More and more pregnant women in Anguilla are now traveling by air during pregnancy. One of the most common questions I get from pregnant women is whether or not it is safe to fly when pregnant? There are many myths associated with pregnant women travelling during pregnancy, but for the vast majority of women with uncomplicated singleton pregnancies there is no harm in travelling by air.
Advice to pregnant women
Most obstetricians will advise that women who are pregnant should avoid air travel after 37 weeks of gestation, as birth is usually expected at this stage. For women with uncomplicated multiple pregnancies, it is 34 weeks.
Although cabin pressure can result in dehydration, there has been concern it could also lead to a range of conditions such as preterm labour, preterm rupture of the membranes and placental abruption for women in advanced stages of pregnancy (after 32 weeks of gestation). There is no evidence that air travel can lead to these adverse pregnancy outcomes. To prevent dehydration, women should avoid caffeine and alcohol and maintain a good fluid intake during the flight, especially if it is a long flight.
The increase in altitude in the plane could result in some discomfort in the ears and nose. Motion sickness (made worse by morning sickness) may also be experienced.
Deep vein thrombosis
A particular concern for pregnant women is deep venous thrombosis (DVT). The risk of DVT is increased during air travel because of the long periods of immobility and the cramped seating arrangements during medium to long-haul flights (four hours and more). The current advice is for women to wear properly fitted graduated elastic compression stockings during the flight to reduce the risk of DVT.
To help prevent DVT, pregnant women are encouraged to have some physical movement by walking along the aisles every 30minutess where possible and by doing some light stretching to increase their blood circulation.
Some factors that can make air travel dangerous
The common risk factors indicating that pregnant women should not travel by air, or will need to take special precautions or treatment, include the following:
• Severe anaemia
• Recent development of sickle cell crisis
• Recent obstetric haemorrhage
• Nephrotic syndrome (a kidney condition)
• Wearing a cast from a recent fracture in the leg
• An ear infection (otitis media) and inflammation of the sinuses (sinusitus)
• Serious respiratory problems marked by breathlessness
• Recent gastrointestinal surgery
• Previous DVT (where treatment to prevent recurrent thrombosis is usually required)
• Severe obesity
Pregnant women with the particular conditions, or indeed any medical condition that concerns them, should seek specific medical advice from their obstetrician before travelling. They should consult an experienced obstetrician prior to making plans for travel.
Women unsure about their risks or other medical conditions are advised to speak to their obstetrician.
When is the best time to travel by air?
If your obstetrician approves air travel, and you have flexibility in your travel plans, the best time to fly might be in the middle of your pregnancy — about weeks 14 to 28. This is when you are likely to feel your best, and the risks of miscarriage and premature labor are the lowest. Travel is not recommended in the last three weeks of pregnancy mainly because of the risk of going into labour. Most airlines do not appreciate deliveries on their planes.
Some tips to help you while traveling by air
• Check the airline’s policy about air travel during pregnancy. Guidelines for pregnant women may vary by carrier and destination.
• Choose your seat carefully. For the most space and comfort, request an aisle seat.
• Buckle up. During the trip, fasten the lap belt under your abdomen and across the tops of your thighs.
• Promote circulation. If possible, take occasional walks up and down the aisle. If you must remain seated, flex and extend your ankles often.
• Drink plenty of fluids. Low humidity in the cabin can lead to dehydration.
• Avoid alcoholic beverages.
Conclusion
Women should be reassured that commercial air travel is not associated with specific problems in pregnancy, and that with simple precaution those with an uncomplicated singleton pregnancy can travel safely up to 37 weeks.
Whilst it is generally safe for women with low risk pregnancies to fly, there are increased risks of deep vein thrombosis (DVT). All pregnant women who intend to travel should see their obstetrician prior to travelling.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
