On the Move

Practicalities Getting Organised Travel in Pregnancy On the Move 

Remaining static on any journey, particularly in a cramped position, is not encouraged in pregnancy or the month after giving birth. As well as potentially causing lower back pain, abdominal discomfort and muscle cramps, when circulation is poor there is a rare chance of blood clots forming in the deep veins of the legs (deep vein thrombosis), sometimes known as economy class syndrome because the lack of space in economy airline seats is an aggravating factor. These clots can travel to the heart or lungs with occasionally fatal results. Circulation is slowed by pressure from the seat on one side and the weight of the foetus on the other.

The chances of deep vein thrombosis on a long-haul journey in the population at large are quantified as one in 12,000 though this is only an estimate. Putting it another way , according to the Institute of Aviation Health 30,000 travellers in 1999 had blood clots after flying. Pregnancy makes the condition marginally more likely and you can consider you are at greater risk if there is a family history of DVT, if you have varicose veins, if you are very tall, or if you are seriously overweight.

Tips for avoiding it are:

• Do not sit with luggage at your feet.



• Take regular walks, even round the aircraft.



• Do not sit with crossed legs.



• Periodically flex each foot while sitting and stand and stretch.



• Drink plenty of water.

By Air

If your carers have expressed any doubts over the baby's growth some consultants recommend avoiding flying altogether.

• Flying is also not considered a good idea if you are very anaemic or if you have sickle cell disease (a form of anaemia). You should also check about the safety of flying if you have any history of deep vein thrombosis (see above).



• If flying is OK, the standard request from airlines is that you provide a medical certificate if you will be more than 28 weeks pregnant on your return flight. Without this they are likely to refuse to carry you. Such a certificate is available from your GP or antenatal carer and should indicate your EDD and level of fitness.



• Carriers may refuse to take women who are more than 32 weeks pregnant and are almost certain not to accept those over 36 weeks. Details may vary not just from airline to airline (charter airlines tend to be stricter) but also from route to route. Even if you will fall short of the specified cut-off dates, if you have a significant bump it is probably wise to take a certificate regardless, to reassure the check-in staff and on board crew.



• One of the reasons for these restrictions is that cabin pressure (particularly on long-haul flights) can cause fluid retention, creating extra pressure on the abdomen. Blood pressure problems may also be worsened. However, the cynical believe that the real issue for airlines is less the issue of any danger to mother and newborn and more the enormous cost of re-routing should this become necessary. If this is the case, no airline has admitted it.



• Another concern for pregnant women is the increased exposure to radiation. Cosmic radiation at normal flying altitudes is more than 100 times that at ground level (the equivalent to a single chest X-ray on a return trip from London to New York). This is a significant reason why pregnant women are advised to avoid unnecessary long distance flights, especially during early pregnancy.



• You may be offered priority boarding if seats are not reserved, but it is worth requesting this up-front, rather than waiting for someone to offer it to you. An aisle seat can make it much easier to get up for the recommended walkabout. Place the seatbelt under, not across, your bump.



• Wear loose, comfortable clothing and shoes you can slip on and off easily, as your feet in particular may swell. Also make sure you drink plenty of non-alcoholic fluids as your kidneys react to the dry atmosphere on board by conserving fluid.



• If you are worried about thrombosis one of the tips is to fly business class as the larger seats offer more room to move and among other things less sustained pressure on the calves.

By Car

• Legislation insists that even pregnant women must use a seat belt when travelling by car. However, a car seat belt placed across the abdomen can be dangerous in the event of an accident, so you need to keep the shoulder strap high above your bump, and place the lap belt across your thighs. Alternatively, if planning much time travelling by car you could invest in one of the specially adapted system, generally known as a Bump Belt.



• Experts advise not undertaking any drive longer than three hours in the last three months, especially if the pregnant woman is driving.