By Medical Advisory Board
American College of Obstetricians and Gynecologists (ACOG) advises that
healthy women with uncomplicated pregnancies may travel observing the
same safety measures as the general population. The safest time for a
pregnant woman to travel is between 18 and 24 weeks, when the most
common obstetric problems are least likely to occur.
However, "travel is not recommended at any
time during pregnancy for women who have either medical or obstetric
complications for which likely emergencies cannot be predicted.
Such complications may include increased risks for, or evidence of,
preterm delivery, pregnancy induced hypertension, poorly controlled
diabetes, or sickle cell disease or trait, which may be exacerbated by
high altitude. "  In addition the CDC recommends that pregnant women
with serious underlying illnesses should not travel to developing
TIPS FOR PREGNANT TRAVELERS
See your doctor before you plan to travel.
Before leaving home
locate the nearest hospital or medical clinic in the place you are
visiting in case of an emergency. Medical facilities should be able to
manage complications of pregnancy, toxemia, and cesarean sections.
Confirm that your health
insurance will provide coverage at your destination.
Ensure prenatal visits
requiring specific timing are not missed.
Consider buying travel
insurance for tickets and deposits that can't be refunded in case you need
to cancel your trip because of pregnancy complications.
Take a copy of your prenatal records with you.
Dimenhydrinate (Dramamine®) or meclizine
(Bonine®) are medications that may be used to prevent motion
sickness or decrease nausea.
If you are traveling by automobile
If you are traveling by plane
- Try to drive no more than 5 or 6 hours
- Wear your seat belt.
Stop to stretch your legs every hour or so. Stretching
your legs will lessen the risk of blood clots.
Check with your airline about possible requirements regarding
documentation of gestational age.
- Some airlines require women traveling
in their ninth month of pregnancy to have an obstetrician’s certificate
dated within 72 hours prior to their flight departure stating the
estimated due date and that the woman is physically fit to travel by
air to a particular destination on a given date. Other airlines will
not carry women after 36 weeks' of pregnancy under any circumstances.
- Avoid foods that cause gas before a flight because
the entrapped gas will expand at high altitude
Stop to stretch your legs every hour or so.
Stretching your legs will lessen the risk of blood clots.
- The American College of
Chest Physicians (ACCP) recommends that travelers who are taking
flights greater than 8 hours avoid constrictive clothing around the lower
extremities or waist, stay well hydrated (drink plenty of fluids), and
frequent calf muscle contraction (walk about).
- The ACCP recommends the use of graduated
compression stockings (GCS) or a single prophylactic dose of low
molecular weight heparin prior to departure if you are a long distance
traveler and your physician believes you to be at high risk for
blood clots and is considering additional measures to prevent
the formation of blood clots,
- The ACCP recommends
against the use of aspirin for venous thromboembolism (VTE) prevention .
- Hand-held metal detectors and walk through metal detectors do not
appear to pose a hazard to for pregnant women and their fetuses [5,6].
Backscatter units create an image from very small amounts of x-ray
that reflect off the person being screened. According to Rapiscan, the manufacturer of the
backscatter units, the dose for one
screening from a backscatter unit is 5 microrems (5 millionths of a rem)
 which is about 1/2000th (0.05% ) the radiation dose received from one
chest x ray , a negligible risk according to the International
Commission on Radiological Protection . Travelers may refuse a body scan and opt for a pat-down
- Remember: All liquids, gels and aerosols must be in three-ounce or
smaller containers placed in a single, quart-size, zip-top, clear
plastic bag. Each container must be three ounces or smaller.
Insulin and heparin vials
or asthma inhalers are usually less than 3 ounces.
- If medically necessary items exceed 3 ounces or are not
contained in a one-quart, zip-top plastic bag, you MUST declare to one
of our Security Officers at the checkpoint for further inspection.
- Visit the
Transportation Security Administration for more information.
Potential Contraindications to International Travel
From: CDC Health Information for International Travel 2008
Obstetrical Risk Factors
History of thromboembolic disease
Severe asthma or other chronic lung disease
Valvular heart disease (if NYHA class III or IV heart failure)
Severe anemia or hemoglobinopathy
Chronic organ system dysfunction requiring frequent medical
History of miscarriage
History of ectopic pregnancy (ectopic with current pregnancy should
be ruled out before travel)
History of premature labor or premature rupture of membranes
History of or existing placental abnormalities
Threatened abortion or vaginal bleeding during current pregnancy
Multiple gestation in current pregnancy
Fetal growth abnormalities
History of toxemia, hypertension, or diabetes with any pregnancy
Primigravida at ≥35 years of age or ≤15 years of age
Foreign Travel 
Before leaving home, locate the nearest hospital or
medical clinic in the place you are visiting. To find a doctor there, call the
International Association for Medical Assistance to Travelers at (716) 754-4883
or check with the American Red Cross (www.redcross.org) or look in your phone
book for the number of your local chapter).
Pregnant women should avoid travel to
potentially hazardous destinations such as:
- Areas endemic for or with ongoing
outbreaks of life-threatening food- or insect borne infections
- Areas where chloroquine resistant
P. falciparum malaria is endemic
- Areas where live virus vaccines are required and recommend
If a pregnant woman must travel to areas with chloroquine-sensitive
Plasmodium falciparum malaria,
chloroquine has been used for malaria chemoprophylaxis for decades with no
documented increase in birth defects.
If a pregnant woman must travel to areas
with chloroquine-resistant P. falciparum,
mefloquine should be recommended for chemoprophylaxis during the second and
third trimesters (3). For women in their first trimester, most evidence
suggests that mefloquine prophylaxis causes no significant increase in
spontaneous abortions or congenital malformations if taken during this period
Health information for specific destinations may be from the CDC obtained at :
The only vaccine required by International Health Regulations is yellow fever vaccination for
travel to certain countries in sub-Saharan Africa and tropical South America.
Meningococcal vaccination is required by the government of Saudi Arabia for
annual travel during the Hajj.
Use the Health Information for International Travel information below
to determine if you will need a yellow fever certificate, and find a clinic
that can give the vaccination and issue the certificate.
For more information call the Centers
for Disease Control and Prevention (CDC). This service has safety tips and
up-to-date vaccination facts for many countries. The number is (800)
CDC Health Information for International Travel 2012 (The Yellow Book) is published by the Centers for Disease
Control, and is made available to health care providers who advise
international travelers of health risks at:
1.American College of Obstetricians and Gynecologists. ACOG Committee
Opinion No. 264. Air travel during pregnancy. Obstet Gynecol. 2001;98:1187-8.
2. Centers for Disease Control and Prevention. CDC 2012 Yellow Book . Traveling
While Pregnant http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-8-advising-travelers-with-specific-needs/pregnant-travelers.htm
3.CDC. Preventing malaria in travelers.
http://www.cdc.gov/malaria/pdf/travelers.pdf. (Accessed 6/5/2010.)
Geerts WH, et al. Prevention of venous thromboembolism: American College of
Chest Physicians Evidence-Based Clinical Practice Guidelines (8th
Edition).Chest. 2008 Jun;133(6 Suppl):381S-453S.PMID:18574271
Kainz W, et al. Calculation of induced current densities and specific absorption
rates (SAR) for pregnant women exposed to hand-held metal detectors. Phys Med
Biol. 2003 Aug 7;48(15):2551-60.PMID:12953914
6. Wu D, et al. Possible overexposure of pregnant women to emissions from a walk through metal detector.
Phys Med Biol. 2007 Oct 7;52(19):5735-48. Epub 2007 Sep 10. PMID: 17881797
Transportation Security Administration’s Use of Backscatter Units, The Department of Homeland Security, Office of Inspector General, February 14, 2012 OIG-12-38
8. Kal HB, Struikmans H. Pregnancy and medical
irradiation; summary and conclusions from the International Commission on
Radiological Protection, Publication 84 Ned Tijdschr Geneeskd. 2002 Feb