Travel during pregnancy

Whether you're visiting seaside resorts or experiencing more tropical climates, travel during pregnancy takes some extra planning and care. If you're planning a journey for business or pleasure, read on to find out everything you need to know about travelling with 'bump'.

• Before you go
• On your way
• Now I'm here
• Back home

Before you go

You cannot be guaranteed a complication-free ride through pregnancy, so before you leave it's important to make sure that you will have access to effective medical care should you need it. Some things to remember while planning your trip:

Insurance
Pregnancy is a health condition and not an illness but most women will have consulted a doctor at some stage during the two months prior to setting off on their holidays. Insurance companies differ in their requirements so it is important to check that your insurance does cover you for any illness or possible situations which may require treatment while away.

Most insurers will not cover women for pregnancy related conditions unless there is at least 8 weeks of the pregnancy left on their return and some will not provide cover after the 27th week. They will also not cover cancellations if the pregnancy was confirmed prior to the policy being taken out. For frequent travellers with annual cover, check with your insurance company if your policy is still valid for travel during pregnancy.

The European Health Insurance Card (EHIC), a more convenient, plastic, credit-card than Form E111 which it has replaced, entitles you to free or reduced-cost medical treatment that becomes necessary during your trip , because of illness or an accident in the other 27 EEA countries and Switzerland. Your EHIC should also cover you for routine maternity care while you are away. Visit www.dh.gov.uk to apply for an EHIC card. You should take out comprehensive private insurance for visits to all countries, regardless of whether you are covered by your EHIC.

Facilities at destination
Very few countries offer such easy access to healthcare as the NHS and, in many places, medical facilities are not at the same level as we are used to in the UK. Even if your final destination is a five star hotel, they may only have basic medical facilities on site, with proper treatment being some distance away. Check with your tour operator what on-site medical facilities are available. It's also worth checking the availability of possible interpreters in foreign lands or learning a few phrases in the native tongue prior to travelling which will explain that you are pregnant. Also, remember to take your hospital notes/antenatal records with you, wherever you travel during pregnancy.

Vaccinations during pregnancy
As with all medications, the use of vaccinations during pregnancy is best avoided. The issue is complicated because manufacturers have often not undertaken the relevant clinical studies to conclusively state whether a particular medicine is safe to take during pregnancy and this includes vaccines.

Dr Charlie Easmon, a specialist adviser in travel medicine says, "In any situation where a medicine is required during pregnancy, your doctor must weigh up the risks to the unborn foetus against the benefits to the mother. If the benefits outweigh the risks, a doctor will probably prescribe the medicine."

Ideally, if possible try to choose a destination where vaccinations are not required.

If you cannot avoid visiting a high risk country, you must visit your GP at least 2 months prior to travelling to discuss immunisations. As a general rule, live vaccines such as polio and yellow fever are deemed unsafe in pregnancy.

Malaria
Malaria is a serious disease, widespread in tropical and subtropical areas, which in the worst case may be fatal. The World Health Organisation say pregnant women should strongly avoid travelling to malarial regions where there is chloroquine-resistant falciparum malaria, because malaria increases the risk of abortion, premature birth, still-birth and maternal death.

Some anti-malarial drugs such chloroquine and proguanil have no special risk for pregnant women, and should be administered together, and a folic acid supplement should betaken when using proguanil. Pregnant women are more susceptible to the effects of malaria, have decreased general immunity and are prone to more severe disease, affecting both the mother and the baby. Furthermore, studies have shown that mosquitoes are particularly attracted to expectant mothers.

Concerns have been raised about the use of mosquito repellents such as DEET, and although there is no evidence confirming harmful effects to mother or baby, they are also best avoided during pregnancy.

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Where to next?

• For information on everything from how to have stress-free travel and summer safety tips, check out the rest of our travel section
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