during pregnancy travel by air

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Is it safe to fly during pregnancy?

Generally, air travel before 36 weeks of pregnancy is considered safe for people who aren't dealing with any pregnancy problems. Still, if you're pregnant, it's a good idea to talk with your health care provider before you fly.

Your provider might suggest that you not fly if you have certain pregnancy complications that could get worse because of air travel or that could require emergency care. Examples include a history of miscarriage or vaginal bleeding, severe anemia, and high blood pressure or diabetes that's not well controlled. If you had preeclampsia during a previous pregnancy — a condition that causes high blood pressure and extra protein in urine — flying may not be advised. The same is true if you're pregnant with twins or other multiples.

Tell your provider how far you are flying, as the length of the flight might make a difference. Also, be aware that some airlines may not allow pregnant people on international flights. Check with your airline before you make travel arrangements.

After 36 weeks of pregnancy, your health care provider may advise against flying. And some airlines don't allow pregnant people to fly after 36 weeks. The airline also may require a letter from your health care provider that states how far along in your pregnancy you are and whether flying is advised.

If your health care provider says it's okay for you to fly, and your plans are flexible, the best time to travel by air might be during the second trimester. The risks of common pregnancy emergencies are lowest during that time.

When you fly:

• Buckle up. During the trip, keep your seatbelt fastened when you are seated, and secure it under your belly.
• Drink plenty of fluids. Low humidity in the airplane could cause you to become dehydrated.
• Avoid gassy foods and drinks before you fly. Gases expand during flight, and that could make you uncomfortable. Examples of foods and drinks to avoid include broccoli and carbonated soda.
• Think about medical care. Plan for how you'll get obstetric care during your trip if you need it. Bring copies of your medical information in case you need care while you're away.

Blood clots

Air travel can raise the risk for blood clots in the legs, a condition called venous thrombosis. The risk is higher for pregnant people. Moving your legs may help prevent this problem. Take a walk up and down the aisle every hour during the flight. If you must remain seated, flex and extend your ankles from time to time. In general, it's best to avoid tightfitting clothing, as that can hinder blood flow. Wearing compression stockings can help with blood circulation during a long flight.

Radiation exposure linked to air travel at high altitudes isn't thought to be a problem for most people who fly during pregnancy. But pilots, flight attendants and others who fly often might be exposed to a level of radiation that raises concerns during pregnancy. If you must fly frequently during your pregnancy, talk about it with your health care provider.

Mary Marnach, M.D.

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• Allergy medications during pregnancy
• AskMayoExpert. Health considerations for air travelers: Pregnancy considerations. Mayo Clinic; 2022.
• Air Travel During Pregnancy: ACOG Practice Bulletin No. 746. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/08/air-travel-during-pregnancy. Accessed Dec. 1, 2022.
• Ram S, et al. Air travel during pregnancy and the risk of venous thrombosis. American Journal of Obstetrics and Gynecology. 2022; doi:10.1016/j.ajogmf.2022.100751.

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Here Are the Rules for Flying When You're Pregnant

Whether you're newly pregnant or planning a babymoon right before welcoming your baby, here's what parents-to-be need to know about airline travel during each trimester.

Expectant parents need to know: Can you fly when pregnant?

While it's mostly OK to travel until the last few weeks of pregnancy, there are some precautions to take depending on when you decide to book a trip and how high risk your pregnancy is. Here's what you need to know before your next vacation.

Pregnancy and Flying: Your Trimester by Trimester Guide

As a general rule of thumb, most airlines will allow pregnant people to fly right up until week 36 of pregnancy, but you should absolutely do your research before booking your flight to check restrictions. You'll also want to consult with your OB-GYN or midwife before traveling—especially if you're at a higher risk for complications during pregnancy.

GETTY IMAGES

Before you travel

While you may be accustomed to planning a vacation on a whim or only packing your usual necessities, there's one extra thing you should consider doing before booking a flight during your pregnancy: Opt for travel insurance.

Should travel restrictions change, your health care provider recommends you stay home, or if you experience any concerning symptoms —like bleeding, abdominal pain, swelling, headaches, vision changes, or decreased fetal movement—you'll want to postpone or cancel your plans and see your doctor as soon as possible.

According to the ACOG, travel is not recommended for pregnant people with certain complications like preeclampsia, premature rupture of membranes (PROM), or who are at risk of preterm labor.

First trimester

Flying earlier on in pregnancy is actually considered pretty safe. And, no, metal detectors won't harm your fetus.

"Pregnant women can observe the same basic precautions for air travel as the general public," Raul Artal, M.D., former vice chairman of the American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice, previously told Parents .

One thing pregnant air travelers should take extra precautions to avoid at any trimester? Blood clots, which pregnant people are 7 times more likely to develop—especially during long flights. To help minimize your risk, you can book an aisle seat, walk around every so often, and wiggle your legs and toes while seated.

And since morning sickness and fatigue might be your biggest first trimester complaints, you may want to check with your health care provider about bringing anti-nausea medicine with you.

Second trimester

According to the ACOG, "The best time to travel is mid-pregnancy (14 to 28 weeks). During these weeks, your energy has returned, morning sickness is improved or gone, and you are still able to get around easily. After 28 weeks , it may be harder to move around or sit for a long time."

If you're flying during your second trimester, it's a good idea to stay hydrated, think about wearing support stockings to reduce edema and clot risk, and make sure you've done your research on hospitals located near your destination should an emergency arise.

Carrying twins or more? Your health care provider might recommend you stop traveling earlier due to the higher risk of complications.

Third trimester

How late in pregnancy can you fly? If you're relatively healthy—and not at risk of complications like preterm labor, preeclampsia, gestational diabetes, or placenta previa—then you're usually OK to travel up until 36 weeks, though some OB-GYNs may prefer you stay closer to your home near the end should you encounter any complications or in case your baby comes sooner than expected.

High-risk patients—and especially those with pregnancy-induced hypertension, diabetes, and sickle-cell disease—may be advised not to fly after 24 weeks—or not at all.

Check with your doctor before traveling at the end of your pregnancy.

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Traveling while pregnant: Your complete guide

Unless you're nearing your due date or have certain complications, your healthcare provider will generally give you the green light for pregnancy travel. Here's how to safely explore – plus what to consider before making plans.

Is traveling while pregnant safe?

When to avoid pregnancy travel, when is the best time to travel while you're pregnant , can pregnant women travel during covid, when should you stop traveling while pregnant, your pregnancy travel checklist, when to call your doctor while traveling.

Yes, it's generally safe to travel during pregnancy as long as you're not too close to your due date and you're not experiencing any serious pregnancy complications. There are special precautions to take, of course, and you may find yourself stopping to use the bathroom more than you're used to, but that babymoon can be within reach.

Before you pack your suitcase, talk with your healthcare provider to make sure it’s safe for you to travel and that your destination is a good choice. You'll want to avoid places where infectious diseases are prevalent (or there are high outbreaks of Zika or malaria, for example). The COVID-19 pandemic has made people reconsider where they feel safe traveling as well; if you're fully vaccinated, the CDC says you can travel Opens a new window , but it's always best to check with your doctor first.

And bear in mind that the activities you take part in might be different than normal – you'll want to skip the Scuba diving lessons, for example (though snorkeling is okay!).

It's safe to fly when you're pregnant as well, and most airlines will allow you to fly domestically until about 36 weeks of pregnancy. International routes may have different rules, so be sure to check with your airline before booking anything. Your doctor will tell you to avoid flying, however, if you have a health concern that might require emergency care or any other health conditions that aren’t well controlled.

It's best to avoid traveling while pregnant if you have any health conditions that can be life-threatening to both you or your baby. If you have any of the following conditions, your doctor will almost certainly advise you against travel:

• Placental abruption  
• Preeclampsia
• You're in preterm or active labor
• Cervical insufficiency  (incompetent cervix)
• Premature rupture of membranes (PROM)
• A suspected ectopic pregnancy
• Vaginal bleeding

You might also need to be extra-cautious or skip travel if you're experiencing intrauterine growth restriction , you have placenta previa , or you have other conditions that may place your pregnancy at a higher risk. It’s always a good idea to discuss your concerns with your healthcare provider before travel regarding any medical conditions you have, and they'll be able to advise you on what's best, depending on the trip.

The sweet spot for pregnancy travel is during your second trimester , between 14 weeks and 27 weeks. By the second trimester, any struggles you’ve had with morning sickness and fatigue during the earlier weeks of pregnancy should have hopefully subsided – and after 12 weeks, your risk of miscarriage decreases significantly as well. And you're not too far along to worry about third trimester exhaustion or going into preterm labor yet, either.

Your energy levels are likely to be good during your second trimester too (bring on the sightseeing!), and it will still be relatively easy and comfortable for you to travel and move around at this time. Keep in mind that once you hit that third trimester, pregnancy travel might be more difficult as you find it harder to move around and stay still for long periods of time.

It's complicated (and often a personal decision based on your own risk factors), but the CDC says that if you're fully vaccinated against COVID-19, you can travel. Of course, it's important you still do everything you can to keep yourself and others around you safe, including following all mask-wearing and social distancing guidelines in the destination you visit.

Women are at an increased risk for severe illness if they contract COVID-19 while pregnant , and they're more likely to experience preterm birth and other poor pregnancy outcomes. (This is why the CDC, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine all recommend that women who are pregnant, breastfeeding, or are planning on becoming pregnant get the COVID vaccine .)

If you're vaccinated and decide to travel, the CDC advises avoiding international destinations that are designated Level 4, due to high rates of local COVID-19 transmission.

Take all this information into account and talk to your doctor before you decide on where and when to travel while you're pregnant. And if you experience any symptoms of COVID-19, whether while traveling or at home, call your healthcare provider as soon as possible.

The guidelines for when to stop traveling while you're pregnant vary based on your mode of travel, but more or less, you should wrap up travel before you're 36 weeks pregnant.

Most airlines will let pregnant women fly domestically until they're 36 weeks pregnant – and many cut that off earlier for international travel. This rule is often enforced on an honor system policy, but some airlines may ask for a doctor’s note – so make sure you have that from your healthcare provider if you're traveling in the third trimester, just in case.

Most cruise ships don't allow travel after 24 weeks of pregnancy. Some cruise lines' cutoff dates vary, so verify policies before booking a cruise.

As for road trips, there's no official deadline for when you need to stop traveling, but your personal comfort level (physically and emotionally) – and your doctor's advice – might help you decide. You can drive while pregnant all the way up until your due date, but things may get considerably less comfortable on longer trips as you approach full term.  

Travel of any kind requires advance preparation, but when you're pregnant and traveling, that pre-trip checklist gets a little longer. Give yourself a little more time than usual to plan for a trip – and use the tips below to stay safe and comfortable on your next adventure.

Before you travel

• Talk to your healthcare provider to determine if your trip is safe for you and if there are any medical concerns to consider. It's a good idea to discuss any activities you plan to do while you're away too. If you're planning an international trip, make sure to ask about any vaccines you may need for the areas you're visiting.
• Make sure you know your prenatal test schedule. Plan travels around any prenatal tests you need to schedule, including ultrasounds and other important screening tests.
• Book an aisle seat. You'll likely be more comfortable being able to get up to stretch or go to the bathroom on longer flights.
• Buy travel insurance. You don't need special travel insurance when you're pregnant, but it's never a bad idea to secure a policy. You may want to consider one with a “cancel for any reason” clause that reimburses you for money lost on cancelled trips for reasons (read: any reason) beyond what’s listed on the base policy. Check with your personal health insurance, too, to make sure it covers potential pregnancy complications while traveling internationally (some don’t). Consider adding evacuation insurance as part of a travel insurance plan, too.
• Gather your medical records and health information . If you’re in your second or third trimester, ask your ob-gyn or midwife for a digital copy of your prenatal chart, and have that easily accessible during your trip. Typically, this chart includes your age, your blood type, the name and contact information for your healthcare provider, the date of your last menstrual period, your due date, information about any prior pregnancies, your risk factors for disease, results of pregnancy-related lab tests (including ultrasounds or other imaging tests), your medical and surgical history, and a record of vital signs taken at each visit.
• Keep a list of key names and numbers you may need in the event of an emergency saved on your phone and written on a piece of paper (in case your battery dies).
• Have a contingency plan for doctors and hospitals that will take your insurance where you're going in case you go into labor early or experience pregnancy complications that require urgent care while you're away from home.
• Pack medicines and prenatal vitamins. That might include an extended supply of prescriptions and over-the-counter remedies , too. Bring enough to cover your entire trip and a written prescription that you can fill if you lose anything. It's a good idea to keep prescription medicine in its original container, so if your bags are searched it will be clear that you're not using medication without a prescription.
• Prepare for the unexpected. On a road trip, that might mean an unexpected breakdown, so join an auto club that provides roadside assistance. Download any apps you use for renting cars and accessing boarding passes before you leave so you can easily reschedule things in the event of a last-minute cancellation.
• If you're flying during your third trimester, be sure to call the airline to check about the cutoff week for pregnancy travel. A note from your doctor that says you’re cleared to travel is always good to have when traveling during your third trimester.

During your trip

• Drink plenty of water and continue to eat healthy foods . Keep in mind that many restaurants abroad commonly serve unpasteurized foods (like soft cheeses and milk), which can be dangerous for pregnant women due to the presence of listeria.
• Avoid eating raw or undercooked meat or fish , drinks with ice (which may be contaminated), non-bottled water, and other foods that can cause traveler's diarrhea, which can be more of a problem for pregnant women than other people.
• On long flights and drives, take time to stretch by pulling over for a walk or strolling up and down the airplane aisle. And when seated, always wear your seat belt .
• Maternity compression socks are handy to have along – both in transit and worn under your clothes while you’re out and about exploring – because they can ease the symptoms of swollen feet and legs. These are a few of our favorite pregnancy compression socks .
• Take advantage of help. Many countries have dedicated lines in shops and airports for pregnant travelers, so don't feel any shame taking a shorter wait if you see one.
• Go easy on yourself. Remember, you're growing a baby. You might not have quite the stamina for sightseeing and late nights like you used to pre-pregnancy. Make the most of your vacation but don't fret you miss out on things because you need more downtime from exploring than you usually would.
• Don’t forget to get photos of your bump. When your baby is older, you'll have fun showing them all the places you traveled with them before they were born.
• Go for the comfy shoes. Travel during pregnancy is the best reason ever to forgo those strappy stilettos for your favorite sneakers .
• Pack snacks so you always have something to curb your appetite if there’s a long wait for a restaurant or you get stuck in transit or someplace remote with no food offerings.
• Try to be in the moment with your travel partners as much as possible. Once your baby is born, your attention will be pulled in a whole new direction.

If you have any medical concerns traveling while pregnant, don’t hesitate to pick up the phone and call your doctor for advice. The below are a few symptoms that definitely warrant calling your ob-gyn or health care provider or seeking emergency care while traveling or at home:

• Signs of pre-term labor (including a constant, low dull backache, bleeding, etc.)
• Ruptured membranes (your water breaks)
• Severe cramping
• Spiking blood pressure
• Severe nausea or vomiting
• COVID-19 symptoms

Was this article helpful?

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

AAFP. 2020. Ultrasound during pregnancy. American Academy of Family Physicians.  https://familydoctor.org/ultrasound-during-pregnancy/ Opens a new window [Accessed April 2023]

ACOG. 2020. FAQ055: Travel during pregnancy. American College of Obstetricians and Gynecologists.  https://www.acog.org/womens-health/faqs/travel-during-pregnancy Opens a new window [Accessed April 2023]

CDC. 2019. Pregnant Travelers. https://wwwnc.cdc.gov/travel/yellowbook/2020/family-travel/pregnant-travelers Opens a new window [Accessed April 2023]

CDC. 2022. Domestic Travel During Covid-19. https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html Opens a new window [Accessed April 2023]

CDC 2023. International Travel During Covid-19. https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel-during-covid19.html Opens a new window [Accessed April 2023]

CDC. 2022. Covid-19: Pregnant and Recently Pregnant People. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html Opens a new window [Accessed April 2023]

Terry Ward is a freelance travel, health, and parenting writer who has covered everything from flying with toddlers to why you should travel with your kids even when they're too young to remember it. She lives in Tampa, Florida, with her husband and their young son and daughter, and enjoys camping, sailing, scuba diving, skiing, and almost anything else done in the great outdoors.

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Safety of Air Travel During Pregnancy

E+ / Getty Images

Pregnancy was once seen as something that sent women to their homes once their bellies began to protrude (hence the term "confinement"). It was not considered appropriate for pregnant people to be seen in public.

Nowadays pregnancy rarely changes schedules, with the exception of high-risk pregnancies or other complications. People usually can continue their normal lives for the duration of the pregnancy, with minor exceptions (like knowing where all the bathrooms are!). Travel is no exception.

Travel is becoming more prevalent as families move further and further apart. Traveling for holidays, or as the last trip to see the family before the baby comes, or as a last romantic vacation, is not unusual. This includes out of the country travel and often air travel.

The Science on Pregnancy and Air Travel

For ethical reasons, there are not many studies on air travel and miscarriage rates. One 2015 study showed a slight increase in first-trimester miscarriage for flight attendants, but this was often associated with high physical job demands and disruptions to their sleep cycles.

In-flight radiation is also a slight risk for flight attendants. An estimated 2% of flight attendants are exposed to a solar particle event during their pregnancies, although the amount of radiation varies by length of time in the air, the routes flown, and so on. However, the risk to the average flier is negligible. The average 10-hour flight only exposes fliers to 0.05 mSv of radiation, or 1/1000th of the limit set by the American Congress of Obstetricians and Gynecologists.

Precautions for Air Travel During Pregnancy

Flying is fairly safe while pregnant, even for flight attendants, with some minor adjustments. There are, however, some issues to bear in mind if you are pregnant and considering multiple, frequent, or very long flights:

• Air travel is extremely dehydrating. You'll need to drink a lot of water while in the air.
• Air travel requires that you sit still for long periods. If you're likely to experience cramps or other pregnancy-associated issues, you may be quite uncomfortable.
• Airplanes are not equipped to handle in-air birth or pregnancy-related complications . Even if your airline permits travel, you may simply be smarter to stay on the ground if you're close to giving birth or are experiencing any pregnancy-related issues.

There are some precautions that a pregnant traveler should consider:

• Talk to your practitioner before flying. If you are more than 36 weeks pregnant, many airlines will not let you fly for fear that you'll deliver on board.
• Try to do the majority of your traveling in the second trimester . Not only will you be more comfortable, but in general the risks of miscarriage and preterm labor are lower.
• Avoid excessive flying. Although there are no hard and fast numbers, one study found that flight attendants with higher miscarriage rates flew on average 74 hours per month.
• Make comfort arrangements. Try to get seats with more legroom, plan to walk in the aisles, anticipate bathroom breaks, and bring water.
• Avoid travel to countries that would require immunizations that you don't already have or are that are not considered safe for pregnancy. Talk to your practitioner for more info on immunizations during pregnancy, as some immunizations are considered appropriate while pregnant.
• Because pregnant people are more vulnerable to COVID-19, you may wish to avoid unnecessary travel, particularly to high-risk areas.

So remember, flying is not contraindicated in an uncomplicated pregnancy, but use your common sense and speak to your practitioner about your travel plans.

Grajewski B, Whelan EA, Lawson CC, et al. Miscarriage among flight attendants . Epidemiology . 2015;26(2):192-203. doi:10.1097/EDE.0000000000000225

Hezelgrave NL, Whitty CJM, Shennan AH, Chappell LC. Advising on travel during pregnancy . BMJ. 2011;342:d2506. doi:10.1136/bmj.d2506

Zubac D, Stella AB, Morrison SA. Up in the air: Evidence of dehydration risk and long-haul flight on athletic performance . Nutrients . 2020;12(9):2574-2589. doi:10.3390/nu12092574

Cone JE, Vaughan LM, Huete A, Samuels S. Reproductive health outcomes among female flight attendants: An exploratory study . J Occup Environ Med. 1998;40(3):210-216.

Ellington S, Strid P, Tong VT, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status — United States, January 22–June 7, 2020 . MMWR Morb Mortal Wkly Rep. 2020;69(25):769-775. doi:10.15585/mmwr.mm6925a1

By Robin Elise Weiss, PhD, MPH Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.

How to Make Long Flights More Comfortable When You're Pregnant

By Joanna Carrigan

All products featured on Condé Nast Traveler are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.

Preparing for a newborn can feel like an exhilarating task; on the one hand, there’s a long-anticipated, already much-loved new arrival making an entrance into your life. On the other, getting yourself into a birthing headspace can feel like a marathon. I’ve already lost count of the amount of  stroller reviews , hypno-birthing manuals, crib catalogs, and paint samples I’ve flicked through in my quest for newborn nirvana. 

With that in mind, many couples are now opting to take a break from the organizational overload in the form of a  long-haul babymoon —a pre-birth couples vacation—as a way of spending those last special moments together as a family of two. And in fact, air travel can generally be considered  safe for most expectant mothers , with advice from your doctor recommended. 

“All pregnancies and mums have individual needs and varying circumstances,” says Marie Louise, midwife and author of  The Modern Midwife’s Guide To Pregnancy . “If mums have any health complications or are close to giving birth, travel should be very carefully considered. Otherwise, mums need a break—it’s good to enjoy and relax on your travels.”

Pregnancy can often feel like a long-haul adventure in itself, and whilst the thought of an extensive flight may not jump out at the top of your to-do list, there are ways to make that coveted trip—and any other air travel during pregnancy that comes up—more comfortable.

Below, I’ve curated an essential list for what to pack in your carry-on for air travel during pregnancy, based in part on my own experience traveling to Europe whilst expecting. 

Strategic carry-ons

A great place to start is your carry-on itself, as the right style can help not only to make your essentials more accessible, but the correct product can be re-used as a diaper bag once your pre-baby vacation is a distant happy memory. The key to  choosing the perfect carry-on is not only to be mindful of the airline guidelines set out around dimensions and weight restrictions, but to think from your own perspective about what will be easiest for you to carry. If back issues prevail—a common complaint during pregnancy—a stylish rucksack may be more suitable than a tote. And if you’re looking for post-pregnancy practicality, a duffel can tick that cross-functional box. 

Pregnancy support bands

Glamour takes a back seat with this essential, but your posture and ligaments will thank me later. If you’re flying internationally or just maneuvering your way through a large airport, you may face long walks between terminals, which can place strain on the lower back. Bump support bands are designed to help relieve the pressure that the additional weight of your bump is putting on your back, and therefore can make a sensible addition to your carry-on packing list. 

Anti-nausea pregnancy methods 

Not every foray into the world of parenthood is a smooth one, and unfortunately  nausea and sickness can play a starring role in pregnancy, especially in the early stages. My first 16 weeks of pregnancy were punctuated with frequent trips to the restroom, and with many flights taken during this time, I became accustomed to having to rely on a few tricks to see me through those difficult moments. 

Travel bands can be an excellent way to relieve pregnancy related nausea, and they’ve taken a high-tech turn in recent years. Hypnotherapy podcasts can also be a calming way to reduce feelings of sickness, and are best listened to with noise-canceling headphones and an eye mask . 

Hydrating skincare for expectant mothers 

Pregnancy can present some interesting  skincare dilemmas , with many people experiencing a change at some point across their nine months. Dry patches, oily T-zones, and acne outbreaks are all common complaints. To help skin stay hydrated when flying, there are many pregnancy-safe products out there which can help replenish and restore your skin's natural barrier. La Mer The Mist Facial Spray is a particular favorite of mine—easy to apply, super lightweight, and long-lasting. 

Travel pillows

During pregnancy, ligaments in the hips and back loosen in preparation for birth and this can often cause secondary strain across the top of the shoulders and neck which can be very uncomfortable for expectant mothers. If you’re traveling whilst pregnant, I recommend investing in a travel neck pillow , and packing your pregnancy pillow if you’re flying in a seat with a lie-flat bed. 

Compression socks

“During pregnancy, you are at an increased risk of developing a blood clot,” Louise says. “That’s why compression socks , hydration, and movement—walking, stretching, and circling ankles—is recommended.”

Again, it’s not the most glamorous addition to your carry-on, but this footwear is important nonetheless. Try to stretch your legs every hour or so if possible, with a walk down the aisle or some lower leg exercises. 

While packing a well-stocked carry-on will undoubtedly enhance your flying experience, there are other ways to ensure that you’re prepared for a relaxing trip. Here are my top three tips for flying while pregnant:

Food and beverage choices 

Whilst it’s unlikely you’ll be able to see the full on-board menu in advance, it’s often a good idea to pre-select your meal genre if you’re having  aversions or preferences during your pregnancy. Being able to rule out meat, dairy, or even opt for a lighter option may be preferable for some mothers-to-be. It could be worth packing a couple of extra snacks in your carry-on, just in case. I’ve been stashing ginger tea bags and plenty of dried fruit and nuts ( dried banana chips are a particular craving of mine) to see me through. 

The airport experience

Lounge access can not only be an enjoyable way to kick-off your vacation, it can also be a lifesaver for tired feet. Having access to a clean and comfortable restroom can also often be advantageous, so if your travel tickets don’t include a lounge as standard, it could be worth a  pay-for-access option to give you peace of mind that you’ll be spending time in a calm and restful environment before or in between flights. 

Your travel outfit

While a stylish airport look is always desirable, comfort should definitely reign supreme during this important period, since your body is already coping with so much. Activewear can provide comfort and support during long-haul travel, and there are  plenty of options out there. I look to brands like  Alo Yoga and  Lululemon for pieces that satisfy both the style and comfort stakes. 

Can I Fly While Pregnant?

Here are expert answers to some of the most-asked questions about air travel during pregnancy, by rosie colosi.

If you’re debating about whether to book that plane ticket for your babymoon in Hawaii, you can most likely get ready to say “aloha”!

The American College of Obstetricians and Gynecologists’ (ACOG) in-depth guidebook, “ Your Pregnancy and Childbirth: Month to Month ,” states: “In the absence of obstetric or medical complications, occasional air travel is safe for pregnant women. Pregnant women can fly safely, observing the same precautions for air travel as the general population.”

Of course, knowing that something is safe and feeling safe are two completely different things. If you’re planning to fly during your pregnancy, you probably have some questions about how to feel safe while in the air. So we asked a pregnancy health expert to weigh in and hopefully put your mind at ease.

When can you fly while pregnant?

According to ACOG , most airlines allow pregnant people to fly domestically up until about 36 weeks of pregnancy (or until 33 weeks if carrying multiples). But that’s not the whole story.

Dr. Kenneth T. Borkowski, lead physician at Women’s Health Group in Connecticut, clarified that these guidelines “are airline policies and they are not therefore medical in nature. The airline carriers do not wish to encounter medical issues mid-flight which would divert a plane to the closest terminal in the event of such issues. Occasional air travel, under most circumstances, is considered safe throughout pregnancy.”

Even so, pregnant people with medical or obstetric conditions (like preeclampsia , higher risk for preterm labor or vaginal bleeding) should consult their doctor before booking air travel.

“The most common obstetric emergencies happen in the first and third trimesters,” Dr. Borkowski says. “Other than taking that into consideration, the ‘best’ time to travel is when the airline rates are the lowest!”

What about flying internationally while pregnant?

Some international flights restrict pregnant people even earlier than 36 weeks, Dr. Borkowski says, and may require documentation of the baby’s gestational age before allowing them to board.

International flights (or even coast-to-coast domestic flights) tend to be longer, increasing the risk for turbulence, blood clots and dehydration. Changes in air pressure can decrease the amount of oxygen you breathe, and sitting still for a long period of time can prohibit healthy blood flow. This is true for anyone who flies, but the risk is higher for pregnant people . Dr. Borkowski recommends taking simple measures like drinking water, moving around the cabin and wearing below-the-knee graduated compression stockings to minimize these risks.

Is it safe to go through airport security while pregnant?

The Travel Security Administration (TSA) assures pregnant people that the airport screening machines are safe because they don’t actually use X-rays. Most airport screening machines use nonionizing radiation , which has much less potential for harm. The Centers for Disease Control and Prevention (CDC) say that “most common exposures to nonionizing radiation are not considered hazardous to you or your unborn baby.” Even older X-ray backscatter scanners do not expose you to enough radiation to threaten the health of you or your baby.

If you’re still nervous, you can request a pat-down instead. And if you have trouble lifting your bags or taking your shoes off at any point in the process, ask a security officer for assistance.

How can I stay safe and comfortable while flying?

ACOG recommends wearing your seatbelt at all times during the flight. It can be fastened lower on your hip bones, below your belly. The seatbelt will help stabilize you in the event of turbulence.

Move your feet, toes and legs often. You may want to book an aisle seat so you can walk the length of the plane to improve your circulation on a longer flight. (And an aisle seat will help you reach the bathroom more easily!)

Avoid carbonated drinks before the flight. High altitudes make gas expand, which won’t exactly help your comfort level. But don’t avoid all beverages—drink lots of water to stay hydrated.

What problems should I watch for while flying?

Again, the likelihood of experiencing any pregnancy-related medical issues during flight is very low. But there are a few symptoms that may warrant a call to your doctor.

An ACOG ob-gyn said that regardless of whether you’re in the air or on the ground, “any bleeding, leaking fluid, abdominal pain or change in fetal activity should trigger a call to the doctor.”

Adding airline travel to the mix puts you at a slightly higher risk of blood clots in the legs or lungs. Major symptoms of blood clots include pain and swelling in the legs, particularly on one side. Chest pain, shortness of breath and a fast heart rate can also be symptoms.

If you notice these symptoms or notice a decrease in the baby’s movement, give your doctor a call.

Should I be worried about additional radiation exposure while flying?

ACOG’s guidebook says that you shouldn’t worry: “Radiation exposure increases at higher altitudes, but the level of exposure generally isn’t a concern for pregnant women. If you are a frequent flier, talk with your ob-gyn about how much flying is safe for you.”

Is airline travel more dangerous for pregnant people during the Covid-19 and monkeypox pandemics?

This is a tough question to answer, Dr. Borkowski says. Because pregnancy lowers immune function, slightly increasing the chances of a poor outcome from Covid-19, pregnant people are considered part of the “at-risk” population and should protect themselves by staying up-to-date on vaccinations and wearing a high quality mask. If you are not vaccinated, if you don’t have some sort of naturally acquired immunity or if you are traveling to areas where Covid transmission is high, you may want to think about how to keep your contact with other people limited, like renting a car rather than ride-sharing, dining outdoors or staying in a rental house rather than a big hotel with common areas.

“My advice would be to follow the recommendations from the CDC as well as those of their local physicians based on the Covid numbers in their region and in the region that they are planning to travel to,” Dr. Borkowski says.

As far as monkeypox, he said that it’s likely not a concern. The likelihood of “prolonged direct contact” with lesions is not likely to occur during airline travel.

Though there may be a few additional things to look out for, flying while pregnant shouldn’t keep you up at night. Chances are high that your trip will be smooth sailing.

So book that babymoon, attend a work conference or travel to visit relatives before the baby comes. “Enjoy your flight and the destination to which it takes you,” Dr. Borkowski says. “There is a wonderful world out there that should be explored and cherished!”

Rosie Colosi

Rosie Colosi writes books for curious kids and articles for parents who are counting the minutes until bedtime. Once upon a lifetime ago, she played Mrs. Claus in The Christmas Spectacular Starring The Radio City Rockettes , but now she mostly focuses on singing songs from  Annie  to her two little girls.

Air travel and pregnancy

Published: May 2015

Please note that this information will be reviewed every 3 years after publication.

Updated: May 2022

This information is for you if you are pregnant and are thinking of travelling by air.

This information is for you if you are pregnant and are thinking of travelling by air. It may also be helpful if you are a partner, relative or friend of someone in this difficult situation.

The information is relevant for short haul (under four hours), medium and long haul (over four hours) flights.

If you are a member of a flight crew or you fly frequently as part of your work, you should seek additional advice from your occupational health department concerning your own situation.

The information here aims to help you better understand your health and your options for treatment and care. Your healthcare team is there to support you in making decisions that are right for you. They can help by discussing your situation with you and answering your questions.

Within this information we may use the terms ‘woman’ and ‘women’. However, it is not only people who identify as women who may want to access this information. Your care should be personalised, inclusive and sensitive to your needs whatever your gender identity.

A glossary of medical terms is available at  A-Z of medical terms .

• Occasional air travel during pregnancy is not harmful for you or your baby as long as you are having an uncomplicated pregnancy
• Long flights may increase your chance of developing a blood clot. There are things you can do to reduce your chance of this happening.
• It is important to check the healthcare facilities that are available at your destination, in case you need any emergency care.

If your pregnancy is straightforward, flying is not harmful for you or your baby:

• If you have a straightforward pregnancy and are healthy, 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 you are pregnant, the safest time to fly is:

• 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.

It is important to know that most obstetric emergencies happen in the first and third trimester .

Most airlines do not allow women to fly after 37 weeks. It is important that you check with your airline before flying. It may also be more difficult to get travel insurance after 37 weeks.

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.

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 (for more information please see the RCOG patient information Reducing the risk of venous thrombosis in pregnancy and after birth.

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. Your midwife or doctor will be able to check your individual risk.

If you are taking a short haul flight (less than four hours), it is unlikely that you will need to take any special measures. Your midwife or doctor should give you an individual risk assessment for venous thrombosis and advice for your own situation.

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. A heparin injection should be taken on the day of the flight and daily for a few days afterward. For security reasons, you will need a letter from your doctor to enable you to carry these injections onto the plane.

Low-dose aspirin does not appear to reduce the risk of a DVT but you should continue to take it if it has been prescribed for another reason.

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. Red blood cells contain the iron-rich pigment haemoglobin, which carries oxygen around your body.
• You have sickle cell disease (a condition which affects red blood cells) and you have recently had a sickle crisis.
• 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.

It is important that you discuss any health issues or pregnancy complications with your midwife or doctor before you fly. If have an increased chance of miscarriage or ectopic pregnancy, ask for an ultrasound scan for reassurance before you fly.

Be aware that the unexpected can happen while travelling which could delay your return home. Some airlines may not allow you to fly if you have fractured a bone, have a middle ear or a sinus infection or have recently had surgery to your abdomen that involved your bowel, such as having your appendix removed.

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?
• 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 about 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 is worth checking before you decide to fly.
• Have you discussed your travel plans with your midwife and informed them that you are thinking about taking a medium or long haul flight?
• If you are over 28 weeks pregnant, your airline may ask you to get a letter from your midwife or doctor stating when your baby is due and confirming that you are in good health, are having a straightforward pregnancy, and are not at an 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.

If you are travelling to Europe, it is recommended that you apply for a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC). This will allow you to access routine healthcare at a reduced cost, or for free. For more information on what the card covers and how to apply, see the GOV.UK website.   .

You will have to go through the normal security checks before flying. This is not considered to be a risk to you or your baby.

You must wear a seatbelt. You should ensure the strap of your seatbelt is reasonably tightly fastened across the top of your thighs and then under your bump. Ask the cabin crew if you need a seatbelt extension.

Any pregnant woman has a small chance of going into labour early or for her waters to break early. If this happens to you on a flight, there is no guarantee that other passengers or crewmembers will be trained and experienced to help you give birth safely. As a result, the pilot may have to divert the flight to get help for you.

Flying while you are pregnant can be stressful. If you are feeling anxious or worried in any way, please speak to your healthcare team who can answer your questions and help you get support. The support may come from healthcare professionals, voluntary organisations or other services. Further information and resources are available on the NHS website:

https://www.nhs.uk/conditions/stress-anxiety-depression/

Further information

• RCOG Scientific Impact Paper Air Travel and Pregnancy
• Tommy’s website: https://www.tommys.org/

If you are asked to make a choice, you may have lots of questions that you want to ask. You may also want to talk over your options with your family or friends. It can help to write a list of the questions you want answered and take it to your appointment.

Ask 3 Questions

To begin with, try to make sure you get the answers to  3 key questions , if you are asked to make a choice about your healthcare:

• What are my options?
• What are the pros and cons of each option for me?
• How do I get support to help me make a decision that is right for me?

*Ask 3 Questions is based on Shepherd et al. Three questions that patients can ask to improve the quality of information physicians give about treatment options: A cross-over trial. Patient Education and Counselling, 2011;84:379-85  

• https://aqua.nhs.uk/resources/shared-decision-making-case-studies/

Sources and acknowledgments

This information has been developed by the RCOG Patient Information Committee. It is based on the RCOG Scientific Impact Paper Air Travel and Pregnancy (May 2013), which contains a full list of the sources of evidence we have used. You can find it online here .

This information was reviewed before publication by women attending clinics in London, the Channel Isles and Northern Ireland, and by the RCOG Women’s Voices Involvement Panel.

A glossary of all medical terms is available on the RCOG website at: www.rcog.org.uk/womens-health/patientinformation/medical-terms-explained .

Please give us feedback by completing our feedback survey:

• Members of the public – patient information feedback
• Healthcare professionals – patient information feedback

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• Section 6 - Medical Tourism
• Section 7 - Travel & Breastfeeding

Pregnant Travelers

Cdc yellow book 2024.

Author(s): Romeo Galang, I. Dale Carroll, Titilope Oduyebo

• The Pretravel Consultation

Infectious Disease Concerns

Environmental health concerns, transportation considerations.

Pregnancy can cause physiologic changes that require special consideration during travel. With careful preparation, however, most pregnant people can travel safely.

Pretravel Consultation

The pretravel consultation and evaluation of pregnant travelers ( Box 7-01 ) should begin with a careful medical and obstetric history, specifically assessing gestational age and the presence of factors and conditions that increase risk for adverse pregnancy outcomes. A visit with an obstetric health care provider also should be a part of the pretravel assessment to ensure routine prenatal care and identify any potential problems. Instruct pregnant travelers to carry with them a copy of their prenatal records and physician’s contact information.

Review the pregnant person’s travel itinerary, including accommodations, activities, and destinations, to guide pretravel health advice. Discourage pregnant travelers from undertaking unaccustomed vigorous activity. Swimming and snorkeling during pregnancy generally are safe, but falls during waterskiing have been reported to inject water into the birth canal. Most experts advise against scuba diving for pregnant people because of risk for fetal gas embolism during decompression (see Sec. 4, Ch. 4, Scuba Diving: Decompression Illness & Other Dive-Related Injuries ). Riding animals, bicycles, or motorcycles presents risks for abdominal trauma.

Educate pregnant people on how to avoid travel-associated risks, manage minor pregnancy discomforts, and recognize more serious complications. Advise pregnant people to seek urgent medical attention if they experience contractions or premature labor; symptoms of deep vein thrombosis (e.g., unusual leg swelling and pain in the calf or thigh) or pulmonary embolism (e.g., unusual shortness of breath); dehydration, diarrhea, or vomiting; severe pelvic or abdominal pain; symptoms of preeclampsia (e.g., severe headaches, nausea and vomiting, unusual swelling, vision changes); prelabor rupture of the membranes; or vaginal bleeding.

Box 7-01 Pretravel consultation for pregnant travelers: a checklist for health care providers

☐ Review vaccination history (e.g., COVID-19, hepatitis A, hepatitis B, measles, pertussis, rubella, varicella, tetanus) and update vaccinations as needed (see text for contraindications during pregnancy)

☐ Policies and paperwork

• Discuss supplemental travel insurance, travel health insurance, and medical evacuation insurance; research specific coverage information and limitations for pregnancy-related health issues
• Advise travelers to check airline and cruise line policies for pregnant travelers
• Provide letter confirming due date and fitness to travel
• Provide copy of medical records

☐ Prepare for obstetric care at destination

• Advise traveler to arrange for obstetric care at destination, as needed

☐ Review signs and symptoms requiring immediate care, including

• Contractions or preterm labor
• Deep vein thrombosis or pulmonary embolism symptoms, which include unusual swelling of leg with pain in calf or thigh, unusual shortness of breath
• Pelvic or abdominal pain
• Preeclampsia symptoms (e.g., unusual swelling, severe headaches, nausea and vomiting, vision changes)
• Rupture of membranes
• Vomiting, diarrhea, dehydration

Contraindications to Travel During Pregnancy

Absolute contraindications are conditions for which the potential harm of travel during pregnancy always outweighs the benefits of travel to the pregnant person or fetus. Relative contraindications are conditions for which travel should be avoided if the potential harm from travel outweighs its benefits ( Box 7-02 ).

Although travel is rarely contraindicated during a normal pregnancy, pregnancies that require frequent antenatal monitoring or close medical supervision might warrant a recommendation that travel be delayed. Educate pregnant travelers that the risk of obstetric complications is greatest in the first and third trimesters of pregnancy.

Box 7-02 Contraindications to travel during pregnancy

Absolute contraindications.

• Abruptio placentae
• Active labor
• Incompetent cervix
• Premature labor
• Premature rupture of membranes
• Suspected ectopic pregnancy
• Threatened abortion / vaginal bleeding
• Toxemia, past or present

RELATIVE CONTRAINDICATIONS

• Abnormal presentation
• Fetal growth restriction
• History of infertility
• History of miscarriage or ectopic pregnancy
• Maternal age <15 or >35 years
• Multiple gestation
• Placenta previa or other placental abnormality

Planning for Emergency Care

Obstetric emergencies are often sudden and life-threatening. Advise all pregnant travelers (but especially those in their third trimester or otherwise at high risk) to identify, in advance, international medical facilities at their destination(s) capable of managing complications of pregnancy, delivery (including by caesarean section), and neonatal problems. Counsel against travel to areas where obstetric care might be less than the standard at home.

Many health insurance policies do not cover the cost of medical treatment for pregnancy or neonatal complications that occur overseas. Pregnant people should strongly consider purchasing supplemental travel health insurance to cover pregnancy-related problems and care of the neonate, as needed. In addition, pregnant travelers should consider medical evacuation insurance coverage in case of pregnancy-related complications (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ).

Medications

Over-the-counter drugs and nondrug remedies can help a pregnant person travel more comfortably. For instance, pregnant people can safely use a mild bulk laxative for constipation. In addition, several simple available remedies are effective in relieving the symptoms of morning sickness. Nonprescription remedies include ginger, available as a powder that can be mixed with food or drinks (e.g., tea), and as candy (e.g., lollipops). Similarly, pyridoxine (vitamin B6) is effective in reducing symptoms of morning sickness and is available in tablet form, as well as lozenges and lollipops. Antihistamines (e.g., dimenhydrinate, meclizine) often are used in pregnancy for morning sickness and motion sickness and appear to have a good safety record.

Carefully consider appropriate pain management and use of analgesics during pregnancy. Acetaminophen remains the nonopioid analgesic of choice during pregnancy. Although low-dose aspirin has been demonstrated to be relatively safe during pregnancy for certain clinical indications, it should be used cautiously. Aspirin can increase the incidence of abruption, and other anti-inflammatory agents can cause premature closure of the ductus arteriosus.

Various systems are used to classify drugs with respect to their safety in pregnancy . Refer to specific data about the effects of a given drug during pregnancy rather than depending on a classification. Counsel patients to help them make a balanced decision on the use of medications during pregnancy.

Vaccinations

In the best possible scenario, people should be up to date on routine vaccinations before becoming pregnant. The most effective way of protecting the infant against many diseases is to vaccinate the pregnant person. See a summary of current Advisory Committee on Immunization Practices (ACIP)  guidelines for vaccinating pregnant people .

Coronavirus Disease 2019

Pregnant people are more likely to become more severely ill from coronavirus disease 2019 (COVID-19) than people who are not pregnant. Having COVID-19 during pregnancy increases a person’s risk of complications that can affect their pregnancy. For these reasons, the Centers for Disease Control and Prevention (CDC) recommends that people who are pregnant, trying to get pregnant, or who might become pregnant in the future get vaccinated against COVID-19 . As of August 2022, the COVID-19 vaccines authorized or approved for use in the United States are nonreplicating vaccines that do not cause infection in the pregnant person or the fetus. Pregnant people may choose to receive any of the COVID-19 vaccines authorized or approved for use in the United States; the ACIP does not state a preference.

COVID-19 vaccination can be safely provided before pregnancy or during any trimester of pregnancy. Available vaccines are highly effective in preventing severe COVID-19, hospitalizations, and deaths; data have shown that the benefits of vaccination during pregnancy, to both the pregnant person and their fetus, outweigh any potential risks. Pregnant people might want to speak with their health care provider before making a decision about receiving COVID-19 vaccine , but a consultation is not required before vaccination. Side effects from COVID-19 vaccination in pregnant people are like those expected among nonpregnant people. Pregnant people can take acetaminophen if they experience fever or other post-vaccination symptoms.

The ACIP recommends that all people who are or who will become pregnant during the influenza season have an annual influenza vaccine using inactivated virus. Influenza vaccines can be administered during any trimester.

The safety of hepatitis A vaccination during pregnancy has not been determined; because hepatitis A vaccine is produced from inactivated virus, though, the risk to the developing fetus is expected to be low. Weigh the risk associated with vaccination against the risk for infection in pregnant people who could be at increased risk for exposure to hepatitis A virus. According to the ACIP, pregnant people traveling internationally are at risk of hepatitis A virus infection; ACIP recommends vaccination during pregnancy for nonimmune international travelers.

Limited data suggest that developing fetuses are not at risk for adverse events resulting from vaccination of pregnant people with hepatitis B vaccine (for details, see Sec. 5, Part 2, Ch. 8, Hepatitis B ). ACIP recommends vaccinating pregnant people identified as being at risk for hepatitis B virus infection during pregnancy; risk factors include >1 sex partner during the previous 6 months, being evaluated or treated for a sexually transmitted infection, recent or current injection drug use, or having a HBsAg-positive sex partner. In November 2021, ACIP recommended vaccination of all adults 19–59 years old.

Japanese Encephalitis

Data are insufficient to make specific recommendations for use of Japanese encephalitis vaccine in pregnant people (see Sec. 5, Part 2, Ch. 13, Japanese Encephalitis ).

Live-Virus Vaccines

Most live-virus vaccines, including live attenuated influenza, measles-mumps-rubella, live typhoid (Ty21a), and varicella, are contraindicated during pregnancy. Postexposure prophylaxis of a nonimmune pregnant person exposed to measles can be provided by administering measles immune globulin (IG) within 6 days of exposure; for varicella exposures, varicella-zoster IG can be given within 10 days. Advise people planning to become pregnant to wait ≥4 weeks after receiving a live-virus vaccine before conceiving.

Yellow Fever

Yellow fever vaccine is the exception to the rule about live-virus vaccines being contraindicated during pregnancy. ACIP considers pregnancy a precaution (i.e., a relative contraindication) for yellow fever vaccine. If travel is unavoidable, and the risk for yellow fever virus exposure outweighs the vaccination risk, it is appropriate to recommend vaccination. If the risks for vaccination outweigh the risks for yellow fever virus exposure, consider providing a medical waiver to the pregnant traveler to fulfill health regulations. Because pregnancy might affect immune responses to vaccination, consider performing serologic testing to document an immune response to yellow fever vaccine. Furthermore, if a person was pregnant (regardless of trimester) when they received their initial dose of yellow fever vaccine, they should receive 1 additional dose before they are next at risk for yellow fever virus exposure (see Sec. 5, Part 2, Ch. 26, Yellow Fever ).

Meningococcal

According to the ACIP , pregnant (and lactating) people should receive quadrivalent meningococcal vaccine, if indicated. Meningococcal vaccine might be indicated for international travelers, depending on risk for infection at the destination (see Sec. 5, Part 1, Ch. 13, Meningococcal Disease ).

No adverse events linked to inactivated polio vaccine (IPV) have been documented among pregnant people or their fetuses. Vaccination of pregnant people should be avoided, however, because of theoretical concerns. IPV can be administered in accordance with the recommended immunization schedule for adults if a pregnant person is at increased risk for infection and requires immediate protection against polio (see Sec. 5, Part 2, Ch. 17, Poliomyelitis ).

Administer rabies postexposure prophylaxis with rabies immune globulin and vaccine after any moderate- or high-risk exposure to rabies; consider preexposure vaccine for travelers who have a substantial risk for exposure (see Sec. 5, Part 2, Ch. 18, Rabies ).

Tetanus-Diphtheria-Pertussis

Tetanus, diphtheria, and acellular pertussis vaccine (Tdap) should be given during each pregnancy irrespective of a person’s history of receiving the vaccine previously. To maximize maternal antibody response and passive antibody transfer to the infant, optimal timing for Tdap administration is between 27 and 36 weeks’ gestation (earlier during this time frame is preferred), but it may be given at any time during pregnancy.

Malaria Prophylaxis

Malaria, caused by Plasmodium spp. parasites transmitted by mosquitoes, can be much more serious in pregnant than in nonpregnant people and is associated with high risks of illness and death for both mother and fetus. Malaria in pregnancy can be characterized by heavy parasitemia, severe anemia, and profound hypoglycemia, and can be complicated by cerebral malaria and acute respiratory distress syndrome. Placental sequestration of parasites might result in fetal loss due to abruption, premature labor, or miscarriage. An infant born to an infected mother is apt to be of low birth weight, and, although rare, congenital malaria is possible.

Because no prophylactic regimen provides complete protection, pregnant people should avoid or delay travel to malaria-endemic areas. If travel is unavoidable, the pregnant person should take precautions to avoid mosquito bites and use an effective prophylactic regimen.

Chloroquine is the drug of choice for pregnant travelers going to destinations with chloroquine-sensitive Plasmodium spp., and mefloquine is the drug of choice for pregnant travelers going to destinations with chloroquine-resistant Plasmodium spp. Doxycycline is contraindicated because of teratogenic effects on the fetus after the fourth month of pregnancy. Primaquine is contraindicated in pregnancy because the infant cannot be tested for glucose-6-phosphate dehydrogenase deficiency, putting the infant at risk for hemolytic anemia. Atovaquone-proguanil is not recommended because of lack of available safety data. A list of the available antimalarial drugs and their uses and contraindications during pregnancy can be found in Sec. 5, Part 3, Ch. 16, Malaria .

Travel Health Kits

In addition to the recommended travel health kit items for all travelers (see Sec. 2, Ch. 10, Travel Health Kits ), pregnant travelers should pack antacids, antiemetic drugs, graduated compression stockings, hemorrhoid cream, medication for vaginitis or yeast infection, prenatal vitamins, and prescription medications. Encourage pregnant travelers to consider packing a blood pressure monitor if travel will limit access to a health center where blood pressure monitoring is available.

Respiratory and urinary infections and vaginitis are more likely to occur and to be more severe during pregnancy. Pregnant people who develop travelers’ diarrhea or other gastrointestinal infections might be more vulnerable to dehydration than nonpregnant travelers. Stress the need for strict hand hygiene and food and water precautions (see Sec. 2, Ch. 8, Food & Water Precautions ). Drinking bottled or boiled water is preferable to chemically treated or filtered water. Pregnant people should not consume water purified by iodine-containing compounds because of potential effects on the fetal thyroid (see Sec. 2, Ch. 9, Water Disinfection ).

As mentioned previously, pregnant people are at increased risk for severe COVID-19–associated illness (e.g., requiring invasive ventilation or extracorporeal membrane oxygenation) and death compared with people who are not pregnant. Underlying medical conditions (e.g., chronic kidney disease, diabetes, obesity) and other factors (e.g., age, occupation) can further increase a pregnant person’s risk for developing severe illness. Additionally, pregnant people with COVID-19 are at greater risk for preterm birth and other adverse outcomes.

Pregnant people, recently pregnant people, and those who live with or visit them should take steps to protect themselves from getting COVID-19. CDC recommends that people (including those who are pregnant) not travel internationally until they are up to date with their COVID-19 vaccines . Additional information for international travelers is available at CDC's International Travel website.

Hepatitis A and hepatitis E are both spread by the fecal–oral route (see Sec. 5, Part 2, Ch. 7, Hepatitis A , and Sec. 5, Part 2, Ch. 10, Hepatitis E ). Hepatitis A has been reported to increase the risk for placental abruption and premature delivery. Hepatitis E is more likely to cause severe disease during pregnancy and could result in a case-fatality rate of 15%–30%; when acquired during the third trimester, hepatitis E is also associated with fetal complications and fetal death.

Listeriosis & Toxoplasmosis

Listeriosis and toxoplasmosis (see Sec. 5, Part 3, Ch. 23, Toxoplasmosis ) are foodborne illnesses of particular concern during pregnancy because the infection can cross the placenta and cause spontaneous abortion, stillbirth, or congenital or neonatal infection. Warn pregnant travelers to avoid unpasteurized cheeses and uncooked or undercooked meat products. Risk for fetal infection increases with gestational age, but severity of infection is decreased.

Other Parasitic Infections & Diseases

Parasitic infections and diseases can be a concern, particularly for pregnant people visiting friends and relatives in low- and middle-income countries. In general, intestinal helminths rarely cause enough illness to warrant treatment during pregnancy. Most, in fact, can be addressed safely with symptomatic treatment until the pregnancy is over. On the other hand, protozoan intestinal infections (e.g., Cryptosporidium , Entamoeba histolytica , Giardia ) often do require treatment. These parasites can cause acute gastroenteritis, severe dehydration, and chronic malabsorption resulting in fetal growth restriction. E. histolytica can cause invasive disease, including amebic liver abscess and colitis. Pregnant people also should avoid bathing, swimming, or wading in freshwater lakes, rivers, and streams that can harbor the parasitic worms (schistosomes) that cause schistosomiasis (see Sec. 5, Part 3, Ch. 20, Schistosomiasis ).

Travelers’ Diarrhea

The treatment of choice for travelers’ diarrhea is prompt and vigorous oral hydration; azithromycin or a third-generation cephalosporin may, however, be given to pregnant people if clinically indicated. Avoid use of bismuth subsalicylate because of the potential impact of salicylates on the fetus. In addition, fluoroquinolones are contraindicated in pregnancy due to toxicity to developing cartilage, as noted in experimental animal studies.

Vectorborne Infections

Pregnant people should avoid mosquito bites when traveling in areas where vectorborne diseases are endemic. Preventive measures include use of Environmental Protection Agency–registered insect repellants , protective clothing, and mosquito nets (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods ). For details on yellow fever vaccine and malaria prophylaxis during pregnancy, see above.

Zika virus is spread primarily through the bite of an infected Aedes mosquito ( Ae. aegypti and Ae. albopictus ) but can also be sexually transmitted. The illness associated with Zika can be asymptomatic or mild; some patients report acute onset of conjunctivitis, fever, joint pain, and rash that last for several days to a week after infection.

Birth defects caused by Zika virus infection during pregnancy include brain, eye, and neurodevelopmental abnormalities. Because of the risk for birth defects, CDC recommends pregnant people avoid travel to areas with a Zika outbreak, and, for the duration of the pregnancy, to avoid sex or use condoms with anyone who has traveled to a risk area.

Advise pregnant people considering travel to areas with Zika to carefully assess the risks of Zika infection during pregnancy; provide information about prevention strategies, signs and symptoms, and the limitations of Zika testing. Pregnant people should strictly follow steps to prevent mosquito bites and sexual transmission. See additional information, including the most current list of countries and territories where Zika is active . Guidance for pregnant people can be found on the CDC Zika website .

Pregnant people should be aware of specific current environmental issues in their international destinations (e.g., natural disasters, special events or gatherings, travel warnings). More information can be found at the CDC Travelers’ Health website and on the destination pages of the US Department of State website.

Air Quality

Air pollution causes more health problems during pregnancy because ciliary clearance of the bronchial tree is slowed, and mucus is more abundant. For more details on traveling to destinations where air quality is poor, see Sec. 4, Ch. 3, Air Quality & Ionizing Radiation .

Extremes of Temperature

Body temperature regulation is not as efficient during pregnancy, and temperature extremes can create more physiological stress on the pregnant person (see Sec. 4, Ch. 2, Extremes of Temperature ). In addition, increases in core temperature (e.g., heat exhaustion, heat stroke), might harm the fetus. The vasodilatory effect of a hot environment and dehydration might cause fainting. For these reasons, then, encourage pregnant travelers to seek air-conditioned accommodations and restrict their level of activity in hot environments. If heat exposure is unavoidable, the duration should be as short as possible to prevent an increase in core body temperature. Pregnant travelers should take measures to avoid dehydration and hyperthermia.

High Elevation Travel

Pregnant people should avoid activities at high elevation unless they have trained for and are accustomed to such activities; those not acclimated to high elevation might experience breathlessness and palpitations. The common symptoms of acute mountain sickness (insomnia, headache, and nausea) frequently are associated with pregnancy, and it might be difficult to distinguish the cause of the symptoms. Most experts recommend a slower ascent with adequate time for acclimatization. No studies or case reports show harm to a fetus if the mother travels briefly to high elevations during pregnancy; recommend that pregnant people not sleep at elevations >12,000 ft (≈3,600 m) above sea level, if possible. Probably the greatest concern is that high-elevation destinations often are inaccessible and far from medical care (see Sec. 4, Ch. 5, High Elevation Travel & Altitude Illness ).

Advise pregnant people to follow safety instructions for all forms of transport and to wear seat belts, when available, on all forms of transportation, including airplanes, buses, and cars (see Sec. 8, Ch. 5, Road & Traffic Safety ). A diagonal shoulder strap with a lap belt provides the best protection. The shoulder belt should be worn between the breasts with the lap belt low across the upper thighs. When only a lap belt is available, pregnant people should wear it low, between the abdomen and across the upper thighs, not above or across the abdomen.

Most commercial airlines allow pregnant travelers to fly until 36 weeks’ gestation. Some limit international travel earlier in pregnancy, and some require documentation of gestational age. Pregnant travelers should check with the airline for specific requirements or guidance, and should consider the gestational age of the fetus on the dates both of departure and of return.

Most commercial jetliner cabins are pressurized to an equivalent outside air pressure of 6,000–8,000 ft (≈1,800–2,500 m) above sea level; travelers might also experience air pressures in this range during travel by hot air balloon or on noncommercial aircraft. The lower oxygen tension under these conditions likely will not cause fetal problems in a normal pregnancy. People with pregnancies complicated by conditions exacerbated by hypoxia (e.g., preexisting cardiovascular problems, sickle cell disease, severe anemia [hemoglobin <8.0 g/dL], intrauterine fetal growth restriction) could, however, experience adverse effects associated with low arterial oxygen saturation.

Risks of air travel include potential exposure to communicable diseases, immobility, and the common discomforts of flying. Abdominal distention and pedal edema frequently occur. The pregnant traveler might benefit from an upgrade in airline seating and should seek convenient and practical accommodations (e.g., proximity to the lavatory). Pregnant travelers should select aisle seating when possible, and wear loose fitting clothing and comfortable shoes that enable them to move about more easily and frequently during flights.

Some experts report that the risk for deep vein thrombosis (DVT) is 5–10 times greater among pregnant than nonpregnant people, although the absolute risk is low. To help prevent DVT, pregnant travelers should stay hydrated, stretch frequently, walk and perform isometric leg exercises, and wear graduated compression stockings (see Sec. 8, Ch. 3, Deep Vein Thrombosis & Pulmonary Embolism ).

Cosmic radiation during air travel poses little threat to the fetus but might be a consideration for pregnant travelers who fly frequently (see Sec. 9, Ch. 3, . . . perspectives: People Who Fly for a Living—Health Myths & Realities ). Older airport security machines are magnetometers and are not harmful to the fetus. Newer security machines use backscatter x-ray scanners, which emit low levels of radiation. Most experts agree that the risk for complications from radiation exposure from these scanners is extremely low.

Cruise Ship Travel

Most cruise lines restrict travel beyond 24 weeks’ gestation (see Sec. 8, Ch. 6, Cruise Ship Travel ). Cruise lines might require pregnant travelers to carry a physician’s note stating that they are fit to travel, including the estimated date of delivery. Pregnant people should check with the cruise line for specific requirements or guidance. For pregnant travelers planning a cruise, provide advice about gastrointestinal and respiratory infections, motion sickness (see Sec. 8, Ch. 7, Motion Sickness ), and the risk for falls on a moving vessel, as well as the possibility of delayed care while at sea.

The following authors contributed to the previous version of this chapter: Diane F. Morof, I. Dale Carroll

Bibliography

Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al.; PregCOV-19 Living Systematic Review Consortium. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.

Bisson DL, Newell SD, Laxton C; on behalf of the Royal College of Obstetricians and Gynaecologists. Antenatal and postnatal analgesia. BJOG. 2018;126(4):114–24.

Centers for Disease Control and Prevention. Guidelines for vaccinating pregnant women. Atlanta: The Centers; 2014. Available from: www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html .

Dotters-Katz S, Kuller J, Heine RP. Parasitic infections in pregnancy. Obstet Gynecol Surv. 2011;66(8):515–25.

Hezelgrave NL, Whitty CJ, Shennan AH, Chappell LC. Advising on travel during pregnancy. BMJ. 2011;342:d2506.

Irvine MH, Einarson A, Bozzo P. Prophylactic use of antimalarials during pregnancy. Can Fam Physician. 2011;57(11):1279–81.

Magann EF, Chauhan SP, Dahlke JD, McKelvey SS, Watson EM, Morrison JC. Air travel and pregnancy outcomes: a review of pregnancy regulations and outcomes for passengers, flight attendants, and aviators. Obstet Gynecol Surv. 2010;65(6):396–402.

Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects—reviewing the evidence for causality. N Engl J Med. 2016;374(20):1981–7.

Rasmussen SA, Watson AK, Kennedy ED, Broder KR, Jamieson DJ. Vaccines and pregnancy: past, present, and future. Semin Fetal Neonatal Med. 2014;19(3):161–9.

Roggelin L, Cramer JP. Malaria prevention in the pregnant traveller: a review. Travel Med Infect Dis. 2014;12(3):229–36.

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Flying while pregnant? Here’s what you need to know

Editors note: This guide has been updated with the latest information.

During pregnancy, seemingly harmless things like eating deli meat and cleaning your cat's litter box are suddenly off-limits, along with more obvious restrictions on sports like skiing and scuba diving.

But what about "grey area" activities like flying in an airplane?

There's no single set of guidelines governing air travel during pregnancy and every airline has different restrictions, timelines and requirements. Some airlines may also require a medical certificate from a primary attending doctor or midwife for air travel during the final months of pregnancy, though even that varies, with U.S. airlines typically offering more flexibility than international carriers.

For more TPG news delivered each morning to your inbox, sign up for our daily newsletter .

In the absence of clear guidelines, TPG turned to Dr. Nithya Gopal , a board-certified OB-GYN physician and the Director of OB-GYN services at Viva Eve in New York City, for her expert recommendations on safe air travel during pregnancy.

Here's what she had to say:

Is it safe to fly when you are pregnant?

There is no evidence of adverse pregnancy outcomes due to flying, according to Dr. Gopal.

"The general consensus is that it is safest to fly in the first and second trimesters," Dr. Gopal told The Points Guy. "While the first and third trimesters tend to be when the most obstetric emergencies are going to happen, I personally become more cautious with my patients after 32 weeks because of the increased risk for premature labor and the possibility of needing urgent medical attention when you are in the sky."

The most important thing you can do, no matter how far along you are in your pregnancy, is to consult with your healthcare provider before flying.

"Any time you are planning to fly during pregnancy , you should be having that conversation," Dr. Gopal said. Your provider will be familiar with any safety precautions you should take to ensure a safe and healthy flight.

Related: Guide to flying in each trimester of pregnancy

The airline you are flying may have its own cutoff, so you will want to confirm with it beforehand whether you will be allowed to fly if you are in (or nearing) your third trimester. We've included a chart below that outlines the rules for most major airline carriers.

What can you do to stay comfortable on a flight?

When you factor in morning sickness and general pregnancy discomfort with the increased risk for blood clots that all fliers need to be aware of, flying during pregnancy can be uncomfortable even when it is deemed safe.

Dr. Gopal shared her recommendations for addressing these common issues when you take to the (baby-) friendly skies during pregnancy. Her number one tip for staying comfortable while in flight is to wear compression socks to help maintain blood flow and reduce swelling in the legs.

In addition, "I also tell my patients to get up and move at least every hour when they are on the plane," Dr. Gopal said.

To prevent clotting, "some doctors may also prescribe a low-dose aspirin," she added. "It isn't something that is recommended by the American College of Obstetricians and Gynecologists (ACOG), but it isn't harmful, either."

If it's nausea or acid reflux that ail you, there are medications generally considered safe that you can take to alleviate your symptoms. These would be the same ones prescribed by your doctor for morning sickness, so speak with your provider before your flight to ensure you have what you need at the ready.

Dr. Gopal also advises wearing loose, unrestrictive clothing (along with your seatbelt, or course) and drinking extra fluids to counteract the pressurized air in the cabin and keep you hydrated.

"Over-the-counter Gas-X may also help with bloating that can happen as a result of the pressurized air," Dr. Gopal said.

Related: What happens when a baby is born in flight?

Must you speak with your healthcare provider before flying?

Even if your pregnancy is considered low-risk, it's always a smart idea to speak with your healthcare provider before flying. "There are a number of potential risks that go along with flying during pregnancy and those risks can change from week to week and month to month, so it's important to have that honest conversation with your doctor," Dr. Gopal said.

Related: Things You Should Do Before, During and After Flying to Stay Healthy

There are certain pregnancy conditions that may make flying more risky or unadvisable. If you are hypertensive, asthmatic or prone to clotting disorders, it's even more critical to speak with your doctor before flying.

Airline policies differ, but if you need documentation, it never hurts to include enough detail to satisfy the most stringent airline requirements.

"As with many things related to air travel, it's better to be safe than sorry," Dr. Gopal said. "It's definitely worth it, and sometimes necessary, to have medical documentation from your provider's office."

A thorough medical certificate or waiver should state:

• The number of weeks of pregnancy.
• The estimated delivery date.
• Whether the pregnancy is single or multiple.
• Whether there are any complications.
• That you are in good health and fit to travel through the date of your final flight.

Additionally, the certificate should be:

• Written on official clinic or hospital letterhead if possible.
• Signed by the doctor or attending midwife.
• Be dated no later than 72 hours before the departure date.
• Be written in clear, simple English.

Carry this certificate with you on your flight. Some airlines won't ask to see it, but others will. Some airlines also may have their own documentation requirements. See the chart below to find out which airlines require it.

Airline policies for pregnant women

Bottom line.

Even though it may be deemed safe, flying during pregnancy can be uncomfortable — and it is perfectly acceptable to implement your own cutoff for flying with your baby bump in tow. The majority of the time, though, flying is perfectly safe during pregnancy, providing that you follow the guidelines of the airline and your healthcare provider. Read on to learn more about traveling before, during and after pregnancy:

• What to expect in every trimester of pregnancy
• 4 tips for planning travel while planning a pregnancy
• Babymoon boom! These are the top 10 spots for a US getaway before the baby comes
• Flying with a baby checklist

Additional reporting by Katherine Fan and Tarah Chieffi.

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Air Travel During Pregnancy

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Is it Safe to Fly During Pregnancy?

It's OK to travel by air during pregnancy unless your due date is near, or your doctor says that you (or your baby) have a medical condition and it's safer for you to stay close to home. Most healthy pregnant women can fly up to 4 weeks before their due date. After that, it's best not to travel far in case you deliver.

When Might Air Travel Be Risky?

Doctors do recommend that pregnant women with some types of health conditions — like high blood pressure (hypertension) or blood clots; or a history of miscarriage , premature labor , ectopic pregnancy, or other prenatal problems — not travel by air.

Note: Pregnant women also should not fly to areas with high altitudes, regions with disease outbreaks or where some kinds infections are common (like Zika or malaria ), or where certain vaccines are recommended for travelers beforehand.

What Are the Possible Risks to a Baby?

For women with healthy pregnancies, there are no significant risks. But anyone who has a difficult pregnancy , especially involving the cardiovascular system, should discuss any flying plans with their doctor.

What Else Should I Know?

Discuss any plans for lengthy or distant travel with your doctor, just in case. Then, check with the airline to find out what their policies are about flying during pregnancy. (Most airlines will allow pregnant women to fly up until week 37 . Some might ask for a document from your doctor with information about the due date and confirming that you are OK to travel.)

Check your health insurance policy to make sure that it covers pregnancy and neonatal health issues while abroad. If it doesn’t, consider getting travel health insurance.

To keep your flight as comfortable as possible:

• Move your lower legs regularly and/or get out of your seat (especially during long flights) to promote blood circulation and help prevent blood clots.
• Wear support stockings to help prevent clotting in your legs.
• Keep your seatbelt on when you're seated to keep the jostling of turbulence to a minimum.

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Air travel during pregnancy

1 Department of Obstetrics and Gynecology, Hospital of Aschaffenburg, Germany

P Tsikouras

2 Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece

Dear Editor,

Air travel does not seem to be harmful to pregnancy, and it is generally considered to be safe; thus most commercial airlines allow pregnant women to fly until the 36 th week of their gestational age. The data regarding the precise effect of air travel on thromboembolism, miscarriage, preterm labor rates, and pregnancy outcomes is limited 1 . Medium- to long-distance travelers have a 2- to 4-fold increased risk of venous thromboembolism (VTE) compared to non-travelers due to immobilization for several hours, hypoxia associated with decreased cabin pressure, and dehydration because of low cabin humidity. An association between air travel and miscarriage is considered contradictory. In the future, studies concerning pregnant woman traveling by air should address personal and work-related risk factors in more detail and include a comparison with other occupational groups. Women with a higher risk of spontaneous miscarriage should be restricted from flying. According to literature, there is no sufficient data that relate preterm labor with air travel.  Freeman et al who addressed potential risk in late (≥ 20 weeks) pregnancy, found that air travel was not associated with increased risk of complications for birth weight, shorter gestation, rate of vaginal bleeding, preterm delivery, preeclampsia or neonatal intensive care admission 2 . Chibber et al presented conflicting results with larger sample size and showed that primigravid women who travel by air appear to be at a higher risk for preterm birth 3 . Such research results are vital, and multicentre large studies are required to confirm or refute these findings and to define new strategies for preventing adverse birth outcomes. Pregnant women suffering from serious medical or obstetric conditions need their management to be individualized. Women with preexisting cardiovascular illness demand special management. In pregnancy it is essential to evaluate the patient’s anamnesis considering cardiovascular, cardiac and pulmonary diseases, renal insufficiency, hypertension, diabetes or a recent VTE. Air travel during pregnancy nowadays is very common especially when international travel for work and pleasure is more commonplace. Despite the increasing number of reviews focussing on air-travel in different stages of pregnancy, our knowledge about the real effects of international flights is limited. The radiation dose to the fetus from exposure to cosmic radiation is negligible. Flights lasting more than 4 hour are associated with a small increase in the relative risk of VTE. Specific prevention methods, e.g., elastic compression stockings should be applied for women who fly medium or long-haul flights (> 4 hours), and low-molecular-weight heparin should be administered to those with significant risk factors such as previous thrombosis or morbid obesity. Low dose Aspirin is not indicated in pregnancy for thromboprophylaxis associated with air travel. A meticulous risk assessment should be completed to identify the main risks and special management strategies for avoiding complications while travelling 4 .

Conflict of interest

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Travelling while pregnant

Find useful information and considerations to help you prepare for safe and healthy travels outside Canada while pregnant.

With careful preparation, travelling while pregnant can be safe. The decision to travel should be made in consultation with your health care professional, based on your personal health circumstances.

On this page

Before you go, while you're away, if you need help.

Medical practices, health standards and infection control measures vary from country to country. You may not have access to the same level of care, procedures, treatments and medications as you would in Canada.

You could also be at increased risk of getting an infection and/or developing severe complications from certain infections, which could also affect the fetus.

Before leaving Canada:

• consult a health care professional or visit a travel health clinic at least 6 weeks before travelling to get personalized health advice and recommendations
• check our Travel Advice and Advisories for country-specific information, including about possible health risks
• know how to seek medical assistance outside of Canada
• review the policy and the coverage it provides
• most policies do not automatically cover pregnancy-related conditions or hospital care for premature infants
• ask your insurance provider about coverage for medical care during pregnancy, giving birth and intensive care for you and your fetus or newborn
• carry a copy of your prenatal records
• talk to your health care professional about any additional items you may want to bring that are specific to your health needs

Local laws and medical services relating to pregnancy can differ from Canada. Learn the local laws, and how these may apply to you before you travel.

Pre-travel vaccines and medications

Many vaccines can be safely given during pregnancy. Due to a higher risk of more severe outcomes for you and your fetus, some vaccines are recommended specifically during pregnancy, such as tetanus-diphtheria-pertussis (DTaP) and influenza.

Don’t take medications you may still have from prior trips. Tell the health care professional about your pregnancy, or intended pregnancy, before filling any prescriptions. The decision to get any pre-travel vaccinations or medications should be discussed with your health care professional.

The decision can depend on:

• your purpose of travel (e.g., tourism, visiting friends and relatives)
• your planned destination(s)
• the length of your trip
• your risk of getting a disease
• how severe the effect of a disease would be to you and/or your fetus
• your planned activities
• any underlying medical issues and/or pregnancy-related complications

Malaria could cause major health problems for a mother and her unborn baby. A pregnant woman may want to consider avoiding travel to areas where malaria transmission occurs.

Description of malaria risk by country and preventative measures.

If you can’t avoid travelling to an area where malaria is present:

• some medications to prevent or treat malaria may not be safe during pregnancy
• take extra care to protect yourself from mosquito bites

Zika virus infection during pregnancy can pose significant risks to your fetus even if you don’t develop symptoms. While pregnant, you may want to consider avoiding travelling to a country or areas with risk of Zika virus.

Latest travel health advice on Zika virus.

If you choose to travel, take precautions to avoid infection with Zika virus:

• prevent mosquito bites at all times
• protect yourself from contact with semen, vaginal fluid and blood
• always use condoms correctly or avoid sexual contact while in countries or areas with risk of Zika virus

Learn more about Zika virus and pregnancy:

• Zika virus: Pregnant or planning a pregnancy
• Zika virus: Advice for travellers
• Pregnancy and travel (tropical medicine and travel)

Monitor your health and be prepared

Emergencies can happen at any time. Know where the nearest hospital or medical centre is while you are travelling and confirm they will accept your medical insurance.

Seek medical attention immediately if you develop any of the following symptoms while travelling:

• persistent vomiting and/or diarrhea
• dehydration
• vaginal bleeding
• passing tissue or clots
• abdominal pain, cramps or contractions
• your water breaks
• excessive swelling of face, hands or legs
• excessive leg pain
• severe headaches
• visual problems

If you develop these symptoms after your return to Canada, you should see a health care professional immediately and tell them about your recent trip.

Transportation

Always wear a seatbelt when travelling by plane or car. When using a diagonal shoulder strap with a lap belt, the straps should be placed carefully above and below your abdomen. If only a lap belt is available, fasten it at the pelvic area, below your abdomen.

If you have any medical or pregnancy-related complications, discuss with your health care professional whether air travel is safe for you.

Most airlines restrict travel in late pregnancy or may require a written confirmation from a physician. Check this with the airline before booking your flight.

During long flights, you may be at higher risk of developing blood clots, known as deep vein thrombosis (DVT). The risk of deep vein thrombosis can be reduced by:

• getting up and walking around occasionally
• exercising and stretching your legs while seated
• selecting an aisle seat when possible
• wearing comfortable shoes and loose clothing

Your health care professional may recommend additional ways to reduce your risk such as wearing compression stockings.

Always stay well hydrated while travelling.

Land travel

The risk of deep vein thrombosis can be reduced by:

• stopping the vehicle to walk around every couple of hours

Motion sickness

Certain medications used to treat nausea and vomiting during pregnancy may also be effective in relieving motion sickness.

If you think you might experience motion sickness during your trip, speak to your health care professional about the use of these medications.

Environmental and recreational risks

Some activities may not be recommended or may require additional precautions. Discuss your travel plans, including any planned or potential recreational activities with a health care professional.

High altitude

You should avoid travelling to an altitude above 3,658 metres (12,000 feet).

However, if you have a high-risk pregnancy and/or are in the late stages of pregnancy, the highest altitude should be 2,500 metres (8,200 feet).

If you have pregnancy-related complications, you should avoid unnecessary high-altitude exposure.

Keep in mind that most high-altitude destinations are far from medical care services.

Personal protective measures

Food-borne and water-borne diseases.

Eat and drink safely while travelling while travelling. Many food-borne and water-borne illnesses can be more severe during pregnancy and pose a risk to the fetus.

This can include:

• toxoplasmosis
• listeriosis
• hepatitis A and E

To help avoid food-borne and water-borne diseases:

• before eating or preparing food
• after using the bathroom or changing diapers
• after contact with animals or sick people
• before and after touching raw meat, poultry, fish and seafood
• if you’re at a destination that lacks proper sanitation and/or access to clean drinking water, only drink water if it has been boiled or disinfected or if it’s in a commercially sealed bottle
• use ice made only from purified or disinfected water
• this could cause the fetus or newborn to develop thyroid problems
• unpasteurized dairy products, such as raw milk and raw milk soft cheeses
• unpasteurized juice and cider
• raw or undercooked eggs, meat or fish, including shellfish
• raw sprouts
• non-dried deli meats, including bologna, roast beef and turkey breast
• don’t use bismuth subsalicylate (Pepto-Bismol®)
• Information on travellers’ diarrhea

Illnesses acquired from insect and other animals

Protect yourself from insect bites:

• wear light-coloured, loose clothes made of tightly woven materials such as nylon or polyester
• prevent mosquitoes from entering your living area with screening and/or closed, well-sealed doors and windows
• use insecticide-treated bed nets if mosquitoes can’t be prevented from entering your living area
• information on insect bite and pest prevention

Some infections, such as rabies and influenza, can be shared between humans and animals. You should avoid contact with animals including dogs, livestock (pigs, cows), monkeys, snakes, rodents, birds, and bats.

Information for if you become sick or injured while travelling outside Canada.

For help with emergencies outside Canada, contact the:

• nearest Canadian office abroad
• Emergency Watch and Response Centre in Ottawa

More information on services available at consular offices outside Canada.

Related links

• Immunization in pregnancy and breastfeeding: Canadian Immunization Guide
• Advice for Canadians travelling to Zika-affected countries
• Advice for women travellers
• If you get sick before or after returning to Canada
• Receiving medical care in other countries
• Travel vaccinations
• What you can bring on a plane

Exposure to air pollution during the first two years of life is associated with worse attention capacity in children

A study highlights the potential impact of traffic-related air pollution (no2) on attentional development.

A growing body of research shows that exposure to air pollution, especially during pregnancy and childhood, may have a negative impact on brain development. Now a study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, has found that exposure to nitrogen dioxide (NO 2 ) during the first two years of life is associated with poorer attention capacity in children aged 4 to 8, especially in boys. NO 2 is a pollutant that comes mainly from traffic emissions.

The study, published in Environment International , shows that higher exposure to NO 2 was associated with poorer attentional function in 4- to 6-year-olds, with increased susceptibility to this pollutant observed in the second year of life. This association persisted at an age of 6 to 8 years of age only in boys, with a slightly greater susceptibility period from birth to 2 years of age.

The researchers used data from 1,703 women and their children from the INMA Project birth cohorts in four Spanish regions. Using the home address, the researchers estimated daily residential exposure to NO 2 during pregnancy and the first 6 years of childhood. In parallel, they assessed the attentional function (the ability to choose what to pay attention to and what to ignore) at 4-6 years and 6-8 years, and working memory (the ability to temporarily hold information) at 6-8 years, using validated computerised tests.

Periods of higher susceptibility to air pollution

A previous INMA study reported that exposure to NO 2 during pregnancy and childhood was associated with impaired attentional function in children at 4-5 years of age. The present study found that:

• Higher exposure to NO 2 between 1.3 and 1.6 years of age was associated with higher hit reaction time standard error, an indicator of speed consistency, in the attentional function test at 4-6 years of age.
• Higher exposure to NO 2 between 1.5 and 2.2 years of age was associated with more omission errors.
• Higher exposure to NO 2 between 0.3 and 2.2 years was associated with higher hit reaction time standard error at 6-8 years only in boys.
• No associations were found between higher exposure to NO 2 and working memory in children aged 6 to 8 years.

"These findings underline the potential impact of increased traffic-related air pollution on delayed development of attentional capacity and highlight the importance of further research into the long-term effects of air pollution in older age groups," explains Anne-Claire Binter , last author of the study and postdoctoral researcher at ISGlobal.

As the brain matures

Attentional function is crucial for the development of the brain's executive functions, which manage and control actions, thoughts and emotions to achieve a goal or purpose. "The prefrontal cortex, a part of the brain responsible for executive functions, develops slowly and it is still maturing during pregnancy and childhood," adds Binter. This makes it vulnerable to exposure to air pollution, which has been linked in animal studies to inflammation, oxidative stress, and impaired energy metabolism in the brain.

"In boys, the association between exposure to N0 2 and attentional function may last longer because their brains mature more slowly, which could make them more vulnerable," she points out. To understand this better, future studies should follow people over time to see how age and gender affect the relationship between air pollution and attention span, especially in older age groups.

In conclusion, "this study suggests that early childhood, up to the age of 2, seems to be a relevant period for implementing preventive measures," says Binter. "Even a small effect at the individual level from relatively low levels of exposure, as in this study, can have large consequences at the population level. Exposure to traffic-related air pollution is therefore a determinant of the health of future generations."

• Intelligence
• Child Development
• Learning Disorders
• Air Quality
• Air Pollution
• Environmental Issues
• Air pollution
• Automobile emissions control
• Mercury poisoning
• Early childhood education
• Fossil fuel
• Familiarity increases liking

Story Source:

Materials provided by Barcelona Institute for Global Health (ISGlobal) . Note: Content may be edited for style and length.

Journal Reference :

• Kellie L.H.A. Crooijmans, Carmen Iñiguez, Kristina W. Withworth, Marisa Estarlich, Aitana Lertxundi, Ana Fernández-Somoano, Adonina Tardón, Jesús Ibarluzea, Jordi Sunyer, Mònica Guxens, Anne-Claire Binter. Nitrogen dioxide exposure, attentional function, and working memory in children from 4 to 8 years: Periods of susceptibility from pregnancy to childhood . Environment International , 2024; 186: 108604 DOI: 10.1016/j.envint.2024.108604

Cite This Page :

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Coming to Alabama: Newsom’s Abortion-Access Ad, Depicting an Arrest

The ad portrays a woman trying to leave the state to have an abortion. The Campaign for Democracy, a political action committee started by Mr. Newsom, the California governor, created it.

• Share full article

By Neil Vigdor

• April 21, 2024

A woman nervously peers into her rearview mirror as a patrolman activates his car’s lights and sirens. She is less than a mile from leaving Alabama to seek abortion services, but it’s too late: The next thing she knows, she is being handed a pregnancy test and is handcuffed.

The encounter is depicted in an unvarnished new television ad called “Fugitive.” The Campaign for Democracy, a political action committee created by Gov. Gavin Newsom, Democrat of California, produced the ad.

It will appear on Monday in Alabama, where Republicans have called for prosecuting women who travel elsewhere for an abortion. The state’s abortion ban, one of the nation’s strictest, outlaws the procedure at all stages of pregnancy, with no exceptions for rape and incest.

“Trump Republicans want to criminalize young Alabama women who travel for reproductive care,” the ad’s narrator says.

The ad then shows the patrolman approaching the vehicle: “Miss, I’m going to need you to step out of the vehicle,” he says, tapping the kit on the driver’s side door, “take a pregnancy test.”

The ad is scheduled to run on broadcast and cable television, along with digital platforms like YouTube, for two weeks, according to the PAC. The cost of the ad buy was not immediately available.

Alabama’s attorney general, Steve Marshall, a Republican, has clashed with the Justice Department and abortion assistance providers over whether the state has the authority to prosecute individuals or groups that help women leave the state to have the procedure.

Last month, Republicans introduced a bill in the Alabama House that would make it a misdemeanor to harbor or transport a minor to seek abortion services.

Mr. Newsom has emerged as a key surrogate for President Biden while harboring future White House ambitions of his own. He has regularly skirmished with G.O.P. governors and Republican-led states over abortion access, immigration, crime and other issues.

While Republicans have seized on crossings at the southern border in their messaging, Democrats have harnessed the issue of abortion-access after the U.S. Supreme Court overturned Roe v. Wade in 2022. It helped propel Democratic candidates to key victories during the midterm elections in 2022 and in races last year.

In February, the Alabama Supreme Court ruled that frozen embryos were people with rights, casting a cloud of uncertainty over in vitro fertilization. The state later passed a law giving I.V.F. clinics criminal and civil immunity, but it did not address whether embryos have the legal status of human beings.

In another seismic ruling, the Arizona Supreme Court this month upheld an 1864 law that bans nearly all abortions. The decision could have far-reaching consequences for women’s health care and election-year politics in the state, a critical political battleground.

Mr. Newsom said in a social media post at the time that California, which borders Arizona, would provide a refuge for women affected by the decision.

“Arizona wasn’t even a state — it was a territory — when this draconian abortion ban was passed,” he said. “That’s how extreme this is. California remains ready to help Arizonans access reproductive health care.”

Neil Vigdor covers politics for The Times, focusing on voting rights issues and election disinformation. More about Neil Vigdor

Meta working on travel mode for using Quest headsets during flights after Vision Pro launches with feature

Today I learned two things. First, apparently Meta Quest headsets don’t work on planes? I guess Apple knew to prioritize that feature for Vision Pro. And second, support is reportedly on the way. Add this to the list of ways competition from Vision Pro is making Meta Quest 3 a better product.

For April, Meta released software update v64 that makes Quest 3 passthrough more like Vision Pro, users say. Motion blur is more noticeable, but still clarity is increased. Meta has also added support for viewing spatial videos captured from iPhone 15 Pro.

Now Meta may be planning to introduce flight support as soon as v65 next month. Per @Lunayian on X ( via Nicholas Sutrich ), several code strings reference travel mode for use on a plane.

Early NUX render to introduce "Flight Mode" I found in Meta Quest OS v65 pic.twitter.com/oq2GzCiaZu — Luna (@Lunayian) April 18, 2024

Apple pushes watching movies and TV shows during flights as a key use case for Apple Vision Pro. It’s one of the first things you see at the top of Apple’s website currently.

Surely Meta has taken notice and prioritized travel mode as it positions Meta Quest 3 as a dramatically cheaper solution to Vision Pro with many of the same capabilities.

The most impactful change, however, would be around multitasking. Quest headsets are limited to three app windows at a time right now. Apple Vision Pro has plenty of other limitations, but there’s virtually no limit to how many windows can be placed around a room and used together.

• Zuckerberg says Meta Quest 3 is better than Apple Vision Pro
• Apple Vision Pro is already making the Meta Quest 3 better
• Vision Pro latency by far the best on passthrough; lags behind Meta on angular motion
• Meta confirms spatial video playback coming to Quest one day before Vision Pro launch

FTC: We use income earning auto affiliate links. More.

Check out 9to5Mac on YouTube for more Apple news:

Zac covers Apple news, hosts the 9to5Mac Happy Hour podcast, and created SpaceExplored.com.

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Air Canada pilots declare emergency during transatlantic flight from Toronto

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A routine Air Canada flight from Toronto Pearson Airport to London, England, declared an emergency on Thursday at the tail end of its journey across the Atlantic Ocean. 

According to Aviation Source News , flight AC858 was travelling over the Atlantic Ocean near Northern Ireland when the emergency declaration was made. 

The aircraft reportedly had less than an hour of its journey remaining when the emergency call came in. The aviation news website notes that the emergency was serious enough to prompt the use of a Squawk Code 7700 , indicating a serious issue onboard the aircraft. 

The code can be inputted by the aircraft's pilots or instructed by air traffic control (ATC) and alerts the ground crew to prepare for the flight's arrival. 

Medical emergency @RadarBoxCom https://t.co/KmUVRYkEk0 — Flight Emergency (@FlightEmergency) April 18, 2024

Initially, it was unclear what the nature of the emergency was, but later,  Aviation Source News determined that it was a medical emergency. 

Pilots eventually changed the squawk code from 7700 to 5170, indicating that the emergency onboard was under control, and that the flight did not need to be diverted to a nearby airport. 

The flight landed safely at Heathrow Airport at 3:14 p.m. local time without further incident. 

Lukas Wunderlich /Shutterstock

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