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Air Travel and Pregnancy

Pregnancy Dr Minke Burke Director
Many women need to travel while pregnant.  Other women are keen to book a last holiday away together (“babymoon”), and enjoy some time with their partner.  Here are some important facts regarding air travel and pregnancy.

When to travel?

The general consensus between obstetricians is to recommend against air travel in your first trimester (up until 12 weeks of pregnancy), as this is the time in pregnancy when you are at the highest risk of miscarriage.  If you can plan your travel, it is best to do so after 12 weeks to minimise the risk of bleeding and complications while you are away from home.

From 20 weeks most women are no longer nauseated, the tiredness has passed, and the “happy hormones” are now ruling your pregnancy.  In general travel is considered relatively safe between 20 and 28 weeks, as the risk of miscarriage is now small and the risk of preterm labour is minimal.

Most airlines will allow you to travel up until 28 weeks gestation without a letter from your obstetrician.   However, we recommend you have one anyway to avoid any issues.

From 28-40 weeks most women feel less comfortable and more tired.  The risk of preterm labour also increases.  Planning a long trip overseas or to an isolated tropical island is not something we recommend.  Airlines will most likely not allow you to travel when over 37 weeks and you will need a letter form your obstetrician if you need to travel at this gestation.

Whenever you travel it is also important to check what your travel insurance will cover – both for you and for the baby (if it should surprise you by coming early).  This will help you avoid large unexpected health care bills should you need to access care while you are overseas.

What are the risks associated with air travel while pregnant?

  • Most importantly, there is an increased risk of Deep Vein Thrombosis (DVT). This is the development of blood clots in your veins.  If the clot is large and dislodges, it can travel to your lungs or other organs.  This is potentially fatal.  The pregnancy itself increases this risk of developing blood clots, but a flight will further increase this as you sit still for a prolonged period of time.  Another risk factor for developing blood clots is dehydration, and long haul flights increase this risk as well.
  • Increased leg swelling due to fluid retention.
  • Nasal congestion and problems with your ears. This may lead to difficulty in adjusting to the air cabin pressure.
  • Pregnancy complications whist mid-air; bleeding, miscarriage, your waters break, or labour.  This may affect your safety and the safety of your baby.  This may also disrupt the flight with a potential need for emergency landing.

How to make your flight safer and more comfortable?

  • The mantra for air travel is mobilise and hydrate!  We recommend you to get up from your seat at least every 2 hours and walk down the aisle.  While seated, move your feet up and down to exercise your calf muscles.  The aim is to promote circulation in your legs.  Drink lots of water as this will prevent dehydration (and it will make you get up to go to the bathroom too).  Avoid soft drinks, juices and alcohol.  Water is best.
  • Wear graduated compression stockings; your local chemist can help you with picking the right size for you.  These stockings will help to prevent DVT’s, swollen and painful legs.
  • Book an aisle seat, so you don’t need to climb over other passengers’ feet; something you can imagine will be hard with your growing tummy!  It will also decrease disruption to other passengers.
  • Pack some nutritious snacks.  When pregnant you may feel the need to have frequent little meals or snacks, so don’t get caught out.  This will also help clearing your ears (as you chew and swallow) with take off and landing.
  • Wear comfortable shoes and clothing.  No heels please – ever!!

Is flying considered harmful to my baby?

No, is the short answer.  Cosmic radiation is mainly in the form of particles from outer space and sun.  The higher the altitude and longer the flight, the more exposure is expected.  Radiation is associated with cell change and cancer formation.

Large studies have determined the radiation safety limits which is expressed in mSv (mili Sievert) per year.  This is important for aircrew.  The acceptable occupational dose limit is 20mSv per year, but most pilots will not exceed 4 mSv per year.  For the general public a dose limit of 1mSv is accepted and safe.

You would have to fly 300 hours at an altitude of 10 km, fly 15 times from Sydney to Buenos Aires, or fly 62 times from Darwin to Perth to reach 1mSv. Therefore the general consensus is that flying does not increase any risks to an unborn child.

And last but not least….

Please don’t forget your antenatal card!  This has all your information and important pregnancy findings.  If you do become unwell while you are away, a doctor will need this important information.