This pamphlet will discuss:

Tips for safe and pleasant travel while you are pregnant When and where you plan to travel What may be the best means of travel for you

Let your doctor know about your travel plans. He or she can offer advice on the safest time and ways for you to travel.

When and Where to Travel

The best time to travel is mid-pregnancy (14–28 weeks of pregnancy). By that time many women are past the morning sickness phase of early pregnancy. During late pregnancy, it's often harder to move around or sit for a long time. There also is an increased risk of preterm labor (labor that starts before the end of the 37th week of pregnancy). Women often are most comfortable during mid-pregnancy.

The best thing to do is follow your body's signals. How you feel is one of the best guides to your well-being and safety. This is true on the road and at home.

Most places are safe to visit during pregnancy. You may need to make special plans, though. If you travel to a higher altitude, you may be short of breath. It will take you a few days to adjust.

Getting There

When choosing how to travel, think about how long the trip will take. The quickest way often is the best. No matter how you travel, take extra steps to ensure your comfort and safety.

By Land

For short trips, a car can be a good way to travel. Try to make each day's drive brief. Spending hours on the road is tiring even when you aren't pregnant. No more than 5 or 6 hours of driving each day is a good target.

Buckling Up During Pregnancy For the best protection in a vehicle, wear a lap–shoulder belt every time you travel. The safety belt will not hurt your baby. You and your baby are far more likely to survive a car crash if you are buckled in. When wearing your safety belt: Always wear both the lap and shoulder belt. Buckle the lap belt low on your hipbones, below your belly. Never put the lap belt across your belly. Place the shoulder belt across the center of the chest (between your breasts)—never under your arm. Make sure the belts fit snugly. Pull any slack out of the belt. The upper part of the belt should cross your shoulder without chafing your neck. Never slip the upper part of the belt off your shoulder. Safety belts worn too loosely or too high on the belly can cause broken ribs or injuries to your belly. More damage is caused when they aren't used at all.

Car safety advice doesn't change for pregnant women. You should wear your seat belt every time you ride in a car or truck, even if it has an air bag.

To prevent injury, buckle up with both the lap and shoulder belts on every trip. Keep your seat as far back from the dashboard as you can (at least 10 inches, if possible). Women should not have their air bags turned off because they are pregnant. The benefits of an air bag outweigh the risks to a pregnant woman and her baby. If you get in a crash—even a minor fender-bender—see your doctor to make sure you and your baby are OK.

If you plan to travel by bus or train, there are a few things to keep in mind. Buses have narrow aisles and small bathrooms. Trains have more space for walking, but the bathrooms are often just as small.

With both modes of transport, the ride may not always be smooth. Be sure to hold on to railings or seat backs when you are up and about. Take special care on stairs. Don't worry that a bumpy ride could bring on labor—it won't.

By Air

Travel in an airplane is almost always safe during pregnancy. Most airlines allow pregnant women to fly until about a month before their due dates.

Planes of major airlines are pressurized. That means the air in the cabin has more oxygen than the air outside. Many private planes are not pressurized. It's best to avoid altitudes higher than about 7,000 feet in small planes.

Don't worry about walking through the metal detector at the airport security check. It will not harm you or your baby.

Choose your seat with care. You may want to reserve an aisle seat. This will make it easier for you to get up and walk around every hour or so. You also won't have to climb over others to get to the bathroom. Try to get a seat near the front of the plane. The ride often is smoother there. A seat just behind the wall that divides first-class and coach seats has extra room to stretch your legs.

By Sea

Sea travel can be fun. It also may upset your stomach. If you have never been on a ship before, this may not be a good time to try it. If you have done this before and you think your stomach can stand the ship's motion, check on cruise rules for pregnant women. Make sure the ship has a doctor or a nurse on board. Also make sure that it docks in areas with modern medical facilities.

Ask your doctor about safe medicines for calming seasickness. You may want to try a pair of the seasickness bands for sale at many drug stores. These bands use acupressure to help ward off an upset stomach.

Foreign Travel

If you are planning a trip out of the country, discuss it with your doctor before calling the travel agent. He or she can help you decide if foreign travel is safe for you. Your doctor also can help you figure out what steps to take before your trip. Allow plenty of time to get any shots you may need. Also be sure to get a copy of your health record to take with you.

Travel Tips Here are some helpful hints that apply to any mode of travel you choose: See your doctor before you plan to travel late in pregnancy. You don't want to go into labor far from home. Take a copy of your health record with you if you'll be far from home. In case of emergency, ask your doctor for the name and phone number of a doctor where you are going to travel. Keep your travel plans easy to change. Problems can come up at any time. Buy travel insurance to cover tickets and deposits that can't be refunded. While you are en route, try to walk around about every hour. Stretching your legs will lessen the risk of blood clots and make you more comfortable. It also will decrease the amount of swelling in your ankles and feet. Wear comfortable shoes and clothing. You may want to wear support or pressure stockings. Carry some light snacks with you to help prevent nausea. Take time to eat. A balanced and healthy diet during your trip will boost your energy and keep you feeling good. Be sure to get plenty of fiber to ease constipation, a common travel (and pregnancy) problem. Drink plenty of fluids to help prevent urinary tract infections. Take a bottle of water or some juice with you. Don't take any medication not prescribed for you. Don't take any medicine—including motion-sickness pills, laxatives, diarrhea remedies, or sleeping pills—before checking with your doctor. Get plenty of sleep, and rest often. Stretch your back muscles from time to time. Don't do too much. It's tempting to squeeze in as many sights as you can, but it's vital to adjust your pace when you are pregnant.

When you are planning your trip, call the International Travelers Hotline at 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 (404) 332-4559. The CDC web site (www.cdc.gov) also has world travel health facts.

Disease Prevention

A disease that's rare in the United States may be common in other areas. As a result, some countries require visitors to get vaccinations before they travel there. Find out before your trip which shots you may need.

Malaria is an infection passed on by mosquito bites. It causes anemia (iron-poor blood) and flu-like symptoms. In pregnant women, it can result in miscarriage, stillbirth, small babies, and other problems. You can help avoid mosquito bites by wearing long-sleeved shirts and using mosquito netting and bug sprays or lotion. No drug fully protects you from malaria. A drug called chloroquine can help prevent and treat it, though. It is safe for use during pregnancy. You must start taking it a few weeks before you travel and keep taking it for a few weeks after the trip is over. There is no other safe drug that prevents malaria.

It's best to get vaccines before you get pregnant. You can't always plan that far ahead, though. Some vaccines are safe during pregnancy. Discuss the shots you need with your doctor.

Unsafe Food and Water

Traveling to other countries means you may be exposed to other kinds of germs. The locals are used to the organisms in the food and water. They can make you ill. This is true whether you are staying in a city or a rural area.

Traveler's diarrhea may be a minor problem to someone who's not pregnant. It's a greater concern for you, though. Severe dehydration can rob your baby of needed fluid and nutrients. Talk with your doctor about using medicine to prevent diarrhea.

If you do get diarrhea, drink plenty of fluids to combat dehydration. Before taking a diarrhea treatment, check with a doctor to make sure it's safe. The best way to prevent illness is to avoid unsafe food and water. Be sure to:

• Drink only pure bottled water, bottled or canned juices and soft drinks, pasteurized dairy products, hot tea, or broth. Iodine used to purify water may not be safe for pregnant women.
• Don't put ice in your drinks. Don't drink out of glasses that may have been washed in impure water. Drink straight from the bottle or use paper cups.
• Avoid fresh fruits and vegetables unless they have been cooked or peeled.
• Don't eat raw or undercooked meat or fish.

Medical Care

Even if you are in perfect health before going on a trip, you never know when an emergency will arise. 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).

If you need to see a doctor who doesn't speak English, it's a good idea to have a foreign language dictionary with you. After you arrive, register with your country's embassy or consulate. This will help if you need to leave the country because of an emergency.

Finally...

Travel can disrupt your daily routine. If you follow a sensible schedule and stay alert to your body's signals, problems should be few. Let your doctor know about your travel plans. He or she can help you with concerns and offer advice on the safest time and ways of travel for you.

This Patient Education Pamphlet was developed under the direction of the Committee on Patient Education of the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as "superior." To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.

Copyright © August 2001 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

ISSN 1074-8601

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