feet above sea level. Anyone with a complicated pregnancy should also avoid traveling to high altitude.

13. Prevent mosquito and tick bites

Pregnant women are more attractive to mosquitoes because they exhale more carbon dioxide. Mosquitoes can transmit numerous infections. To protect yourself, use any of the EPA-registered insect repellents that contain DEET (10 to 30 percent), oil of lemon eucalyptus, picaridin (20 percent), or IR3535, following the label directions. Buy permethrin-treated clothes or treat your clothing (not your skin) with this chemical. Wear long sleeves and pants as well as closed-toed shoes and socks. Wear light-colored clothing that’s loose fitting—mosquitoes target darker or bright colors and can bite through tight clothing.

These recommendations will also help ward off ticks, which carry a variety of infectious agents including the bacterium that causes Lyme disease. If untreated, Lyme disease can be dangerous to the fetus. After visiting areas prone to tick infestations, shower thoroughly and examine your skin closely for the presence of ticks.

14. Don’t travel to areas with malaria or Zika virus

Malaria and Zika virus pose serious risks to the developing fetus, so avoid travel to areas where mosquitoes transmit those diseases. Although there are drugs to prevent malaria, pregnant women should not take them—and they’re not 100 percent effective anyway. Malaria can cause placental abruption, premature labor, or miscarriage. It’s just not worth the risk.

Zika virus can cause brain abnormalities, as well as hearing and eye impairment, in fetuses. The CDC recommends that pregnant women (no matter what trimester) avoid any travel to areas with the Zika virus. If your partner has traveled to a Zika area, the CDC recommends that you use condoms or refrain from sex throughout pregnancy.

Also see Travel Safely in Hot Weather.