TORONTO - Should you take a pregnant pause from travelling just because you’re pregnant?
Family doctors and specialists, are frequently asked questions about travelling while pregnant, but physicians normally give short answers like “it’s okay to fly up to 36 weeks, but after that stay at home.”
Many organizations have published opinions about travel in pregnancy, and they all seem to be fairly supportive.
As a consultant obstetrician at North York General Hospital since 1976, I have seen many patients who have asked if it is safe to travel in pregnancy.
My response is always “why are you travelling?”
My reasoning focuses on the motivation for the holiday, need to go, and possible risk to the mother and the baby while travelling.
Though travel is fairly safe, things can go wrong. It is a well known fact that pregnancy is associated with an increase in some conditions such as blood clots in the legs and lungs, and that flying can make matters worse.
It is also important to ascertain how safe the holiday destination is for a pregnant woman. Many tropical areas are associated with diseases that are not known in urban areas like Canada. Sanitation is often not good, and the quality of medical care is below that which is expected by Canadians.
For patients who have to travel because of a family emergency, I ascertain which trimester they are in, and will go through the issues that might be important for them to know while away.
Trimesters are the three divisions that pregnancy is divided into. From conception to 14 weeks: first trimester; 14 weeks to 28 weeks: second trimester; and 28 weeks to delivery, third trimester.
In the first trimester, maternal medical problems such as hyperemesis (nausea and vomiting) maybe a problem. It is important to establish the pregnancy is going well, as a non-viable pregnancy is fraught with miscarriage. There are many tests that are done in the first trimester, and that it is good to have these results in hand before embarking on a big vacation. You should also have an ultrasound as well as blood tests before you leave.
Pain and bleeding can occur at any time, and that can be another serious problem while you’re away.
In the second trimester, the risk of having a premature baby starts to rise. It is generally conceded that travelling is best between 20 to 28 weeks, assuming all your tests are good.
The issue of travelling in the third trimester depends on the need to travel. Though air travel restrictions are commonplace, check with your airline before you go - the onus is on you and your health care provider.
Insurance will normally cover pregnancy to 28 weeks, but insurance companies may well exclude pregnancy later for obvious reasons. A birth of a baby at 32 weeks can be horrendously expensive. Your doctor may be reluctant to sign a health certificate, since if anything goes wrong he may be liable for your expenses.
So, here’s a few questions to ask yourself before heading off on vacation:
- Why you are going, and is it necessary?
- If you are to do tests, can you get the results before you go? And if treatments are necessary, will you cancel the trip and will the insurance company pay?
- Can the trip wait until a safer time in the pregnancy - at 20 to 28 weeks?
- Can you put off the trip until after the baby is born?
- Are you prepared for illness while travelling and at your destination and can you get treatment?
- Can you put off that business trip?
- Did you check with your health care provider before you paid for the trip?
- Did you check with international medical advisory services for vaccinations or other medical assistance that can make the trip safer?
- Have you gone to the web and searched out the answers to your particular trip?
- Does your family know of the risks of travelling?
Many a time other family members are involved and that can incur larger costs if things go wrong.
When you can answer all these questions, then it is time to speak to you travel advisor. All reputable travel organizations will help in sorting out not only the tickets and bookings, but also advise on medical insurance matters.
Make sure that your doctor is up to date on medical issues surrounding travel. Always take a reasonable approach, delaying the trip if need be. And remember, those exotic places will be there long after you’ve had your baby.
Bon voyage.