Travel in pregnancy

Whether travelling for work, a destination wedding or a babymoon, pregnant women should consider these factors before packing their bags. By Kirsten Braun.

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pregnant belly and passport

With women leading busier lives, travel during pregnancy is quite common. Whether it is for work, a best friend's destination wedding or a baby-moon, there are a number of factors pregnant women should 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 (measles, mumps, rubella, chicken-pox) 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: how many weeks pregnant; single or multiple pregnancy; length of flight and if there are any existing pregnancy complications. Different airlines have different policies so it is important to check all airlines used in a travel itinerary. 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.

Using Qantas as an example, if the flight is less than four hours a woman with no complications can travel up to the end of the 40 week (single pregnancy) or the end of the 36 week (multiple pregnancy). If the flight is four hours a woman with no complications can travel up to the end of the 36th week (single pregnancy) or end of the 32nd week (multiple 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

Pregnant women should check that they have adequate travel and health insurance in place before travelling. Many policies consider pregnancy a pre-existing condition and so 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. As well as checking that the policy covers the right circumstances the monetary value that the policy covers should also be confirmed as medical costs in countries like the United States are particularly expensive.

Eating and drinking

Women are more vulnerable to contracting food and water borne illnesses during pregnancy. Travellers' diarrhoea, while a nuisance for the average traveller, can be dangerous for a pregnant woman and her baby due to the associated dehydration. Similarly, bacterial infections like listeria or salmonellae can harm the unborn baby. Pregnant women need to take extra care with what they eat and drink if traveling where water and food borne illnesses are present. 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 woman develops travellers' diarrhoea she should see a doctor as soon as possible as many of the common diarrhoea relief medications are not considered safe to take during pregnancy.

Malaria

As with food and water borne illnesses, pregnant women are also more susceptible to contracting malaria. It appears that mosquitoes are more attracted to pregnant women and pregnancy reduces a woman's immunity to the disease. If a pregnant woman contracts malaria it increases her risk of miscarriage, stillbirth and premature birth. Women should discuss with their doctor the risk of malaria at their travel destination and whether anti-malarial medications are required. Not all anti-malarial medications are recommended for use by pregnant women.

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 metropolitan city. If a pregnancy complication occurs there may be limited support at the local hospital. In developing countries basic facilities might also mean there is a greater risk of infection, including blood borne viruses like hepatitis C and HIV. Women should ask their doctor about where to go to if they require medical assistance for each destination in their travel itinerary.

Last updated: June 2014

© Women's Health Queensland Wide Inc. This article was written by Kirsten Braun and reviewed by the Women's Health Queensland Wide editorial committee. It was published in Health Journey 2014 Issue 2.

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