Traveling During Pregnancy

• History of: miscarriage, ectopic pregnancy, premature labor, premature rupture of membranes, infertility, difficult conceiving, or thromboembolic disease
• Being pregnant with multiples or being over age 35 and pregnant for the first time
• History or presence of placental abnormalities, toxemia, hypertension, or diabetes during any pregnancy
• Incompetent cervix, severe anemia, valvular heat disease, or congestive heart failure
• Signs of possible miscarriage or vaginal bleeding during present pregnancy
• Chronic organ system dysfunction that requires frequent medical intervention

• Areas of high altitude
• Areas known for outbreaks of life-threatening food and/or insect-borne infections
• Areas where live-virus vaccines are required or recommended
• Areas where chloroquine-resistant forms of malaria are present

• Anticipate any complications or emergencies that could arise. Call your health insurance provider to see if your insurance is valid while you are abroad, and check to see whether the policy will cover a newborn, should you deliver while away. You may want to consider obtaining a supplemental travel insurance policy and/or medical evacuation insurance policy.
  
• Research medical facilities at  your destination. Women in the last trimester of pregnancy should look for facilities that can manage complications of pregnancy, toxemia, cesarean sections and neonatal emergency needs.
  
• If you will need prenatal care while you are away, arrange for this before you leave. Consult with your physician to determine the best way to handle this.
  
• Know your blood type. If you are traveling out of the country, check to make sure blood is screened for HIV and hepatitis B in the areas you will be visiting.
  
• Check on the availability of safe food and beverages, including bottled water and pasteurized milk, at  your destinations.
  
• Arrange to travel with a companion if at all possible.
  
• Try to rest as much as possible while away. Exercise and activity during pregnancy are important, but try not to overdo it.

• Speak with your doctor about taking Ginger capsules (250 mg/dose). Ginger has long been associated with alleviating nausea.
• Carry a handkerchief with a few drops of essential oil (lemon for example) on it. Breathe through it to help with relieve nausea.
• Heat can increase the nausea. If possible, avoid sitting next to others when traveling, or at least sit next to the aisle. Wear lightweight clothing and layers so you can take layers off as needed to remain cool.
• Make sure you eat something before and perhaps during your trip. Dry foods like crackers and dried fruits, such as raisins or apricots, are good choices to carry with you. Other options include cereal bars, nuts and trail mix. Small, frequent snacks also tend to help.

• Vaginal bleeding
• Contractions
• Impaired vision
• Ruptured membranes
• Abdominal pain or cramping
• Passing clots or tissue
• Headaches
• Excessive swelling of your legs

• Always wear a seatbelt. Position the lap portion of the belt snugly under your abdomen and across your upper thighs. The seat belt should NOT cross your abdomen.
• Air bags are just as safe during pregnancy as they are at any other time, so don’t turn them off. To minimize the risk of injury during airbag deployment, sit as far back as possible—at least ten inches away from the dashboard or steering wheel.
• Pull over at least once every two hours to stretch your legs and move around. You’ll probably need to stop and use the restroom this frequently anyway.
• If you are in a car accident of any sort, regardless of severity or how far along you are in your pregnancy, you should be checked out by a doctor immediately, even if you feel fine.

• Be sure to hold on to the seat backs when walking up and down the aisles.
• These may not be the best modes of transportation if you are experiencing any pregnancy sickness.
• Avoid train cars or buses that permit smoking.
• Move and stretch every few hours to prevent blood clots.
• Drink plenty of water to diminish motion sickness.

• Avoid all flights where smoking is allowed. While smoking is not permitted on USA domestic flights, some foreign carriers still permit smoking. Even though aircrafts are divided into smoking and non-smoking sections, trying to keep the air in a smoking section is like trying to chlorinate half a swimming pool.
• Be sure your plane has a pressurized cabin. Be especially careful with commuter flights, as they are not pressurized, since they usually fly at low altitudes. While a short time spent in an un-pressurized cabin above 7,000 feet is unlikely to harm your baby (baby's oxygen level in the womb is already lower than mother's), it can reduce the oxygen in your blood, causing you to feel lightheaded and impair your thinking and ability to move.
• Request a seat as far forward on the aircraft as possible. Not only is the air circulation better in front, it's easier to get on and off the aircraft. Some women find a window seat helpful for minimizing early-pregnancy queasiness; others prefer an aisle seat, which makes it easier to walk and go to the bathroom. If you are traveling with a companion, request the aisle and window seat, and ask that the middle seat be left vacant to give you some extra space for maneuvering unless the space is needed.
• Consider requesting a bulkhead seat if you need additional leg room. Note that the armrests are stationary, which can restrict your sideways mobility and prevent you from stretching out, should the adjacent seat be vacant.
• If morning sickness is a problem, try to arrange travel during a time of day when you generally feel well. Seats over the wing in the midplane region will provide the smoothest ride.
• Calling ahead to request a special meal can increase your chance of getting the airline food most friendly to your stomach. Better yet, pack your own meal. Alert the flight attendant of any special needs.

• Metal detectors, which all passengers must pass through before boarding a plane, won’t harm your unborn baby.
• Changes in air pressure on a high-altitude flight should present no unusual problems for you or your baby.
• Try to walk every half-hour during a smooth flight, and flex and extend your ankles frequently to prevent phlebitis (blood clots in your legs).
• Fasten your seat belt at the pelvis level (below your belly).
• Make sure to drink plenty of fluids before and during your flight. Extra fluids can help prevent dehydration, which can lead to nausea.
• Elevate your feet as much as possible and walk frequently during the flight to lessen leg swelling. On long flights, expect your feet to expand a size—no matter what you do. Once you remove your shoes, you may not be able to get them back on, so be sure to take along a roomier pair, or even a pair of slippers.
• While normal air humidity can reach 57% or more, the humidity of cabin air is only around 7%. Besides being uncomfortable to your nasal passages, dry air can contribute to dehydration. In addition to drinking extra fluids, you can help prevent your nasal passages from drying out by breathing the steam from a hot cup of water. You can also take along a bottle of saline nasal spray (available at any pharmacy without a prescription), and spray it into your nose every hour or so.
• Pregnant women, like senior citizens, should always be given assistance with luggage. However, it would appear that many people are afraid of insulting a woman's independence by offering aid. Don't be afraid to ask! Be especially careful to avoid stretching and reaching into overhead compartments for heavy luggage. You don't want to strain any muscles unnecessarily.

• If you are taking a cruise during your first trimester, the motion of the boat may exacerbate or initiate pregnancy sickness.
• Some cruise lines will not permit women who are 27 weeks or more pregnant to sail because of the risk of premature labor. Other lines require a physician's Fit to Travel note, stating that you are in good health, and do not have a high risk pregnancy.
• Check with the cruise line to determine whether there is a physician on board in case you develop any complications. Most small ships (with 100 passengers or less) generally do not have medical personnel on staff.
• Larger ships are more stable on rough seas. For the smoothest ride, get a cabin in the middle of the ship, close to the water line.
• Check your scheduled ports-of-call to find out about their medical facilities and other safety issues such as water supplies, disease outbreaks, etc. Less developed countries may have a shortage of trained doctors and nurses, sterile equipment, and safe blood, so it may be best not to get off the boat at those destinations.

• Contact the Centers for Disease Control and Prevention at (www.cdc.gov or 1-877-394-8747) to receive safety information and vaccination facts related to your travel itinerary.
• Drink only bottled water. Don’t use ice cubes made from tap water in your drinks and don’t use glasses or cups that have been washed in tap water. Canned juices and soft drinks are acceptable alternatives.
• Make sure the milk you drink is pasteurized.
• Avoid fresh fruits and vegetables unless they are cooked or can be peeled.
• Only eat meat and fish that are well cooked.