Pregnant woman traveling

Traveling While Pregnant or Breastfeeding

Special considerations for traveling while pregnant

Traveling during pregnancy is normal and a lot of women do it. But it's important to think about potential problems that could come up during international travel. Also think about how you would get quality health care in the countries you are visiting. Get all of the vaccines you need before becoming pregnant instead of waiting to get them during pregnancy.

The American College of Obstetricians and Gynecologists says the safest time for a woman to travel is in the second trimester of her pregnancy, from 14 to 28 weeks. This is the time when you will feel your best. You are also at the lowest risk for spontaneous abortion or premature labor. During the third trimester (25 to 40 weeks), many healthcare providers and midwives advise staying within a 300-mile radius of home because of potential problems such as high blood pressure, phlebitis, and false or preterm labor. Generally, women are not allowed to travel by air after 36 weeks for domestic travel, and after 28 to 35 weeks for international travel. The decision on whether to travel and how far to travel at any time during pregnancy should be a joint decision between you and your healthcare provider or midwife.

According to the CDC, pregnant women with the following conditions may be advised against traveling to countries that require pre-travel vaccines. This list may be incomplete. So discuss your health history with your provider or midwife before planning travel:

History of miscarriage
Incompetent cervix
History of ectopic pregnancy
History of premature labor or premature rupture of membranes
History of or current placental abnormalities
Threatened miscarriage or vaginal bleeding during current pregnancy
Multiple fetuses in current pregnancy
History of toxemia, high blood pressure, or diabetes with any pregnancy
History of infertility or trouble getting pregnant
Pregnancy for the first time over the age of 35 years
Heart valve disease or congestive heart failure
History of blood clots
Severe anemia
Chronic organ system problems that need to be treated

You may also be advised against traveling to places that may have hazards. The list below may be incomplete. Talk about your travel plans with your healthcare provider or midwife before planning a trip.

Places with high altitudes
Places that have outbreaks of life-threatening food- or insect-borne infections
Places where malaria is common
Places where live-virus vaccines are needed or recommended

Healthy tips for traveling while pregnant

Here are tips for traveling while pregnant:

Try to plan ahead for any problems or emergencies that could come up before you travel. Check that your health insurance is valid while you are abroad. Also check to see whether the plan will cover a newborn, should you deliver while away. You may want to think about getting a supplemental travel and medical evacuation insurance.
Research medical facilities in your destination. Women in the last trimester of pregnancy should look for places that can manage complications of pregnancy, toxemia, and cesarean sections.
If you will need prenatal care while you are abroad, arrange for this before you leave. Talk with your healthcare provider or midwife to figure out the best way to handle this.
Know your blood type and check that blood is screened for HIV and hepatitis B in the areas you will be visiting.
Check that safe food and beverages such as bottled water and pasteurized milk are available at your destinations.
If flying, ask for an aisle seat at the bulkhead. This gives you the most space and comfort. 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 give you the smoothest ride.
Try to walk every half-hour during a smooth flight. Flex and extend your ankles often to prevent blood clots in the veins (thrombophlebitis).
Fasten your seat belt at the pelvis level, below your hips.
Drink plenty of fluids to stay hydrated. Aircraft cabins have low humidity.
Try to rest as much as possible while away. Exercise and activity during pregnancy are important. But try not to overdo it.

Special considerations for traveling while breastfeeding

Breastfeeding gives babies the most nutritional start in life. It also gives them vital protection against certain infections. But traveling internationally while nursing can be challenging.

If you are breastfeeding only, you don't have to worry about sterilizing bottles or having clean water. You may get vaccines to protect against disease, depending on where you are traveling. But diseases such as yellow fever, measles, and meningococcal meningitis may be a threat to infants who can't be vaccinated at birth. Discuss this with both your healthcare provider or midwife and your infant's care giver before you travel.

If you are feeding your baby formula, it's best to use powdered formula made with boiled water. You may also want to carry a supply of prepared infant formula in cans or ready-to-feed bottles for emergencies.

Breastfeeding helps lower the chance of your baby getting traveler's diarrhea. If you get traveler's diarrhea, drink more fluids, and continue to nurse your baby.

Watch your eating and sleeping patterns, as well as your stress levels. This will affect your milk output. Drink more fluids. Stay away from alcohol and caffeine, as well as exposure to smoke.

Pregnant Travelers | Travelers' Health

Pregnant travelers can generally travel safely with appropriate preparation. But they should avoid some destinations, including those with risk of Zika and malaria. Learn more about traveling during pregnancy and steps you can take to keep you and your baby healthy.

Before Travel

Before you book a cruise or air travel, check the airlines or cruise operator policies for pregnant women. Some airlines will let you fly until 36 weeks, but others may have an earlier cutoff. Cruises may not allow you to travel after 24–28 weeks of pregnancy, and you may need to have a note from your doctor stating you are fit to travel.

Zika and Malaria

Zika can cause severe birth defects. The Zika virus is spread through mosquito bites and sex. If you are pregnant, do not travel to areas with risk of Zika. If you must travel to an area with Zika, use insect repellent and take other steps to avoid bug bites. If you have a sex partner who lives in or has traveled to an area with Zika, you should use condoms for the rest of your pregnancy.

Pregnant travelers should avoid travel to areas with malaria, as it can be more severe in pregnant women. Malaria increases the risk for serious pregnancy problems, including premature birth, miscarriage, and stillbirth. If you must travel to an area with malaria, talk to your doctor about taking malaria prevention medicine. Malaria is spread by mosquitoes, so use insect repellent and take other steps to avoid bug bites.

Make an appointment with your healthcare provider or a travel health specialist at least one month before you leave. They can help you get destination-specific vaccines, medicines, and information. Discussing health concerns as well as your itinerary and planned activities with your provider allows them to give more specific advice and recommendations.

Plan for the unexpected. It is important to plan for unexpected events as much as possible. Doing so can help you get quality health care or avoid being stranded at a destination. A few steps you can take to plan for unexpected events are to get travel insurance,  learn where to get health care during travel, pack a travel health kit, and enroll in the Department of State’s STEP.

Be sure your healthcare policy covers pregnancy and neonatal complications while overseas. If it doesn’t get travel health insurance that covers those items. Consider getting medical evacuation insurance too.

Recognize signs and symptoms that require immediate medical attention, including pelvic or abdominal pain, bleeding, contractions, symptoms of preeclampsia (unusual swelling, severe headaches, nausea and vomiting, and vision changes), and dehydration.

Prepare a travel health kit. Pregnant travelers may want to include in your kit prescription medications, hemorrhoid cream, antiemetic drugs, antacids, prenatal vitamins, medication for vaginitis or yeast infection, and support hose, in addition to the items recommended for all travelers.

During Travel

Your feet may become swollen on a long flight, so wear comfortable shoes and loose clothing and try to walk around every hour or so. Sitting for a long time, like on long flight, increases your chances of getting blood clots, or deep vein thrombosis. Pregnant women are also more likely to get blood clots. To reduce your risk of a blood clot, your doctor may recommend compression stockings or leg exercises you can do in your seat. Also, see CDC’s Blood Clots During Travel page for more tips on how to avoid blood clots during travel.

Choose safe food and drink. Contaminated food or drinks can cause travelers’ diarrhea and other diseases and disrupt your travel. Travelers to low or middle income destinations are especially at risk. Generally, foods served hot are usually safe to eat as well as dry and packaged foods. Bottled, canned, and hot drinks are usually safe to drink. Learn more about how to choose safer food and drinks to prevent getting sick.

Pregnant women should not use bismuth subsalicylate, which is in Pepto-Bismol and Kaopectate. Travelers to low or middle income destinations are more likely to get sick from food or drinks. Iodine tablets for water purification should not be used since they can harm thyroid development of the fetus.

After Travel

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider immediately, and tell them about your travel. Avoid contact with other people while you are sick.

More Information

CDC Yellow Book: Pregnant Travelers

Holidays and travel during pregnancy

Before planning a trip, be sure to consult a gynecologist whom you trust to manage your pregnancy. He will prescribe tests and ultrasound to exclude placental pathologies, anemia, gestosis and many other problems in which long-distance travel is not recommended. Bleeding and miscarriages in history are also on the list of contraindications. In addition, safety and comfort also depend on the gestational age.

IMPORTANT: CORONAVIRUS AND PREGNANCY

At the moment, there is no confirmed information that pregnant women are more or less susceptible to infection with COVID-19 coronavirus infection than others. However, the US Centers for Disease Control and Prevention* reminds that due to changes in the immune system and emotional state, pregnant women are generally more prone to viral respiratory diseases, so be sure to take all measures to protect yourself. First of all, avoid traveling to high-risk countries. So, for example, by decree of the Mayor of Moscow "On high alert mode", citizens arriving from Italy, Iran, Spain, France, Germany, South Korea and China must ensure home quarantine (self-isolation at home) for a period of 14 days and provide their contact information to hotline of the city of Moscow. In fact, the list of countries with coronavirus is longer. Recently, the Netherlands, Norway, Sweden, Great Britain, Switzerland got into it - before making a decision on a trip, look for information about in which countries the coronavirus was found in reliable sources on the Internet, for example, on the WHO website or the official website of the Mayor of Moscow.

To prevent infection, pregnant women should take the same measures as everyone else: wash their hands more often and treat them with disinfectants, avoid crowded places, try not to touch your face, wear a mask or respirator in public places, minimize contacts, etc. ** There is not enough data yet to say for sure whether COVID-19 is transmitted from a pregnant woman to her child. But it is reported that at the moment there are no cases of transmission of the virus from an infected mother to the fetus during pregnancy, during or immediately after childbirth.

What is the best trimester to travel?

Traveling in the first trimester will not be a pleasant memory for every pregnant woman. Many are tormented by toxicosis, an acute reaction to stuffiness and odors, and increased fatigue. Any discomfort can be annoying - if you encounter this during the planning stage of your trip, consider alternative options. Also at an early stage, when the main organs and systems of the fetus are formed, pregnancy is most vulnerable. But it is important to understand that many women travel without problems in the early stages of pregnancy (in fact, some do not know about their situation), go on business trips, go to new places and have a great time there.

Weeks 14 to 27 are considered the safest and most comfortable time to travel if the mother-to-be is well. It is only important not to stay in the sun for a long time, not to abuse exotic food (especially those prepared from animal products without heat treatment), to avoid crowded resorts , on the territory of which intestinal and other infections are raging.

In the third trimester (from the 28th week) there are restrictions related to flights: Many airlines do not allow women on board if their pregnancy is 36 weeks or more, and even earlier in case of multiple pregnancies. Sometimes airlines even ask expectant mothers to provide certificates indicating the current gestational age. Starting from the 28th week, airline representatives have the right to ask you to present certificate that you are allowed to fly.

Another nuance is that childbirth on the territory of a foreign state can turn into difficulties when returning to your homeland. For example, a baby born in Greece automatically becomes a citizen of this country, and in order to travel with him, you will have to overcome many legal delays.

Choosing a place to rest

Good rest during pregnancy includes sleep, outdoor activities and good nutrition. So you can have a good and calm time in the nearest holiday homes, boarding houses, park hotels and eco-camps. Now many hotels offer special vacation programs for expectant mothers.

If you want not only to relax, but also to gain new impressions, you should choose the direction of travel according to its ecological and epidemiological situation, as well as the level of medicine. Don't forget to take out good travel insurance - take one that includes services for pregnant women (if you take out a policy online, make sure that it is designed for expectant mothers).

If you are purchasing a packaged tour, please note that the standard package does not usually cover maternity cases. Contact the tour operator to clarify the possibility of changing the terms of insurance.

Be sure to read the reviews on the Internet about medical care in the selected country - how quickly you can get help, how childbirth is in local maternity hospitals.

Which transport is preferable?

The main condition for traveling during pregnancy is the ability to get up and walk a little at any time. All types of transport (sometimes even tourist buses, but this is not for everybody) meet this criterion. But the train, and the plane, and the car have features that need to be taken into account.

Vehicle

The main convenience of this method of transportation is that you can stop at any time to warm up and quickly get to the nearest hospital or maternity hospital in case of unforeseen circumstances.

But there are also disadvantages - in the later stages it can be uncomfortable to sit in a chair even for half an hour in a row, besides, some pregnant women can get motion sickness in a car. Special pillows for the back and neck, comfortable air conditioning, as well as a seat belt adapter for pregnant women will facilitate the journey. It removes the load from the abdomen, does not press, does not rub and fixes firmly, ensuring safety.

Train

The train makes it possible to change position at least every five minutes - to sit, lie down, walk around. It is better to sit on the bottom shelf and take care of your personal hygiene to the maximum - take antibacterial gel and wipes, toilet pads, slippers, and a toothbrush with you. The negative aspects of traveling by rail are obvious - it is much slower than an airplane, and changing the route or making an unplanned situation, like by car, simply will not work.

Aircraft

The main advantages of traveling by plane are speed and safety. The cons relate mainly to health hazards and airline regulations.

If the doctor has approved the flight, this is only the first step to a successful trip. Although there is no scientific evidence that air travel increases the risk of preterm birth or has a negative effect on the fetus, airlines play it safe to avoid emergency landings and additional costs. As mentioned above, many airlines have strict rules for flying while pregnant. It is better to consult about the prohibitions on the carriage of pregnant women before buying a ticket from a tour operator or directly from the air carrier.

What should be considered before the holiday?

Make an appointment with your doctor one week before your holiday. Be sure to let us know where and how you want to go: doctors have life hacks in stock that you didn’t know about.

Specify which of the medicines can be taken during pregnancy if you become ill in transport, in the heat, in case of poisoning, cystitis, candidiasis or a cold; what first aid may be needed for standard ailments during pregnancy - swelling, pulling pains in the abdomen, headache, heartburn.

In addition to the basic documents, ask the doctor for your exchange card with the results of tests and examinations (if you are seen in a private clinic, you will most likely have a duplicate in your hands). If you are flying abroad and understand that at some point you may need to consult local doctors, take translations of your most important medical documents with you.

Take snacks and plenty of water on the transport, and do not go out into the sun without sunscreen - this rule applies not only to pregnant women, but also to their relatives! It is better to relax on the beach before 11 am and after 5 pm, when the heat begins to subside. Choose clothes made from natural fabrics and comfortable shoes. Minimize the risks and enjoy your vacation!

*US Centers for Disease Control and Prevention. Frequently Asked Questions: COVID-19 and pregnancy.

** Rospotrebnadzor in the mountains. Moscow. On recommendations to citizens on the prevention of a new coronavirus infection

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How to travel while pregnant?

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Many modern pregnant women continue to live their usual lives and do not refuse business trips or trips abroad during their holidays. What should be the fate of planning a vacation or a work trip while in position?

State of health and duration of pregnancy

The second trimester of pregnancy (14-28 weeks) is considered ideal for travel, when toxicosis has already passed, and the stomach still does not interfere with either sitting or moving around. You can travel both earlier and later, the possibility of a trip depends on the condition of the woman.
Before any trip - to the country or to another country - you should consult with your gynecologist. If the doctor believes that the woman is healthy, nothing threatens the fetus, then you can go.
The trip is canceled if the woman has a low placenta, signs of preeclampsia are noticeable, any chronic disease has worsened, an allergy attack has occurred.

Insurance

Going on a trip abroad, you need to take care of insurance. It is important to know that not all insurance companies issue policies for pregnant women (some insurance companies include pregnancy up to the eighth week in the standard insurance for traveling abroad, on the grounds that at this time a woman may not know anything about her situation.
When an insurance company is selected, you need to familiarize yourself with the terms of insurance: some issue policies for women with a gestational age of no more than 24 weeks, but there are firms that work with those who travel for longer periods (up to 36 weeks).

Childbirth and subsequent stay in the postpartum ward are almost never included in the list of insured events. The birth of a child can be paid for by the insurance if childbirth (or abortion) has become a necessary measure as part of the provision of emergency care to a pregnant woman.

Pregnancy policies are issued for a short period of time, usually about seven to ten days. This should also be taken into account when planning a vacation.

Traveling far is not worth it: even the healthiest pregnant woman does not need a long journey on several modes of transport and harsh acclimatization.
It is better to choose a place with weather conditions similar to those familiar to the expectant mother and not to leave winter for summer and vice versa. That is, a trip from Novosibirsk to Fiji will not be the most reasonable trip.
No need to experiment with countries: during pregnancy, it is better to refuse to travel to exotic and too distant countries. It is undesirable to visit places where a woman did not go before pregnancy. It is better to go to a familiar place and even to a familiar hotel if possible.

Purpose of the trip

A "pregnant" vacation should not be extreme - you don't have to go skiing or riding down the mountains.

You don't need to plan to visit as many attractions as possible. Hiking along the sea in the early morning, sitting on the balcony with a delicious lunch, a book and a view of the water during the day and going to a small quiet restaurant in the evening will be more useful than spending many hours in the halls of museums.

Beach holidays should be planned so as to be in the sun as little as possible. It is harmful not only to pregnant women, but to all women in general. Swimming is possible and necessary for the expectant mother, only it should be done in the early morning or evening, when the sea is still warm, the sun no longer bakes, and there are much fewer people on the beach than at rush hour.

If you have to work while traveling, you need to take care of the correct daily routine and not take on additional workloads where this can be avoided. For example, many on business trips take extra work for the evening in a room or a rented apartment, since it seems that there is nothing else to do in an unfamiliar city. A pregnant woman always has something to do - she can relax in all ways available to her.

Transport

The fastest way to get from point A to point B is by plane. But it must be borne in mind that some major airlines do not allow pregnant women on board after 34-36 weeks, so it is better to clarify this point before buying a ticket. Before flying, be sure to visit a doctor. If the go-ahead is given for the flight, in the sky - even if the flight lasts only two hours - you need to move more: you can walk around the cabin, stretch with your arms up, rotate your feet, tilt your head. If the flight is expected to be longer, a special pillow for travelers, which is worn around the neck, will come in handy. You can ask the flight attendants for a pillow under your back and a blanket if your feet get cold.
It is convenient to travel by train if the journey is not too long - shaking in the car for more than 18-24 hours can be difficult for a pregnant woman. Food from the restaurant car can be unsafe, and sleeping on a narrow shelf, even with a small belly, will only be comfortable for miniature expectant mothers. In addition, it is problematic to carry out hygiene procedures in Russian trains, and the general sanitary level in them leaves much to be desired.
By car, especially if the journey is long, a pregnant woman should not drive herself. And it’s better to sit in the back seat, where you can sit with a little more comfort and, of course, more safety than in the front. On the trip, you need to take breaks, stopping every 200 kilometers for ten minutes. During this time, you can have time to warm up, drink tea or eat an apple, walk back and forth and run to the toilet. In the car, be sure to take water and a pillow under your back.