Monday, 8 February 2016, Pregnancy can be an invigorating time but, while many women feel on top of the world whilst expecting, this special time does come with additional risks for expectant mums wanting to travel.
“Being pregnant is a wonderful experience for most women and it should not be perceived as putting an absolute handbrake on travel. There are, however, certain precautions that they should observe to ensure their own safety and that of their unborn child.”
This is according to Dr Pete Vincent of Netcare Travel Clinics and Medicross Tokai family medical and dental centre. He advises expectant mothers to discuss their travel plans with their obstetrician and, if travelling to areas associated with particular risks, consult with a travel clinic.
“If you are planning to travel, empower yourself by doing some research about your destination and any known health risks linked to that region, particularly those affecting pregnant women,” Dr Vincent advises.
“Many tropical and sub-tropical destinations, for example, are high risk areas for malaria infection and this can not only place the pregnancy and the mother’s life at significant risk but could also lead to birth defects. Furthermore, a number of malaria prophylactics are contraindicated for pregnancy,” Dr Vincent warns.
“Due to the serious risks involved, pregnant women are advised to avoid travelling to malaria areas, as far as possible. Many African countries, including parts of north eastern South Africa from September to April, Central and South America, and much of Asia are considered high-risk regions for malaria.”
Another virus transmitted by daytime-feeding mosquitos which expectant mothers need to be aware of is the Zika virus. “In recent years this virus, named after the Zika forest in Central Africa where it was first identified, has spread to a number of Central and South American countries, as well as the Caribbean. Infection in pregnant women has been linked to a higher incidence of microcephaly, a neurological disorder characterised by smaller and under-developed skulls and brains in infants. Affected children usually have reduced life expectancy, limited brain function and suffer seizures. For this reason travel to affected countries including Brazil, Colombia, Haiti and El Salvador is not recommended for pregnant women. Your travel clinic will be able to provide you with a full list of countries where the virus is prevalent.”
There are many other illnesses associated with travel to different countries, and there are often prerequisite vaccines for anyone visiting such regions. “Many of the vaccines are not recommended for pregnant women and it is therefore vital that you disclose your pregnancy status when visiting a travel clinic for the purpose of receiving such vaccinations.”
Whatever your means of transport, Dr Vincent warns against travel in the first trimester, and extreme caution for third trimester travel. “Usually, in terms of safety, and specifically in the case of low-risk pregnancies, the second trimester is a better time for pregnant women to travel.”
“In normal pregnancy, the period from 18 to 24 weeks is considered safest time for air travel, However there is generally no restriction from 23 to 36 weeks but you will need to get an ultrasound scan and a letter from your doctor confirming whether your pregnancy is normal and when your due date is. Most airlines will require a doctor’s letter before you can board an aeroplane. It is important to keep in mind that some airlines have specific policies pertaining to pregnant passengers. It is therefore important to check these out with your chosen airline ahead of time. If you are carrying twins, then cut off date for flying is 32 weeks.”
Dr Vincent advises frequent stretching and leg exercises throughout longer flights. Compression stockings are furthermore recommended as pregnant women carry a higher risk of blood clotting and deep vein thrombosis. “For long-haul flights especially, it is very important that women maintain these precautions for two days after the flight.”
Long journeys by car or bus may also carry risks for deep vein thrombosis. “A pregnant woman should walk around to ensure healthy circulation at least every two hours. The medicines that are usually prescribed to prevent deep vein thrombosis are often unsuitable for pregnant women. If such medication is prescribed it should only be used under close supervision of your doctor.”
Remember to keep your seatbelt buckled to keep yourself and your unborn baby safe during air and road travel. “For normal car seatbelts, the diagonal strap should rest between the breasts, and the lower section of the belt should be worn low across the upper thighs. Some vehicles have only a lap belt, and in this case it should be worn low, so that the strap rests between the abdomen and pelvis.”
For normal pregnancies, travel by ship or cruise liner is generally considered safe up until the 28th week. “Before embarking on a cruise, however, consider that motion sickness and morning sickness are often exacerbated during travel by sea. Powdered ginger can soothe these symptoms. It can be taken either in hot water as a tea and can also be added to food.”
During your holiday or travel, many fun and relaxing activities are considered safe for pregnant women including walking, swimming and snorkelling. “Any activity that is strenuous or could result in abdominal injury, however, should be avoided. This includes horse-riding, mountain biking, motorcycling, snowboarding and skiing. There are also risks associated with high altitude, water-skiing and strenuous hiking.”
It is important to protect yourself from the sun’s damaging UV rays with sunscreen but check the ingredients, as those containing oxybenzone have been linked to lower birth weights.
“Pregnant women should also avoid after-sun products, as these frequently contain chemicals that could cause problems for your unborn child. Even herbal remedies, such as those derived from aloe vera should be avoided unless your gynaecologist or obstetrician expressly confirms that they are safe for use during pregnancy.”
- If you are planning a pregnancy
For women who are planning to conceive, additional planning is strongly recommended ahead of travel.
“There has been debate about the safety of the yellow fever vaccine, for example, in pregnant women. To be safe, it is recommended that women who are planning to fall pregnant have travel vaccines, including those for yellow fever; measles, mumps, and rubella (MMR) or varicella, at least 28 days before attempting to conceive a child.” It has now been established that the Yellow Fever and Mumps, Measles, Rubella vaccine should be given a month apart to provide optimum protection. This means planning at least two months ahead.
- Be safe and have fun, in that order
“No matter which stage of pregnancy you are in, it is best to check your travel plans with your doctor to be on the safe side.”
“Always keep your antenatal records, doctor’s contact details and documents detailing any medical conditions in a safe place, as the availability of this information could prove critical, particularly when travelling in a foreign country,” concludes Dr Vincent.