Travelling While Pregnant: The Window, The Rules, The Seatbelt

There are special considerations you have to take when travelling if you're pregnant. Read these tips to help ensure your health while on vacation.

Asked whether it’s safe to travel while pregnant, our readers mostly didn’t know.

“How safe do you think it is to travel while you are pregnant?” 13,520 votes

51%: I’m not sure
25%: Quite safe
15%: Unsafe
8%: Very safe

Half of thirteen thousand people had no idea, and 60% of readers didn’t travel at all while pregnant.

In an uncomplicated pregnancy, travel is generally safe, and the second trimester is the window.

When to go

Weeks 14 to 27 are the sweet spot. Nausea has usually settled, energy is better, and the risks of miscarriage and preterm labour are at their lowest.
First trimester isn’t unsafe, but you may feel dreadful and be tired, and miscarriage risk is at its highest. That has nothing to do with travelling, though it’ll feel connected if it happens away from home.
Third trimester gets progressively impractical, and the airlines make the decision for you.

The airline rules people find out at the gate

Most airlines require a doctor’s letter from around 28 weeks, and refuse carriage from around 36 weeks, often 32 weeks for a multiple pregnancy.

Policies differ by airline and they’re enforced at check-in. Check your specific airline’s rules before booking, not before flying, and note that the letter usually has to be dated within a few days of travel.

And the more expensive oversight: most travel insurance excludes pregnancy beyond a certain gestation, and many policies don’t cover the care of a baby born prematurely overseas. That’s the scenario that costs a fortune. Read the exclusions specifically, and don’t assume a standard policy covers you.

Flying itself

Clots are the real in-flight risk. Pregnancy increases the tendency of blood to clot, and long periods of sitting compound it.
Get up and walk every hour, and flex your ankles while seated.
Compression stockings for any flight over about four hours: the most effective single measure.
Drink far more water than usual; cabin air is very dry.
Aisle seat, for the walking and the toilet trips.
Seatbelt below the bump, across the hips.
Cabin radiation and pressure aren’t a concern for occasional flying in an uncomplicated pregnancy.

In the car

A great many pregnant women get this wrong, and it takes two seconds to get right:

The lap belt goes under the bump, low across the hips and the tops of the thighs. The shoulder strap goes between the breasts and off to the side of the bump, never across it. A belt worn over the bump transfers crash forces directly to the uterus.

Keep wearing it. Not wearing a seatbelt is far more dangerous than any of this.

Choosing where

Check for Zika before booking. Infection in pregnancy can cause serious birth defects, and affected areas change. Check the current advisory, not an old list.
Malaria areas need care. Malaria is more severe in pregnancy, and several standard preventive medications aren’t suitable. Get advice well in advance.
Vaccinations take planning. Live vaccines, including yellow fever, are generally avoided in pregnancy. That can rule out some destinations entirely.
Know where the nearest decent hospital is, and how you’d get there.
Somewhere with reliable food and water hygiene. Listeria, toxoplasmosis and hepatitis E all mean higher stakes in pregnancy.
Avoid altitude above about 2,500m, scuba diving entirely, and hot tubs and saunas.

Practicalities

Carry your antenatal records, and your blood group.
Take your prenatal vitamins in hand luggage, and any medication.
Eat and drink carefully: avoid raw and undercooked food, unpasteurised dairy, and anything left standing.
Build in rest. This isn’t the trip for eight cities in ten days.
Move often on long car and train journeys too, not just flights.

When not to travel

Discuss with your obstetrician if any of these apply, and expect to be advised against it:

Placenta praevia
Pre-eclampsia or raised blood pressure
A history of preterm labour, or cervical weakness
Any bleeding
A multiple pregnancy, particularly later on
Significant anaemia, or a clotting disorder

Frequently asked questions

Is it safe to travel while pregnant?

Generally yes, in an uncomplicated pregnancy, though half of our readers said they were unsure. Weeks 14 to 27 are the best window: nausea has usually settled and the risks of miscarriage and preterm labour are lowest.

Until when can I fly?

Most airlines require a doctor’s letter from around 28 weeks and refuse carriage from around 36 weeks, or 32 for a multiple pregnancy. Policies vary and are enforced at check-in, so check your specific airline before booking. Note the letter usually has to be dated within a few days of travel.

Does travel insurance cover pregnancy?

Often not beyond a certain gestation, and many policies don’t cover the care of a baby born prematurely overseas. That’s the scenario that costs a fortune. Read the exclusions specifically instead of assuming a standard policy covers you.

How do I reduce the risk of blood clots on a flight?

Pregnancy increases clotting tendency and sitting compounds it. Walk every hour, flex your ankles while seated, wear compression stockings on any flight over about four hours, drink much more water than usual, and take an aisle seat.

How should I wear a seatbelt while pregnant?

Lap belt under the bump, low across the hips and tops of the thighs; shoulder strap between the breasts and off to the side of the bump, never across it. A belt worn over the bump transfers crash forces to the uterus. Keep wearing it. Not wearing one is far more dangerous.

Which destinations should I avoid?

Anywhere with current Zika transmission, since infection in pregnancy can cause serious birth defects. Malaria areas need advice well in advance because malaria is more severe in pregnancy and several preventive drugs are unsuitable. Live vaccines including yellow fever are generally avoided, which rules out some destinations. Also avoid altitude above about 2,500m, scuba diving and hot tubs.

What to remember

Second trimester, weeks 14 to 27. That’s the answer half our readers didn’t have.

Check the airline’s cutoff before booking and the insurance exclusions before paying, especially whether it covers a premature birth abroad.

Compression stockings, walk every hour, and wear the seatbelt under the bump.