Pregnancy creates an altered state of health which requires practical consideration before travel. In the first instance travel plans should be discussed with your GP, practice nurse, midwife or obstetrician, ideally before booking and well in advance of your intended departure date.

Fluctuating hormone levels and the psychological impact of pregnancy, as regards changing routines and responsibilities, may adversely affect your capacity to cope with the stressful nature of travel. It is therefore worth considering if you will have access to sufficient emotional and physical support during travel.

Disease Risks

Many diseases have more severe consequences in pregnancy, with significant risk to both mother and unborn baby. For example, malaria in pregnancy is harmful to both you and your unborn baby with an increased risk of severe illness or death for both. Consequently, where possible, you should avoid all non-essential travel to tropical destinations during pregnancy, in particular those with a risk of diseases such as malaria, zika virus or yellow fever.

The association between infection with zika virus and birth defects means that non-essential travel to areas with ongoing high risk of zika virus transmission should be postponed by women who are pregnant or planning pregnancy. For further information see our zika virus page.

Maternity Notes and Medical Care

Take a copy of your hand held maternity notes in case you need medical care during travel; include information about any pre-existing medical conditions and your blood group.

Carefully consider your intended destinations prior to booking, find out about:

• availability and standard of medical care

• existing health risks in the destination countries

• any other travel warnings.

The Foreign, Commonwealth and Development Office (FCDO) website provides advice on the availability of medical treatment and facilities alongside any travel warnings on an individual country basis.

It is essential that all your early pregnancy examinations are carried out prior to travel in order to rule out potential complications. If travelling after 28 weeks of pregnancy, it is important to ensure that available medical facilities at the destination are suitable to manage complications of pregnancy such as pre-eclampsia and caesarean section.

Be aware that blood supplies may not be safe in some destinations; this can increase the risks of blood borne infections such as hepatitis B, C and HIV.

Misunderstandings due to language barriers or cultural problems could make communication and therefore diagnosis and treatment of any illness more difficult than it would be at home.

Travel Insurance

Ensure that your travel insurance policy covers both you and your unborn child, and if delivery should occur during travel, that your newborn is insured.

Failure to notify your travel insurance provider that you are pregnant is likely to invalidate your insurance policy.

Additionally, it should be remembered that insurance policies are only as good as the medical facilities available.

Air Travel

Air travel is generally considered safe in uncomplicated pregnancy. However, it is important to discuss your fitness to fly with your GP, practice nurse, midwife or obstetrician before departure.

Be aware that policies vary between each airline but generally:

• Most commercial airlines accept pregnant travellers up to 36 weeks if single pregnancy or up to 32 weeks if a multiple pregnancy. This is because labour is more likely after 37 weeks, or around 32 weeks if carrying an uncomplicated twin pregnancy.

• Some airlines require written documentation from your practice nurse, midwife or obstetrician. This is to confirm you are in good health, that your pregnancy is uncomplicated and your due date.

• Flying during the first 12 weeks of pregnancy may be considered risky as miscarriage is more common during this early stage. Additionally, at this stage pregnant travellers may be suffering from pregnancy induced nausea and fatigue which could make travelling uncomfortable.

• You may be at greater risk of deep vein thrombosis (DVT) during pregnancy and the postpartum period; please refer to our Deep Vein Thrombosis page for further information.

The Royal College of Obstetricians and Gynaecologists have produced an advice leaflet for pregnant women planning to undertake air travel: Air Travel and Pregnancy

Vaccinations

Pregnancy does not prevent you from receiving vaccines that can protect the health of you and your unborn baby.

A general rule is that most recommended vaccines can be used if the risk of infection is substantial and if there are serious consequences of infection. However, a careful risk versus benefit analysis is needed for every individual, and the decision on whether to vaccinate should be made in conjunction with an appropriately qualified health care professional.

Inactivated Vaccines in Pregnancy

Inactivated vaccines cannot replicate which means they cannot cause disease in either the mother or her unborn baby. Most inactivated vaccines can be used if the risk of disease is considered high.

Live Vaccines in Pregnancy

The risk of the disease versus the benefit of administering any live vaccine during pregnancy requires expert consideration and expert advice should be sought. This is due to a theoretical concern that vaccinating pregnant women with live vaccines, such as: measles, mumps, rubella, chicken pox (varicella) and yellow fever, could potentially infect the unborn baby. Consequently, live vaccines are usually avoided during pregnancy. However, the use of live vaccines in pregnancy may be appropriate if travel is unavoidable and the risk of the disease is high.

Malaria Prevention

Malaria in pregnancy is associated with miscarriage, premature delivery, low birth weight, severe illness or death, affecting both the mother and unborn baby. Consequently, you should avoid all non-essential travel to known malaria risk areas during your pregnancy.

If travel to a malaria area is unavoidable then it is important that you seek expert advice. In the first instance contact your GP for advice, however, be aware that they may refer you to a specialist travel medicine service.

Mosquito bite avoidance is essential in the prevention of malaria. Pregnant women are more attractive to mosquitoes and should therefore be particularly careful to avoid mosquito bites.

For further information please see our mosquito bite avoidance page.

Malaria Medication in Pregnancy

If antimalarial tablets are recommended then you should seek expert advice about which malaria tablets are safest for you to take.

The choice of malaria tablets will largely be determined by your destination, stage of pregnancy and any other pre-existing medical conditions you may have.

Malaria tablets should always be used in combination with mosquito bite avoidance.

Disclaimer: This information has been developed for educational purposes only. It is not a substitute for professional medical advice. Should you have questions or concerns about any topic described here, please consult your healthcare professional.