Pregnancy Passport: Should I Travel?

By Sonia Alvarado, CTIS Pregnancy Health Information Line Counselor

Spring and summer are a busy travel time for Americans who take advantage of school vacations and seasonal slow-downs in their jobs to travel within the U.S. and abroad. Americans will travel by the millions this year in search of adventure, culture and relaxation. This holds true for expectant moms. However, I can't tell you how often I get the question from worried callers to our non-profit's information line, can I travel even though I'm pregnant? It's a great question and common concern, so I thought I'd spread the word of what research shows: pregnancy should not be a barrier for travel except in the most limited of circumstances.

First of all, whether you are pregnant or not, it's a good idea to check if there are any issues you need to be aware of that could affect your health or your plans. For example, if you are traveling to an area that is hurricane prone, you might want to check a website like the Weather Channel before you fly or drive to look at seasonal or historical weather patterns in the area. You might also check with your travel agency and hotel for their emergency and guest relocation plans in the event of a hurricane. Finally, you want to check the State Department website for information on the projected hurricane season: http://www.travel.state.gov/travel/cis_pa_tw/pa/pa_5472.html

The American Congress of Obstetricians and Gynecologists (ACOG) has a free, downloadable patient pamphlet on travel: http://www.acog.org/publications/patient_education/bp055.cfm

ACOG states the best time to travel is the middle of the pregnancy based on the observation that in general, most women who have pregnancy complications such as spontaneous abortion (miscarriage) etc., would likely experience it in the first or third trimester. Unfortunately, there is a lack of good research on travel during pregnancy for either occupational purposes or recreational purposes.

The CDC has a website that provides information on travel immunization recommendations as well as health warnings. Whether you are pregnant or not, it's just good common sense to check this site when planning travel, and again before the actual travel date, to check for updates on either disease outbreaks or immunization recommendations. This website is http://wwwnc.cdc.gov/travel/destinations/list.htm . It's possible that based on the CDC health warnings, an individual might change their travel plans.

If you are pregnant, healthy, have no known health risks, and you are traveling in your first or second trimesters within the U.S. and major modern cities throughout the world, and you've performed the recommendations mentioned above, and you are satisfied with what you have read, there are no recommendations against travel.

If you are in your third trimester, because potentially any woman could go into premature labor, it's a good idea to take another step and research the health facilities in the area you are visiting. While the chances are not high that a healthy woman would go into premature labor, it could still occur and you'd want to have a voice in where you receive your health care. Of course, you also need to check with your health insurance and travel agency to follow up on coverage issues.

The CDC has a site dedicated to travel issues for pregnant women and its recommended reading particularly if you are leaving the continental U.S. This website covers everything from airport scanners to potential complication concerns with long distance air travel. The website is http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-8/traveling-while-pregnant.htm

Many of the recommendations both in the ACOG and CDC site are based on observations of the physiology of pregnancy and effects from travel on the general public, as well as small studies. Unfortunately, there is a lack of good research specific to the issue of travel during pregnancy. A review article published in 2010 looked at air travel issues related to the recreational/occasional pregnant traveler and occupational exposure (business and frequent travelers/airline pilots or flight attendants). They attempted to assess risks related to cosmic radiation, cabin pressure, thromboembolism, infectious disease, spontaneous abortion, preterm birth, preeclampsia, low birth weight, intrauterine growth restriction and other complications. They found the quality of the data was generally poor, and concluded that based on existing data, it appeared that the risk of preterm birth (<37 weeks) was greater in passengers than controls, however, the risk of preeclampsia, neonatal intensive care unit admission or low birth weight was not increased.

For my part, I travel not to go anywhere, but to go, someone once told me, and many Americans will go far and near. Whether it's for a babymoon, special event or family gathering, we hope our pregnant readers will get informed, be prepared and take the road less traveled&while they still can!

Sonia Alvarado is a bilingual (Spanish/English) Teratogen Information Specialist with the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, a statewide service that aims to educate women about exposures during pregnancy and breastfeeding. Along with answering women's and health professionals' questions regarding exposures during pregnancy/lactation via CTIS' toll-free hotline and email service, she's provided educational talks regarding pregnancy health in community clinics and high schools over the past decade. In addition, Sonia contributes to the service's website, develops training materials for new CTIS staff, and is the supervising Teratogen Information Specialist trainer. Sonia attended San Diego State University and has worked in Tuberculosis Control for San Diego County's Public Health Department. Sonia's work has also been published through several tuberculosis studies. In her spare time, she loves to volunteer with the March of Dimes as an expert speaker on themes related to pregnancy.

CTIS Pregnancy Health Information Line is part of the The Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. California women with questions or concerns about pregnancy exposures can be directed to (800) 532-3749 or by visiting CTISPregnancy.org. Outside of California, please call OTIS counselors at (866) 626-OTIS (6847).

References:

Magann EF, Chauhan SP Dahlke JD, McKelvey SS, Watson EM, Morrison JC. Air travel and pregnancy outcomes: a review of pregnancy regulations and outcomes for passengers, flight attendants, and aviators. Obstetrical and Gynecological Survey 2010 Jun;65(6):396-402.