Fredrick H. Creutzmann, M.D.

Obstetrics, Gynecology and Infertility
4323 North Josey Lane
Plaza I, Suite #203
Carrollton, Texas 75010
972-394-7277or www.DrCmd.com

Travel In Pregnancy

Can I travel while I'm pregnant? Are there any precautions I should take? Are some forms of transportation better than others? Is timing important? These are just some of the questions pregnant women ask about travel during pregnancy. The answers depend on whether your pregnancy is high-risk, involving complications needing special care, how long you have been pregnant, and your personal needs. Let me know that you are going on a trip, where you want to go, and how you will get there.

I recommend that you choose the second trimester (the forth through the sixth month) if you are planning a trip. Although travel is generally safe at other times this is the period with the lowest chance of complications. You may find the second trimester to be the most comfortable time to travel as well. When you first become pregnant, you are adjusting to many changes, both physical and emotional. You may be tired or sleepy; you may have some morning sickness. By the second trimester morning sickness is usually no longer a problem. Your body has adjusted to the pregnancy, and you have more energy. Toward the end of pregnancy your size may make moving around more difficult and sitting comfortable for long periods of time nearly impossible. For these reasons, when planning a vacation or business trip, schedule it for the middle part of your pregnancy if you can.

The best method of transportation in pregnancy is often the one you enjoy most, pregnant or not. Sometimes speed of travel, resulting in less time spent getting there, is an advantage. Whether you choose car, plane, bus, or train, take steps to ensure comfort and safety.

Using seat belts is the best precaution to take when traveling by automobile. Statistics show that in a crash, a person who is wearing a seat belt is much safer than one who is not. Unfortunately, only about 14% of all pregnant women in the United States wear their seat belts. Some women worry that if the car stops quickly or if there is an impact, that the belt will squeeze the unborn baby, but this is very unlikely. Inside the uterus, which is protected by muscles, organs, and bones, the baby is cushioned in a fluid filled sac. The most common cause of fetal death, in an accident, is maternal death. Belts with both shoulder and lap straps are safer and more comfortable than those with only lap restraints. Fasten the belt snugly across your shoulders and low on your hips, under the bulge of your abdomen. Putting something small and soft like a wool scarf or a thin blanket between the belt and your body may increase your comfort.

Most likely, you have your own system for travel and your favorite items to bring along to make the ride go smoothly. Consider these suggestions for comfort:

If you are a passenger, take along a few small pillows. You can tuck one behind the small of your back and rest your head on another.

Wear loose-fitting clothing that doesn't bind your legs or abdomen when you are seated. Skirts and dresses are often more comfortable than pants.

Plan for frequent rest stops. Every 2 hours or so.

Keep your circulation going. Sitting still for a long time is uncomfortable when you are pregnant so stop and walk around often. If someone else is driving, do foot and ankle exercises in the car; put your seat back as far as possible and prop your feet up on something.

Make each days drive short enough to be fun. Ten hours on the road is wearing even when you are not pregnant! 5 or 6 hours a day driving is a reasonable target.

Airplane travel is safe in pregnancy, although I discourage it after 32 weeks. Travel on commercial airlines is best. Procedures vary with different airlines, but any airlines require a doctor's release when you are traveling late in pregnancy because of the possibility of early labor. Airline professionals suggest the forward part of the cabin, in front of the wings, for the more stable ride. You can usually get your seat assignment either when you book your flight or when you check in. Ask for an aisle seat (so you can walk around and can get to the lavatory easily) near the bulk head, the wall dividing first class and coach. You will have extra leg room there as well as a smooth ride. Most airlines offer early boarding for passengers who may need more time to get seated; take the option. Eat lightly to avoid air sickness. Special meals are available on many flights. If you order in advance you can choose anything from a low salt diet to a vegetarian diet. Carry your own supple of bland crackers; they can help with nausea, too. Since cabin temperature can fluctuate, even on short flights, wear a few layers of light clothing that will allow you to bundle up or remove a layer of two. Pregnancy can make you more sensitive to temperature changes.

Unless you have a special reason for going by bus you may want to use another kind of transportation while you are pregnant. Train travel, on the other hand, can be an excellent choice. You shed the worries of driving, and there is more space for walking around than on a plane or a bus. How about a cruise or an ocean voyage? Here you will have to rely on common sense, consultation with your doctor, and shipboard rules. Sea travel can really upset your stomach, so if you have never been on a boat, this is not a good time to try it. But if you are a seasoned sailor and you know your stomach can stand the motion of a ship in the water, check with your travel agent for cruise regulations on pregnant women.

If travel to foreign lands attracts you, being pregnant need not stop you from taking a holiday abroad. Since you will be far from your home and my office, you will want to take some extra precautions. A medical summary, useful wherever you travel, is especially important when you go overseas. Having all the facts gathered saves time in an emergency. Sometimes, too, it is easier for a foreign doctor to understand written statements than spoken ones. I will give you a copy of your prenatal record, carry it with you, and make sure your traveling companion knows where it is. A medical emergency is unlikely, but you will be more relaxed knowing you are prepared if one occurs. Carry a good foreign language dictionary to help express your needs. I can tell you what the most common emergencies are and you can buy a pocket dictionary that includes words and phrases that apply. Find out where medical facilities and doctors are located in the countries you plan to visit. Again, you probably won't need this information, but it's good to have. The American Red Cross, as well as foreign embassies and consulates, can help you. An organization called the International Association for Medical Assistance to Travelers (IAMAT, 736 Center Street, Lewiston, New York 14092) offers a list of approved, English speaking doctors and member hospitals abroad. You should write to IAMAT at least 8 weeks in advance. Your travel agent may be able to help with similar information. Your body may take a bit longer to adjust to a new time zone than it would if you were not pregnant, so allow a couple of days for rest after the flight.

Requirements for immunization vary; find out which ones are needed for the country or countries you plan to visit as well as those that may be required to get back in the United States. Travel to most western European countries does not require immunization. However, vaccines against viral diseases, such as yellow fever, have potential risk to the fetus, so check with me before getting any immunizations. You may have to change travel plans.

Trying new dishes is one of the great pleasures of foreign travel! Your digestive system can be upset easily when you are pregnant, however, and you will want to watch what you eat. Sample small amounts of unusual or spicy foods to see how they agree with you. Abroad, as in the United States, stay away from raw or undercooked meat; it can contain an organism that causes toxoplasmosis, a disease that will not harm you, but may cause injury to the fetus. To help prevent digestive problems, avoid fresh fruit and raw vegetables. Long-time residents of any country become used to the microorganisms found on local produce and are not harmed by consuming them. Since you are a visitor, you do not have that built-in protection and must be careful. The same is true of local water. When you are pregnant, it is best to be cautious and drink only bottled water while you are visiting other countries. Some of the mineral waters available abroad are sparkling, or carbonated, and can be helpful for an upset stomach. When traveling abroad, it's easy to develop irregular eating habits. But when you are pregnant, keeping up the balanced, healthy diet you follow at home is very important. You will have more energy and feel better if you do.

Another pleasure of travel is sightseeing, which usually involves considerable walking. Take a pair of low-heeled, comfortable walking shoes and walk as much as you wish until you tire. Wonderful though it is, travel can make you tired or upset your stomach, and while pregnant you may find yourself more vulnerable than usual to the wear and tear of the journey. If you follow sensible routines and stay alert to your body's signals, problems will be kept to a minimum. If they do arise, some self-help techniques can prevent or help deal with them:

Wear support stockings if you have varicose veins or problems with swelling.

Wear low-heeled, comfortable shoes, make sure you have a firm mattress, and sit in chairs with good back support and stretch back muscles occasionally.

Travel in loose, light clothing that does not cut off circulation. Choose natural fabrics like cotton or wool that absorb sweat (you may sweat more when pregnant).

Eat five or six small meals and munch on crackers or dry toast to reduce nausea.

Try to get more sleep and rest often so you will not feel tired and irritable.

Lengthy business trips and long vacations do come up. If you are away from home for more than a few weeks, you could miss a regular appointment. Ask me for the name of another doctor in the area for a checkup. While you are pregnant, be sure to let me know about your travel plans. I can help you with concerns and offer advice on the safest time and means of travel for you. Do not take any medication that I have not approved. I will also warn you if travel is not recommended because of any medical problems you may have. The rule of thumb for domestic and foreign travel is to pay attention to your body's signals. Your own physical feelings are among the best guides to your safety and well being, on the road as well as at home.