Travelling while pregnant

With careful preparation, travelling while pregnant can be safe, but there are additional risks and challenges to take into consideration. Pregnant women can be at increased risk of becoming infected and/or developing severe complications from certain infections, which can also affect the unborn baby. 

It is important that you consult a health care provider or visit a travel health clinic to discuss your travel plans, preferably six weeks before you travel.

Timing of travel

• The safest time to travel is between the 18th and 24th weeks of pregnancy. Most common obstetric emergencies occur in the first and third trimesters.
• The decision to travel should be made in consultation with your health care provider.  Discuss the purpose of travel, destination(s), length of the trip, planned activities, underlying medical and/or pregnancy related complications and available medical care in other countries.
• If you decide to travel while pregnant, make sure that you have proper travel health insurance. Review your policy and the coverage it provides, as most policies do not automatically cover pregnancy-related conditions or hospital care for premature infants.

Vaccines

• Generally, it is advised that pregnant women avoid live vaccines (for example, measles, mumps and rubella); however, inactivated vaccines are considered safe (for example, hepatitis B).
• The decision to get vaccinated while pregnant must be evaluated with your health care provider, taking into consideration such factors as your personal health, destination, length of trip and the risk of contracting the disease.

Malaria

• 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.
• If you cannot avoid travel to an area where malaria is present, take extra care to protect yourself from mosquito bites. Consult a health care provider to discuss whether anti-malarial medications are needed to reduce the risk of infection, and if so, which medications are appropriate. 
• Seek medical attention immediately if you develop a fever while travelling or when you return home. Tell the health care provider that you have been travelling to an area where malaria is present.

Transportation risk

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

• Air travel
  • Pregnant travellers can normally travel safely by air. In the absence of medical or obstetrical complications, pregnant women can safely fly up to 36 weeks gestation.
  • Most airlines restrict travel in late pregnancy or may require a written confirmation from a physician. Check with the airline regarding their requirements before booking your flight.
  • Pregnant women have a higher risk of developing blood clots known as deep vein thrombosis (DVT). The risk of DVT can be reduced by getting up and walking around occasionally, exercising and stretching your legs while seated and selecting an aisle seat when possible. Remember to wear comfortable shoes and loose clothing. Your health care provider may recommend additional ways to reduce your risk such as wearing compression stockings.

• 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 provider about the use of these medications.

Environmental and recreational risks

Pregnant women should remember to discuss their travel plans, including any planned or potential recreational activities, with a health care provider, as some may not be recommended or may require additional precautions.

• High altitude
  • It is recommended that pregnant women avoid altitudes above 3,658 metres (12,000 feet). For high-risk pregnancies and women in the late stages of pregnancy, altitudes should be limited to 2,500 metres (8,200 feet).
  • Women with pregnancy-related complications should avoid unnecessary high-altitude exposure.
  • Keep in mind that most high-altitude destinations are far from medical care services. Remember to discuss all planned activities with your health care provider.

Personal protective measures

• Food-borne and water-borne diseases
  • Pregnant women need to be especially cautious and practise safe food and water precautions. Many food-borne and water-borne illnesses can be more severe during pregnancy and pose a risk to the unborn baby (for example, toxoplasmosis, listeriosis and hepatitis E):
    • Always wash your hands before eating or preparing food. It is also important to remember to wash your hands after using the bathroom, changing diapers, or having contact with animals or sick people.
    • Drink water only if it has been boiled or disinfected or if it is in a commercially sealed bottle.
    • Avoid using iodine for water purification for long periods of time because this could cause the fetus or newborn to develop thyroid problems.
    • Avoid unpasteurized dairy products as well as raw or undercooked meat or fish, including shellfish.
    • If you develop persistent travellers’ diarrhea, consult a health care provider as soon as possible. Avoid using bismuth subsalicylate (Pepto Bismol®) to treat diarrhea.

• Insect and animal illnesses
  • Protect yourself from insect bites. This includes the use of bed nets, insect repellents and protective clothing.
  • Avoid contact with animals including dogs, monkeys, snakes, rodents, birds, and bats. 

•  Pack a travel health kit
  • Pregnant travellers may also pack items such as haemorrhoid cream, prenatal vitamins, medication for yeast infection, and support hose, in addition to the items listed in the travel health kit. Talk to your health care professional about other items you may want to bring that are specific to your health needs.

Monitor your health

• 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 or cramps, contractions, if your water breaks, excessive leg swelling or pain, severe headaches or visual problems.
• If you develop these symptoms after you return to Canada, you should see a health care provider and let them know about your recent travel.