Air travel while pregnant

By Dr Shelley Rowlands, East Melbourne Obstetric Group

These days everyone travels by air for work and pleasure. You will likely want or need to fly during your pregnancy and information about safety can be confusing. If you are thinking of air travel while pregnant by either short haul (under four hours), medium or long haul (over four hours) flights we have put together information to help you.

Will flying harm me or my baby?

• If your pregnancy is straightforward, flying is not harmful for you or your baby.
• 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 is the safest time to fly during pregnancy?

• 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.

Most airlines do not allow women to fly after 37 weeks, or require a medical note from your local GP to deem it safe to fly. It may also be more difficult to get travel insurance after 35-37 weeks.

Am I at increased risk of problems if I travel by air?

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.

Deep vein thrombosis (DVT)

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. 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.

How can I reduce the risk of a DVT?

If you are taking a short haul flight (less than four hours), it is unlikely that you will need to take any special measures.
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.

Are there any reasons I shouldn’t fly?

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.
• 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.

You should check that you are not going to an area that’s infected by Zika virus.

Be aware that the unexpected can happen while travelling which could delay your return home.

Should I be going at all?

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?
• How many weeks pregnant will you be when you travel and when you return?
• 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 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 worth checking before you decide to fly.

What should I take with me?

• A copy of your pregnancy notes
• Any medication you are taking
• If you are over 28 weeks pregnant, your airline may ask you to get a letter stating when your baby is due and confirming that you are in good health, are having a straightforward pregnancy and are not at any 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.
• Travel insurance documents

Safe travels!

Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.

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