Considerations for the Pregnant Traveler
Matthew Rusk, M.D.
Most airlines will not allow women to fly during the last month of pregnancy. Earlier in a pregnancy, it is generally safe to fly on modern commercial aircraft that are pressurized. The pressure at cruising altitude, however, is not equal to that seen at sea level and may be a problem for patients who have sickle cell anemia or other blood disorders. In this situation, patients should check with their obstetricians before flying.
Pregnant travelers with a history of blood clots should avoid flying.
Airport metal detectors pose no risk to the fetus.
Driving in Other Countries
Motor vehicle accidents are the leading cause of death for travelers abroad. Pregnant patients, like other travelers, should use extra caution while driving on unfamiliar roads and in countries where traffic rules may be different. The seatbelt should be adjusted so that it rests across the pelvic bones and not the abdomen, and the shoulder strap should rest between the breasts.
Generally, all vaccines that are not live are safe to use in pregnancy. Live vaccines, such as yellow fever, should generally be avoided unless the risk of infection outweighs the potential risk of the vaccine to the fetus. Make sure you visit a physician who is experienced in travel medicine to discuss exactly which vaccines you should receive for the itinerary you have planned.
Pregnant women should avoid travel to areas with malaria if possible. Pregnant women who contract malaria are more likely to become seriously ill and have complications with their pregnancy. Some medications taken to prevent malaria, such as chloroquine and mefloquine, appear to be safe for the developing fetus. Other drugs, such as doxycycline, are likely to be harmful to the fetus. If travel to an area with malaria is unavoidable during pregnancy, patients should discuss the relative risks and benefits of each medication with a travel medicine physician. For women who are breastfeeding and taking antimalarial medications, their infants must also take prophylactic medications since only small amounts of most antimalarial drugs are transmitted through breast milk.