Pregnancy and travel

Once a pregnant woman has decided to travel a number of issues need to be considered prior to the departure:

• Avoid travel to malarious areas if possible
• If travelling to malarious areas do always consult your health care provider for advice as not all malaria chemoprophylasis are recommended to be used when pregnant. Malaria chemoprophylaxis with no documented increase in birth defects are:
  • Chloroquine
  • Proguanine
  • Quinine
• Air travel is usually permitted until the pregnant traveller is in her 36th week of gestation but check with your airline as each airline has policies regarding pregnancy and flying;
• An aisle seat at the bulkhead will provide the most space and comfort, but a seat over the wing in the midplane region will give the smoothest ride;
• The safety belt should always be fastened at the pelvic level;
• Take a walk every half hour during a smooth flight and flex and extend ankles frequently to prevent phlebitis;
• Air travel is not recommended for infants less than 7 days old. For premature babies, medical advice should be sought in each case.

Relative contraindications to international travel during pregnancy are:

Travellers with obstetrical risk factors as:

• History of miscarriage.
• Incompetent cervix.
• History of ectopic pregnancy (ectopic with present pregnancy should be ruled out prior to travel).
• History of premature labor or premature rupture of membranes.
• History of or existing placental abnormalities.
• Threatened abortion or vaginal bleeding during present pregnancy.
• Multiple gestation in present pregnancy.
• History of toxemia, hypertension, or diabetes with any pregnancy.
• Primigravida at 35 years of age or older or 15 years of age or younger.

Traveller's with general medical risk factors as:

• Valvular heart disease.
• History of thromboembolic disease.
• Severe anemia.
• Chronic organ system dysfunction that requires frequent medical interventions

Travellers contemplating travel to potentially hazardous destinations

• High altitudes.
• Areas endemic for or with ongoing outbreaks of life-threatening food- or insect-borne infections.
• Areas where chloroquine-resistant Plasmodium falciparum is endemic.
• Areas where live virus vaccines are required and recommended.

Checklist

The pregnant traveler should be advised to: