safe air travel during pregnancy

Nowadays pregnancy rarely changes schedules, with the exception of high-risk pregnancies or other complications. People usually can continue their normal lives for the duration of the pregnancy, with minor exceptions (like knowing where all the bathrooms are!). Travel is no exception.

Travel is becoming more prevalent as families move further and further apart. Traveling for holidays, or as the last trip to see the family before the baby comes, or as a last romantic vacation, is not unusual. This includes out of the country travel and often air travel.

The Science on Pregnancy and Air Travel

For ethical reasons, there are not many studies on air travel and miscarriage rates. One 2015 study showed a slight increase in first-trimester miscarriage for flight attendants, but this was often associated with high physical job demands and disruptions to their sleep cycles.

In-flight radiation is also a slight risk for flight attendants. An estimated 2% of flight attendants are exposed to a solar particle event during their pregnancies, although the amount of radiation varies by length of time in the air, the routes flown, and so on. However, the risk to the average flier is negligible. The average 10-hour flight only exposes fliers to 0.05 mSv of radiation, or 1/1000th of the limit set by the American Congress of Obstetricians and Gynecologists.

Precautions for Air Travel During Pregnancy

Flying is fairly safe while pregnant, even for flight attendants, with some minor adjustments. There are, however, some issues to bear in mind if you are pregnant and considering multiple, frequent, or very long flights:

• Air travel is extremely dehydrating. You'll need to drink a lot of water while in the air.
• Air travel requires that you sit still for long periods. If you're likely to experience cramps or other pregnancy-associated issues, you may be quite uncomfortable.
• Airplanes are not equipped to handle in-air birth or pregnancy-related complications . Even if your airline permits travel, you may simply be smarter to stay on the ground if you're close to giving birth or are experiencing any pregnancy-related issues.

There are some precautions that a pregnant traveler should consider:

• Talk to your practitioner before flying. If you are more than 36 weeks pregnant, many airlines will not let you fly for fear that you'll deliver on board.
• Try to do the majority of your traveling in the second trimester . Not only will you be more comfortable, but in general the risks of miscarriage and preterm labor are lower.
• Avoid excessive flying. Although there are no hard and fast numbers, one study found that flight attendants with higher miscarriage rates flew on average 74 hours per month.
• Make comfort arrangements. Try to get seats with more legroom, plan to walk in the aisles, anticipate bathroom breaks, and bring water.
• Avoid travel to countries that would require immunizations that you don't already have or are that are not considered safe for pregnancy. Talk to your practitioner for more info on immunizations during pregnancy, as some immunizations are considered appropriate while pregnant.
• Because pregnant people are more vulnerable to COVID-19, you may wish to avoid unnecessary travel, particularly to high-risk areas.

So remember, flying is not contraindicated in an uncomplicated pregnancy, but use your common sense and speak to your practitioner about your travel plans.

Grajewski B, Whelan EA, Lawson CC, et al. Miscarriage among flight attendants . Epidemiology . 2015;26(2):192-203. doi:10.1097/EDE.0000000000000225

Hezelgrave NL, Whitty CJM, Shennan AH, Chappell LC. Advising on travel during pregnancy . BMJ. 2011;342:d2506. doi:10.1136/bmj.d2506

Zubac D, Stella AB, Morrison SA. Up in the air: Evidence of dehydration risk and long-haul flight on athletic performance . Nutrients . 2020;12(9):2574-2589. doi:10.3390/nu12092574

Cone JE, Vaughan LM, Huete A, Samuels S. Reproductive health outcomes among female flight attendants: An exploratory study . J Occup Environ Med. 1998;40(3):210-216.

Ellington S, Strid P, Tong VT, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status — United States, January 22–June 7, 2020 . MMWR Morb Mortal Wkly Rep. 2020;69(25):769-775. doi:10.15585/mmwr.mm6925a1

By Robin Elise Weiss, PhD, MPH Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.

Pregnancy Travel Tips

Medical review policy, latest update:, can you travel while pregnant , read this next, when should you stop traveling while pregnant, how should you prepare for a trip during pregnancy, what do pregnant women need to know about travel and the zika virus, travel tips for pregnant people, when should you seek medical care while traveling during pregnancy.

While traveling during pregnancy is generally considered safe for most moms-to-be, you’ll need to take some precautions before making any plans — and get the green light from your practitioner first.

What to Expect When You’re Expecting , 5th edition, Heidi Murkoff. WhatToExpect.com, Zika Virus and Pregnancy , October 2020. WhatToExpect.com, What to Know About COVID-19 if You’re Pregnant , February 2021. American College of Obstetricians and Gynecologists, Travel During Pregnancy , August 2020. Johns Hopkins Medicine, Traveling While Pregnant or Breastfeeding , 2021. Centers for Disease Control and Prevention, COVID-19 Travel Recommendations by Destination , May 2021. Centers for Disease Control and Prevention, Pregnant and Recently Pregnant People , May 2021. Centers for Disease Control and Prevention, Pregnant Travelers , December 2020. Centers for Disease Control and Prevention, Travel: Frequently Asked Questions and Answers , April 2021. Centers for Disease Control and Prevention, COVID-19 and Cruise Ship Travel , March 2020.

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Is it safe to fly while I'm pregnant?

Yes, just like other kinds of pregnancy travel , flying while pregnant is safe as long as you're not too close to your due date and don't have any medical complications.

Talk with your healthcare provider before you book your flight to discuss any potential issues and get their go ahead. Know that almost every airline won't let women who are past 36 weeks pregnant fly – and sometimes that's even earlier for international travel.

As long as you and your baby are healthy, you shouldn't have any trouble in the pressurized cabin of a commercial airliner. (Just remember to keep your seat belt on while you're seated – it should sit under your belly and low on your hips.) You don't need to worry about the screening machines at the airport, either. They won't harm your baby.

Your ob-gyn or midwife may be able to help you find a provider at the destination you're visiting in case you need medical attention while you're away. You'll also want to verify what your health and travel insurance policies cover regarding emergencies abroad and flight cancellations, in the event that something happens or you need to cancel your trip.

When is flying while pregnant not safe?

There are some situations when it's not safe to fly while you're pregnant, including if you:

• are having signs of a possible miscarriage , such as cramping, pain, or bleeding
• have cervical insufficiency (an incompetent cervix)
• have preeclampsia
• have vaginal bleeding
• are under observation for preterm labor
• have premature rupture of membranes (PROM), which means you're leaking amniotic fluid or your water has broken but you're not yet in labor

Your healthcare provider may also recommend you not fly if you:

• are carrying twins or higher multiples after 28 weeks
• have intrauterine growth restriction
• have a history of miscarriage or ectopic pregnancy
• have placenta previa or another placental abnormality
• have any chronic medical condition, such as diabetes or high blood pressure
• have a history of blood clots
• have any other conditions that put your pregnancy at extra risk

How late in pregnancy can you fly?

Most airlines won't let pregnant women fly after 36 weeks – if you're planning to get on a plane sometime during your third trimester, check with your airline on their specific pregnancy travel policies before booking your flight.

If your bump makes it look like you're more pregnant than you are , airline employees may ask you to provide a note from your OB or midwife stating you've been cleared to fly, as well as how many weeks pregnant you are. In most cases, it's no problem at all to get this letter from your healthcare provider – just be sure not to wait until the day of travel to ask for it. That's the last bit of travel stress anyone needs!

Tips for flying when pregnant

These tips will help you and your baby stay safe and comfortable on your next flight:

• For the smoothest ride, request a seat in the middle of the plane over the wing. (This is the area where you're least likely to get airsick too.)
• For more legroom, try to get a seat in the bulkhead or pay for an upgrade. Stretch your legs and flex your feet as often as possible to minimize swelling.
• Choose an aisle seat so you can get up easily to go to the bathroom or walk around and stretch – which you should do at least once an hour (every half hour is even better). Pregnant women who sit still for long periods have a higher risk of developing deep vein thrombosis .
• Wearing compression socks can also help you avoid clots because they keep the blood moving in your legs.
• Wear comfortable shoes, as your feet may become swollen when flying. Opt for loose clothing to stay as comfortable as possible too.
• Drink lots of fluids (especially water) to avoid the dehydrating effects of dry cabin air. It's best to avoid carbonated drinks when flying – gas expands at higher altitudes and that effect can be uncomfortable.
• Go to the bathroom frequently, especially before the plane begins its descent. You don't want to be stuck in your seat with a full bladder during the time it takes to land and taxi to the gate.
• If you're prone to nausea, ask your healthcare provider if you can take prescription anti-nausea medication .
• Don't be afraid to ask a flight attendant or other passengers who appear able to help you lift your carry-on into the overhead bin.
• Be sure to pack some healthy snacks and a bottle of water in case you have any unexpected delays on the ground or in the air.

Flying during COVID-19

As long as you're fully vaccinated against COVID-19, it's okay to travel, which includes flying, according to the CDC. If you're not vaccinated, the CDC says you should delay or avoid travel unless it's absolutely essential. Pregnant women who get COVID-19 are at a higher risk for severe illness and hospitalization, as well as preterm birth and other poor pregnancy outcomes. (This is why major health organizations are recommending that women who are pregnant, breastfeeding, or are planning on becoming pregnant get the COVID-19 vaccine .)

If you have any questions about flying during COVID-19 or the COVID-19 vaccine, talk to your healthcare provider. They can help you make the best decisions for you and your baby's health.

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

ACOG. 2019. Air travel during pregnancy. Committee Opinion No. 746. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/08/air-travel-during-pregnancy Opens a new window [Accessed October 2021]

ACOG. 2016. Travel during pregnancy. FAQ055.  http://www.acog.org/Patients/FAQs/Travel-During-Pregnancy Opens a new window  [Accessed October 2021]

March of Dimes. 2016. Travel during pregnancy.  http://www.marchofdimes.org/pregnancy/travel-during-pregnancy.aspx Opens a new window  [Accessed October 2021]

Morof, D.F. 2015. CDC. Travelers' Health, Chapter 8, Advising Travelers with Specific Needs, Pregnant Travelers.  http://wwwnc.cdc.gov/travel/yellowbook/2016/advising-travelers-with-specific-needs/pregnant-travelers Opens a new window  [Accessed October 2021]

CDC. 2021. Covid-19: Pregnant and Recently Pregnant People. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html Opens a new window [Accessed October 2021]

CDC. 2021. International Travel During Covid-19. https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel-during-covid19.html Opens a new window [Accessed October 2021]

Terry Ward is a freelance travel, health, and parenting writer who has covered everything from flying with toddlers to why you should travel with your kids even when they're too young to remember it. She lives in Tampa, Florida, with her husband and their young son and daughter, and enjoys camping, sailing, scuba diving, skiing, and almost anything else done in the great outdoors.

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• Section 6 - Medical Tourism
• Section 7 - Travel & Breastfeeding

Pregnant Travelers

Cdc yellow book 2024.

Author(s): Romeo Galang, I. Dale Carroll, Titilope Oduyebo

• The Pretravel Consultation

Infectious Disease Concerns

Environmental health concerns, transportation considerations.

Pregnancy can cause physiologic changes that require special consideration during travel. With careful preparation, however, most pregnant people can travel safely.

Pretravel Consultation

The pretravel consultation and evaluation of pregnant travelers ( Box 7-01 ) should begin with a careful medical and obstetric history, specifically assessing gestational age and the presence of factors and conditions that increase risk for adverse pregnancy outcomes. A visit with an obstetric health care provider also should be a part of the pretravel assessment to ensure routine prenatal care and identify any potential problems. Instruct pregnant travelers to carry with them a copy of their prenatal records and physician’s contact information.

Review the pregnant person’s travel itinerary, including accommodations, activities, and destinations, to guide pretravel health advice. Discourage pregnant travelers from undertaking unaccustomed vigorous activity. Swimming and snorkeling during pregnancy generally are safe, but falls during waterskiing have been reported to inject water into the birth canal. Most experts advise against scuba diving for pregnant people because of risk for fetal gas embolism during decompression (see Sec. 4, Ch. 4, Scuba Diving: Decompression Illness & Other Dive-Related Injuries ). Riding animals, bicycles, or motorcycles presents risks for abdominal trauma.

Educate pregnant people on how to avoid travel-associated risks, manage minor pregnancy discomforts, and recognize more serious complications. Advise pregnant people to seek urgent medical attention if they experience contractions or premature labor; symptoms of deep vein thrombosis (e.g., unusual leg swelling and pain in the calf or thigh) or pulmonary embolism (e.g., unusual shortness of breath); dehydration, diarrhea, or vomiting; severe pelvic or abdominal pain; symptoms of preeclampsia (e.g., severe headaches, nausea and vomiting, unusual swelling, vision changes); prelabor rupture of the membranes; or vaginal bleeding.

Box 7-01 Pretravel consultation for pregnant travelers: a checklist for health care providers

☐ Review vaccination history (e.g., COVID-19, hepatitis A, hepatitis B, measles, pertussis, rubella, varicella, tetanus) and update vaccinations as needed (see text for contraindications during pregnancy)

☐ Policies and paperwork

• Discuss supplemental travel insurance, travel health insurance, and medical evacuation insurance; research specific coverage information and limitations for pregnancy-related health issues
• Advise travelers to check airline and cruise line policies for pregnant travelers
• Provide letter confirming due date and fitness to travel
• Provide copy of medical records

☐ Prepare for obstetric care at destination

• Advise traveler to arrange for obstetric care at destination, as needed

☐ Review signs and symptoms requiring immediate care, including

• Contractions or preterm labor
• Deep vein thrombosis or pulmonary embolism symptoms, which include unusual swelling of leg with pain in calf or thigh, unusual shortness of breath
• Pelvic or abdominal pain
• Preeclampsia symptoms (e.g., unusual swelling, severe headaches, nausea and vomiting, vision changes)
• Rupture of membranes
• Vomiting, diarrhea, dehydration

Contraindications to Travel During Pregnancy

Absolute contraindications are conditions for which the potential harm of travel during pregnancy always outweighs the benefits of travel to the pregnant person or fetus. Relative contraindications are conditions for which travel should be avoided if the potential harm from travel outweighs its benefits ( Box 7-02 ).

Although travel is rarely contraindicated during a normal pregnancy, pregnancies that require frequent antenatal monitoring or close medical supervision might warrant a recommendation that travel be delayed. Educate pregnant travelers that the risk of obstetric complications is greatest in the first and third trimesters of pregnancy.

Box 7-02 Contraindications to travel during pregnancy

Absolute contraindications.

• Abruptio placentae
• Active labor
• Incompetent cervix
• Premature labor
• Premature rupture of membranes
• Suspected ectopic pregnancy
• Threatened abortion / vaginal bleeding
• Toxemia, past or present

RELATIVE CONTRAINDICATIONS

• Abnormal presentation
• Fetal growth restriction
• History of infertility
• History of miscarriage or ectopic pregnancy
• Maternal age <15 or >35 years
• Multiple gestation
• Placenta previa or other placental abnormality

Planning for Emergency Care

Obstetric emergencies are often sudden and life-threatening. Advise all pregnant travelers (but especially those in their third trimester or otherwise at high risk) to identify, in advance, international medical facilities at their destination(s) capable of managing complications of pregnancy, delivery (including by caesarean section), and neonatal problems. Counsel against travel to areas where obstetric care might be less than the standard at home.

Many health insurance policies do not cover the cost of medical treatment for pregnancy or neonatal complications that occur overseas. Pregnant people should strongly consider purchasing supplemental travel health insurance to cover pregnancy-related problems and care of the neonate, as needed. In addition, pregnant travelers should consider medical evacuation insurance coverage in case of pregnancy-related complications (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ).

Medications

Over-the-counter drugs and nondrug remedies can help a pregnant person travel more comfortably. For instance, pregnant people can safely use a mild bulk laxative for constipation. In addition, several simple available remedies are effective in relieving the symptoms of morning sickness. Nonprescription remedies include ginger, available as a powder that can be mixed with food or drinks (e.g., tea), and as candy (e.g., lollipops). Similarly, pyridoxine (vitamin B6) is effective in reducing symptoms of morning sickness and is available in tablet form, as well as lozenges and lollipops. Antihistamines (e.g., dimenhydrinate, meclizine) often are used in pregnancy for morning sickness and motion sickness and appear to have a good safety record.

Carefully consider appropriate pain management and use of analgesics during pregnancy. Acetaminophen remains the nonopioid analgesic of choice during pregnancy. Although low-dose aspirin has been demonstrated to be relatively safe during pregnancy for certain clinical indications, it should be used cautiously. Aspirin can increase the incidence of abruption, and other anti-inflammatory agents can cause premature closure of the ductus arteriosus.

Various systems are used to classify drugs with respect to their safety in pregnancy . Refer to specific data about the effects of a given drug during pregnancy rather than depending on a classification. Counsel patients to help them make a balanced decision on the use of medications during pregnancy.

Vaccinations

In the best possible scenario, people should be up to date on routine vaccinations before becoming pregnant. The most effective way of protecting the infant against many diseases is to vaccinate the pregnant person. See a summary of current Advisory Committee on Immunization Practices (ACIP)  guidelines for vaccinating pregnant people .

Coronavirus Disease 2019

Pregnant people are more likely to become more severely ill from coronavirus disease 2019 (COVID-19) than people who are not pregnant. Having COVID-19 during pregnancy increases a person’s risk of complications that can affect their pregnancy. For these reasons, the Centers for Disease Control and Prevention (CDC) recommends that people who are pregnant, trying to get pregnant, or who might become pregnant in the future get vaccinated against COVID-19 . As of August 2022, the COVID-19 vaccines authorized or approved for use in the United States are nonreplicating vaccines that do not cause infection in the pregnant person or the fetus. Pregnant people may choose to receive any of the COVID-19 vaccines authorized or approved for use in the United States; the ACIP does not state a preference.

COVID-19 vaccination can be safely provided before pregnancy or during any trimester of pregnancy. Available vaccines are highly effective in preventing severe COVID-19, hospitalizations, and deaths; data have shown that the benefits of vaccination during pregnancy, to both the pregnant person and their fetus, outweigh any potential risks. Pregnant people might want to speak with their health care provider before making a decision about receiving COVID-19 vaccine , but a consultation is not required before vaccination. Side effects from COVID-19 vaccination in pregnant people are like those expected among nonpregnant people. Pregnant people can take acetaminophen if they experience fever or other post-vaccination symptoms.

The ACIP recommends that all people who are or who will become pregnant during the influenza season have an annual influenza vaccine using inactivated virus. Influenza vaccines can be administered during any trimester.

The safety of hepatitis A vaccination during pregnancy has not been determined; because hepatitis A vaccine is produced from inactivated virus, though, the risk to the developing fetus is expected to be low. Weigh the risk associated with vaccination against the risk for infection in pregnant people who could be at increased risk for exposure to hepatitis A virus. According to the ACIP, pregnant people traveling internationally are at risk of hepatitis A virus infection; ACIP recommends vaccination during pregnancy for nonimmune international travelers.

Limited data suggest that developing fetuses are not at risk for adverse events resulting from vaccination of pregnant people with hepatitis B vaccine (for details, see Sec. 5, Part 2, Ch. 8, Hepatitis B ). ACIP recommends vaccinating pregnant people identified as being at risk for hepatitis B virus infection during pregnancy; risk factors include >1 sex partner during the previous 6 months, being evaluated or treated for a sexually transmitted infection, recent or current injection drug use, or having a HBsAg-positive sex partner. In November 2021, ACIP recommended vaccination of all adults 19–59 years old.

Japanese Encephalitis

Data are insufficient to make specific recommendations for use of Japanese encephalitis vaccine in pregnant people (see Sec. 5, Part 2, Ch. 13, Japanese Encephalitis ).

Live-Virus Vaccines

Most live-virus vaccines, including live attenuated influenza, measles-mumps-rubella, live typhoid (Ty21a), and varicella, are contraindicated during pregnancy. Postexposure prophylaxis of a nonimmune pregnant person exposed to measles can be provided by administering measles immune globulin (IG) within 6 days of exposure; for varicella exposures, varicella-zoster IG can be given within 10 days. Advise people planning to become pregnant to wait ≥4 weeks after receiving a live-virus vaccine before conceiving.

Yellow Fever

Yellow fever vaccine is the exception to the rule about live-virus vaccines being contraindicated during pregnancy. ACIP considers pregnancy a precaution (i.e., a relative contraindication) for yellow fever vaccine. If travel is unavoidable, and the risk for yellow fever virus exposure outweighs the vaccination risk, it is appropriate to recommend vaccination. If the risks for vaccination outweigh the risks for yellow fever virus exposure, consider providing a medical waiver to the pregnant traveler to fulfill health regulations. Because pregnancy might affect immune responses to vaccination, consider performing serologic testing to document an immune response to yellow fever vaccine. Furthermore, if a person was pregnant (regardless of trimester) when they received their initial dose of yellow fever vaccine, they should receive 1 additional dose before they are next at risk for yellow fever virus exposure (see Sec. 5, Part 2, Ch. 26, Yellow Fever ).

Meningococcal

According to the ACIP , pregnant (and lactating) people should receive quadrivalent meningococcal vaccine, if indicated. Meningococcal vaccine might be indicated for international travelers, depending on risk for infection at the destination (see Sec. 5, Part 1, Ch. 13, Meningococcal Disease ).

No adverse events linked to inactivated polio vaccine (IPV) have been documented among pregnant people or their fetuses. Vaccination of pregnant people should be avoided, however, because of theoretical concerns. IPV can be administered in accordance with the recommended immunization schedule for adults if a pregnant person is at increased risk for infection and requires immediate protection against polio (see Sec. 5, Part 2, Ch. 17, Poliomyelitis ).

Administer rabies postexposure prophylaxis with rabies immune globulin and vaccine after any moderate- or high-risk exposure to rabies; consider preexposure vaccine for travelers who have a substantial risk for exposure (see Sec. 5, Part 2, Ch. 18, Rabies ).

Tetanus-Diphtheria-Pertussis

Tetanus, diphtheria, and acellular pertussis vaccine (Tdap) should be given during each pregnancy irrespective of a person’s history of receiving the vaccine previously. To maximize maternal antibody response and passive antibody transfer to the infant, optimal timing for Tdap administration is between 27 and 36 weeks’ gestation (earlier during this time frame is preferred), but it may be given at any time during pregnancy.

Malaria Prophylaxis

Malaria, caused by Plasmodium spp. parasites transmitted by mosquitoes, can be much more serious in pregnant than in nonpregnant people and is associated with high risks of illness and death for both mother and fetus. Malaria in pregnancy can be characterized by heavy parasitemia, severe anemia, and profound hypoglycemia, and can be complicated by cerebral malaria and acute respiratory distress syndrome. Placental sequestration of parasites might result in fetal loss due to abruption, premature labor, or miscarriage. An infant born to an infected mother is apt to be of low birth weight, and, although rare, congenital malaria is possible.

Because no prophylactic regimen provides complete protection, pregnant people should avoid or delay travel to malaria-endemic areas. If travel is unavoidable, the pregnant person should take precautions to avoid mosquito bites and use an effective prophylactic regimen.

Chloroquine is the drug of choice for pregnant travelers going to destinations with chloroquine-sensitive Plasmodium spp., and mefloquine is the drug of choice for pregnant travelers going to destinations with chloroquine-resistant Plasmodium spp. Doxycycline is contraindicated because of teratogenic effects on the fetus after the fourth month of pregnancy. Primaquine is contraindicated in pregnancy because the infant cannot be tested for glucose-6-phosphate dehydrogenase deficiency, putting the infant at risk for hemolytic anemia. Atovaquone-proguanil is not recommended because of lack of available safety data. A list of the available antimalarial drugs and their uses and contraindications during pregnancy can be found in Sec. 5, Part 3, Ch. 16, Malaria .

Travel Health Kits

In addition to the recommended travel health kit items for all travelers (see Sec. 2, Ch. 10, Travel Health Kits ), pregnant travelers should pack antacids, antiemetic drugs, graduated compression stockings, hemorrhoid cream, medication for vaginitis or yeast infection, prenatal vitamins, and prescription medications. Encourage pregnant travelers to consider packing a blood pressure monitor if travel will limit access to a health center where blood pressure monitoring is available.

Respiratory and urinary infections and vaginitis are more likely to occur and to be more severe during pregnancy. Pregnant people who develop travelers’ diarrhea or other gastrointestinal infections might be more vulnerable to dehydration than nonpregnant travelers. Stress the need for strict hand hygiene and food and water precautions (see Sec. 2, Ch. 8, Food & Water Precautions ). Drinking bottled or boiled water is preferable to chemically treated or filtered water. Pregnant people should not consume water purified by iodine-containing compounds because of potential effects on the fetal thyroid (see Sec. 2, Ch. 9, Water Disinfection ).

As mentioned previously, pregnant people are at increased risk for severe COVID-19–associated illness (e.g., requiring invasive ventilation or extracorporeal membrane oxygenation) and death compared with people who are not pregnant. Underlying medical conditions (e.g., chronic kidney disease, diabetes, obesity) and other factors (e.g., age, occupation) can further increase a pregnant person’s risk for developing severe illness. Additionally, pregnant people with COVID-19 are at greater risk for preterm birth and other adverse outcomes.

Pregnant people, recently pregnant people, and those who live with or visit them should take steps to protect themselves from getting COVID-19. CDC recommends that people (including those who are pregnant) not travel internationally until they are up to date with their COVID-19 vaccines . Additional information for international travelers is available at CDC's International Travel website.

Hepatitis A and hepatitis E are both spread by the fecal–oral route (see Sec. 5, Part 2, Ch. 7, Hepatitis A , and Sec. 5, Part 2, Ch. 10, Hepatitis E ). Hepatitis A has been reported to increase the risk for placental abruption and premature delivery. Hepatitis E is more likely to cause severe disease during pregnancy and could result in a case-fatality rate of 15%–30%; when acquired during the third trimester, hepatitis E is also associated with fetal complications and fetal death.

Listeriosis & Toxoplasmosis

Listeriosis and toxoplasmosis (see Sec. 5, Part 3, Ch. 23, Toxoplasmosis ) are foodborne illnesses of particular concern during pregnancy because the infection can cross the placenta and cause spontaneous abortion, stillbirth, or congenital or neonatal infection. Warn pregnant travelers to avoid unpasteurized cheeses and uncooked or undercooked meat products. Risk for fetal infection increases with gestational age, but severity of infection is decreased.

Other Parasitic Infections & Diseases

Parasitic infections and diseases can be a concern, particularly for pregnant people visiting friends and relatives in low- and middle-income countries. In general, intestinal helminths rarely cause enough illness to warrant treatment during pregnancy. Most, in fact, can be addressed safely with symptomatic treatment until the pregnancy is over. On the other hand, protozoan intestinal infections (e.g., Cryptosporidium , Entamoeba histolytica , Giardia ) often do require treatment. These parasites can cause acute gastroenteritis, severe dehydration, and chronic malabsorption resulting in fetal growth restriction. E. histolytica can cause invasive disease, including amebic liver abscess and colitis. Pregnant people also should avoid bathing, swimming, or wading in freshwater lakes, rivers, and streams that can harbor the parasitic worms (schistosomes) that cause schistosomiasis (see Sec. 5, Part 3, Ch. 20, Schistosomiasis ).

Travelers’ Diarrhea

The treatment of choice for travelers’ diarrhea is prompt and vigorous oral hydration; azithromycin or a third-generation cephalosporin may, however, be given to pregnant people if clinically indicated. Avoid use of bismuth subsalicylate because of the potential impact of salicylates on the fetus. In addition, fluoroquinolones are contraindicated in pregnancy due to toxicity to developing cartilage, as noted in experimental animal studies.

Vectorborne Infections

Pregnant people should avoid mosquito bites when traveling in areas where vectorborne diseases are endemic. Preventive measures include use of Environmental Protection Agency–registered insect repellants , protective clothing, and mosquito nets (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods ). For details on yellow fever vaccine and malaria prophylaxis during pregnancy, see above.

Zika virus is spread primarily through the bite of an infected Aedes mosquito ( Ae. aegypti and Ae. albopictus ) but can also be sexually transmitted. The illness associated with Zika can be asymptomatic or mild; some patients report acute onset of conjunctivitis, fever, joint pain, and rash that last for several days to a week after infection.

Birth defects caused by Zika virus infection during pregnancy include brain, eye, and neurodevelopmental abnormalities. Because of the risk for birth defects, CDC recommends pregnant people avoid travel to areas with a Zika outbreak, and, for the duration of the pregnancy, to avoid sex or use condoms with anyone who has traveled to a risk area.

Advise pregnant people considering travel to areas with Zika to carefully assess the risks of Zika infection during pregnancy; provide information about prevention strategies, signs and symptoms, and the limitations of Zika testing. Pregnant people should strictly follow steps to prevent mosquito bites and sexual transmission. See additional information, including the most current list of countries and territories where Zika is active . Guidance for pregnant people can be found on the CDC Zika website .

Pregnant people should be aware of specific current environmental issues in their international destinations (e.g., natural disasters, special events or gatherings, travel warnings). More information can be found at the CDC Travelers’ Health website and on the destination pages of the US Department of State website.

Air Quality

Air pollution causes more health problems during pregnancy because ciliary clearance of the bronchial tree is slowed, and mucus is more abundant. For more details on traveling to destinations where air quality is poor, see Sec. 4, Ch. 3, Air Quality & Ionizing Radiation .

Extremes of Temperature

Body temperature regulation is not as efficient during pregnancy, and temperature extremes can create more physiological stress on the pregnant person (see Sec. 4, Ch. 2, Extremes of Temperature ). In addition, increases in core temperature (e.g., heat exhaustion, heat stroke), might harm the fetus. The vasodilatory effect of a hot environment and dehydration might cause fainting. For these reasons, then, encourage pregnant travelers to seek air-conditioned accommodations and restrict their level of activity in hot environments. If heat exposure is unavoidable, the duration should be as short as possible to prevent an increase in core body temperature. Pregnant travelers should take measures to avoid dehydration and hyperthermia.

High Elevation Travel

Pregnant people should avoid activities at high elevation unless they have trained for and are accustomed to such activities; those not acclimated to high elevation might experience breathlessness and palpitations. The common symptoms of acute mountain sickness (insomnia, headache, and nausea) frequently are associated with pregnancy, and it might be difficult to distinguish the cause of the symptoms. Most experts recommend a slower ascent with adequate time for acclimatization. No studies or case reports show harm to a fetus if the mother travels briefly to high elevations during pregnancy; recommend that pregnant people not sleep at elevations >12,000 ft (≈3,600 m) above sea level, if possible. Probably the greatest concern is that high-elevation destinations often are inaccessible and far from medical care (see Sec. 4, Ch. 5, High Elevation Travel & Altitude Illness ).

Advise pregnant people to follow safety instructions for all forms of transport and to wear seat belts, when available, on all forms of transportation, including airplanes, buses, and cars (see Sec. 8, Ch. 5, Road & Traffic Safety ). A diagonal shoulder strap with a lap belt provides the best protection. 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, pregnant people should wear it low, between the abdomen and across the upper thighs, not above or across the abdomen.

Most commercial airlines allow pregnant travelers to fly until 36 weeks’ gestation. Some limit international travel earlier in pregnancy, and some require documentation of gestational age. Pregnant travelers should check with the airline for specific requirements or guidance, and should consider the gestational age of the fetus on the dates both of departure and of return.

Most commercial jetliner cabins are pressurized to an equivalent outside air pressure of 6,000–8,000 ft (≈1,800–2,500 m) above sea level; travelers might also experience air pressures in this range during travel by hot air balloon or on noncommercial aircraft. The lower oxygen tension under these conditions likely will not cause fetal problems in a normal pregnancy. People with pregnancies complicated by conditions exacerbated by hypoxia (e.g., preexisting cardiovascular problems, sickle cell disease, severe anemia [hemoglobin <8.0 g/dL], intrauterine fetal growth restriction) could, however, experience adverse effects associated with low arterial oxygen saturation.

Risks of air travel include potential exposure to communicable diseases, immobility, and the common discomforts of flying. Abdominal distention and pedal edema frequently occur. The pregnant traveler might benefit from an upgrade in airline seating and should seek convenient and practical accommodations (e.g., proximity to the lavatory). Pregnant travelers should select aisle seating when possible, and wear loose fitting clothing and comfortable shoes that enable them to move about more easily and frequently during flights.

Some experts report that the risk for deep vein thrombosis (DVT) is 5–10 times greater among pregnant than nonpregnant people, although the absolute risk is low. To help prevent DVT, pregnant travelers should stay hydrated, stretch frequently, walk and perform isometric leg exercises, and wear graduated compression stockings (see Sec. 8, Ch. 3, Deep Vein Thrombosis & Pulmonary Embolism ).

Cosmic radiation during air travel poses little threat to the fetus but might be a consideration for pregnant travelers who fly frequently (see Sec. 9, Ch. 3, . . . perspectives: People Who Fly for a Living—Health Myths & Realities ). Older airport security machines are magnetometers and are not harmful to the fetus. Newer security machines use backscatter x-ray scanners, which emit low levels of radiation. Most experts agree that the risk for complications from radiation exposure from these scanners is extremely low.

Cruise Ship Travel

Most cruise lines restrict travel beyond 24 weeks’ gestation (see Sec. 8, Ch. 6, Cruise Ship Travel ). Cruise lines might require pregnant travelers to carry a physician’s note stating that they are fit to travel, including the estimated date of delivery. Pregnant people should check with the cruise line for specific requirements or guidance. For pregnant travelers planning a cruise, provide advice about gastrointestinal and respiratory infections, motion sickness (see Sec. 8, Ch. 7, Motion Sickness ), and the risk for falls on a moving vessel, as well as the possibility of delayed care while at sea.

The following authors contributed to the previous version of this chapter: Diane F. Morof, I. Dale Carroll

Bibliography

Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al.; PregCOV-19 Living Systematic Review Consortium. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.

Bisson DL, Newell SD, Laxton C; on behalf of the Royal College of Obstetricians and Gynaecologists. Antenatal and postnatal analgesia. BJOG. 2018;126(4):114–24.

Centers for Disease Control and Prevention. Guidelines for vaccinating pregnant women. Atlanta: The Centers; 2014. Available from: www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html .

Dotters-Katz S, Kuller J, Heine RP. Parasitic infections in pregnancy. Obstet Gynecol Surv. 2011;66(8):515–25.

Hezelgrave NL, Whitty CJ, Shennan AH, Chappell LC. Advising on travel during pregnancy. BMJ. 2011;342:d2506.

Irvine MH, Einarson A, Bozzo P. Prophylactic use of antimalarials during pregnancy. Can Fam Physician. 2011;57(11):1279–81.

Magann EF, Chauhan SP, Dahlke JD, McKelvey SS, Watson EM, Morrison JC. Air travel and pregnancy outcomes: a review of pregnancy regulations and outcomes for passengers, flight attendants, and aviators. Obstet Gynecol Surv. 2010;65(6):396–402.

Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects—reviewing the evidence for causality. N Engl J Med. 2016;374(20):1981–7.

Rasmussen SA, Watson AK, Kennedy ED, Broder KR, Jamieson DJ. Vaccines and pregnancy: past, present, and future. Semin Fetal Neonatal Med. 2014;19(3):161–9.

Roggelin L, Cramer JP. Malaria prevention in the pregnant traveller: a review. Travel Med Infect Dis. 2014;12(3):229–36.

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Is It Safe to Fly During the First Trimester?

With the proper precautions, flying during the first trimester of pregnancy is safe. Here's what you should know about air travel during early pregnancy.

• Myths About Pregnancy and Air Travel

Tips for Flying During Early Pregnancy

The bottom line.

If you're currently pregnant, planning to be, or just curious, it's possible you've wondered about whether or not it's safe to fly during the first trimester. After all, the first three months of pregnancy are crucial, and most instances of pregnancy loss occur during the first trimester, so it's understandable to have questions or concerns about air travel during that time.

However, the good news is that air travel during the first trimester is generally considered safe. Ahead, learn more about flying during early pregnancy, what experts have to say about precautions, and tips for having a safe flight during the first trimester.

Common Myths About Pregnancy and Air Travel

The first trimester is actually an especially low-risk time to travel during pregnancy . Contrary to popular belief, noise vibration, cosmic radiation, and cabin pressure create no increased risks for the pregnant air traveler. And if you were concerned that security equipment could radiate or somehow hurt your baby, set those fears aside. "Metal detectors are not a risk to the baby," says Raul Artal, M.D., vice chairman of the American College of Obstetricians and Gynecologists (ACOG) committee on obstetric practice.

That being said, it's still a good idea to chat with an OB-GYN or health care provider before you schedule your babymoon or any work trips during the first trimester. A health care professional can give you specific, individualized advice, based on your needs and unique pregnancy journey.

Below are a few more travel tips for the first trimester.

Check your health before you go

Travel isn't recommended for those with high-risk pregnancy conditions (hypertension, sickle-cell disease, history of premature labor, placental abnormalities such as placenta previa, etc.) Pregnant people with preexisting medical conditions (like heart disease) should also check with a health care provider before flying.

Move around

One issue of concern for all air passengers—pregnant or not—is the formation of blood clots, or thrombosis, especially during long flights. Pregnant travelers should take special precautions to minimize risks, like wearing support stockings and/or moving your lower extremities every half-hour or so. "Wiggle your toes," Dr. Artal suggests, "Move your legs around, and take a stroll up the cabin every once in a while."

Book a comfortable seat

The aisle seat will make it easier to get up frequently for restroom trips or walking through the cabin. The bulkhead seats, which are located right behind a dividing wall between cabins, tend to have the most legroom. If you're concerned about a bumpy ride, try choosing a seat over a wing, which will give you the smoothest flight.

Make sure you buckle up, keeping the seatbelt low on the hips and under the belly. Flying can be unpredictable when it comes to severe turbulence, which can cause injury. Therefore, it is wise to buckle up and remain buckled while seated throughout the entire flight.

Stay hydrated

The cabin of an aircraft has low humidity, which can cause anyone to have a dry nose and throat. Make sure to drink water throughout the flight to avoid dehydration .

Prevent air sickness

Morning sickness and fatigue often kick in around seven to eight weeks of pregnancy . Ask a health care provider for tips to help with nausea, and inquire about safe anti-nausea medication to take with you, just in case.

Don't drink or eat gas-producing items

Try to avoid consuming food and drinks that are known to cause gas (such as beans, cruciferous vegetables, and carbonated beverages) before or during your flight. Entrapped gas expands at higher altitudes and can give you a stomachache.

Prepare for digestion problems

You may want to ask a health care provider about diarrhea medications or remedies that are safe to use during pregnancy, especially if you are traveling internationally, which can elevate the risk of exposure to bacteria that can cause diarrhea.

Consider updating your vaccinations

Depending on where your final destination is, you may be required to be vaccinated against certain diseases, especially if you're traveling internationally. The Centers for Disease Control and Prevention (CDC) offers a travel vaccine and medication guide that covers travel-related diseases you can be inoculated against from food-borne illnesses to influenza.

Always tell a health care provider about your plans before booking your trip. Depending on your travel plans, you may need to pre-book a prenatal appointment at your destination. Educate yourself on hospitals located near where you will be staying while traveling, and purchase travel insurance.

Check on travel advisories

Before flying anywhere , it is worth checking for any health or travel advisories that could pose a risk to pregnant travelers. The CDC compiles up-to-date data on travel health advisories as well as other safety information for countries around the globe. You can easily look up your destination and check to make sure that there are not any health alerts that could put you or your pregnancy at risk.

Ultimately, flying during the first trimester of pregnancy is considered safe for many people. However, those with pre-existing medical conditions or high-risk pregnancies might be advised to skip air travel during those early weeks. When in doubt, be sure to consult with an OB-GYN or health care provider. Together, you can determine the right course of action and travel plans for you.

ACOG. Early Pregnancy Loss .

ACOG. Air Travel During Pregnancy .

Csorba R, Tsikouras P. Air travel during pregnancy . Hippokratia. 2017 Jan-Mar;21(1):62. PMID: 29904265; PMCID: PMC5997026.

Centers for Disease Control and Prevention. Pregnant? Don't Overlook Blood Clots .

Related Articles

Air travel and pregnancy

Published: May 2015

Please note that this information will be reviewed every 3 years after publication.

Updated: May 2022

This information is for you if you are pregnant and are thinking of travelling by air.

This information is for you if you are pregnant and are thinking of travelling by air. It may also be helpful if you are a partner, relative or friend of someone in this difficult situation.

The information is relevant for short haul (under four hours), medium and long haul (over four hours) flights.

If you are a member of a flight crew or you fly frequently as part of your work, you should seek additional advice from your occupational health department concerning your own situation.

The information here aims to help you better understand your health and your options for treatment and care. Your healthcare team is there to support you in making decisions that are right for you. They can help by discussing your situation with you and answering your questions.

Within this information we may use the terms ‘woman’ and ‘women’. However, it is not only people who identify as women who may want to access this information. Your care should be personalised, inclusive and sensitive to your needs whatever your gender identity.

A glossary of medical terms is available at  A-Z of medical terms .

• Occasional air travel during pregnancy is not harmful for you or your baby as long as you are having an uncomplicated pregnancy
• Long flights may increase your chance of developing a blood clot. There are things you can do to reduce your chance of this happening.
• It is important to check the healthcare facilities that are available at your destination, in case you need any emergency care.

If your pregnancy is straightforward, flying is not harmful for you or your baby:

• If you have a straightforward pregnancy and are healthy, there is no evidence that the changes in air pressure and/or the decrease in humidity have a harmful effect on you or your baby.
• There is no evidence that flying will cause miscarriage, early labour or your waters to break.

Anyone who flies is exposed to a slight increase in radiation. Occasional flights are not considered to present a risk to you or your baby

When you are pregnant, the safest time to fly is:

• Before 37 weeks, if you are carrying one baby. From 37 weeks of pregnancy you could go into labour at any time, which is why many women choose not to fly after this time.
• Before 32 weeks, if you are carrying an uncomplicated twin pregnancy.

It is important to know that most obstetric emergencies happen in the first and third trimester .

Most airlines do not allow women to fly after 37 weeks. It is important that you check with your airline before flying. It may also be more difficult to get travel insurance after 37 weeks.

Some pregnant women may experience discomfort during flying. You may have:

• swelling of your legs due to fluid retention (oedema)
• nasal congestion/problems with your ears – during pregnancy you are more likely to have a blocked nose and, combined with this, the changes in air pressure in the plane can also cause you to experience problems in your ears
• pregnancy sickness – if you experience motion sickness during the flight, it can make your sickness worse.

A DVT is a blood clot that forms in your leg or pelvis. If it travels to your lungs (pulmonary embolism) it can be life threatening. When you are pregnant and for up to six weeks after the birth of your baby, you have a higher risk of developing a DVT compared with women who are not pregnant (for more information please see the RCOG patient information Reducing the risk of venous thrombosis in pregnancy and after birth.

There is an increased risk of developing a DVT while flying, due to sitting for a prolonged length of time. The risk of a DVT increases with the length of the flight. Your risk is also increased if you have additional risk factors such as a previous DVT or you are overweight. Your midwife or doctor will be able to check your individual risk.

If you are taking a short haul flight (less than four hours), it is unlikely that you will need to take any special measures. Your midwife or doctor should give you an individual risk assessment for venous thrombosis and advice for your own situation.

To minimise the risk of a DVT on a medium or a long haul flight (over four hours), you should:

• wear loose clothing and comfortable shoes
• try to get an aisle seat and take regular walks around the plane
• do in-seat exercises every 30 minutes or so – the airline should give you information on these
• have cups of water at regular intervals throughout your flight
• cut down on drinks that contain alcohol or caffeine (coffee, fizzy drinks)
• wear graduated elastic compression stockings – your midwife or doctor will need to provide the correct size and type for you as they are different from standard flight socks.

If you have other risk factors for a DVT, regardless of the length of your flight, you may be advised to have heparin injections. These will thin your blood and help prevent a DVT. A heparin injection should be taken on the day of the flight and daily for a few days afterward. For security reasons, you will need a letter from your doctor to enable you to carry these injections onto the plane.

Low-dose aspirin does not appear to reduce the risk of a DVT but you should continue to take it if it has been prescribed for another reason.

A medical condition or health problem can complicate your pregnancy and put you and your baby at risk. For this reason, if any of the following apply, you may be advised not to fly:

• You are at increased risk of going into labour before your due date.
• You have severe anaemia. This is when the level of red blood cells in your blood is lower than normal. Red blood cells contain the iron-rich pigment haemoglobin, which carries oxygen around your body.
• You have sickle cell disease (a condition which affects red blood cells) and you have recently had a sickle crisis.
• You have recently had significant vaginal bleeding.
• You have a serious condition affecting your lungs or heart that makes it very difficult for you to breathe.

It is important that you discuss any health issues or pregnancy complications with your midwife or doctor before you fly. If have an increased chance of miscarriage or ectopic pregnancy, ask for an ultrasound scan for reassurance before you fly.

Be aware that the unexpected can happen while travelling which could delay your return home. Some airlines may not allow you to fly if you have fractured a bone, have a middle ear or a sinus infection or have recently had surgery to your abdomen that involved your bowel, such as having your appendix removed.

To help decide whether or not to fly, think about your own medical history and any increased risks that you may have. The following questions may also help you in making your decision:

• Why do you want to fly at this particular time?
• Is your flight necessary?
• How long is your flight? Will this increase your risk of medical problems?
• Your chance of going into labour is higher the further you are in pregnancy.
• It is also important to remember that having a miscarriage, whether you fly or not, is common (one in five) in the first three months of pregnancy.
• What are the medical facilities at your destination in the event of an unexpected complication with your pregnancy?
• Have you had all the relevant immunisations and/or medication for the country you are travelling to? Have you checked with your doctor about how these affect your pregnancy?
• Does your travel insurance cover pregnancy and/or care for your newborn baby if you give birth unexpectedly? There is huge variation among airlines and travel insurance policies so it is worth checking before you decide to fly.
• Have you discussed your travel plans with your midwife and informed them that you are thinking about taking a medium or long haul flight?
• If you are over 28 weeks pregnant, your airline may ask you to get a letter from your midwife or doctor stating when your baby is due and confirming that you are in good health, are having a straightforward pregnancy, and are not at an increased risk of complications.
• Any document needed to confirm your due date and that you are fit to fly. Some airlines have their own forms/documents that will need to be completed at any stage of pregnancy. Contact your airline if you are unsure.

If you are travelling to Europe, it is recommended that you apply for a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC). This will allow you to access routine healthcare at a reduced cost, or for free. For more information on what the card covers and how to apply, see the GOV.UK website.   .

You will have to go through the normal security checks before flying. This is not considered to be a risk to you or your baby.

You must wear a seatbelt. You should ensure the strap of your seatbelt is reasonably tightly fastened across the top of your thighs and then under your bump. Ask the cabin crew if you need a seatbelt extension.

Any pregnant woman has a small chance of going into labour early or for her waters to break early. If this happens to you on a flight, there is no guarantee that other passengers or crewmembers will be trained and experienced to help you give birth safely. As a result, the pilot may have to divert the flight to get help for you.

Flying while you are pregnant can be stressful. If you are feeling anxious or worried in any way, please speak to your healthcare team who can answer your questions and help you get support. The support may come from healthcare professionals, voluntary organisations or other services. Further information and resources are available on the NHS website:

https://www.nhs.uk/conditions/stress-anxiety-depression/

Further information

• RCOG Scientific Impact Paper Air Travel and Pregnancy
• Tommy’s website: https://www.tommys.org/

If you are asked to make a choice, you may have lots of questions that you want to ask. You may also want to talk over your options with your family or friends. It can help to write a list of the questions you want answered and take it to your appointment.

Ask 3 Questions

To begin with, try to make sure you get the answers to  3 key questions , if you are asked to make a choice about your healthcare:

• What are my options?
• What are the pros and cons of each option for me?
• How do I get support to help me make a decision that is right for me?

*Ask 3 Questions is based on Shepherd et al. Three questions that patients can ask to improve the quality of information physicians give about treatment options: A cross-over trial. Patient Education and Counselling, 2011;84:379-85  

• https://aqua.nhs.uk/resources/shared-decision-making-case-studies/

Sources and acknowledgments

This information has been developed by the RCOG Patient Information Committee. It is based on the RCOG Scientific Impact Paper Air Travel and Pregnancy (May 2013), which contains a full list of the sources of evidence we have used. You can find it online here .

This information was reviewed before publication by women attending clinics in London, the Channel Isles and Northern Ireland, and by the RCOG Women’s Voices Involvement Panel.

A glossary of all medical terms is available on the RCOG website at: www.rcog.org.uk/womens-health/patientinformation/medical-terms-explained .

Please give us feedback by completing our feedback survey:

• Members of the public – patient information feedback
• Healthcare professionals – patient information feedback

How to Make Long Flights More Comfortable When You're Pregnant

By Joanna Carrigan

All products featured on Condé Nast Traveler are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.

Preparing for a newborn can feel like an exhilarating task; on the one hand, there’s a long-anticipated, already much-loved new arrival making an entrance into your life. On the other, getting yourself into a birthing headspace can feel like a marathon. I’ve already lost count of the amount of  stroller reviews , hypno-birthing manuals, crib catalogs, and paint samples I’ve flicked through in my quest for newborn nirvana. 

With that in mind, many couples are now opting to take a break from the organizational overload in the form of a  long-haul babymoon —a pre-birth couples vacation—as a way of spending those last special moments together as a family of two. And in fact, air travel can generally be considered  safe for most expectant mothers , with advice from your doctor recommended. 

“All pregnancies and mums have individual needs and varying circumstances,” says Marie Louise, midwife and author of  The Modern Midwife’s Guide To Pregnancy . “If mums have any health complications or are close to giving birth, travel should be very carefully considered. Otherwise, mums need a break—it’s good to enjoy and relax on your travels.”

Pregnancy can often feel like a long-haul adventure in itself, and whilst the thought of an extensive flight may not jump out at the top of your to-do list, there are ways to make that coveted trip—and any other air travel during pregnancy that comes up—more comfortable.

Below, I’ve curated an essential list for what to pack in your carry-on for air travel during pregnancy, based in part on my own experience traveling to Europe whilst expecting. 

Strategic carry-ons

A great place to start is your carry-on itself, as the right style can help not only to make your essentials more accessible, but the correct product can be re-used as a diaper bag once your pre-baby vacation is a distant happy memory. The key to  choosing the perfect carry-on is not only to be mindful of the airline guidelines set out around dimensions and weight restrictions, but to think from your own perspective about what will be easiest for you to carry. If back issues prevail—a common complaint during pregnancy—a stylish rucksack may be more suitable than a tote. And if you’re looking for post-pregnancy practicality, a duffel can tick that cross-functional box. 

Pregnancy support bands

Glamour takes a back seat with this essential, but your posture and ligaments will thank me later. If you’re flying internationally or just maneuvering your way through a large airport, you may face long walks between terminals, which can place strain on the lower back. Bump support bands are designed to help relieve the pressure that the additional weight of your bump is putting on your back, and therefore can make a sensible addition to your carry-on packing list. 

Anti-nausea pregnancy methods 

Not every foray into the world of parenthood is a smooth one, and unfortunately  nausea and sickness can play a starring role in pregnancy, especially in the early stages. My first 16 weeks of pregnancy were punctuated with frequent trips to the restroom, and with many flights taken during this time, I became accustomed to having to rely on a few tricks to see me through those difficult moments. 

Travel bands can be an excellent way to relieve pregnancy related nausea, and they’ve taken a high-tech turn in recent years. Hypnotherapy podcasts can also be a calming way to reduce feelings of sickness, and are best listened to with noise-canceling headphones and an eye mask . 

Hydrating skincare for expectant mothers 

Pregnancy can present some interesting  skincare dilemmas , with many people experiencing a change at some point across their nine months. Dry patches, oily T-zones, and acne outbreaks are all common complaints. To help skin stay hydrated when flying, there are many pregnancy-safe products out there which can help replenish and restore your skin's natural barrier. La Mer The Mist Facial Spray is a particular favorite of mine—easy to apply, super lightweight, and long-lasting. 

Travel pillows

During pregnancy, ligaments in the hips and back loosen in preparation for birth and this can often cause secondary strain across the top of the shoulders and neck which can be very uncomfortable for expectant mothers. If you’re traveling whilst pregnant, I recommend investing in a travel neck pillow , and packing your pregnancy pillow if you’re flying in a seat with a lie-flat bed. 

Compression socks

“During pregnancy, you are at an increased risk of developing a blood clot,” Louise says. “That’s why compression socks , hydration, and movement—walking, stretching, and circling ankles—is recommended.”

Again, it’s not the most glamorous addition to your carry-on, but this footwear is important nonetheless. Try to stretch your legs every hour or so if possible, with a walk down the aisle or some lower leg exercises. 

While packing a well-stocked carry-on will undoubtedly enhance your flying experience, there are other ways to ensure that you’re prepared for a relaxing trip. Here are my top three tips for flying while pregnant:

Food and beverage choices 

Whilst it’s unlikely you’ll be able to see the full on-board menu in advance, it’s often a good idea to pre-select your meal genre if you’re having  aversions or preferences during your pregnancy. Being able to rule out meat, dairy, or even opt for a lighter option may be preferable for some mothers-to-be. It could be worth packing a couple of extra snacks in your carry-on, just in case. I’ve been stashing ginger tea bags and plenty of dried fruit and nuts ( dried banana chips are a particular craving of mine) to see me through. 

The airport experience

Lounge access can not only be an enjoyable way to kick-off your vacation, it can also be a lifesaver for tired feet. Having access to a clean and comfortable restroom can also often be advantageous, so if your travel tickets don’t include a lounge as standard, it could be worth a  pay-for-access option to give you peace of mind that you’ll be spending time in a calm and restful environment before or in between flights. 

Your travel outfit

While a stylish airport look is always desirable, comfort should definitely reign supreme during this important period, since your body is already coping with so much. Activewear can provide comfort and support during long-haul travel, and there are  plenty of options out there. I look to brands like  Alo Yoga and  Lululemon for pieces that satisfy both the style and comfort stakes. 

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Travelling while pregnant

Find useful information and considerations to help you prepare for safe and healthy travels outside Canada while pregnant.

With careful preparation, travelling while pregnant can be safe. The decision to travel should be made in consultation with your health care professional, based on your personal health circumstances.

On this page

Before you go, while you're away, if you need help.

Medical practices, health standards and infection control measures vary from country to country. You may not have access to the same level of care, procedures, treatments and medications as you would in Canada.

You could also be at increased risk of getting an infection and/or developing severe complications from certain infections, which could also affect the fetus.

Before leaving Canada:

• consult a health care professional or visit a travel health clinic at least 6 weeks before travelling to get personalized health advice and recommendations
• check our Travel Advice and Advisories for country-specific information, including about possible health risks
• know how to seek medical assistance outside of Canada
• review the policy and the coverage it provides
• most policies do not automatically cover pregnancy-related conditions or hospital care for premature infants
• ask your insurance provider about coverage for medical care during pregnancy, giving birth and intensive care for you and your fetus or newborn
• carry a copy of your prenatal records
• talk to your health care professional about any additional items you may want to bring that are specific to your health needs

Local laws and medical services relating to pregnancy can differ from Canada. Learn the local laws, and how these may apply to you before you travel.

Pre-travel vaccines and medications

Many vaccines can be safely given during pregnancy. Due to a higher risk of more severe outcomes for you and your fetus, some vaccines are recommended specifically during pregnancy, such as tetanus-diphtheria-pertussis (DTaP) and influenza.

Don’t take medications you may still have from prior trips. Tell the health care professional about your pregnancy, or intended pregnancy, before filling any prescriptions. The decision to get any pre-travel vaccinations or medications should be discussed with your health care professional.

The decision can depend on:

• your purpose of travel (e.g., tourism, visiting friends and relatives)
• your planned destination(s)
• the length of your trip
• your risk of getting a disease
• how severe the effect of a disease would be to you and/or your fetus
• your planned activities
• any underlying medical issues and/or pregnancy-related complications

Malaria could cause major health problems for a mother and her unborn baby. A pregnant woman may want to consider avoiding travel to areas where malaria transmission occurs.

Description of malaria risk by country and preventative measures.

If you can’t avoid travelling to an area where malaria is present:

• some medications to prevent or treat malaria may not be safe during pregnancy
• take extra care to protect yourself from mosquito bites

Zika virus infection during pregnancy can pose significant risks to your fetus even if you don’t develop symptoms. While pregnant, you may want to consider avoiding travelling to a country or areas with risk of Zika virus.

Latest travel health advice on Zika virus.

If you choose to travel, take precautions to avoid infection with Zika virus:

• prevent mosquito bites at all times
• protect yourself from contact with semen, vaginal fluid and blood
• always use condoms correctly or avoid sexual contact while in countries or areas with risk of Zika virus

Learn more about Zika virus and pregnancy:

• Zika virus: Pregnant or planning a pregnancy
• Zika virus: Advice for travellers
• Pregnancy and travel (tropical medicine and travel)

Monitor your health and be prepared

Emergencies can happen at any time. Know where the nearest hospital or medical centre is while you are travelling and confirm they will accept your medical insurance.

Seek medical attention immediately if you develop any of the following symptoms while travelling:

• persistent vomiting and/or diarrhea
• dehydration
• vaginal bleeding
• passing tissue or clots
• abdominal pain, cramps or contractions
• your water breaks
• excessive swelling of face, hands or legs
• excessive leg pain
• severe headaches
• visual problems

If you develop these symptoms after your return to Canada, you should see a health care professional immediately and tell them about your recent trip.

Transportation

Always wear a seatbelt when travelling by plane or car. When using a diagonal shoulder strap with a lap belt, the straps should be placed carefully above and below your abdomen. If only a lap belt is available, fasten it at the pelvic area, below your abdomen.

If you have any medical or pregnancy-related complications, discuss with your health care professional whether air travel is safe for you.

Most airlines restrict travel in late pregnancy or may require a written confirmation from a physician. Check this with the airline before booking your flight.

During long flights, you may be at higher risk of developing blood clots, known as deep vein thrombosis (DVT). The risk of deep vein thrombosis can be reduced by:

• getting up and walking around occasionally
• exercising and stretching your legs while seated
• selecting an aisle seat when possible
• wearing comfortable shoes and loose clothing

Your health care professional may recommend additional ways to reduce your risk such as wearing compression stockings.

Always stay well hydrated while travelling.

Land travel

The risk of deep vein thrombosis can be reduced by:

• stopping the vehicle to walk around every couple of hours

Motion sickness

Certain medications used to treat nausea and vomiting during pregnancy may also be effective in relieving motion sickness.

If you think you might experience motion sickness during your trip, speak to your health care professional about the use of these medications.

Environmental and recreational risks

Some activities may not be recommended or may require additional precautions. Discuss your travel plans, including any planned or potential recreational activities with a health care professional.

High altitude

You should avoid travelling to an altitude above 3,658 metres (12,000 feet).

However, if you have a high-risk pregnancy and/or are in the late stages of pregnancy, the highest altitude should be 2,500 metres (8,200 feet).

If you have pregnancy-related complications, you should avoid unnecessary high-altitude exposure.

Keep in mind that most high-altitude destinations are far from medical care services.

Personal protective measures

Food-borne and water-borne diseases.

Eat and drink safely while travelling while travelling. Many food-borne and water-borne illnesses can be more severe during pregnancy and pose a risk to the fetus.

This can include:

• toxoplasmosis
• listeriosis
• hepatitis A and E

To help avoid food-borne and water-borne diseases:

• before eating or preparing food
• after using the bathroom or changing diapers
• after contact with animals or sick people
• before and after touching raw meat, poultry, fish and seafood
• if you’re at a destination that lacks proper sanitation and/or access to clean drinking water, only drink water if it has been boiled or disinfected or if it’s in a commercially sealed bottle
• use ice made only from purified or disinfected water
• this could cause the fetus or newborn to develop thyroid problems
• unpasteurized dairy products, such as raw milk and raw milk soft cheeses
• unpasteurized juice and cider
• raw or undercooked eggs, meat or fish, including shellfish
• raw sprouts
• non-dried deli meats, including bologna, roast beef and turkey breast
• don’t use bismuth subsalicylate (Pepto-Bismol®)
• Information on travellers’ diarrhea

Illnesses acquired from insect and other animals

Protect yourself from insect bites:

• wear light-coloured, loose clothes made of tightly woven materials such as nylon or polyester
• prevent mosquitoes from entering your living area with screening and/or closed, well-sealed doors and windows
• use insecticide-treated bed nets if mosquitoes can’t be prevented from entering your living area
• information on insect bite and pest prevention

Some infections, such as rabies and influenza, can be shared between humans and animals. You should avoid contact with animals including dogs, livestock (pigs, cows), monkeys, snakes, rodents, birds, and bats.

Information for if you become sick or injured while travelling outside Canada.

For help with emergencies outside Canada, contact the:

• nearest Canadian office abroad
• Emergency Watch and Response Centre in Ottawa

More information on services available at consular offices outside Canada.

Related links

• Immunization in pregnancy and breastfeeding: Canadian Immunization Guide
• Advice for Canadians travelling to Zika-affected countries
• Advice for women travellers
• If you get sick before or after returning to Canada
• Receiving medical care in other countries
• Travel vaccinations
• What you can bring on a plane

Travelling in pregnancy

With the proper precautions such as travel insurance, most women can travel safely well into their pregnancy.

Wherever you go, find out what healthcare facilities are at your destination in case you need urgent medical attention. It's a good idea to take your maternity medical records (sometimes called handheld notes) with you so you can give doctors the relevant information if necessary.

Find out more about getting healthcare abroad .

Make sure your travel insurance covers you for any eventuality, such as pregnancy-related medical care during labour, premature birth and the cost of changing the date of your return trip if you go into labour .

When to travel in pregnancy

Some women prefer not to travel in the first 12 weeks of pregnancy because of  nausea and vomiting and feeling very tired during these early stages. The risk of  miscarriage is also higher in the first 3 months, whether you're travelling or not.

Travelling in the final months of pregnancy can be tiring and uncomfortable. So, many women find the best time to travel or take a holiday is in mid-pregnancy, between 4 and 6 months.

Flying in pregnancy

Flying isn't harmful to you or your baby, but discuss any health issues or pregnancy complications with your midwife or doctor before you fly.

The chance of going into labour is naturally higher after  37 weeks (around 32 weeks if you're carrying twins), and some airlines won't let you fly towards the end of your pregnancy. Check with the airline for their policy on this.

After week 28 of pregnancy, the airline may ask for a letter from your doctor or midwife confirming your due date, and that you are not at risk of complications. You may have to pay for the letter and wait several weeks before you get it.

Long-distance travel (longer than 4 hours) carries a small risk of blood clots (deep vein thrombosis (DVT)) . If you fly, drink plenty of water and move about regularly – every 30 minutes or so. You can buy a pair of graduated compression or support stockings from the pharmacy, which will help reduce leg swelling.

Travel vaccinations when you're pregnant

Most vaccines that use live bacteria or viruses aren't recommended during pregnancy because of concerns that they could harm the baby in the womb.

However, some live travel vaccines may be considered during pregnancy if the risk of infection outweighs the risk of live vaccination. Ask your GP or midwife for advice about specific travel vaccinations. Non-live (inactivated) vaccines are safe to use in pregnancy.

Malaria tablets

Some anti-malaria tablets aren't safe to take in pregnancy so ask your GP for advice.

Zika virus is mainly spread by mosquitoes found in some parts of the world. For most people it's mild and not harmful, but can cause problems if you're pregnant.

If you are pregnant, it is not recommended to travel to parts of the world where the Zika virus is present, such as parts of:

• South and Central America
• the Caribbean
• the Pacific islands

Check before you travel

It's important to check the risk for the country you're going to before you travel.

Find out more about the Zika virus risk in specific countries on the Travel Health Pro website

Car travel in pregnancy

It's best to avoid long car journeys if you're pregnant. However, if it can't be avoided, make sure you stop regularly and get out of the car to stretch and move around.

You can also do some exercises in the car (when you're not driving), such as flexing and rotating your feet and wiggling your toes. This will keep the blood flowing through your legs and reduce any stiffness and discomfort. Wearing compression stockings while on long car journeys (more than 4 hours) can also increase the blood flow in your legs and help prevent blood clots.

Tiredness and dizziness are common during pregnancy so it's important on car journeys to drink regularly and eat natural, energy-giving foods, such as fruit and nuts.

Keep the air circulating in the car and wear your seatbelt with the cross strap between your breasts and the lap strap across your pelvis under your bump, not across your bump.

Road accidents are among the most common causes of injury in pregnant women. If you have to make a long trip, don't travel on your own. You could also share the driving with your companion.

Sailing in pregnancy

Ferry companies have their own restrictions and may refuse to carry heavily pregnant women (often beyond 32 weeks on standard crossings and 28 weeks on high-speed crossings ). Check the ferry company's policy before you book.

For longer boat trips, such as cruises, find out if there are onboard facilities to deal with pregnancy and medical services at the docking ports.

Food and drink abroad in pregnancy

Take care to avoid food- and water-borne conditions, such as stomach upsets and travellers' diarrhoea . Some medicines for treating stomach upsets and travellers' diarrhoea aren't suitable during pregnancy.

Always check if tap water is safe to drink. If in doubt, drink bottled water. If you get ill, keep hydrated and continue eating for the health of your baby, even if you're not hungry.

Find out about a healthy diet in pregnancy , and foods to avoid in pregnancy .

Page last reviewed: 17 August 2022 Next review due: 17 August 2025