International Travel and PregnancyKristen J. Gough
Whether you’re traveling abroad while pregnant for business or pleasure, you should take steps to ensure your health and that of your unborn baby—before you ever set foot on the plane.
When to Travel
Your second trimester is the best time to travel, according to Dr. Robyn Horsager-Boehrer, medical director of Obstetrics and Gynecology at University Hospital-St. Paul, which is part of the UT Southwestern Medical Center in Dallas, Texas. “In the first trimester many women are not feeling well due to nausea or fatigue,” explains Dr. Horsager-Boehrer, while “the third trimester brings along the risk of preterm delivery.”
In fact many airlines won’t let you fly past 36 weeks, says Dr. Bob Wheeler, MD, an emergency medicine specialist, a cruise ship medical consultant, and the medical director for On Call International, a company that provides medical insurance for over seven million travelers. “After all, you don’t want to be having a baby at 45,000 feet.”
Where Should You Go?
You’re much more likely to get sick in a developing or newly-industrialized country, such as Mexico, India, Brazil, or the Philippines, which may not adequately treat its water and food, versus countries like Canada or Europe. According to Dr. G. Richard Olds, a travel-disease specialist and chairman of medicine at the Medical College of Wisconsin, 35 percent of travelers will get sick during a standard two-week stay in a developing country. Some studies, reports Dr. Olds, put the rate much higher at 85 percent.
While you might not be traveling for two weeks, Dr. Olds says pregnant women need to be especially careful because during pregnancy you’re body is already partially immuno-suppressed to accommodate your growing baby.
Be a Picky Eater
Germs that make you sick can come from a variety of sources, but certainly food is top on the list, especially in developing countries. When it comes to food choices, “think about how the food has been prepared,” says Dr. Olds. Baking, frying, or boiling the food kills most germs. Fresh foods, however, like salads, can be harder to clean. Dr. Olds gives the recent spinach scare—right here in the US—as an example of how difficult it is to get fresh vegetables and fruits clean.
That’s not to say you should avoid fresh fruits and veggies altogether. Opt for peelable fruits, like oranges or mangoes, says Dr. Olds, and avoid fruits with high water content like watermelon.
Tom Kime, chef and author of Street Foods: Exploring the World’s Most Authentic Tastes, has visited—and eaten—food in developing countries around the world. He says travelers often make mistakes about food choices because they go for something familiar instead of the local fare.
“You’re much more likely to get sick from the hotel’s all-day buffet, which has been sitting out in the air conditioning gathering bacteria, than the food on the street, which is cooked right in front of you,” offers Kime.
Kime points out that food might be making you sick simply because it’s different than what you’re used to, not necessarily because it’s contaminated. “I once felt ill in Thailand but it wasn’t from food poisoning, I’d just eaten too much chili,” says Kime, who dined on bananas the rest of the day. Bananas are his secret remedy for calming an upset stomach. According to Kim, other starchy, bland foods, such as noodles or rice, are also good stomach soothers.
But there are local foods to be wary of. Watch out for unpasteurized cheeses, meats and fish that may not be prepared fresh (or may have a high level or mercury or pesticides), and dishes with undercooked eggs (steer clear of soft-boiled eggs) or meats (sorry, no steak tartar!).
Be Careful with Water
If you’re traveling in Europe you probably won’t have a problem drinking tap water, but if you’re traveling in Mexico or Jamaica, you need to be careful about drinking local water, which may not be treated properly for germs.
“Most people make common mistakes,” says Dr. Olds. For example, drinking bottled water, but then using local ice or brushing their teeth with local water. He points out that even if you’re on a luxurious cruise ship and your boat is docking in developing countries, chances are it’s taking on local water.
But don’t avoid drinking water—staying hydrated during pregnancy is important. Instead, buy it bottled—as often as you can.
A Word about Bugs
Mosquitoes carry a variety of serious illnesses such as malaria and dengue fever. While many luxury resorts spray their properties to keep mosquitoes at bay, you should bring along bug spray (and even a mosquito net for sleeping) if the area you’re visiting is prone to the flying pests.
Before you depart, talk with your OB-GYN about what types of bug spray are safest for you to use during your pregnancy.
Talking to Your Healthcare Provider
Discuss your plans with your OB-GYN before you travel. If you are taking any medications, makes sure to bring along enough to cover your trip (and even a little extra just in case).
You may also consider bringing along a copy of your basic pregnancy records, advises Dr. Horsager-Boehrer. “If something should happen and you need medical care, a copy of the prenatal record with your lab and sonogram results makes it much easier for a physician to understand how the pregnancy has progressed thus far.”
Traveler’s First-Aid Kit
Avoid purchasing medications in another country, where pharmacies may offer over-the-counter medications that are prescription-only in the US. Pack your own obstetrician-approved survival kit, including medications to treat common travel complaints, such as “an antacid for indigestion, Tylenol for aches and pains, Claritin or Benadryl for allergies, Sudafed or its generic for cold symptoms,” says Dr. Horsager-Boehrer.
If You Get Sick
Before you travel, call you healthcare provider to make sure you know about your coverage. “You can get sick whether you’re walking down the beach in Jamaica or sitting in your living room,” says Dr. Wheeler. “A common complaint in pregnancy is spontaneous bleeding or spotting, which can happen anywhere.”
Dr. Wheeler recalls a case where a young woman visiting Cabo San Lucas experienced unexpected vaginal bleeding when she was six months along. On Call International helped coordinate her healthcare through a local hospital and then flew down a nurse to accompany the young woman home. Both she and her baby turned out to be fine, but once in the US she was admitted to the hospital as a precaution.
“You need to have a contingency plan,” believes Dr. Wheeler, who says that medical facilities in countries outside of the US and certainly within developing countries are not comparable to the care you receive here in the States.
Location, Location, Location
“Things change so quickly, you need to check the country out at the time of planning your trip,” cautions Dr. Horsager-Boehrer. Find information from reliable sources like the CDC or the State Department to alert you to any political or disease concerns you should know about.
Traveling abroad isn’t a no-no while pregnant—it just takes some careful planning. After all, it might be easier to travel now with your pregnancy medical kit rather than later with an overstuffed diaper bag.