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Dr. Neumann’s KidsTravelDoc Ten Tips: The Littlest Travelers of them all

Date September 9, 2013

Many kids travel even before they’re born, hitchhiking, so to speak, while comfortably embedded in their mothers’ wombs. All the ado about traveling during pregnancy is to ensure that these hitchhikers remain safe/healthy during their journeys.

Here is what you should know:

pregnant11. Prevailing attitudes about pregnancy are overly optimistic. While pregnancy is a normal phase of life, it does require some adjustments in everyday living.  Problems do occur and minor issues are commonplace. Travel further complicates pregnancy by exposing you to new situations and removing you by distance and time from the people helping you to manage your pregnancy. Travel during pregnancy requires expert foresight and planning to minimize hitches. Read cancellation policies before booking trips so you know what to expect should you need to cancel your travel plans.

2. The best time to travel is during the second trimester. Problems tend to arise in the first and last three months. By the second trimester (the fourth month), most signs of future complications have surfaced, morning sickness is largely over, and moving about is still reasonably comfortable. In the last three months, fatigue and balance issues set in, and premature labor may occur.

pregnant23. Check if you are a good candidate for travel – or should stay close to home. Obstetricians can make recommendations based on your previous pregnancies (if any), physical exam, sonograms evaluating fetal growth and position in the uterus, and whether you are carrying twins, for example.

Ask if your routine immunizations are up-to-date. Diseases rare in North America (rubella and chickenpox, for example) still circulate in much of the world, including Western Europe. If you are not immune, you may become infected with a disease that can harm the fetus. (A dilemma can arise because some vaccines are contraindicated in pregnancy.) Flu vaccine is safe and should be given during pregnancy.

4. See a travel medicine expert if your plans include countries that call for travel-related immunizations or medications. These substances are sometimes unnecessarily given by inexperienced health care providers. They check itineraries by country and find that the country you are visiting is on the list for a medication or immunization. But the disease may exist only in remote areas, far from where you will be. Experts can also help you choose anti-malarial medications and insect repellents that are both safe for you and effective against local types of malaria, and  appropriate medications to prevent altitude sickness and treat diarrhea.

pregnant35. Set up communications with your health care providers. They should be accessible 24/7 from your cell phone wherever you will be. Ask if they promptly answer emails. Consider sending pictures; these can be very helpful for rashes, for example.

6. Review your health and accident insurance policies. Some policies exclude all medical events that occur while traveling during pregnancy, particularly events occurring overseas. Exclusions may include certain activities, skiing or scuba diving, for example, as well as newborn care if you deliver prematurely (extremely expensive).  Consider travel assistance insurance that may cover such events. See the web to find insurance providers.

pregnant47. Carry a medical kit. Include your latest medical/pregnancy data. Carry medications you have used in the past few years and are likely to need again.  Check to be sure these items are compatible with pregnancy. Include pregnancy related items; see books on pregnancy or check the web. Minimize buying medications overseas; names and doses may be confusing and, in developing countries, medications may be outdated, improperly stored or otherwise adulterated.

8. Recognize symptoms that could affect you pregnancy. Swollen legs abdominal pain, vomiting/diarrhea, shortness of breath and weakness/dizziness, for example, are fairly common travel-related conditions, often due to air travel, bad food, altitude or hot weather. But such symptoms can also be pregnancy-related, and regardless of the cause, can affect your pregnancy. Reasonable exercise, safe food/water, and air conditioning can help minimize these symptoms. But if they persist or are severe, check with your experts back home.

pregnant59. Air Travel. Airport security machines are safe during pregnancy. However, on request, security personnel will check you with hand-held devices. Routine air travel does not appear to affect the fetus. Minimize travel in the last eight weeks; some airlines require an obstetrician’s note for travel during the final months (but every year a handful of babies are born in flight). Walking helps prevent swollen  legs and possible blood clot formation. Move your feet up and down when seatbelt signs are lit. Wear loose, non-restrictive undergarments. Ask your doctors regarding elastic stockings.

10. Cruises are generally safe. Travel is restricted in the last trimester. Even earlier, carry a letter from your obstetrician if you appear “very” pregnant when boarding. Ships have physicians and nurses trained in emergency medicine, including handling basic pregnancy issues. They also have access to sophisticated telemedicine backup ashore. Check if seasickness remedies are compatible with pregnancy. Be careful walking during rough weather. Seek assistance when transferring from your ship to smaller boats. For vomiting or diarrhea, drink fluids. Dehydration can affect the fetus. For severe symptoms, consult the ship’s medical staff.

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