The Plane Truth

With a few precautions, you can continue to fly when pregnant.

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I was five months pregnant when my husband and I celebrated our last days as an unencumbered couple with a trip to London. Unfortunately, the flight home, which was bookended by two long and bumpy taxi rides, left me nauseated and exhausted ... and spotting. I called my midwife in a panic. After reassuring me that my symptoms didn’t seem serious—and they weren’t—she prescribed several days of rest and advised that I forgo traveling for the rest of my pregnancy. Fortunately, my experience was unusual. Most pregnant women can travel without experiencing unusual symptoms or suffering adverse effects on their pregnancies or unborn children, according to a December 2001 report from the American College of Obstetricians and Gynecologists (ACOG). “In the absence of a reasonable expectation for obstetric or medical complications, air travel is safe up to 36 weeks’ gestation,” says Raul Artal, M.D., vice chairman of ACOG’s committee on obstetric practice. “Pregnant women can observe the same basic precautions for air travel as the general public.” When you shouldn’t fly>While traveling in an airplane is almost always safe during pregnancy, ACOG notes that there are some instances in which it is not recommended. Women who have medical or obstetrical complications, such as pregnancy-induced hypertension, poorly controlled diabetes, sickle-cell disease or other conditions that could result in an emergency medical situation, are encouraged to stay on the ground. Women who are at significant risk for premature labor, those with an incompetent cervix, or those with placental abnormalities such as placenta previa also should not fly. Also of concern are women with certain medical conditions unrelated to their pregnancies. For example, because low cabin humidity and changes in cabin pressure may result in an increased heart rate, people with heart disease may experience increased blood pressure and difficulty breathing. While several U.S. airlines allow women to fly at any time during pregnancy, some require a doctor’s note after 36 weeks. “The flight itself is not considered to be the issue,” says Artal, who is chairman of the department of obstetrics, gynecology and women’s health at Saint Louis University School of Medicine in St. Louis. “Airlines do not want women to travel during the last weeks because of the risk of going into labor.”

Contrary to popular opinion, noise vibration, cosmic radiation and cabin pressure pose no increased risks for the pregnant air traveler, according to ACOG. And if you were concerned that security equipment could “radiate” or somehow hurt your baby, set those fears aside. “Metal detectors are not a risk to the baby,” Artal says.

Making travel even safer> One issue of concern for all air travelers is the formation of blood clots, or thrombosis, especially during long flights. Pregnant women should take special precautions to minimize risks. Try wearing support stockings and/or moving your lower extremities every half-hour or so. “Wiggle your toes,” Artal suggests, “move your legs around, and take a stroll up the cabin every once in a while.” Drink plenty of water throughout the flight to avoid dehydration, and stay away from gas-producing foods and drinks to decrease gastrointestinal discomfort, which can be worsened by cabin pressure and exacerbated by pregnancy. While many people take vacations to relax, the stress of travel itself might factor into your decision to book that ticket. Some studies have shown a possible link between stress and premature labor, according to Judith Hibbard, M.D., a specialist in maternal-fetal medicine and professor of obstetrics and gynecology at the University of Chicago. So make every effort to minimize the stress associated with travel: Arrive at the airport with plenty of time to spare, or pay extra for a direct flight instead of choosing a cheaper one that requires you to change planes. So what might have accounted for my own post-travel bleeding? I don’t know, but there’s a good chance it was completely unrelated to my trip. “There are so many reasons a woman could bleed during pregnancy,” Hibbard says, “but even so, traveling isn’t for everyone. It comes down to common sense. Check with your doctor first; if you have a history of health troubles, you need to rethink why you’re hopping on a plane.”

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