Introduction to Travel during Pregnancy
Introducing the chapter, the topic of travelling while pregnant and the need to consider all travel facets are addressed. While pregnancy is a normal occurrence in life, travel during pregnancy is a multidimensional health issue requiring in-depth investigations. Learning how to travel, when to travel, and how to get in touch with healthcare providers, alongside the importance of being aware of geographical accessibility toward healthcare services, is no trivial matter.
Research highlights the need for proper healthcare delivery, where local cultures and travel styles are taken into consideration as pregnant travellers are often not tourists like others. Discussion focuses on the factors that need to be considered before a trip is planned, discussed, or consented. This chapter provides the foundational knowledge base upon which all other discussions in this book are built by addressing the pregnant woman herself.
Pregnancy should not imperatively confine women to one geographic location nor constrain their right to travel. Taking holidays and resting are generally recommended during pregnancy. Thus, travelling is an excellent way to relax, to bond with one’s partner and/or children, and to break away from everyday demands. Should any complications with the journey or travel have previously occurred in a pregnancy, a doctor should be visited.
However, the ultimate decision to travel is dependent on the benefit of travel compared to potential risks to one’s health and to that of the fetus. All the factors presented here should be considered by each pregnant woman to make an informed decision about whether to travel or not and when under consultation with her gynaecologist.
Consulting with a Healthcare Provider Before Travel
A medical consultation before travel assists in establishing safety. Contact a healthcare provider four to six weeks in advance of travel. Many different variables can affect risk and decision-making, so this should not be considered a substitute for personalized medical advice.
If you are pregnant, the best source of advice is your obstetric care provider. Before your consultation, think about what specific issues or questions concern you, which may include: - your pregnancy history (so far) - your plans while travelling - your opinion about relevant vaccines and medicines. Based on the conversation, a healthcare provider can help: - personalized decision-making.
Top up the advice given here with information available regarding your destination and time of year. Consult your prenatal care provider. Choose a healthcare provider with a depth of geographical medicine experience. Review your destination and accommodations. Ask about pre-purchased insurance for your trip. Assess the availability and standard of medical care at your destination.
Vaccination and immunization: For itineraries, travel considerations exist that would indicate a vaccine; is already provided for pregnancy reasons where a vaccine is indicated, a vaccine with live weakened virus contraindicated during pregnancy, or the vaccine is not usually recommended during pregnancy. From 20 weeks of gestation, some live virus vaccinations cannot be provided for safety reasons. Some recommendations and vaccine product information include separate restrictions based on trimester. Medications: Find out if any medication you are taking or have been prescribed is legal at your destination. There may be complications or implications of travel that are hard to predict.
Risk Assessment and Destination Selection
The ideal travel destination and duration should ideally be based on a thorough pre-travel risk assessment tailored to the needs of pregnant travellers. Important factors should be taken into account, such as the climate of the destination and the time of year of travel. The planning should also include an assessment of the maternity services in the destination country or countries, as well as a consideration of how civilized the location is and what healthcare resources are available.
A conservative destination should always be chosen; this is not a time to visit remote or dangerous destinations. This point applies not only to the choice of the destination but also to the choice of resort or accommodation. The journey environment should be well considered. Some airlines have time restrictions on women flying to reduce the likelihood of in-flight obstetric emergencies. Travel insurance can be difficult to obtain, especially once the second trimester has been reached.
However, there are some locations and types of travel that require destination avoidance at any stage:
• An area of the world with a high medical risk of an infectious disease.
• Travel to a country with very limited medical facilities; if complications develop, it would be difficult to arrange for life-saving evacuation. Certain tropical destinations will be more suitable in terms of only being exposed to diseases transmitted by mosquitoes in the cooler months. The advice can be tailored to a woman considering travel, and the destination’s latitude can be one of the considerations in making a decision. In the first trimester, the counsellor should also take into account how the destination's time of year can affect pregnancy-related aspects.
For example, travelling to a very hot or cold destination (depending on the time of year) when suffering nausea or when very heavily pregnant does not ensure the physical or psychological well-being of the pregnant woman. Each of these points should be considered by the pregnant woman for a risk-benefit assessment. It is generally always better to enjoy the destination and its sights and experiences than to experience them under a cloud of physical discomfort.
Destination choice is often based on personal attitudes and booking preferences. For example, doing a two-month research project in a city is not practical, and a three-week holiday in another city is. Personal staging is thus an individual decision but a proactive one.
Precautions and Tips for Safe Travel
When travelling during pregnancy, some policies suggest that it is better not to travel after the 36th week of gestation. Others suggest avoiding travel from the 28th week on, as there is a slight chance for the pregnant woman to go into early labour. Complications occurring at this stage of pregnancy may happen in any country but may be more severe in low-resource countries.
While anyone can develop travel-related illnesses, the risks are increased for some pregnant women. For example, travel-related illnesses can make pre-existing medical conditions worse. Pregnant women are also at higher risk of developing complications from some travel-related illnesses, such as malaria. Pregnant women must follow the guidance for preventing infectious diseases. This means protecting against mosquito bites, avoiding areas at risk for malaria, and preventing sexual transmission of the Zika virus.
Missing vaccinations in case of special risks, such as yellow fever, should not be a reason for changing travel plans if options are available. Making sure a travel insurance policy is in place is important for all pregnant women travelling abroad. It should cover any eventuality should the need for medical care arise while outside of the country of regular residence. - Drink as much water as possible. Pregnant women should normally drink 8 to 10 cups each day. The heat and air conditioning can have a large impact on body dehydration. It can cause uterine contractions and reduce blood circulation.
- Have small snacks throughout the day. A mixed snack of protein, fruit, and whole grains will leave you feeling more satisfied and, as a result, will prevent nausea.
- Move: Twists and shakes make the body secrete endorphins, which are natural painkillers.
- Dress comfortably. Tight clothing can impede blood circulation. Bring a pillow on the plane, and make sure seat belts are always worn under your belly.
- Get comfortable. Distract yourself from the discomforts of travel by watching a movie, sleeping, talking to your neighbours, and performing movements and exercises to keep you comfortable.
- Plan stops every 90 to 120 minutes when travelling by car or bus. Walking around for 10-15 minutes will reduce the risk of blood clot formation in the legs.
- Bring hygienic precautions: Pack some hand sanitiser or soap, as well as some wipes, to wash your hands or any surrounding surfaces.
- Pack all your medications, your obstetric documents from your doctor, and an ID in a place that is easy to reach. Ensure that there are instructions on the use of medication, as well as emergency contact information and insurance information available.
- Use seat belts when travelling in vehicles. During the flight, the crew will explain how to fasten and secure the belt.
Always consult medical professionals before making arrangements in case your pregnancy status requires any changes in travel preparation. Be sure to inform your travel companions about any specifications that must be met, and inform them of any emergency event. Always inform the staff of your status as pregnant. They are the best people to guarantee your safety.
Medical Emergencies and Resources for Pregnant Travellers
Most pregnant women who are travelling in a standard-risk area will not have medical or obstetric problems that will require major medical intervention. However, pregnant travellers are still at risk for common medical problems that can become quite serious.
Problems such as orthopaedic injury, dehydration, or infection have the potential to lead to preterm labour and premature births. The one thing that can make a simple medical emergency worse is trying to figure out where the right hospital for your medical condition is. Knowing where the nearest medical care facility is to your location is important.
Hospitals and phone numbers need to be readily available where you are staying, as using the telephone directory information can be difficult, time-consuming, and during an emergency may be a barrier to treatment. When travelling, always consider having a first-aid kit with you. Travellers, particularly high-risk travellers, should have a well-stocked first-aid kit that includes such things as a thermometer, bandages, gauze pads, iodine pads, scissors, tweezers, sunscreen, aspirin-free pain and fever relievers, remedies for common ailments such as diarrhoea, cough, cold, or allergies, a first-aid manual, water purification tablets, feminine hygiene products, and lip balm.
Within the kit, carry a set of potential medications or referrals for medicines that could be acquired to assist with a possible traveller’s medical emergency. Regardless of travel destination, the one person that pregnant women can rely on for immediate medical help is their travel companions. Providing brief information on what to do in the event of bleeding, pain, or illness will give the pregnant traveller a sense of support in case of need.
A well-outlined medical information document will give the caretaker clues about an individual’s health problem when it becomes serious. A clear document with a health history will provide more information about existing health problems. A list of the current pregnancy care provider and planned delivery locations should also be included. In an anxious mind, knowing where to go will be of comfort.
For further information on other travel-related health considerations, download our ebook “Travel Smart: Your Essential Guide to Medicine on the Go”. The best way to stay safe and healthy during your travel is to be informed and minimise the health dangers related to travel for work, business, or leisure. You can download it by clicking HERE.
