The Best Time to Go
Pamela Waldrop Shaw was just three days shy of her due date when she got on a plane bound for Texas. A national sales director for Mary Kay Cosmetics who'd led her team to a million-dollar sales year, the Fort Lauderdale-based Shaw was determined to attend the company's annual meeting and be recognized for her achievement. She wasn't going to let a little thing like her due date stand in the way. Four hours after touching down in Dallas, her water broke. The next day, she gave birth to her son, Thomas. Two days later, she collected her laurels. Shaw has a newfound perspective when reflecting on this experience: "I realize that I could have had Thomas on the plane. Flying at that point was not very smart."
Sure enough, you'd be hard-pressed to find an ob-gyn who'd sanction unnecessary travel late in one's pregnancy. Indeed, even Shaw admits her own doctor had tried to dissuade her from going on her trip. Most ob-gyns will tell you that if you have a choice, the ideal time to travel is during your second trimester. That's typically when you'll feel your best, have the most energy, and the risk for complications is relatively low.
A caveat: If you're doing genetic testing and are expecting results back, you may not want to venture far, says Wendy Wilcox, MD, MPH, assistant professor of obstetrics and gynecology at Albert Einstein College of Medicine/Montefiore Medical Center, in New York City. "If you do travel, make sure your OB knows how to contact you and that you can come home if necessary," she says.
Playing It Safe
Of course, it's not that you shouldn't travel during the first trimester, but nausea and fatigue can often make it uncomfortable. Miscarriages are also more likely to occur during the first trimester. "Air travel doesn't cause miscarriage, but women who miscarry when they travel have a hard time believing it's not their fault," says Pamela Berens, MD, associate professor of obstetrics and gynecology at the University of Texas, in Houston.
And once you reach your third trimester, obstetricians prefer you stay closer to home, just in case there's a sudden, unexpected complication...or your baby decides to make an early appearance. Shaw's adventure notwithstanding, you probably don't want your baby delivered by an unknown OB in an unfamiliar hospital or in the aisle of an airplane. "All OBs agree with not traveling after 36 weeks, and many would argue that you probably shouldn't travel beyond 34 weeks," says William Rayburn, MD, chair of the obstetrics and gynecology department at the University of New Mexico, in Albuquerque.
If you're high risk, OBs are even more cautious. Edward Lazarus, MD, assistant professor of obstetrics and gynecology at the University of Tennessee Health Science Center, in Memphis, recommends that his high-risk patients stay put after 24 to 28 weeks. "And if you're carrying twins, or more, you probably should not travel after 20 weeks," he says. Women with multiple pregnancies have a higher risk for preterm labor and c-section delivery, as well as other health ailments.
15 Tips on Staying Safe and Comfortable
Still, traveling when you're pregnant can be exciting -- a chance to get away before the baby changes your life forever. Here's what you need to know to stay safe and comfortable.
- Get your OB's okay. Before you go, be sure your pregnancy is progressing without complications. If you're late in your second trimester, have an ultrasound to make sure the placenta isn't covering the cervix (a condition called placenta previa, which occurs in fewer than 1 percent of births). "You may not have had any trouble with your pregnancy, and then you reach 27 weeks and begin hemorrhaging," says Dr. Lazarus, who still vividly remembers when his wife began hemorrhaging from a placenta previa at 2 a.m. -- while they were in Yellowstone National Park.
- You might also discuss your mode of transportation. Airport security checkpoints and jets' pressurized cabins pose no dangers to pregnant women, and motion sickness (in a car or on a boat) is unlikely to worsen just because you're pregnant. However, your doctor may recommend skipping cruises: Norwalk virus, a common cause of vomiting and diarrhea that's spread by poor bathroom hygiene, proliferates aboard ships. "You can get sick and dehydrated pretty quickly," warns Dr. Lazarus. "The baby wouldn't be at risk, but you'd be miserable."
- Consult a specialist. If you're planning a jaunt to less-developed regions, see a doctor or nurse practitioner who has travel-medicine expertise about food and water safety precautions, endemic diseases, and requisite vaccinations, advises Kip Baggett, MD, medical epidemiologist in the travelers' health section of the Centers for Disease Control and Prevention, in Atlanta (to find a travel health specialist near you, go to www.cdc.gov/travel/travel_clinics.htm). The general rule on vaccinations is that killed virus vaccines, like Hepatitis A or flu shots, are safe during pregnancy, but live virus vaccines, such as yellow fever or tuberculosis, are not. Live vaccines contain small amounts of the weakened virus; killed vaccines are considered safer because the disease-causing viruses in them are inactive. (For more info on vaccinations, go to www.cdc.gov/travel/vaccinat.htm.) If the risks for both the disease and the vaccinations are too great, your OB will recommend you rethink your travel plans.
- Call your airline. Surprisingly, airlines don't have consistent rules about when pregnant women can fly, so check your carrier's policy before buying any nonrefundable tickets. You may also need a note from your OB stating your due date and verifying that you're fit for travel.
- Pack a copy of your prenatal record. It has information about your due date, blood type, blood pressure, and ultrasound results. "If you need to go to an emergency room in a different city, having your record on hand can save you extra phone calls as well as blood work and ultrasounds; plus, your record can help ensure that you get the critical care you need sooner," says Susan Warhus, MD, author of The Countdown to Baby (Addicus Books).
- Check your health insurance. Make sure your policy covers you if you need emergency care when traveling. Many insurance companies cover emergency care within the U.S. but not abroad. However, some companies allow you to purchase additional travel policies that cover you and your baby, should you deliver out of state or in another country.
- Find an alternate OB. Prior to leaving for her trip, Pamela Waldrop Shaw made arrangements with a Dallas OB to deliver her baby if she went into labor at her conference. It's a good idea to have the name and number of another OB if you get into trouble in a distant city, affirms Dr. Rayburn. Ask your OB for a referral.
- Don't be a hero. Airports are huge and when you're pregnant, you're often achy and tired, so don't be too proud to request a wheelchair to help you get around. And check your bags. "Even if my bag fit in the overhead, I'd check it so I didn't have to ask someone to put it up for me," says Brooklyn writer Caroline Kaye, who recently gave birth to her first child.
- Wear your seatbelt. That means in the car or on an airplane (if the seatbelt won't reach across your belly, ask the flight attendant for an extender). And if you're in an automobile accident, be sure to go to the emergency room. "Even if you have no cuts or bruises, if you've been significantly jostled, it's worth getting checked out because you could be at risk for preterm labor," says Dr. Lazarus.
- Get your fluids. Dehydration can lead to preterm labor, so drink the recommended eight 8-ounce glasses a day. When flying, don't be shy about asking the flight attendant for plenty of water.
- Move frequently. With all that water you'll be drinking, there's no doubt you'll need the bathroom often. If you're traveling by car, stretch your legs at rest stops; if you're flying or going by train, stroll up and down the aisles. Not only will frequent bathroom trips help prevent UTIs and bladder infections (which can lead to preterm labor), but moving around every hour or so helps prevent blood clots in your legs. A clot can cause a deadly pulmonary embolism if it reaches your lungs. "Pregnancy hormones make your blood clot more easily, and when you're sitting still, your blood tends to stay in your lower extremities," explains Dr. Wilcox.
- Pack healthy snacks. Carrying fruit, nuts, energy bars, or yogurt means you won't be trapped on a runway sans food or at the mercy of fast-food joints -- plus, snacks help keep nausea at bay.
- Wear comfortable clothes. Stretchy knits and spandex are comfy to travel in, and comfortable shoes are a must because feet tend to swell when you're pregnant. Celeste Ribbins, a Cleveland communications consultant whose daughter is now 7 months old, kept two pairs in the car when she was pregnant -- wide, comfortable slides for quick bathroom stops and shoes with good arch support for walking.
- Change your bag. Using a backpack helps cut down on back strain, notes Michelle McLaughlin, an Orlando pediatric occupational therapist who traveled often when she was pregnant with each of her three boys.
- Pack a travel health kit. Good things to include: acetaminophen, Imodium, Dramamine, Preparation H, Tums, Tylenol PM for insomnia, Cepacol for sore throat, a thermometer, and some packets of Gatorade powder to mix with bottled water in case of dehydration.
Remember, these journeys are preparing you for the one that is right around the corner: the journey of motherhood.
6 Signs You Shouldn't Travel
While the following pregnancy complications are rare, if you experience any, put your travel plans on hold and see your obstetrician immediately:
- Bleeding: This could indicate a miscarriage, preterm labor, or blockage of the cervix by the placenta (called placenta previa). Excessive bleeding may require a transfusion and can be life-threatening for you and the baby.
- Abdominal pain: Cramps that don't go away when you lie down can be a sign of miscarriage or preterm labor. Severe pain with bleeding may indicate that the placenta has separated from the uterus (called placenta abruption).
- Swelling: Extreme swelling in your arms, hands, legs, feet, or around your eyes could mean that you've developed preeclampsia, a potentially life-threatening condition for you and the baby. Since it typically worsens until the baby is delivered, your obstetrician needs to monitor you closely.
- Headaches: Pain that doesn't go away with rest and a few Tylenol may signal a sudden rise in blood pressure, another symptom of preeclampsia.
- Vision changes: Blurred vision, light flashes, or sparkles can indicate swelling around the optic nerve, yet another symptom of preeclampsia.
- Fetal movement changes: Any significant change in fetal movement could be a sign that the baby is in distress and requires immediate medical attention.
Norine Dworkin-McDaniel, mother of a son, lives in Winter Garden, Florida.
Originally in American Baby magazine.
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your won health or the health of others.