The Special Traveller: The Pregnant Traveller
There is a time and place for everything, and when it comes to travel, women must sometimes decide whether pregnancy is the time, and Borneo the place! Certainly, pregnancy should not be a bar to travelling, but it is necessary to consider some of the additional risks involved, and to take measures which can reduce these risks.
If you do plan to travel, perhaps the first step should be to ensure that you are in as good health as possible. If you are suffering from morning sickness, extreme fatigue, or are anemic, it might be best to delay your travel until these conditions go away or are corrected. Miscarriage, when it occurs, usually happens during the first trimester of pregnancy, and this might be a prudent time to avoid extensive travel. Perhaps the fourth to six month of pregnancy are the ideal time to take that trip.
When picking your destination, in addition to checking out the hotels and sights, make sure that there is adequate medical care available. Trips to urban centres are probably quite reasonable. Trekking to the middle of nowhere would not. Also, check your medical insurance to be certain that you are covered for any medical treatment required abroad.
Travel to the tropics requires a few more considerations than to California. Certain inoculations may be required or advisable, depending upon your destination and other risk factors. While some vaccines are quite safe in pregnancy, others should probably be avoided where possible. Consult a travel medicine specialist for the best advice.
Malaria may be a threat to anyone off to the tropics, but it presents an even greater risk to a pregnant mom and her fetus. Personal precautions against mosquitoes, such as staying indoors in the evening and wearing long sleeves will reduce the risk. Insect repellents containing DEET may be used, but a lower concentration is advisable. The decision to use antimalarials, and which one to use, will depend upon your destination. Mefloquine, the most commonly used antimalarial, is now considered to be safe in the second and third trimesters of pregnancy, and would probably be warranted in the first trimester as well if the risk of exposure was great.
Montezuma's Revenge and dehydration are no treat for you, or your baby. Strict attention must be paid to food and water when travelling. If you do develop diarrhea, the most important aspect of treatment is hydration. Imodium should be avoided. If you are very sick, an antibiotic such as azythromycin (Zithromax) would be considered safe in pregnancy. Toxoplasmosis, a parasitic infection which can be contracted through eating undercooked meat, can cause serious fetal abnormalities. So make sure your steak is well done!
What if you feel you need to trek the Andes or Himalayas? Travelling to moderate altitudes for a short time is probably not a great risk to your fetus. The main concern is what if you develop a compication of pregnancy such as bleeding, and you are far from medical care. As I said, there is a time and place for everything, and when you are pregnant, Everest or Kilimanjaro may not be the place.
Finally, what about the flight itself. The actual oxygen content of the air in most pressurized commercial aircraft is equivalent to what we would find at an altitude of about 8,000 feet. This does not pose a problem for mom or the fetus, as long as there are no complicating factors such as anemia. It is important to drink lots of fluids, and to walk or stretch regularly, to lessen the risk of leg swelling and blood clots. An aisle seat might be a bonus!
Airplanes double as meeting rooms, movie theatres and fine restaurants. But they were not meant to be maternity wards. Hence, most airlines will not accept passengers more than 36 weeks pregnant. A letter from your doctor might be required to prove your actual due date.
When it comes to travelling with children, it is probably more convenient to carry your baby in your uterus rather than your backpack. But give it some thought before you fly. Weigh the risks against the benefits, and if you decide to travel, be sure to minimize your risks.