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Travelling when Pregnant

Travelling when Pregnant


Planning a holiday when you’re pregnant? Great! As long as there are no identified complications or concerns with your pregnancy, following the proper precautions and gaining information on when to travel, vaccinations and malaria advice, it is generally safe to travel at all times during your pregnancy.

Here are some general tips to ensure you and your baby stay healthy during your travels

Plan ahead

Choose your holiday destination wisely. Some locations may carry extra risks and could require vaccinations and may have a high risk of malaria.

Destinations with a high risk of malaria or other mosquito-borne disease, such as dengue or zika should be avoided when pregnant.

Zika advice when pregnant or trying to conceive.

Seek advice early from your doctor or midwife, at least 6-8 weeks before your trip. If you have less time than this before you go, an appointment is still worthwhile. They can advise you whether it is safe for you to travel.

The early pregnancy scan that is usually performed between 10 to 13 weeks gestation, should ideally be done prior to your trip to confirm the viability of the pregnancy, exclude ectopic pregnancy and assess the gestation. It is also a good idea that you know your blood group before departure. You should be aware that the blood supply may not be safe in some countries, there may be a risk of blood-borne infection. Consider joining the Blood Care Foundation, members can have access to screened blood worldwide for use in an emergency. You can become a member at Blood Care Foundation

Travelling with certain pre-existing medical conditions or pregnancy complications (past or current) is not recommended, specific advice should be sought from your obstetrician and midwife.

You should take your ante-natal records and next of kin details with you when travelling.

Suitable gynaecological, obstetric and neonatal care may be limited or non-existent in some areas. Emergency plans should be made before you travel. It is a good idea to find out what healthcare facilities are at your destination in case you require urgent medical attention. The Foreign and Commonwealth Office (FCO) website provides advice on availability of medical treatment/facilities and any travel warnings on an individual country basis.

Don’t forget that misunderstandings due to language barriers or cultural problems might make communication and treatment more difficult than it would be when you’re at home.

Comprehensive travel insurance is essential for all travellers, particularly when pregnant. You must make a full declaration of any medical conditions, including pregnancy to your insurers. Pregnant women should check that the policy will cover the cost of medical treatment if a pregnancy related problem occurs, this should include the care of a pre-term baby and repatriation costs if applicable. You should also make sure that all equipment and planned activities will be covered by your policy.

Further information on travel insurance visit Fit For Travel

When to travel

The best time to travel is in your second trimester. In most cases, feelings of nausea and extreme tiredness will have passed by the end of the first trimester. The risk of miscarriage is also higher in the first three months, whether you’re travelling or not. Travelling in the last months of pregnancy can be tiring and uncomfortable.

Air travel in pregnancy

If your pregnancy is uncomplicated, flying is not harmful for you or your baby. Before you book your tickets, check with your airline and insurance company that they will allow you to travel while pregnant. Women with high-risk pregnancies, which include abnormalities of the placenta or increased risk of premature labour, should avoid flying.

The safest time to fly in your pregnancy is:

Single baby pregnancy – before 37 weeks.

Uncomplicated twin pregnancy – Before 32 weeks.

The likelihood of going into labour is naturally higher after these times (1).

Most airlines do not allow women to fly after 37 weeks. It is important that you check with your airline before flying. Remember to factor in the date of your return journey (1).

After week 28 of your pregnancy, your airline may ask for a letter from your doctor or midwife confirming your due date, and that you aren’t at risk of complications (1)

Deep vein Thrombosis

When you are pregnant and for up to six weeks after the birth of your baby long-distance travel (more than four hours) carries an increased risk of developing a blood clot, otherwise known as deep vein thrombosis (DVT). A DVT is a blood clot that can form in your leg or pelvis. If it travels to your lungs it can be life threatening. When you fly, drink plenty of water and move about regularly – every 30 minutes or so. 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 that you buy from a pharmacy. Your doctor or midwife may advise you take other medication if your risk is high.

The Royal College of Obstetricians have produced an excellent information sheet on Flying in Pregnancy

Sailing in pregnancy

Some cruise liner companies or ferry companies may decline to carry pregnant women in the mid to late stages of their pregnancy. You should check your individual liners company requirements when booking and also take into account any connecting flights. It’s a good idea to find out if there are on-board medical facilities to deal with pregnancy and what medical services are at the docking ports.

Vaccinations

Pregnancy does not prevent a woman from receiving vaccines that are considered safe and will protect her health and that of her unborn baby. Most inactivated vaccines are considered safe in pregnancy and can be used if the risk of infection is high and both the mother and the baby would be in serious danger if she were to contract infections such as such as typhoid and hepatitis. A careful risk assessment will be made by your healthcare professional and a joint decision would be made with you whether vaccinations are recommended.

Vaccines that use live bacteria or viruses are not recommended during pregnancy because of concerns that the virus or bacteria in the vaccine could potentially infect the baby in the womb. However, the use of live vaccines in pregnancy may be appropriate if the woman’s travel is unavoidable and the risk of the disease is high. Lives vaccines would include Yellow Fever and MMR vaccinations.

Malaria

It is recommended that women do not travel to known malaria risk areas when pregnant. You should consider postponing your trip, unless it is essential. Malaria carries serious risks for both you and your unborn baby.

Pregnant women are more attractive to mosquitoes and are therefore more likely to get a severe form of malaria. It is very likely that you would develop severe complications from malaria. Malaria in pregnancy increases the risk of miscarriage, premature delivery, low birth weight and maternal or neonatal death. It can also be very difficult to diagnose malaria in pregnancy.

 If you are travelling to malaria risk areas it is essential that you are aware of your increased risk and advice is sought about the safest malaria prophylaxis medication available.

The Royal College of Obstetricians have produced an excellent information sheet on Malaria and Pregnancy

As with all travellers, bite prevention is crucial in the prevention of malaria, and other mosquito borne diseases. The use of insect repellents is essential. DEET should not be used in concentrations higher than 50% during pregnancy.

Mosquito bite avoidance advice sheet

Food and water safety and travellers’ diarrhoea

Travellers’ diarrhoea is a common concern when travelling abroad. This can affect up to 50% of travellers and can lead to dehydration. Ensure you drink plenty of bottled water, or use canned juices or soft drinks as an alternative. Always check that dairy products are pasteurised. Fruit should be peeled. Salads should be avoided as could be contaminated with soil or washed with local water. All vegetables should ideally be cooked. Fish and shellfish are best avoided. Some medicines for treating stomach upsets and traveller’s diarrhoea aren’t suitable during pregnancy.

If you are pregnant and planning a trip we recommend that you book an appointment to discuss your trip with one of our nurses at our clinic.

To book an appointment call 01273 749100 or 01903 254774 or book ONLINE

 Happy travelling from the Sussex Travel Clinic team!

Pregnant woman at sunset

Written by Nicki Harrison Lead Clinic Nurse – RGN 

 Bibliography and references:

1.https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/air-travel-pregnancy.pdf

2. https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/air-travel-pregnancy.pdf

3. http://www.nhs.uk/chq/Pages/927.aspx?CategoryID=54&SubCategoryID=133

4. http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/travel-pregnant.aspx

5.https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-malaria-and-pregnancy.pdf

6.http://travelhealthpro.org.uk/pregnancy/

7.http://www.nhs.uk/Conditions/zika-virus/Pages/Introduction.aspx

 

 

 

 

 

 

 

 

 

Posted May 20, 2016
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