tips for travelling during pregnancy

Pregnancy Travel Tips

Can you travel while pregnant , read this next, when should you stop traveling while pregnant, how should you prepare for a trip during pregnancy, what do pregnant women need to know about travel and the zika virus, travel tips for pregnant people, when should you seek medical care while traveling during pregnancy.

While traveling during pregnancy is generally considered safe for most moms-to-be, you’ll need to take some precautions before making any plans — and get the green light from your practitioner first.

What to Expect When You’re Expecting , 5th edition, Heidi Murkoff. WhatToExpect.com, Zika Virus and Pregnancy , October 2020. WhatToExpect.com, What to Know About COVID-19 if You’re Pregnant , February 2021. American College of Obstetricians and Gynecologists, Travel During Pregnancy , August 2020. Johns Hopkins Medicine, Traveling While Pregnant or Breastfeeding , 2021. Centers for Disease Control and Prevention, COVID-19 Travel Recommendations by Destination , May 2021. Centers for Disease Control and Prevention, Pregnant and Recently Pregnant People , May 2021. Centers for Disease Control and Prevention, Pregnant Travelers , December 2020. Centers for Disease Control and Prevention, Travel: Frequently Asked Questions and Answers , April 2021. Centers for Disease Control and Prevention, COVID-19 and Cruise Ship Travel , March 2020.

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Traveling while pregnant: Your complete guide

Unless you're nearing your due date or have certain complications, your healthcare provider will generally give you the green light for pregnancy travel. Here's how to safely explore – plus what to consider before making plans.

Is traveling while pregnant safe?

When to avoid pregnancy travel, when is the best time to travel while you're pregnant , can pregnant women travel during covid, when should you stop traveling while pregnant, your pregnancy travel checklist, when to call your doctor while traveling.

Yes, it's generally safe to travel during pregnancy as long as you're not too close to your due date and you're not experiencing any serious pregnancy complications. There are special precautions to take, of course, and you may find yourself stopping to use the bathroom more than you're used to, but that babymoon can be within reach.

Before you pack your suitcase, talk with your healthcare provider to make sure it’s safe for you to travel and that your destination is a good choice. You'll want to avoid places where infectious diseases are prevalent (or there are high outbreaks of Zika or malaria, for example). The COVID-19 pandemic has made people reconsider where they feel safe traveling as well; if you're fully vaccinated, the CDC says you can travel Opens a new window , but it's always best to check with your doctor first.

And bear in mind that the activities you take part in might be different than normal – you'll want to skip the Scuba diving lessons, for example (though snorkeling is okay!).

It's safe to fly when you're pregnant as well, and most airlines will allow you to fly domestically until about 36 weeks of pregnancy. International routes may have different rules, so be sure to check with your airline before booking anything. Your doctor will tell you to avoid flying, however, if you have a health concern that might require emergency care or any other health conditions that aren’t well controlled.

It's best to avoid traveling while pregnant if you have any health conditions that can be life-threatening to both you or your baby. If you have any of the following conditions, your doctor will almost certainly advise you against travel:

• Placental abruption  
• Preeclampsia
• You're in preterm or active labor
• Cervical insufficiency  (incompetent cervix)
• Premature rupture of membranes (PROM)
• A suspected ectopic pregnancy
• Vaginal bleeding

You might also need to be extra-cautious or skip travel if you're experiencing intrauterine growth restriction , you have placenta previa , or you have other conditions that may place your pregnancy at a higher risk. It’s always a good idea to discuss your concerns with your healthcare provider before travel regarding any medical conditions you have, and they'll be able to advise you on what's best, depending on the trip.

The sweet spot for pregnancy travel is during your second trimester , between 14 weeks and 27 weeks. By the second trimester, any struggles you’ve had with morning sickness and fatigue during the earlier weeks of pregnancy should have hopefully subsided – and after 12 weeks, your risk of miscarriage decreases significantly as well. And you're not too far along to worry about third trimester exhaustion or going into preterm labor yet, either.

Your energy levels are likely to be good during your second trimester too (bring on the sightseeing!), and it will still be relatively easy and comfortable for you to travel and move around at this time. Keep in mind that once you hit that third trimester, pregnancy travel might be more difficult as you find it harder to move around and stay still for long periods of time.

It's complicated (and often a personal decision based on your own risk factors), but the CDC says that if you're fully vaccinated against COVID-19, you can travel. Of course, it's important you still do everything you can to keep yourself and others around you safe, including following all mask-wearing and social distancing guidelines in the destination you visit.

Women are at an increased risk for severe illness if they contract COVID-19 while pregnant , and they're more likely to experience preterm birth and other poor pregnancy outcomes. (This is why the CDC, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine all recommend that women who are pregnant, breastfeeding, or are planning on becoming pregnant get the COVID vaccine .)

If you're vaccinated and decide to travel, the CDC advises avoiding international destinations that are designated Level 4, due to high rates of local COVID-19 transmission.

Take all this information into account and talk to your doctor before you decide on where and when to travel while you're pregnant. And if you experience any symptoms of COVID-19, whether while traveling or at home, call your healthcare provider as soon as possible.

The guidelines for when to stop traveling while you're pregnant vary based on your mode of travel, but more or less, you should wrap up travel before you're 36 weeks pregnant.

Most airlines will let pregnant women fly domestically until they're 36 weeks pregnant – and many cut that off earlier for international travel. This rule is often enforced on an honor system policy, but some airlines may ask for a doctor’s note – so make sure you have that from your healthcare provider if you're traveling in the third trimester, just in case.

Most cruise ships don't allow travel after 24 weeks of pregnancy. Some cruise lines' cutoff dates vary, so verify policies before booking a cruise.

As for road trips, there's no official deadline for when you need to stop traveling, but your personal comfort level (physically and emotionally) – and your doctor's advice – might help you decide. You can drive while pregnant all the way up until your due date, but things may get considerably less comfortable on longer trips as you approach full term.  

Travel of any kind requires advance preparation, but when you're pregnant and traveling, that pre-trip checklist gets a little longer. Give yourself a little more time than usual to plan for a trip – and use the tips below to stay safe and comfortable on your next adventure.

Before you travel

• Talk to your healthcare provider to determine if your trip is safe for you and if there are any medical concerns to consider. It's a good idea to discuss any activities you plan to do while you're away too. If you're planning an international trip, make sure to ask about any vaccines you may need for the areas you're visiting.
• Make sure you know your prenatal test schedule. Plan travels around any prenatal tests you need to schedule, including ultrasounds and other important screening tests.
• Book an aisle seat. You'll likely be more comfortable being able to get up to stretch or go to the bathroom on longer flights.
• Buy travel insurance. You don't need special travel insurance when you're pregnant, but it's never a bad idea to secure a policy. You may want to consider one with a “cancel for any reason” clause that reimburses you for money lost on cancelled trips for reasons (read: any reason) beyond what’s listed on the base policy. Check with your personal health insurance, too, to make sure it covers potential pregnancy complications while traveling internationally (some don’t). Consider adding evacuation insurance as part of a travel insurance plan, too.
• Gather your medical records and health information . If you’re in your second or third trimester, ask your ob-gyn or midwife for a digital copy of your prenatal chart, and have that easily accessible during your trip. Typically, this chart includes your age, your blood type, the name and contact information for your healthcare provider, the date of your last menstrual period, your due date, information about any prior pregnancies, your risk factors for disease, results of pregnancy-related lab tests (including ultrasounds or other imaging tests), your medical and surgical history, and a record of vital signs taken at each visit.
• Keep a list of key names and numbers you may need in the event of an emergency saved on your phone and written on a piece of paper (in case your battery dies).
• Have a contingency plan for doctors and hospitals that will take your insurance where you're going in case you go into labor early or experience pregnancy complications that require urgent care while you're away from home.
• Pack medicines and prenatal vitamins. That might include an extended supply of prescriptions and over-the-counter remedies , too. Bring enough to cover your entire trip and a written prescription that you can fill if you lose anything. It's a good idea to keep prescription medicine in its original container, so if your bags are searched it will be clear that you're not using medication without a prescription.
• Prepare for the unexpected. On a road trip, that might mean an unexpected breakdown, so join an auto club that provides roadside assistance. Download any apps you use for renting cars and accessing boarding passes before you leave so you can easily reschedule things in the event of a last-minute cancellation.
• If you're flying during your third trimester, be sure to call the airline to check about the cutoff week for pregnancy travel. A note from your doctor that says you’re cleared to travel is always good to have when traveling during your third trimester.

During your trip

• Drink plenty of water and continue to eat healthy foods . Keep in mind that many restaurants abroad commonly serve unpasteurized foods (like soft cheeses and milk), which can be dangerous for pregnant women due to the presence of listeria.
• Avoid eating raw or undercooked meat or fish , drinks with ice (which may be contaminated), non-bottled water, and other foods that can cause traveler's diarrhea, which can be more of a problem for pregnant women than other people.
• On long flights and drives, take time to stretch by pulling over for a walk or strolling up and down the airplane aisle. And when seated, always wear your seat belt .
• Maternity compression socks are handy to have along – both in transit and worn under your clothes while you’re out and about exploring – because they can ease the symptoms of swollen feet and legs. These are a few of our favorite pregnancy compression socks .
• Take advantage of help. Many countries have dedicated lines in shops and airports for pregnant travelers, so don't feel any shame taking a shorter wait if you see one.
• Go easy on yourself. Remember, you're growing a baby. You might not have quite the stamina for sightseeing and late nights like you used to pre-pregnancy. Make the most of your vacation but don't fret you miss out on things because you need more downtime from exploring than you usually would.
• Don’t forget to get photos of your bump. When your baby is older, you'll have fun showing them all the places you traveled with them before they were born.
• Go for the comfy shoes. Travel during pregnancy is the best reason ever to forgo those strappy stilettos for your favorite sneakers .
• Pack snacks so you always have something to curb your appetite if there’s a long wait for a restaurant or you get stuck in transit or someplace remote with no food offerings.
• Try to be in the moment with your travel partners as much as possible. Once your baby is born, your attention will be pulled in a whole new direction.

If you have any medical concerns traveling while pregnant, don’t hesitate to pick up the phone and call your doctor for advice. The below are a few symptoms that definitely warrant calling your ob-gyn or health care provider or seeking emergency care while traveling or at home:

• Signs of pre-term labor (including a constant, low dull backache, bleeding, etc.)
• Ruptured membranes (your water breaks)
• Severe cramping
• Spiking blood pressure
• Severe nausea or vomiting
• COVID-19 symptoms

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

AAFP. 2020. Ultrasound during pregnancy. American Academy of Family Physicians.  https://familydoctor.org/ultrasound-during-pregnancy/ Opens a new window [Accessed April 2023]

ACOG. 2020. FAQ055: Travel during pregnancy. American College of Obstetricians and Gynecologists.  https://www.acog.org/womens-health/faqs/travel-during-pregnancy Opens a new window [Accessed April 2023]

CDC. 2019. Pregnant Travelers. https://wwwnc.cdc.gov/travel/yellowbook/2020/family-travel/pregnant-travelers Opens a new window [Accessed April 2023]

CDC. 2022. Domestic Travel During Covid-19. https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html Opens a new window [Accessed April 2023]

CDC 2023. International Travel During Covid-19. https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel-during-covid19.html Opens a new window [Accessed April 2023]

CDC. 2022. Covid-19: Pregnant and Recently Pregnant People. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html Opens a new window [Accessed April 2023]

Terry Ward is a freelance travel, health, and parenting writer who has covered everything from flying with toddlers to why you should travel with your kids even when they're too young to remember it. She lives in Tampa, Florida, with her husband and their young son and daughter, and enjoys camping, sailing, scuba diving, skiing, and almost anything else done in the great outdoors.

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15 Tips for Traveling While Pregnant

These tips will help pregnant women travel the world in comfort and style.

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Experts share their best travel tips for expecting mothers.

Pregnancy can be a magical experience, but that doesn't mean creating new life comes without challenges. From what you wear to how you move your body to how well you sleep, pregnancy changes your day to day in myriad of ways – both good and bad.

However, that doesn't mean you should stay home and avoid travel for the entire nine months you're with child. The American College of Obstetricians and Gynecologists says it's typically safe to travel until you're 36 weeks pregnant, so you may as well get out and see the world.

These tips can help you ensure your pre-baby travel is safe, comfortable and fun.

Travel When You're Most Comfortable

According to the ACOG, the best time for pregnant women to travel is between 14 and 28 weeks, or during the middle of your pregnancy.

The most common pregnancy problems occur in the first and third trimesters, according to the health organization. "During midpregnancy, your energy has returned, morning sickness usually is gone, and it is still easy to get around," according to the ACOG.

If you have the option to be flexible with your travel dates, steering clear of early and late pregnancy trips may save you from having to endure an unenjoyable experience.

[Read: 9 Reasons Getting Away for the Weekend is Good for Your Mental Health .]

Have a Plan B

Robert Quigley, senior vice president at International SOS and MedAire, says you should meet with your doctor and get cleared to travel before you depart on any trip. Also, take the time to research medical facilities near where you'll be staying, he says, since you won't want to have to frantically figure out where to go if you experience complications.

Early planning can include checking nearby hospitals that you contact ahead of your trip, and locating pharmacies and additional prenatal resources in your destination should you go into early labor.

"This may also include a communication plan for friends or family should they need to join you, and an evacuation plan to upgrade your care in the event of a complication," he says.

Purchase Travel Insurance

Travel writer and mom of two Natalie Preddie, who blogs at NattyPOnline.com , says you should buy travel insurance that includes medical coverage before your trip if you're visiting a destination where your health insurance won't apply.

Preddie says when she was pregnant, she had to go to a hospital in Florida during a trip because she thought her baby wasn't moving. She says she was glad her health insurance was accepted right away, but she worries what would have happened if she had to pay for a lengthy hospital stay or tests out of pocket.

Bring Your Medical Records with You

Lee Roosevelt, who works as nurse midwife at the University of Michigan – Ann Arbor, says you can gain peace of mind and expedite any medical care you might need by bringing a copy of your pregnancy-related medical records along on your trip.

"Offices can take a day or two to return a request for records, and if you need care quickly it means your team of providers [is] making decisions without knowing the details of your pregnancy," she says.

Be Proactive About Your Health

Roosevelt also says that when it comes to pregnancy, you should take steps to avoid common health problems regardless of whether you're on a trip or at home. She recommends taking plenty of walking breaks since "pregnant women are at higher risk for blood clots and prolonged sitting increases that risk."

You should try to get up and walk for five to 10 minutes every few hours if you can, even if you're on an airplane.

Roosevelt also noted that buying and wearing compression socks during air travel can help you avoid swelling, blood clots and more.

[Read: 30 Travel Accessories That Make Vacationing Easier .]

Stay Hydrated

In the same vein of being mindful about your health and wellness, drink lots of water so you stay hydrated. Dehydration can make you feel unwell and put you at risk for pre-term contractions, Roosevelt says.

Plan to bring your own refillable water bottle while you travel so you can stay hydrated no matter where you are, whether that's on the road or in the air.

Pack Healthy Snacks

Airports don't always have many healthy dining options, and what is available tends to be expensive. To save money and avoid having to nosh on empty calories, it can help to bring your own selection of sensible snacks along.

Consider packing healthy snacks like dried fruit and vegetables if you can. The U.S. Department of Health and Human Services also recommends eating whole grain toast or crackers when you’re feeling nauseous or unwell, and healthy crackers should be easy to pack in your bag and bring along.

Bring Sanitizing Wipes and Gel

The ACOG says that, if you're going on a cruise specifically, you'll want to take steps to avoid norovirus – a group of viruses that can spread quickly and cause severe nausea and vomiting.

Washing your hands frequently is the best way to avoid it, but antibacterial hand gel can help you ward off germs as well. Meanwhile, disinfecting wipes are good to have on hand to wipe down airplane tray tables and arm rests.

The Government of Canada also recommends pregnant women vigorously wash their hands before eating or preparing food as well. Following these recommendations is especially important when you're in a busy airport or dining on a germ-infested airplane.

Keep Car Rides Short

If you're planning a road trip or need to drive a long distance to reach your destination, it can be beneficial to break up your travel over several days. That way, you'll only have to sit for shorter spurts of time rather than long stretches that can leave you vulnerable to swelling, blood clots and other pregnancy-related complications.

The ACOG also notes that you should buckle your seatbelt low on your hipbones, below your belly, and "place the shoulder belt off to the side of your belly and across the center of your chest."

Plan to make frequent stops so that you can get out and stretch your legs, and your car ride will be more enjoyable and keep you and the baby safe.

Book an Aisle Seat When You Fly

If you plan to fly while you're pregnant, book an aisle seat ahead of time – even if you need to pay extra for it. Having an aisle seat will make it easier for you to get up and walk around, and to head to the toilet for the many bathroom breaks you'll likely need to take.

If you can, splurge (or use points ) for business class to score some extra room.

Don't Overbook Yourself

Sightseeing is a lot of fun pregnant or not, but don't forget that your energy levels may be lower by the time you're ready to depart.

Make sure to plan an itinerary that includes plenty of breaks and downtime. You may even want to plan a relaxation-themed trip altogether, such as a spa getaway or a trip to an all-inclusive resort .

Be Choosy About Your Destination

Be mindful of seasonal weather trends and how they might work for your pregnant self. If you are planning a beach getaway in the middle of July and considering Naples in southern Florida, for example, it's smart to know ahead of time that daily high temperatures usually reach 89 degrees and humidity levels often fall in the "oppressive" or "miserable" range in the summer. Doing your research could help you find a destination with better weather, such as a beach spot with lower humidity like Virginia Beach, Virginia or Cape Cod, Massachusetts .

When it comes to trip planning, Google is your friend. Make sure you know how the weather might look no matter where you are planning to travel or you could live to regret it.

[See: 30 Relaxing Meditation Retreats Around the World .]

Pack a First-Aid Kit

There's nothing worse than being in transit for hours without supplies for headaches, heartburn and other pregnancy-related ailments. If you're prone to not feeling well at home or when you travel, you may want to bring a small first-aid kit along.

While your kit can include whatever you want, consider packing medicine for heartburn, bloating, gas and nausea – or whatever has been bugging you the most.

Check If You Need Clearance to Fly

While most airlines let you fly without question until you're up to 36 weeks pregnant, some international carriers, including Cathay Pacific and Emirates, need verification of your health from your doctor with a medical certificate before you board the plane.

If you plan to fly domestically or abroad, make sure to check with the air carriers you're considering as you organize the trip. Most airlines typically list this information on their websites, but you can also call to ask if you'll need any specific documentation.

Choose the Right Luggage

Finally, don't forget to bring luggage that's easy to move around from place to place. Spinner-style luggage on wheels is typically the easiest to transport, and you should strive to pack light (within reason) so you're not stuck lugging around all the clothing and shoes you own.

Don't hesitate to check your luggage either – especially if you have a layover to endure. The less you have to carry around, the smoother your trip should be.

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Travel During Pregnancy

As long as there are no identified complications or concerns with your pregnancy, it is generally safe to travel during your pregnancy. The ideal time to travel during pregnancy is the second trimester .  In most cases, you are past the morning sickness of the first trimester and several weeks from the third stage of pregnancy when you are more easily fatigued .

Is it safe to travel during pregnancy?

Traveling by air is considered safe for women while they are pregnant; however, the following ideas might make your trip safer and more comfortable.

• Most airlines allow pregnant women to travel through their eighth month. Traveling during the ninth month is usually allowed if there is permission from your health care provider.
• Most airlines have narrow aisles and smaller bathrooms, which makes it more challenging to walk and more uncomfortable when using the restroom. Because of potential turbulence that could shake the plane, make sure you are holding on to the seatbacks while navigating the aisle.
• You may want to choose an aisle seat which will allow you to get up more easily to reach the restroom or just to stretch your legs and back.
• Travel on major airlines with pressurized cabins and avoid smaller private planes. If you must ride in smaller planes, avoid altitudes above 7,000 feet.
• Although doubtful, the risk of DVT can be further reduced by wearing compression stockings.

The Royal College of Obstetricians and Gynaecologists and the International Air Travel Association recommend that expecting mothers in an uncomplicated pregnancy avoid travel from the 37th week of pregnancy through birth. Avoiding travel from 32 weeks through birth is recommended for women who have complicated pregnancies with risk factors for premature labor, such as mothers carrying multiples.

Risk factors that warrant travel considerations include the following:

• Severe anemia
• Cardiac disease
• Respiratory disease
• Recent hemorrhage
• Current or recent bone fractures

Traveling by Sea During Pregnancy

Traveling by sea is generally safe for women while they are pregnant; the motion of the boat may accentuate any morning sickness or make you feel nauseous all over again. There are a few considerations to make your trip safer and more comfortable:

• Check with the cruise line to ensure that there is a health care provider on board in case there are any pregnancy complications .
• Review the route and port-of-calls to identify if there is access to any medical facilities if needed.
• Make sure any medications for seasickness are approved for women who are pregnant and that there is no risk to the developing baby.
• Seasickness bands use acupressure points to help prevent upset stomach and maybe a good alternative to medication.

International Travel During Pregnancy

Traveling overseas has the same considerations that local or domestic travel has, but it also has additional concerns that you need to know about before making an international trip. The information below is provided to help you assess whether an international trip is good for you at this time:

• It is important to talk with your health care provider before you take a trip internationally to discuss safety factors for you and your baby.
• Discuss immunizations with your health care provider and carry a copy of your health records with you.
• With international travel, you may be exposed to a disease that is rare here in the United States but is common in the country you visit.
• Contact the Centers for Disease Control and Prevention at (800) 311-3435 or visit their website at www.cdc.gov to receive safety information along with immunization facts related to your travels.
• Diarrhea is a common concern when traveling overseas because you may not be used to the germs and organisms found in the food and water of other countries. This can lead to a problem of dehydration .

Here are some tips to avoid diarrhea and help keep you safe:

• Drink plenty of bottled water
• Used canned juices or soft drinks as alternatives
• Make sure the milk is pasteurized
• Avoid fresh fruits and vegetables unless they have been cooked or can be peeled (such as an orange or a banana)
• Make certain that all meat and fish has been cooked completely; if you are unsure, do not eat it

Travel Tips During Pregnancy

Whether you are going by car, bus, or train, it is generally safe to travel while you are pregnant; however, there are some things to consider that could make your trip safer and more comfortable.

• It is essential to buckle-up every time you ride in a car. Make sure that you use both the lap and shoulder belts for the best protection of you and your baby.
• Keep the airbags turned on. The safety benefits of the airbag outweigh any potential risk to you and your baby.
• Buses tend to have narrow aisles and small restrooms. This mode of transportation can be more challenging.  The safest thing is to remain seated while the bus is moving. If you must use the restroom, make sure to hold on to the rail or seats to keep your balance.
• Trains usually have more room to navigate and walk. The restrooms are usually small. It is essential to hold on to rails or seat backs while the train is moving.
• Try to limit the amount of time you are cooped up in the car, bus, or train. Keep travel time around five to six hours.
• Use rest stops to take short walks and to do stretches to keep the blood circulating.
• Dress comfortably in loose cotton clothing and wear comfortable shoes.
• Take your favorite pillow.
• Plan for plenty of rest stops, restroom breaks and stretches.
• Carry snack foods with you.
• If you are traveling any distance, make sure to carry a copy of your prenatal records.
• Enjoy the trip.

Want to Know More?

• How to Treat Jet Lag Naturally During Pregnancy

Compiled using information from the following sources:

1. Planning Your Pregnancy and Birth Third Ed. The American College of Obstetricians and Gynecologists, Ch. 5. William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 8.

2. Royal College of Obstetricians and Gynaecologists, Air Travel and Pregnancy (Scientific Impact Paper No. 1), https://www.rcog.org/uk, May 22, 2013.

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9 Tips for Traveling While Pregnant

An ob-gyn shares advice about traveling while pregnant and what you can do to stay safe..

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For many, the holiday season is a time to travel and gather with family and friends. For expectant mothers, holiday travel, coupled with the ongoing challenges posed by the flu, RSV (respiratory syncytial virus), and COVID-19, can introduce a unique set of considerations and uncertainties. Traveling while pregnant may require some extra precautions to ensure their comfort and safety as well as the baby’s safety.

“For those with a low-risk pregnancy, travel is generally considered safe,” says Dr. Cassandra Simmons , division chief of General Obstetrics & Gynecology at NewYork-Presbyterian Westchester. “Most patients should feel comfortable benefiting from the positive aspects of travel during holidays — by car or by plane — and be able to enjoy their time with friends and family.”

Health Matters spoke with Dr. Simmons to learn what advice she has for people traveling while pregnant.

Dr. Cassandra Simmons

1. Check in with your doctor before traveling.

Travel is not recommended for those with certain complications, such as preeclampsia , preterm labor, or pre-labor rupture of membranes (PROM).

According to Dr. Simmons, there may be slightly higher risk associated with traveling in the first trimester (when there is a greater risk of bleeding) and the third trimester (when you’re closer to delivery). Most doctors advise a pregnant person not to fly by commercial flight after 36 weeks of pregnancy. In fact, most airlines restrict air travel for pregnant people if they are close to their due date. “As one approaches their due date, the risk of labor exists, and medical care in flight is limited or not available at all,” says Dr. Simmons.

2. Plan for unexpected situations.

Locate the closest obstetric healthcare provider and hospital, regardless of where you’re traveling. “When traveling domestically and internationally, you should ensure that there are options for obstetric care near your destination so that you have a place to go if you experience unexpected symptoms related to your pregnancy while traveling,” says Dr. Simmons.

3. Stay up to date on vaccinations.

Make sure you’re up to date on your flu and COVID-19 vaccines. If you plan to travel internationally, keep in mind that some countries require specific vaccines. While some vaccines are safe during pregnancy, others may not be. “Communicate with your provider as to what vaccines are recommended based on the country to which you plan to travel,” says Dr. Simmons.

4. Take extra precautions when traveling internationally.

It’s best to avoid areas with a high risk of infectious diseases — such as malaria or Zika, two mosquito-borne diseases. Check the Centers for Disease Control and Prevention (CDC) website for current information on countries where Zika and malaria are reported. Dr. Simmons reminds pregnant people that “the main way to mitigate risk with regard to malaria and Zika is to avoid infection altogether.”

If you absolutely must travel to areas where malaria and Zika are reported, you will need to use long-acting insect repellents that are safe for use while pregnant, like EPA-registered bug spray with DEET, picaridin, IR3535, or oil of lemon eucalyptus. Wear long-sleeved shirts and pants to protect against mosquito bites. If you’re going to a malaria-endemic area, your doctor will prescribe anti-malarial pills that are safe during pregnancy.

If you’re in a country where tap water is unsafe to drink, remember to stick with bottled water — even for things like brushing your teeth — to reduce the risk of gastrointestinal (GI) infection.

5. Wear your seat belt low and snug across your hips, not over your belly.

“For comfort and safety, avoid placing your seat belt on top of your pregnant abdomen,” says Dr. Simmons. It should be worn under your belly, just above your hips.

6. If you’re on a long flight or long car ride, get up and move often to help prevent blood clots.

During pregnancy, you are at an increased risk of developing what is called deep vein thrombosis (a blood clot in a deep vein in the body, like in the leg). Sitting for too long, as during a car or plane ride, can exacerbate blood clots. “Avoid sitting or standing in one position for extended periods,” explains Dr. Simmons. Anything you can do to improve blood flow helps. For flights, stand and walk up and down the aisle of the plane every hour. Choosing an aisle seat may make it easier to get up often. For long car rides, try and stop every hour to stretch your legs. If you can’t get up and walk around, “even calf raises in your seat help with circulation when you are sedentary during travel,” says Dr. Simmons.

“Wearing compression socks is another way to promote circulation while on a long trip,” adds Dr. Simmons. These tight-fitting socks reach up to the knees and help with blood flow and circulation.

"Most patients should feel comfortable benefiting from the positive aspects of travel during holidays — by car or by plane — and be able to enjoy their time with friends and family." — Dr. Cassandra Simmons

7. Be prepared with comfortable clothing, snacks, water, and anti-nausea medicines.

Whether you have a two-hour drive or a six-hour flight ahead of you, wear comfortable clothing and shoes. Keep snacks and water on hand as well, “to stay hydrated and keep up with the metabolic demands of being pregnant,” says Dr. Simmons. And if you’re feeling nauseous or have GI discomfort while traveling, Reglan, Dramamine, and Imodium are considered safe to take while pregnant.

8. Mask up and use hand sanitizer.

“I advise my pregnant patients to wear a mask when traveling or when in the presence of large crowds, as an added precaution for safety for themselves and their unborn babies,” says Dr. Simmons. Because COVID-19, RSV, and the flu are all airborne viruses — meaning they spread through tiny respiratory droplets in the air — wearing a mask adds a layer of protection. You may also want to ask family members, friends, and loved ones to take a COVID-19 test prior to large gatherings.

And don’t forget to wash your hands and use hand sanitizer often. Keep sanitizer handy, especially if you are traveling with young children. Keep their hands sanitized as well to help keep your family safe.

9. Upon arrival, avoid any unsafe activities.

“It’s important that you enjoy your planned activities, but try and avoid adventures that may significantly increase your risk of trauma while pregnant,” says Dr. Simmons. For example, if you’re going to an amusement park or participating in an activity that could put you at risk of falling or for sudden jerky movements (like skiing or other high-impact sports), it’s important to proceed cautiously. Stick to lower-impact exercises and sports like jogging, walking, or swimming.

Cassandra Blot Simmons, M.D. , is chief of the Division of General Obstetrics & Gynecology at NewYork-Presbyterian Westchester and NewYork-Presbyterian/Columbia University Irving Medical Center. She is also an assistant professor of obstetrics and gynecology at Columbia University Vagelos College of Physicians and Surgeons. Dr. Simmons specializes in women’s gynecological health and obstetrics care before, during, and after pregnancy.

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How to Make Long Flights More Comfortable When You're Pregnant

By Joanna Carrigan

All products featured on Condé Nast Traveler are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.

Preparing for a newborn can feel like an exhilarating task; on the one hand, there’s a long-anticipated, already much-loved new arrival making an entrance into your life. On the other, getting yourself into a birthing headspace can feel like a marathon. I’ve already lost count of the amount of  stroller reviews , hypno-birthing manuals, crib catalogs, and paint samples I’ve flicked through in my quest for newborn nirvana. 

With that in mind, many couples are now opting to take a break from the organizational overload in the form of a  long-haul babymoon —a pre-birth couples vacation—as a way of spending those last special moments together as a family of two. And in fact, air travel can generally be considered  safe for most expectant mothers , with advice from your doctor recommended. 

“All pregnancies and mums have individual needs and varying circumstances,” says Marie Louise, midwife and author of  The Modern Midwife’s Guide To Pregnancy . “If mums have any health complications or are close to giving birth, travel should be very carefully considered. Otherwise, mums need a break—it’s good to enjoy and relax on your travels.”

Pregnancy can often feel like a long-haul adventure in itself, and whilst the thought of an extensive flight may not jump out at the top of your to-do list, there are ways to make that coveted trip—and any other air travel during pregnancy that comes up—more comfortable.

Below, I’ve curated an essential list for what to pack in your carry-on for air travel during pregnancy, based in part on my own experience traveling to Europe whilst expecting. 

Strategic carry-ons

A great place to start is your carry-on itself, as the right style can help not only to make your essentials more accessible, but the correct product can be re-used as a diaper bag once your pre-baby vacation is a distant happy memory. The key to  choosing the perfect carry-on is not only to be mindful of the airline guidelines set out around dimensions and weight restrictions, but to think from your own perspective about what will be easiest for you to carry. If back issues prevail—a common complaint during pregnancy—a stylish rucksack may be more suitable than a tote. And if you’re looking for post-pregnancy practicality, a duffel can tick that cross-functional box. 

Pregnancy support bands

Glamour takes a back seat with this essential, but your posture and ligaments will thank me later. If you’re flying internationally or just maneuvering your way through a large airport, you may face long walks between terminals, which can place strain on the lower back. Bump support bands are designed to help relieve the pressure that the additional weight of your bump is putting on your back, and therefore can make a sensible addition to your carry-on packing list. 

Anti-nausea pregnancy methods 

Not every foray into the world of parenthood is a smooth one, and unfortunately  nausea and sickness can play a starring role in pregnancy, especially in the early stages. My first 16 weeks of pregnancy were punctuated with frequent trips to the restroom, and with many flights taken during this time, I became accustomed to having to rely on a few tricks to see me through those difficult moments. 

Travel bands can be an excellent way to relieve pregnancy related nausea, and they’ve taken a high-tech turn in recent years. Hypnotherapy podcasts can also be a calming way to reduce feelings of sickness, and are best listened to with noise-canceling headphones and an eye mask . 

Hydrating skincare for expectant mothers 

Pregnancy can present some interesting  skincare dilemmas , with many people experiencing a change at some point across their nine months. Dry patches, oily T-zones, and acne outbreaks are all common complaints. To help skin stay hydrated when flying, there are many pregnancy-safe products out there which can help replenish and restore your skin's natural barrier. La Mer The Mist Facial Spray is a particular favorite of mine—easy to apply, super lightweight, and long-lasting. 

Travel pillows

During pregnancy, ligaments in the hips and back loosen in preparation for birth and this can often cause secondary strain across the top of the shoulders and neck which can be very uncomfortable for expectant mothers. If you’re traveling whilst pregnant, I recommend investing in a travel neck pillow , and packing your pregnancy pillow if you’re flying in a seat with a lie-flat bed. 

Compression socks

“During pregnancy, you are at an increased risk of developing a blood clot,” Louise says. “That’s why compression socks , hydration, and movement—walking, stretching, and circling ankles—is recommended.”

Again, it’s not the most glamorous addition to your carry-on, but this footwear is important nonetheless. Try to stretch your legs every hour or so if possible, with a walk down the aisle or some lower leg exercises. 

While packing a well-stocked carry-on will undoubtedly enhance your flying experience, there are other ways to ensure that you’re prepared for a relaxing trip. Here are my top three tips for flying while pregnant:

Food and beverage choices 

Whilst it’s unlikely you’ll be able to see the full on-board menu in advance, it’s often a good idea to pre-select your meal genre if you’re having  aversions or preferences during your pregnancy. Being able to rule out meat, dairy, or even opt for a lighter option may be preferable for some mothers-to-be. It could be worth packing a couple of extra snacks in your carry-on, just in case. I’ve been stashing ginger tea bags and plenty of dried fruit and nuts ( dried banana chips are a particular craving of mine) to see me through. 

The airport experience

Lounge access can not only be an enjoyable way to kick-off your vacation, it can also be a lifesaver for tired feet. Having access to a clean and comfortable restroom can also often be advantageous, so if your travel tickets don’t include a lounge as standard, it could be worth a  pay-for-access option to give you peace of mind that you’ll be spending time in a calm and restful environment before or in between flights. 

Your travel outfit

While a stylish airport look is always desirable, comfort should definitely reign supreme during this important period, since your body is already coping with so much. Activewear can provide comfort and support during long-haul travel, and there are  plenty of options out there. I look to brands like  Alo Yoga and  Lululemon for pieces that satisfy both the style and comfort stakes. 

• Second Trimester
• Travel During Pregnancy

Top Tips for Traveling While Pregnant

Thinking about planning a trip during your pregnancy? Whether you’re exploring your options for an upcoming babymoon, visiting family across the country or planning a quick girlfriends’ getaway, you likely have questions about traveling while pregnant. Is it better to drive or take the flight? And are there any pregnancy travel restrictions to know about? When should you stop traveling in pregnancy? Keep reading for expert guidance on pregnancy travel safety—plus tips on how to stay comfortable during your trip.

When Is It Safe to Travel While Pregnant?

According to the American College of Obstetricians and Gynecologists (ACOG), as long as you haven’t experienced complications, traveling while pregnant is typically considered safe until you’re close to your due date .

The best time for pregnancy travel is in your second trimester, between 14 and 28 weeks, says Meleen Chuang , MD, an ob-gyn and clinical associate professor at the Family Health Centers at NYU Langone. “The risk of complications is lower during this period,” she says. Plus, most people report feeling more energized, are able to move around easily and are past the worst of their morning sickness during this time.

According to Sherry Ross , MD, an ob-gyn and women’s sexual health expert, some people may also be able to safely travel up to 34 weeks. That said, while most airlines allow pregnant people to fly domestically up to 36 weeks and 28 weeks internationally, some restrictions may apply, so it’s essential to check with the airline beforehand, Chuang notes.

Are There Reasons Not to Travel While Pregnant?

There are some medical conditions that may make it inadvisable for you to travel during pregnancy. However, it’s important to note that most of the following information may only be applicable when taking a flight or traveling internationally. The Centers for Disease Control and Prevention (CDC) cite the following as reasons not to travel while pregnant:

• History of preeclampsia or gestational diabetes
• History of premature labor or premature rupture of membranes
• History of blood clots
• Previous miscarriage or ectopic pregnancy
• History of infertility
• Severe anemia
• A twin or multiples pregnancy
• Placental abnormalities (like placental abruption or placenta previa ) or vaginal bleeding during pregnancy
• An cervical insufficiency and uterine irritability
• Any conditions that can increase risk of preterm labor

It’s important to note that this list is not all-inclusive—and may look vary based on your unique medical history and circumstances. For these reasons, it’s always best to check with your ob-gyn prior to making any extensive travel arrangements.

What to Consider When Planning a Trip During Pregnancy

While it’s okay to travel while pregnant with the green light from your ob-gyn, there are some things you’ll want to consider and prepare for beforehand.

Medical access in case of emergency

No one wants to think about emergencies while traveling or vacationing, but sometimes things can go wrong. For this reason, Chuang recommends picking travel destinations with accessible medical facilities, and researching their prenatal care beforehand. Moreover, you’ll want to make sure your medical insurance covers you while traveling, and that your travel insurance provides coverage for pregnancy-related issues.

As you prepare for your trip, make note of any local emergency numbers and important contacts (like your doctor) and keep them in a handy place. The ACOG also suggests getting a prenatal checkup done before you leave. “Bring a copy of your prenatal records with you,” Chuang advises, as well as a travel health kit with any medications and comfort essentials. And don’t forget to make sure your immunizations are up to date, particularly for the COVID and flu vaccines.

Symptoms that constitute a medical emergency

What constitutes a medical emergency during travel? Below, ACOG notes the following red flag symptoms to watch out for:

• Vaginal bleeding
• Pelvic or abdominal pain
• Contractions
• Fluid leakage (i.e. if your water breaks)
• Persistent headaches
• Seeing spots or changes in eyesight
• Swelling in your hands and face
• Severe vomiting or diarrhea
• Any signs of deep vein thrombosis (warmth, sudden swelling, pain, redness, etc.)
• Discolored spot on leg that’s warm to touch (especially if it’s behind the knee)
• Decreased fetal movement
• Chest pain or shortness of breath

“If you experience any of these symptoms while traveling, seek medical attention immediately,” Chuang says.

Vaccines for international travel during pregnancy

Any pre-travel requirements, such as vaccinations, are a big thing to consider when picking your destination, particularly if you’re traveling internationally. You’ll want to be careful of places that require live-virus vaccines. “Check if any vaccines are recommended or required for your destination, and consult with your healthcare provider to ensure they’re safe during pregnancy,” Chaung says. And be wary of places that have high altitudes and routine infectious outbreaks (i.e. malaria, Zika, etc.), advises Johns Hopkins Medicine .

Where to stay during pregnancy travel

Where you stay will ultimately depend on your personal preferences—and there’s no right or wrong answers. “Whether it’s an Airbnb or a hotel, make sure it meets your needs and comfort level,” Chuang says. One way to help make your decision is to find out what amenities you’ll be offered. You might also want to consider how far your lodgings are from activities and how you’ll be getting around.

Food safety for traveling while pregnant

A healthy diet is key—and you already know there’s a slew of food options you should avoid during pregnancy , such as raw items, unpasteurized dairy and more. While the FDA has select laws in place around pasteurization and food quality in the US, those same rules may not apply in an international destination. You’ll want to take extra precautions to avoid anything that’s undercooked, unpasteurized or has been sitting out for too long.

You’ll also want to stay on top of your hydration needs, and this can be hard while traveling. Make sure the tap water is safe to drink, or opt for bottled water to be safe. “If you’re prone to constipation while you travel, you may want to take a magnesium supplement while you’re away to help keep your bowel movements more regular,” adds Rebekah Mustaleski , CPM, a certified professional midwife and compression director at Motif Medical .

What to Know About Types of Travel During Pregnancy

Wondering if some pregnancy travel methods are safer than others? According to Chuang, it’s usually safe to travel by car, train or boat, as well as by air, if you’ve been cleared by your doctor. Below, some tips to keep in mind depending on your mode of transportation.

Flying while pregnant

Again, always check in with your airline to find out their specific requirements and policies around [flying during pregnancy](( thebump.com/a/flying-while-pregnant ). Some may have documentation required or pregnancy travel restrictions, Chuang says. It may also be helpful to let your airline know you’re pregnant while booking in case they can provide any additional assistance as needed. Another important tip for flying while pregnant? Chuang advises pregnant flyers to stay hydrated and get up to move around from time to time to prevent the risk of blood clots (which pregnant people are already at risk for).

Driving while pregnant

“The decision to drive while pregnant depends on individual comfort and safety,” Chuang says. For some, driving while pregnant may be easier than other methods of transportation. For starters, it allows you to have more room to pack comfort essentials you may not otherwise be able bring, such as a pregnancy pillow , foot rest, extra large bottle of water, etc. Just be sure to wear your seatbelt throughout your journey. According to the National Highway Traffic Safety Administration (NHTSA), buckling up through all stages of pregnancy is the single most effective action you can take to protect you and baby in the event of a crash. Wear your seatbelt correctly by placing it across your chest between your breasts, with the lap belt secured below your belly so that it’s snug across your hips and upper thighs.

Taking a cruise while pregnant

Going on a cruise while pregnant is generally safe, but it’s important to check with the cruise line regarding their policies and any restrictions they may have for pregnant passengers, Chuang says. For example, Royal Caribbean and Celebrity Cruises don’t allow pregnant people travel on their ships past 23 weeks, while Carnival Cruise Lines and Princess Cruise Lines place the cutoff at 24 weeks. One important note if you book a cruise: Make sure there’s medical access on board.

Train or bus travel while pregnant

As long as you’re comfortable and feel safe on your train or bus, using this travel method is usually considered safe for pregnant people, Chuang says. Remember to get up and move around from time to time to improve circulation, Chuang says. She also recommends elevating your legs when possible, doing ankle exercises, wearing compression socks , loose fitting clothing and drinking lots of water to help with swelling. Plus, ensure you have snacks and medicines should you start to feel sick during your travels.

Regardless of how you travel, Ross advises following a healthy routine, staying on top of taking any prenatal vitamins recommended by your doctor and making sure you get movement. If you feel sick after your vacation or have symptoms, reach out to your provider immediately.

When to Stop Traveling When Pregnant

When should you stop traveling when pregnant? “If you’re close to your estimated due date, you may want to stay at home in case you do go into labor,” says Mustaleski. But, again, the timing will vary depending on multiple circumstances and your mode of transportation: “It’s best to consult with your healthcare provider to determine the most appropriate time for you to stop traveling,” Chuang says.

Real Parent Tips for Traveling While Pregnant

When it comes to top tips for traveling while pregnant, few people are able to help the way real parents who’ve been there can. Below, some tips from moms on how to stay comfortable.

“Bake in extra time for everything you do: catching a flight, making road trip pit stops, heading to the beach. Don’t hold yourself to an unrealistic schedule—travel should be relaxing, not stressful. And whatever you do, make sure you bring your maternity pillow . I don’t care what you need to eliminate from your suitcase to accommodate that big bed-hog eye-sore. A comfortable night’s sleep is worth the extra carry-on item!” - Lauren B., mom of three

“Since I wasn’t exactly a speedy walker during the third trimester, it helped to stay in walkable areas where everything is near the hotel. Also—and this might seem obvious—if you’re further along, be sure to stay in places that have elevators (unless you enjoy walking up and down the stairs several times a day while carrying 30 extra pounds on you—in which case, you do you!” - Natalie G., mom of one

“During the first trimester, I’d definitely say bring ginger candies or whatever works for you to fight nausea, because takeoff and landing can provoke it inflight. And choose the aisle set. We all love window seats, but remember that you’ll have to pee 200 times.” - Milena K., mom of two

“Wear compression socks and comfortable shoes. Also dress in layers, since pregnant moms can run hot. And don’t forget to wear sunscreen!” - Ashlee N., mom of two

“I brought along a few books to give me the encouragement and sense of calm I needed during this time of so many unknowns. I found Ina May Gaskin’s Guide to Childbirth inspirational and moving, and it ended up pacifying some of my major concerns around giving birth. Oh, and pantyliners! Don’t forget to pack some pantyliners for unexpected discharge.” - Daniela M., mom of two

While it may seem intimidating, know that traveling during pregnancy is usually completely safe up until around 36 weeks, Chuang says. The best thing you can do for a safe and comfortable trip is consult with your doctor to get their input and advice for your specific pregnancy.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

21 Babymoon Trips and Tips for Real Life Couples

These Are the Most Popular Babymoon Destinations in the World

What to Know About Flying During Pregnancy

Meleen Chuang , MD, is an ob-gyn and clinical associate professor at the Family Health Centers at NYU Langone. She earned her medical degree from SUNY Stony Brook.

Rebekah Mustaleski , CPM-TN, IBCLC, is a certified professional midwife specializing in evidence-based maternity care. She co-founded Roots & Wings Midwifery in Knoxville, Tennessee. Mustaleski received her bachelor’s degree in psychology from Centre College, and worked as a doula and birth photographer prior to establishing Roots & Wings.

Sherry Ross , MD, is an ob-gyn, women’s sexual health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period. and She-ology, The She-quel: Let’s Continue the Conversation . She earned her medical degree from New York Medical College.

American College of Obstetricians and Gynecologists, Travel During Pregnancy , July 2023

Centers for Disease Control and Prevention, Pregnant Travelers: CDC Yellow Book 2024 , May 2023

Johns Hopkins Medicine, Traveling While Pregnant or Breastfeeding , 2023

National Highway Traffic Safety Administration, If You’re Pregnant: Seat Belt Recommendations for Drivers and Passengers

Royal Caribbean International, May I board a Royal Caribbean ship if I am pregnant?

Celebrity Cruises, Medical Needs , 2023

Carnival Corporation, Pregnancy Policy

Princess Cruises, Pregnancy , 2023

Centers for Disease Control and Prevention, Vessel Sanitation Program , August 2023

Learn how we ensure the accuracy of our content through our editorial and medical review process .

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Is it safe to fly during pregnancy?

Generally, air travel before 36 weeks of pregnancy is considered safe for people who aren't dealing with any pregnancy problems. Still, if you're pregnant, it's a good idea to talk with your health care provider before you fly.

Your provider might suggest that you not fly if you have certain pregnancy complications that could get worse because of air travel or that could require emergency care. Examples include a history of miscarriage or vaginal bleeding, severe anemia, and high blood pressure or diabetes that's not well controlled. If you had preeclampsia during a previous pregnancy — a condition that causes high blood pressure and extra protein in urine — flying may not be advised. The same is true if you're pregnant with twins or other multiples.

Tell your provider how far you are flying, as the length of the flight might make a difference. Also, be aware that some airlines may not allow pregnant people on international flights. Check with your airline before you make travel arrangements.

After 36 weeks of pregnancy, your health care provider may advise against flying. And some airlines don't allow pregnant people to fly after 36 weeks. The airline also may require a letter from your health care provider that states how far along in your pregnancy you are and whether flying is advised.

If your health care provider says it's okay for you to fly, and your plans are flexible, the best time to travel by air might be during the second trimester. The risks of common pregnancy emergencies are lowest during that time.

When you fly:

• Buckle up. During the trip, keep your seatbelt fastened when you are seated, and secure it under your belly.
• Drink plenty of fluids. Low humidity in the airplane could cause you to become dehydrated.
• Avoid gassy foods and drinks before you fly. Gases expand during flight, and that could make you uncomfortable. Examples of foods and drinks to avoid include broccoli and carbonated soda.
• Think about medical care. Plan for how you'll get obstetric care during your trip if you need it. Bring copies of your medical information in case you need care while you're away.

Blood clots

Air travel can raise the risk for blood clots in the legs, a condition called venous thrombosis. The risk is higher for pregnant people. Moving your legs may help prevent this problem. Take a walk up and down the aisle every hour during the flight. If you must remain seated, flex and extend your ankles from time to time. In general, it's best to avoid tightfitting clothing, as that can hinder blood flow. Wearing compression stockings can help with blood circulation during a long flight.

Radiation exposure linked to air travel at high altitudes isn't thought to be a problem for most people who fly during pregnancy. But pilots, flight attendants and others who fly often might be exposed to a level of radiation that raises concerns during pregnancy. If you must fly frequently during your pregnancy, talk about it with your health care provider.

Mary Marnach, M.D.

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• Allergy medications during pregnancy
• AskMayoExpert. Health considerations for air travelers: Pregnancy considerations. Mayo Clinic; 2022.
• Air Travel During Pregnancy: ACOG Practice Bulletin No. 746. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/08/air-travel-during-pregnancy. Accessed Dec. 1, 2022.
• Ram S, et al. Air travel during pregnancy and the risk of venous thrombosis. American Journal of Obstetrics and Gynecology. 2022; doi:10.1016/j.ajogmf.2022.100751.

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Is It Safe to Fly During the First Trimester?

With the proper precautions, flying during the first trimester of pregnancy is safe. Here's what you should know about air travel during early pregnancy.

• Myths About Pregnancy and Air Travel

Tips for Flying During Early Pregnancy

The bottom line.

If you're currently pregnant, planning to be, or just curious, it's possible you've wondered about whether or not it's safe to fly during the first trimester. After all, the first three months of pregnancy are crucial, and most instances of pregnancy loss occur during the first trimester, so it's understandable to have questions or concerns about air travel during that time.

However, the good news is that air travel during the first trimester is generally considered safe. Ahead, learn more about flying during early pregnancy, what experts have to say about precautions, and tips for having a safe flight during the first trimester.

Common Myths About Pregnancy and Air Travel

The first trimester is actually an especially low-risk time to travel during pregnancy . Contrary to popular belief, noise vibration, cosmic radiation, and cabin pressure create no increased risks for the pregnant air traveler. And if you were concerned that security equipment could radiate or somehow hurt your baby, set those fears aside. "Metal detectors are not a risk to the baby," says Raul Artal, M.D., vice chairman of the American College of Obstetricians and Gynecologists (ACOG) committee on obstetric practice.

That being said, it's still a good idea to chat with an OB-GYN or health care provider before you schedule your babymoon or any work trips during the first trimester. A health care professional can give you specific, individualized advice, based on your needs and unique pregnancy journey.

Below are a few more travel tips for the first trimester.

Check your health before you go

Travel isn't recommended for those with high-risk pregnancy conditions (hypertension, sickle-cell disease, history of premature labor, placental abnormalities such as placenta previa, etc.) Pregnant people with preexisting medical conditions (like heart disease) should also check with a health care provider before flying.

Move around

One issue of concern for all air passengers—pregnant or not—is the formation of blood clots, or thrombosis, especially during long flights. Pregnant travelers should take special precautions to minimize risks, like wearing support stockings and/or moving your lower extremities every half-hour or so. "Wiggle your toes," Dr. Artal suggests, "Move your legs around, and take a stroll up the cabin every once in a while."

Book a comfortable seat

The aisle seat will make it easier to get up frequently for restroom trips or walking through the cabin. The bulkhead seats, which are located right behind a dividing wall between cabins, tend to have the most legroom. If you're concerned about a bumpy ride, try choosing a seat over a wing, which will give you the smoothest flight.

Make sure you buckle up, keeping the seatbelt low on the hips and under the belly. Flying can be unpredictable when it comes to severe turbulence, which can cause injury. Therefore, it is wise to buckle up and remain buckled while seated throughout the entire flight.

Stay hydrated

The cabin of an aircraft has low humidity, which can cause anyone to have a dry nose and throat. Make sure to drink water throughout the flight to avoid dehydration .

Prevent air sickness

Morning sickness and fatigue often kick in around seven to eight weeks of pregnancy . Ask a health care provider for tips to help with nausea, and inquire about safe anti-nausea medication to take with you, just in case.

Don't drink or eat gas-producing items

Try to avoid consuming food and drinks that are known to cause gas (such as beans, cruciferous vegetables, and carbonated beverages) before or during your flight. Entrapped gas expands at higher altitudes and can give you a stomachache.

Prepare for digestion problems

You may want to ask a health care provider about diarrhea medications or remedies that are safe to use during pregnancy, especially if you are traveling internationally, which can elevate the risk of exposure to bacteria that can cause diarrhea.

Consider updating your vaccinations

Depending on where your final destination is, you may be required to be vaccinated against certain diseases, especially if you're traveling internationally. The Centers for Disease Control and Prevention (CDC) offers a travel vaccine and medication guide that covers travel-related diseases you can be inoculated against from food-borne illnesses to influenza.

Always tell a health care provider about your plans before booking your trip. Depending on your travel plans, you may need to pre-book a prenatal appointment at your destination. Educate yourself on hospitals located near where you will be staying while traveling, and purchase travel insurance.

Check on travel advisories

Before flying anywhere , it is worth checking for any health or travel advisories that could pose a risk to pregnant travelers. The CDC compiles up-to-date data on travel health advisories as well as other safety information for countries around the globe. You can easily look up your destination and check to make sure that there are not any health alerts that could put you or your pregnancy at risk.

Ultimately, flying during the first trimester of pregnancy is considered safe for many people. However, those with pre-existing medical conditions or high-risk pregnancies might be advised to skip air travel during those early weeks. When in doubt, be sure to consult with an OB-GYN or health care provider. Together, you can determine the right course of action and travel plans for you.

ACOG. Early Pregnancy Loss .

ACOG. Air Travel During Pregnancy .

Csorba R, Tsikouras P. Air travel during pregnancy . Hippokratia. 2017 Jan-Mar;21(1):62. PMID: 29904265; PMCID: PMC5997026.

Centers for Disease Control and Prevention. Pregnant? Don't Overlook Blood Clots .

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Travelling while pregnant

Find useful information and considerations to help you prepare for safe and healthy travels outside Canada while pregnant.

With careful preparation, travelling while pregnant can be safe. The decision to travel should be made in consultation with your health care professional, based on your personal health circumstances.

On this page

Before you go, while you're away, if you need help.

Medical practices, health standards and infection control measures vary from country to country. You may not have access to the same level of care, procedures, treatments and medications as you would in Canada.

You could also be at increased risk of getting an infection and/or developing severe complications from certain infections, which could also affect the fetus.

Before leaving Canada:

• consult a health care professional or visit a travel health clinic at least 6 weeks before travelling to get personalized health advice and recommendations
• check our Travel Advice and Advisories for country-specific information, including about possible health risks
• know how to seek medical assistance outside of Canada
• review the policy and the coverage it provides
• most policies do not automatically cover pregnancy-related conditions or hospital care for premature infants
• ask your insurance provider about coverage for medical care during pregnancy, giving birth and intensive care for you and your fetus or newborn
• carry a copy of your prenatal records
• talk to your health care professional about any additional items you may want to bring that are specific to your health needs

Local laws and medical services relating to pregnancy can differ from Canada. Learn the local laws, and how these may apply to you before you travel.

Pre-travel vaccines and medications

Many vaccines can be safely given during pregnancy. Due to a higher risk of more severe outcomes for you and your fetus, some vaccines are recommended specifically during pregnancy, such as tetanus-diphtheria-pertussis (DTaP) and influenza.

Don’t take medications you may still have from prior trips. Tell the health care professional about your pregnancy, or intended pregnancy, before filling any prescriptions. The decision to get any pre-travel vaccinations or medications should be discussed with your health care professional.

The decision can depend on:

• your purpose of travel (e.g., tourism, visiting friends and relatives)
• your planned destination(s)
• the length of your trip
• your risk of getting a disease
• how severe the effect of a disease would be to you and/or your fetus
• your planned activities
• any underlying medical issues and/or pregnancy-related complications

Malaria could cause major health problems for a mother and her unborn baby. A pregnant woman may want to consider avoiding travel to areas where malaria transmission occurs.

Description of malaria risk by country and preventative measures.

If you can’t avoid travelling to an area where malaria is present:

• some medications to prevent or treat malaria may not be safe during pregnancy
• take extra care to protect yourself from mosquito bites

Zika virus infection during pregnancy can pose significant risks to your fetus even if you don’t develop symptoms. While pregnant, you may want to consider avoiding travelling to a country or areas with risk of Zika virus.

Latest travel health advice on Zika virus.

If you choose to travel, take precautions to avoid infection with Zika virus:

• prevent mosquito bites at all times
• protect yourself from contact with semen, vaginal fluid and blood
• always use condoms correctly or avoid sexual contact while in countries or areas with risk of Zika virus

Learn more about Zika virus and pregnancy:

• Zika virus: Pregnant or planning a pregnancy
• Zika virus: Advice for travellers
• Pregnancy and travel (tropical medicine and travel)

Monitor your health and be prepared

Emergencies can happen at any time. Know where the nearest hospital or medical centre is while you are travelling and confirm they will accept your medical insurance.

Seek medical attention immediately if you develop any of the following symptoms while travelling:

• persistent vomiting and/or diarrhea
• dehydration
• vaginal bleeding
• passing tissue or clots
• abdominal pain, cramps or contractions
• your water breaks
• excessive swelling of face, hands or legs
• excessive leg pain
• severe headaches
• visual problems

If you develop these symptoms after your return to Canada, you should see a health care professional immediately and tell them about your recent trip.

Transportation

Always wear a seatbelt when travelling by plane or car. When using a diagonal shoulder strap with a lap belt, the straps should be placed carefully above and below your abdomen. If only a lap belt is available, fasten it at the pelvic area, below your abdomen.

If you have any medical or pregnancy-related complications, discuss with your health care professional whether air travel is safe for you.

Most airlines restrict travel in late pregnancy or may require a written confirmation from a physician. Check this with the airline before booking your flight.

During long flights, you may be at higher risk of developing blood clots, known as deep vein thrombosis (DVT). The risk of deep vein thrombosis can be reduced by:

• getting up and walking around occasionally
• exercising and stretching your legs while seated
• selecting an aisle seat when possible
• wearing comfortable shoes and loose clothing

Your health care professional may recommend additional ways to reduce your risk such as wearing compression stockings.

Always stay well hydrated while travelling.

Land travel

The risk of deep vein thrombosis can be reduced by:

• stopping the vehicle to walk around every couple of hours

Motion sickness

Certain medications used to treat nausea and vomiting during pregnancy may also be effective in relieving motion sickness.

If you think you might experience motion sickness during your trip, speak to your health care professional about the use of these medications.

Environmental and recreational risks

Some activities may not be recommended or may require additional precautions. Discuss your travel plans, including any planned or potential recreational activities with a health care professional.

High altitude

You should avoid travelling to an altitude above 3,658 metres (12,000 feet).

However, if you have a high-risk pregnancy and/or are in the late stages of pregnancy, the highest altitude should be 2,500 metres (8,200 feet).

If you have pregnancy-related complications, you should avoid unnecessary high-altitude exposure.

Keep in mind that most high-altitude destinations are far from medical care services.

Personal protective measures

Food-borne and water-borne diseases.

Eat and drink safely while travelling while travelling. Many food-borne and water-borne illnesses can be more severe during pregnancy and pose a risk to the fetus.

This can include:

• toxoplasmosis
• listeriosis
• hepatitis A and E

To help avoid food-borne and water-borne diseases:

• before eating or preparing food
• after using the bathroom or changing diapers
• after contact with animals or sick people
• before and after touching raw meat, poultry, fish and seafood
• if you’re at a destination that lacks proper sanitation and/or access to clean drinking water, only drink water if it has been boiled or disinfected or if it’s in a commercially sealed bottle
• use ice made only from purified or disinfected water
• this could cause the fetus or newborn to develop thyroid problems
• unpasteurized dairy products, such as raw milk and raw milk soft cheeses
• unpasteurized juice and cider
• raw or undercooked eggs, meat or fish, including shellfish
• raw sprouts
• non-dried deli meats, including bologna, roast beef and turkey breast
• don’t use bismuth subsalicylate (Pepto-Bismol®)
• Information on travellers’ diarrhea

Illnesses acquired from insect and other animals

Protect yourself from insect bites:

• wear light-coloured, loose clothes made of tightly woven materials such as nylon or polyester
• prevent mosquitoes from entering your living area with screening and/or closed, well-sealed doors and windows
• use insecticide-treated bed nets if mosquitoes can’t be prevented from entering your living area
• information on insect bite and pest prevention

Some infections, such as rabies and influenza, can be shared between humans and animals. You should avoid contact with animals including dogs, livestock (pigs, cows), monkeys, snakes, rodents, birds, and bats.

Information for if you become sick or injured while travelling outside Canada.

For help with emergencies outside Canada, contact the:

• nearest Canadian office abroad
• Emergency Watch and Response Centre in Ottawa

More information on services available at consular offices outside Canada.

Related links

• Immunization in pregnancy and breastfeeding: Canadian Immunization Guide
• Advice for Canadians travelling to Zika-affected countries
• Advice for women travellers
• If you get sick before or after returning to Canada
• Receiving medical care in other countries
• Travel vaccinations
• What you can bring on a plane
• Tips for healthy travel

Healthy Pregnancy

Tips For Having a Healthy Pregnancy

Traveling While Pregnant: Tips and Cautions for Traveling During the Third Trimester

In today’s modern world, it’s often necessary to travel while you’re pregnant. While it’s best to restrict your activity during the third trimester, it’s still possible to travel safely provided you adhere to some basic principles. The comfort levels and safety of traveling while pregnant vary dramatically from one month to the other. Traveling during the first two trimesters is generally regarded as safe with no restrictions. The first trimester is often completely safe, but you may experience a bit more fatigue during this time. Only pregnant women that have been advised by their doctor to avoid travel during the first two trimesters should be concerned. Generally, airlines will prohibit you from traveling in your ninth month of pregnancy and some may limit your travel before then.

The Case for Avoiding Travel

Complications of Pregnancy

While most women can travel throughout the majority of their pregnancy and into the beginning of their third trimester, there are some women who should minimize all travel. Women who experience preterm contractions, pregnancy-induced hypertension, bleeding or gestational diabetes should limit their travel at all stages. If you feel a need to travel with any of these conditions, aim for short trips that are close to home. Often, you can find enjoyable activities within a 30-minute drive of any location. Your pregnancy is a good time to become more familiar with your home and area if you are in the high-risk pregnancy group.

Best Modes of Travel

Traveling by train is another good option for your first two trimesters. It should generally be avoided in the third trimester, but at other times it can be an enjoyable way of going a long distance. Traveling by train offers the convenience of a bathroom when you need it, comfortable seats and the ability to walk around whenever needed.

Boat traveling is also okay during the first two trimesters. Since most boats have medical personnel available, you should be able to get the help you need should a problem arise. Check with the cruise ship to ensure they will be able to accommodate you. Some insurance plans may not cover issues that occur aboard boats during a pregnancy since it’s not seen as an essential mode of transportation.

Flying is a good option during your first two trimesters, but many airlines may prohibit you from traveling during the third trimester without a recent note from your doctor. In some cases, they may not allow travel at all. It’s important to check with the airline you plan to travel with ahead of your travel dates to ensure you won’t experience any issues with the airline’s policies. If you have connecting flights, leave enough time to get between flights so that you don’t have to hurry. Drink lots of water or juice and wear support hose while flying to keep your circulation going.

When to Avoid Travel

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Traveling Abroad While Pregnant: Is It Safe?

• Last updated Jun 25, 2024
• Difficulty Beginner

• Category Travel

Travelling during pregnancy requires extra care and planning, but it is possible to travel safely during the second trimester, usually between 4 and 6 months. It is important to consult a doctor or midwife before travelling, especially if there are pregnancy complications, and to be aware of any relevant travel advisories and restrictions.

Travelling abroad when 4 months pregnant

What you'll learn, the best time to travel during pregnancy is mid-pregnancy, between 4 and 6 months, pregnant women should avoid travelling to developing nations, pregnant women should be cautious of taking medications, pregnant women should take precautions to avoid food poisoning, pregnant women should consider the quality of medical care at their destination.

Travelling during pregnancy can be safe and enjoyable, especially if you take some precautions and plan ahead. Most women can travel safely well into their pregnancy, but it's always a good idea to consult your doctor or midwife before making any travel plans. They can advise you on any potential risks and ensure you have the necessary information and preparations in place.

During mid-pregnancy, you're also more mobile than in the later stages. After 28 weeks, it may become more challenging to move around or sit for extended periods, so travelling between 4 and 6 months can be more comfortable. This period offers a window of opportunity to enjoy a holiday before the final months of pregnancy, when travelling can become tiring and uncomfortable.

When travelling during mid-pregnancy, it's essential to take some precautions. Ensure you have adequate travel insurance that covers any pregnancy-related eventualities, such as medical care during labour or premature birth. It's also a good idea to find out about healthcare facilities at your destination and carry your maternity medical records with you.

To minimise the risk of blood clots (deep vein thrombosis or DVT), stay hydrated by drinking plenty of water and move around regularly, especially on long journeys. Compression stockings can also help increase blood flow in your legs and prevent DVT. Additionally, be cautious when taking medications, as some commonly used travel medicines may not be suitable during pregnancy.

In summary, the best time to travel during pregnancy is between 4 and 6 months. With the right preparations and by following your healthcare provider's advice, you can have a safe and enjoyable trip during this exciting time in your life.

Is it Safe to Travel to London During the Coronavirus Outbreak?

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Some vaccines, such as for yellow fever, may cautiously be given after the first trimester, but it is recommended that pregnant women delay any travel to developing nations until after their babies are born. Malaria is also an infection carried by mosquitoes that is prevalent in developing nations, and a pregnant woman who catches malaria risks miscarriage, premature labour and stillbirth.

In addition, Zika virus is mainly spread by mosquitoes found in some parts of the world, and while it is mild for most people, it can cause problems for pregnant women. It is not recommended to travel to parts of the world where the Zika virus is present, such as parts of South and Central America.

Furthermore, food-borne and water-borne diseases are more common in developing nations, and pregnant women should take extra care to avoid these. In developing nations, only eat fruit that you have peeled yourself, and avoid leafy greens and salads, as they could have been washed in contaminated water. Drink bottled water if you are unsure of the water supply, and use bottled water when brushing your teeth.

The Ultimate Guide on How to Travel from Dublin Airport to Belfast

Pregnant women can generally travel abroad when they are four months pregnant, which is considered the second trimester of pregnancy. This is usually considered the safest time to travel, provided there are no complications with the pregnancy. However, it is important to consult a doctor before planning travel, especially for high-risk pregnancies. Taking certain precautions, such as having adequate travel insurance and knowing the healthcare facilities at the destination, can also help ensure a safe trip.

Pregnant women should indeed be cautious of taking medications, as some medicines may have harmful effects on the unborn baby, including birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities. It is important to consult a doctor before taking any medications, even those commonly used to treat traveller's diarrhoea, as some medicines may not be suitable during pregnancy. Over-the-counter medications should also be used with caution and only if necessary. Prenatal vitamins are generally considered safe, but other vitamins, herbal remedies, and supplements have not been proven safe during pregnancy.

The effects of many medications on the unborn baby are still unknown, and most medications have not been adequately studied for their safety during pregnancy. Therefore, it is crucial for pregnant women to discuss the risks and benefits of any medications with their doctor, including prescription and over-the-counter drugs. If a woman was taking prescription medications before becoming pregnant, she should consult her doctor about the safety of continuing those medications. The doctor will weigh the benefits against the risks and advise accordingly.

Additionally, alternative therapies and natural products should also be used with caution during pregnancy. While some alternative therapies, such as acupuncture, acupressure, and ginger root, have been shown to be safe and effective for relieving pregnancy symptoms, many other "natural" products have not been adequately tested for safety and effectiveness. Therefore, it is important to consult a doctor before taking any alternative therapies or natural remedies during pregnancy.

Furthermore, travel vaccinations during pregnancy require special consideration. Most vaccines that use live bacteria or viruses are not recommended during pregnancy due to potential harm to the baby. However, some live travel vaccines may be considered if the risk of infection outweighs the risk of live vaccination. Non-live (inactivated) vaccines are generally safe to use during pregnancy. Pregnant women should also be cautious when taking anti-malaria tablets, as some are not safe during pregnancy.

10 Best Places to Solo Travel in Indonesia

Pregnant women can travel abroad, and the second trimester (between 4 and 6 months) is often considered the safest time to do so. However, it is important to take certain precautions, such as consulting with a doctor, especially if the pregnancy is high-risk, and ensuring that travel insurance covers any pregnancy-related eventualities.

Pregnant women should also be cautious about food poisoning when travelling, as their weakened immune systems make them more susceptible to foodborne illnesses. Here are some precautions that pregnant women should take to avoid food poisoning:

• Wash hands thoroughly with soap and water before and after handling food.
• Keep raw foods separate from ready-to-eat foods.
• Avoid raw or unpasteurized dairy products.
• Thoroughly cook raw meat using a meat thermometer if needed.
• Avoid packaged meats, if possible.
• Wash fruits and vegetables well before consumption.
• Store perishable foods safely in the refrigerator or freezer.
• Pay attention to expiration dates and store foods in the freezer to retain optimum freshness.
• Defrost foods in the refrigerator or microwave instead of leaving them at room temperature.
• Avoid uncooked or raw meat, poultry, seafood, and eggs.
• Do not consume unpasteurized fruit or vegetable juices.
• Stay away from soft cheeses and meat spreads that are not canned or jarred.
• Avoid pre-made chicken, ham, or seafood salads from a deli.
• Do not consume smoked fish unless it is canned or cooked.
• Only drink bottled water or water from a trusted source when travelling to areas with questionable water quality.

By following these precautions, pregnant women can significantly reduce their risk of food poisoning and its potential complications.

Keeping Condoms Cool: Essential Tips for Travelers

Pregnant women should take several precautions when travelling abroad, and one of the most important considerations is the quality of medical care at their destination. Before booking a trip, it is recommended that pregnant women discuss their travel plans with their GP, practice nurse, midwife, or obstetrician. They can provide advice on the potential risks and ensure that all early pregnancy examinations are carried out before departure.

When considering the quality of medical care at the destination, pregnant women should research the availability and standard of medical care, existing health risks in the country, and any travel warnings. The Foreign, Commonwealth and Development Office (FCDO) website is a valuable resource for this information. It is also essential to ensure that the available medical facilities are equipped to handle pregnancy-related complications, especially after 28 weeks of pregnancy.

Pregnant women should also be aware of potential language barriers or cultural differences that could impact the diagnosis and treatment of any illnesses or complications. In addition, it is crucial to have adequate travel insurance that covers both the mother and the unborn child in case of any pregnancy-related issues or emergencies.

To summarise, by carefully considering the quality of medical care at their destination, pregnant women can help ensure their safety and well-being while travelling abroad. This includes seeking professional advice, researching medical facilities and risks, addressing language barriers, and obtaining appropriate travel insurance coverage.

Exploring the Possibilities: Can I Travel with an Approved U Visa?

Frequently asked questions.

Yes, it is generally considered safe to travel abroad when you are 4 months (16 weeks) pregnant, as this falls within the second trimester, which is often cited as the best time to travel during pregnancy. However, it is important to consult with your doctor or midwife before travelling, especially if your pregnancy is high-risk.

Before booking your trip, it is recommended that you consult with your doctor and share the trip details. If you get cleared for flying, there are some additional precautions you can take before and during your flight to ensure a safe and healthy journey. These include:

- Checking the policies of the airline you are flying with regarding pregnant travellers. Some airlines may require a letter from your doctor or midwife confirming your due date and that you are fit to fly.

- Reviewing your insurance plan to ensure it covers any medical costs and allows for trip cancellation due to pregnancy-related issues.

- If travelling internationally, consider purchasing supplemental insurance for overseas coverage and medical evacuation insurance in case you need to be flown home for medical care.

- A few weeks or months before your trip, visit your doctor to get cleared for takeoff, especially if you have any chronic medical issues.

- Ask your doctor about any nausea remedies if you are prone to motion sickness.

- Discuss gas and diarrhoea remedies with your doctor, as international travel may expose you to bacteria that can cause diarrhoea.

- Plan your prenatal care and identify medical facilities and doctors at your destination, in case you need them.

- Ask your doctor about any necessary vaccinations, such as the flu vaccine, before travelling.

Here are some tips to make your flight more comfortable:

- Stay hydrated by drinking plenty of fluids throughout the flight.

- Bring healthy snacks to stick to your regular eating plan.

- Bring items that will make you more comfortable, such as an extra pillow or warm socks.

- Walk around the cabin every half hour during a smooth flight to improve blood circulation.

- Flex and extend your ankles frequently to boost circulation, especially if you experience turbulence and cannot walk around.

- Choose an aisle seat to make it easier to get up and move around or go to the bathroom.

- Opt for a bulkhead seat for extra legroom or a seat over the wing for a smoother ride.

Yes, while activities like walking and swimming are generally considered safe during pregnancy, it is recommended to avoid any activities where you might fall. It is also important to take extra care to avoid food and water that could cause stomach upsets, as some medications for treating diarrhoea may not be suitable during pregnancy.

Long-distance travel, particularly air travel, can increase the risk of deep vein thrombosis (DVT), which is the formation of blood clots in the deep veins of the leg, calf, or pelvis. This risk is higher in pregnant women due to increased blood pooling in the legs when sitting for long periods. To mitigate this risk, it is recommended to:

- Drink plenty of water and move around regularly during the flight.

- Wear graduated compression or support stockings to improve blood flow and reduce leg swelling.

- Consult with your doctor or midwife about any additional precautions or medications that may be needed.

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• Arjun Yadav Author Editor Reviewer

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Tips for getting baby back on schedule after travel.

Traveling with a baby requires a lot – a lot of flexibility, a lot of luggage, a lot of patience. Whether you’re traveling for the holidays, to visit family, or just for fun, going away with an infant can take a little bit more planning.

Taking your baby on vacation also requires a bit of acceptance – any change to your baby’s daily routine will likely affect your baby’s sleep schedule. Even if you try hard to keep your baby’s feeding and sleep schedule consistent when traveling and bring along some of the comforts from home, the likelihood of some part of the schedule shifting is inevitable.

In this article, we'll tackle some of the most common questions you may have about getting a baby back on schedule after a vacation, which includes how to help your baby to adjust to a different time zone and whether you need to revisit sleep training when you get home from vacation. We’ll also give you advice straight from sleep consultants on how to get your baby back on schedule after you get home from a trip.

How Does Traveling Impact My Baby’s Sleep?

Any change in your baby’s routine, whether it be a shift in naptime, change in environment, or new time zone, may impact your baby’s sleep schedule. Despite your best efforts to maintain consistency, sometimes even just the excitement of travel can make it harder for your baby to sleep.

Not being in their familiar sleeping space or different sleeping arrangements might also cause some changes to when they sleep.

Travelling with your baby can also lead to some new habits that they may continue to rely on when they get home. For example, if you are sharing a hotel room with your baby, they may become used to you sleeping nearby. Other times, if a strange environment makes it harder for them to settle to sleep and you help them by rocking or feeding them, they may develop a sleep association that’s continued when you get home.

However, as with anything, how travel affects your baby’s sleep schedule differs from little one to little one!

Tips to Help Your Baby Readjust to Their Schedule After Traveling Locally

If your baby’s sleep schedule is thrown after getting back from a vacation, don’t stress –sleep struggles and sleep regressions are normal after traveling. Even if you’re in the same time zone or just gone for a weekend, any disruption to your baby’s normal sleep schedule can be a trigger!

Here are tips for adjusting to getting home: If you were able to keep your baby on the same sleep schedule while on vacation, stick with it! It’s helpful to stay as close as possible to your baby's regular schedule if you’re staying in the same time zone.

If your baby’s sleep schedule shifts during travel though, don’t worry. There are ways to get them back on track quickly.

Slowly Readjust Their Schedule: When you get home you can start by putting them to bed at the same time they slept during your trip. Over the next few days adjust their bedtime by 15 minutes closer to their usual bedtime.

For example: if your baby usually goes to bed at 7:00 PM but goes down closer to 8:30 PM while you are away, continue with an 8:30 PM bedtime on your first night home. The next night try for 8:15 PM and then 8:00 PM the following night. Keep shifting back 15 minutes until you’re back on your schedule pre-travel.

Restart Their Bedtime Routine: A consistent bedtime routine and a calm sleep environment can signal that it’s time for sleep. Getting your baby back on track with their nightly routine is key for helping them readjust to being home from vacation.

Revisit Sleep Training: If you had implemented a sleep training approach before your trip, it can be helpful to reinforce that approach when you get home. Often this helps them get back in the swing of sleep fast. If your baby is still struggling with bedtime after vacation or you want to explore sleep training now that you’re home, the Smart Sleep Coach by Pampers™ can walk you step-by-step through a sleep training method of your choice to help you get your baby back on track after travel.

How to Return Home from a Different Time Zone with a Baby

Traveling home from east to west time zone with baby.

The first night home, put your baby down for sleep at the same time you put them to sleep while away according to the clocks

The next morning, wake your baby at their normal time, according to their schedule before you went away – the sunlight helps them realign with their circadian rhythm

The second night, shift bedtime a little closer to their usual bedtime before your trip – after a few nights their baby’s bedtime should be back to what it was before your trip

If your trip is longer than a week, some parents choose to start shifting your baby’s bedtime closer to their “home” bedtime a few days before they go home. For shorter trips, it’s often easiest to just wait until you get home.

Traveling home from west to east time zone with baby

The first night home, put your baby down to sleep at the same time you put them to sleep according to their bedtime when they were away. For example, if you live in New York and were visiting California where your baby went to sleep at 7PM PT, when you return home put your baby to sleep at 10PM ET.

The next morning wake them up at their normal wake up time at home. Get them outside – they may be a little cranky but it’ll help them adjust to being home!

That night, put them to sleep about 15 minute to 30 minutes closer to when they usually go to bed. For example, try 9:30PM ET if you were in California.

Continue waking your baby at their usual wake time and putting them to sleep closer to their usual bedtime until all is back to normal.

Do I Need to Sleep Train Again After Travel?

A common question sleep consultants are asked by parents going on vacation with a baby is, “Do I need to sleep train again after travel?”

Regardless of if you are changing time zones or not, if you sleep trained your baby in the past you may find that revisiting that sleep training approach can help your baby readjust to their sleep schedule.

If previously successful, sleep training can quickly remind your baby that it’s bedtime, helping them fall asleep faster and readjust to home after vacation faster.

If you're new to sleep training or interested in learning about what approach may work for your baby and parenting style, take this free 3-minute sleep quiz and get a personalized plan tailored to you.

The Bottom Line

Traveling with a baby can be wonderful – yet stressful. While a disruption to your baby’s sleep schedule may be inevitable when you go on vacation, there are ways to make the readjustment period when you return home easier for both you and your baby.

Don’t let concern of your baby’s sleep schedule while traveling deter you from getting out and exploring the world with them! There are ways to get them back on track when you get back to reality.

How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.

• “Developing circadian rhythmicity in infants,” Pediatrics.
• “Disruption of Circadian Rhythms by Light During Day and Night,” Current Sleep Medicine Reports.
• “The development of circadian rhythms in a human infant,” Sleep.

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High Elevation Travel & Altitude Illness

Cdc yellow book 2024.

Author(s): Peter Hackett, David Shlim

Acclimatization

Altitude illness, medications, preventing severe altitude illness or death.

Typical high-elevation travel destinations include Colorado ski resorts with lodgings at 8,000–10,000 ft (≈2,440–3,050 m); Cusco, Peru (11,000 ft; ≈3,350 m); La Paz, Bolivia (12,000 ft; ≈3,650 m); Lhasa, Tibet Autonomous Region (12,100 ft; ≈3,700 m); Everest base camp, Nepal (17,700 ft; ≈5,400 m); and Mount Kilimanjaro, Tanzania (19,341 ft; ≈5,900 m). High-elevation environments expose travelers to cold, low humidity, increased ultraviolet radiation, and decreased air pressure, all of which can cause health problems. The biggest concern, however, is hypoxia, due to the decreased partial pressure of oxygen (PO2). At 10,000 ft (≈3,050 m), for example, the inspired PO2 is only 69% of that at sea level; acute exposure to this reduced PO2 can lower arterial oxygen saturation to 88%–91%.

The magnitude and consequences of hypoxic stress depend on the elevation, rate of ascent, and duration of exposure; host genetic factors may also contribute. Hypoxemia is greatest during sleep; day trips to high-elevation destinations with an evening return to a lower elevation are much less stressful on the body. Because of the key role of ventilation, travelers must avoid taking respiratory depressants at high elevations.

The human body can adjust to moderate hypoxia at elevations ≤17,000 ft (≈5,200 m) but requires time to do so. Some acclimatization to high elevation continues for weeks to months, but the acute process, which occurs over the first 3–5 days following ascent, is crucial for travelers. The acute phase is associated with a steady increase in ventilation, improved oxygenation, and changes in cerebral blood flow. Increased red cell production does not play a role in acute acclimatization, although a decrease in plasma volume over the first few days does increase hemoglobin concentration.

Altitude illness can develop before the acute acclimatization process is complete, but not afterwards. In addition to preventing altitude illness, acclimatization improves sleep, increases comfort and sense of well-being, and improves submaximal endurance; maximal exercise performance at high elevation will always be reduced compared to that at low elevation.

Travelers can optimize acclimatization by adjusting their itineraries to avoid going “too high too fast” (see  Box 4-08 ). Gradually ascending to elevation or staging the ascent provides crucial time for the body to adjust. For example, acclimatizing for a minimum of 2–3 nights at 8,000–9,000 ft (≈2,450–≈2,750 m) before proceeding to a higher elevation is markedly protective against acute mountain sickness (AMS). The Wilderness Medical Society recommends avoiding ascent to a sleeping elevation of ≥9,000 ft (≈2,750 m) in a single day; ascending at a rate of no greater than 1,650 ft (≈500 m) per night in sleeping elevation once above 9,800 ft (≈3,000 m); and allowing an extra night to acclimatize for every 3,300 ft (≈1,000 m) of sleeping elevation gain. These reasonable recommendations can still be too fast for some travelers and annoyingly slow for others.

Box 4-08 Acclimatization tips: a checklist for travelers

☐ Ascend gradually. ☐ Avoid going directly from low elevation to >9,000 ft (2,750 m) sleeping elevation in 1 day. ☐ Once above 9,000 ft (≈2,750 m), move sleeping elevation by no more than 1,600 ft (≈500 m) per day, and plan an extra day for acclimatization every 3,300 ft (≈1,000 m). ☐ Consider using acetazolamide to speed acclimatization if abrupt ascent is unavoidable. ☐ Avoid alcohol for the first 48 hours at elevation. ☐ If a regular caffeine user, continue using to avoid a withdrawal headache that could be confused with an altitude headache. ☐ Participate in only mild exercise for the first 48 hours at elevation. ☐ A high-elevation exposure (> 9,000 ft [≈2,750 m]) for ≥2 nights, within 30 days before the trip, is useful, but closer to the trip departure is better.

Risk to Travelers

Susceptibility and resistance to altitude illness are, in part, genetically determined traits, but there are no simple screening tests to predict risk. Training or physical fitness do not affect risk. A traveler’s sex plays a minimal role, if any, in determining predisposition. Children are as susceptible as adults; people aged >50 years have slightly less risk. Any unacclimatized traveler proceeding to a sleeping elevation of ≥8,000 ft (≈2,450 m)—and sometimes lower—is at risk for altitude illness. In addition, travelers who have successfully adjusted to one elevation are at risk when moving to higher sleeping elevations, especially if the elevation gain is >2,000–3,000 ft (600–900 m).

How a traveler previously responded to high elevations is the most reliable guide for future trips, but only if the elevation and rate of ascent are similar, and even then, this is not an infallible predictor. In addition to underlying, inherent baseline susceptibilities, a traveler’s risk for developing altitude illness is influenced by 3 main factors: elevation at destination, rate of ascent, and exertion ( Table 4-04 ). Creating an itinerary to avoid any occurrence of altitude illness is difficult because of variations in individual susceptibility, as well as in starting points and terrain. The goal for the traveler might not be to avoid all symptoms of altitude illness but to have no more than mild illness, thereby avoiding itinerary changes or the need for medical assistance or evacuation.

Table 4-04 Risk categories for developing acute mountain sickness (AMS)

RISK CATEGORY

DESCRIPTION

PROPHYLAXIS RECOMMENDATIONS

• People with no prior history of altitude illness ascending to <9,000 ft (2,750 m)
• People taking ≥2 days to arrive at 8,200–9,800 ft (≈2,500–3,000 m), with subsequent increases in sleeping elevation <1,600 ft (≈500 m) per day, and an extra day for acclimatization every 3,300 ft (1,000 m) increase in elevation

Acetazolamide prophylaxis generally not indicated

• People with prior history of AMS and ascending to 8,200–9,200 ft (≈2,500–2,800 m) elevation (or above) in 1 day
• People with no history of AMS ascending to >9,200 ft (2,800 m) elevation in 1 day
• All people ascending >1,600 ft (≈500 m) per day (increase in sleeping elevation) at elevations >9,900 ft (3,000 m), but with an extra day for acclimatization every 3,300 ft (1,000 m)

Acetazolamide prophylaxis would be beneficial and should be considered

• People with a history of AMS ascending to >9,200 ft (≈2,800 m) in 1 day
• All people with a prior history of HAPE or HACE
• All people ascending to >11,400 ft (≈3,500 m) in 1 day
• All people ascending >1,600 ft (≈500 m) per day (increase in sleeping elevation) at elevations >9,800 ft (≈3,000 m), without extra days for acclimatization
• People making very rapid ascents (e.g., <7-day ascent of Mount Kilimanjaro)

Acetazolamide prophylaxis strongly recommended

Abbreviations: HACE, high-altitude cerebral edema; HAPE, high-altitude pulmonary edema

Destinations of Risk

Some common high-elevation destinations require rapid ascent by a non-pressurized airplane to >11,000 ft (≈3,400 m), placing travelers in a high-risk category for AMS. A common travel medicine question is whether to recommend acetazolamide for travelers when gradual or staged acclimatization is not feasible. With rates of altitude illness approaching 30%–40% in these situations, a low threshold for chemoprophylaxis is advised. In some cases (e.g., Cusco and La Paz), travelers can descend to elevations much lower than the airport to sleep for 1–2 nights and then begin their ascent, perhaps obviating the need for medication.

Itineraries along some trekking routes in Nepal, particularly Everest base camps, push the limits of many people’s ability to acclimatize. Even on standard schedules, incidence of altitude illness can approach 30% at the higher elevations. Whenever possible, adding extra days to the trek can make for a more enjoyable and safer climb.

Altitude Illness Syndromes

Altitude illness is divided into 3 syndromes: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). Some clinicians consider high-altitude headache a separate entity because isolated headache can occur without the combined symptoms that define AMS.

Acute Mountain Sickness

AMS is the most common form of altitude illness, affecting 25% of all visitors sleeping at elevations >8,000 ft (≈2,450 m) in Colorado.

Diagnosis of AMS is based on a history of recent ascent to high elevation and the presence of subjective symptoms. AMS symptoms are like those of an alcohol hangover; headache is the cardinal symptom, usually accompanied by ≥1 of the following: anorexia, dizziness, fatigue, nausea, or, occasionally, vomiting. Uncommonly, AMS presents without headache. Symptom onset is usually 2–12 hours after initial arrival at a high elevation or after ascent to a higher elevation, and often during or after the first night. Preverbal children with AMS can develop loss of appetite, irritability, and pallor. AMS generally resolves within 12–48 hours if travelers do not ascend farther.

The condition is typically self-limited, developing and resolving over 1–3 days. Symptoms starting after 3 days of arrival to high elevation and without further ascent should not be attributed to AMS. AMS has no characteristic physical findings; pulse oximetry is usually within the normal range for the elevation, or slightly lower than normal.

The differential diagnosis of AMS is broad; common considerations include alcohol hangover, carbon monoxide poisoning, dehydration, drug intoxication, exhaustion, hyponatremia, and migraine. Travelers with AMS will improve rapidly with descent ≥1,000 ft (≈300 m), and this can be a useful indication of a diagnosis of AMS.

Although rarely available, supplemental oxygen at 1–2 liters per minute will relieve headaches within about 30 minutes and resolve other AMS symptoms over hours. The popular small, handheld cans of compressed oxygen can provide brief relief, but contain too little oxygen (5 liters at most) for sustained improvement. Travelers with AMS but without HACE or HAPE (both described below) can remain safely at their current elevation and self-treat with non-opiate analgesics (e.g., ibuprofen 600 mg or acetaminophen 500 mg every 8 hours) and antiemetics (e.g., ondansetron 4 mg orally disintegrating tablets).

Acetazolamide speeds acclimatization and resolves AMS, but is more commonly used and better validated for use as prophylaxis. Dexamethasone is more effective than acetazolamide at rapidly relieving the symptoms of moderate to severe AMS. If symptoms worsen while the traveler is at the same elevation, or despite supplemental oxygen or medication, descent is mandatory.

High-Altitude Cerebral Edema

As an encephalopathy, HACE is considered “end stage” AMS. Fortunately, HACE is rare, especially at elevations <14,000 ft (≈4,300 m). HACE is often a secondary consequence of the severe hypoxemia that occurs with HAPE.

Unlike AMS, HACE presents with neurological findings, particularly altered mental status, ataxia, confusion, and drowsiness, similar to alcohol intoxication. Focal neurologic findings and seizures are rare in HACE; their presence should lead to suspicion of an intracranial lesion, a seizure disorder, or hyponatremia. Other considerations for the differential diagnosis include carbon monoxide poisoning, drug intoxication, hypoglycemia, hypothermia, and stroke. Coma can ensue within 24 hours of onset.

In populated areas with access to medical care, HACE can be treated with supplemental oxygen and dexamethasone. In remote areas, initiate descent for anyone suspected of having HACE, in conjunction with dexamethasone and oxygen, if available. If descent is not feasible, supplemental oxygen or a portable hyperbaric device, in addition to dexamethasone, can be lifesaving. Coma is likely to ensue within 12–24 hours of the onset of ataxia in the absence of treatment or descent.

High-Altitude Pulmonary Edema

HAPE can occur by itself or in conjunction with AMS and HACE; incidence is roughly 1 per 10,000 skiers in Colorado, and ≤1 per 100 climbers at >14,000 ft (≈4,300 m).

Early diagnosis is key; HAPE can be more rapidly fatal than HACE. Initial symptoms include chest congestion, cough, exaggerated dyspnea on exertion, and decreased exercise performance. If unrecognized and untreated, HAPE progresses to dyspnea at rest and frank respiratory distress, often with bloody sputum. This typical progression over 1–2 days is easily recognizable as HAPE, but the condition sometimes presents only as central nervous system dysfunction, with confusion and drowsiness.

Rales are detectable in most victims. Pulse oximetry can aid in making the diagnosis; oxygen saturation levels will be at least 10 points lower in HAPE patients than in healthy people at the same elevation. Oxygen saturation values of 50%–70% are common. The differential diagnosis for HAPE includes bronchospasm, myocardial infarction, pneumonia, and pulmonary embolism.

In most circumstances, descent is urgent and mandatory. Administer oxygen, if available, and exert the patient as little as possible. If immediate descent is not an option, use of supplemental oxygen or a portable hyperbaric chamber is critical.

Patients with mild HAPE who have access to oxygen (e.g., at a hospital or high-elevation medical clinic) might not need to descend to a lower elevation and can be treated with oxygen over 2–4 days at the current elevation. In field settings, where resources are limited and there is a lower margin for error, nifedipine can be used as an adjunct to descent, oxygen, or portable hyperbaric oxygen therapy. A phosphodiesterase inhibitor can be used if nifedipine is not available, but concurrent use of multiple pulmonary vasodilators is not recommended. Descent and oxygen are much more effective treatments than medication.

Recommendations for use and dosages of medications to prevent and treat altitude illness are outlined in  Table 4-05 .

Table 4-05 Recommended medication dosing to prevent & treat altitude illness

Abbreviations: AMS, acute mountain sickness; HACE, high-altitude cerebral edema; HAPE, high-altitude pulmonary edema; IM, intramuscular; IV, intravenous; PO, by mouth; SR, sustained release. 1 This dose can also be used as an adjunct to dexamethasone for HACE treatment; dexamethasone remains the primary treatment for HACE. 2 Use only in conjunction with oral medications and not as monotherapy for HAPE prevention.

Acetazolamide

Mechanism of action.

When taken preventively, acetazolamide hastens acclimatization to high-elevation hypoxia, thereby reducing occurrence and severity of AMS. It also enhances recovery if taken after symptoms have developed. The drug works primarily by inducing a bicarbonate diuresis and metabolic acidosis, which stimulates ventilation and increases alveolar and arterial oxygenation. By using acetazolamide, high-elevation ventilatory acclimatization that normally takes 3–5 days takes only 1 day. Acetazolamide also eliminates central sleep apnea, or periodic breathing, which is common at high elevations, even in those without a history of sleep disorder breathing.

An effective dose for prophylaxis that minimizes the common side effects of increased urination and paresthesia of the fingers and toes is 125 mg every 12 hours, beginning the day before ascent and continuing the first 2 days at elevation, and longer if ascent continues. Acetazolamide can also be taken episodically for symptoms of AMS, as needed. To date, the only dose studied for treatment is 250 mg (2 doses taken 8 hours apart), although the lower dosage used for prevention has anecdotally been successful. The pediatric dose is 5 mg/kg/day in divided doses, up to 125 mg, twice a day.

Adverse & Allergic Reactions

 Allergic reactions to acetazolamide are uncommon. Since acetazolamide is a sulfonamide derivative, cross-sensitivity between acetazolamide, sulfonamides, and other sulfonamide derivatives is possible.

Dexamethasone

Dexamethasone is effective for preventing and treating AMS and HACE and might prevent HAPE as well. Unlike acetazolamide, if the drug is discontinued at elevation before acclimatization, mild rebound can occur. Acetazolamide is preferable to prevent AMS while ascending, and dexamethasone generally should be reserved for treatment, usually as an adjunct to descent. The adult dose is 4 mg every 6 hours; rarely is it needed for more than 1–2 days. An increasing trend is to use dexamethasone for “summit day” on high peaks (e.g., Aconcagua and Kilimanjaro) to prevent abrupt altitude illness.

Recent studies have shown that taking ibuprofen 600 mg every 8 hours helps prevent AMS, although not quite as effectively as acetazolamide. Ibuprofen is, however, available over the counter, inexpensive, and well tolerated.

Nifedipine both prevents and ameliorates HAPE. For prevention, nifedipine is generally reserved for people who are particularly susceptible to the condition. The adult dose for prevention or treatment is 30 mg of extended release every 12 hours, or 20 mg every 8 hours.

Phosphodiesterase-5 Inhibitors

Phosphodiesterase-5 inhibitors selectively lower pulmonary artery pressure, with less effect on systemic blood pressure than nifedipine. Tadalafil, 10 mg taken twice a day during ascent, can prevent HAPE. It is also being studied as a possible treatment.

The main point of instructing travelers about altitude illness is not to eliminate the possibility of mild illness but to prevent death or evacuation. Because the onset of symptoms and the clinical course are sufficiently slow and predictable, there is no reason for anyone to die from altitude illness unless they are trapped by weather or geography in situations where descent is impossible. Travelers can adhere to 3 rules to help prevent death or serious consequences from altitude illness:

• Know the early symptoms of altitude illness and be willing to acknowledge when symptoms are present.
• Never ascend to sleep at a higher elevation when experiencing symptoms of altitude illness, no matter how minor the symptoms seem.
• Descend if the symptoms become worse while resting at the same elevation.

For trekking groups and expeditions going into remote high-elevation areas, where descent to a lower elevation could be problematic, a pressurization bag (e.g., the Gamow bag) can be beneficial. A foot pump produces an increased pressure of 2 lb/in2, mimicking a descent of 5,000–6,000 ft (≈1,500–1,800 m) depending on the starting elevation. The total packed weight of bag and pump is about 14 lb (6.5 kg).

Preexisting Medical Conditions

Travelers with preexisting medical conditions must optimize their treatment and have their conditions stable before departure. In addition, these travelers should have plans for dealing with exacerbation of their conditions at high elevations. Travelers with underlying medical conditions (e.g., coronary artery disease, any form of chronic pulmonary disease or preexisting hypoxemia, obstructive sleep apnea [OSA], or sickle cell trait)—even if well controlled—should consult a physician familiar with high-elevation medical issues before undertaking such travel ( Table 4-06 ).

Clinicians advising travelers should know that in most high-elevation resorts and cities, “home” oxygen is readily available. In North America, this requires a prescription that the traveler can carry, or oxygen can be arranged beforehand. Supplemental oxygen, whether continuous, episodic, or nocturnal, depending on the circumstances, is very effective at restoring oxygenation to low elevation values and eliminates the risk for altitude illness and exacerbation of preexisting medical conditions.

Table 4-06 Ascent risk associated with various underlying medical conditions & risk factors

LIKELY NO EXTRA RISK

CAUTION REQUIRED 1

ASCENT CONTRAINDICATED

• Asthma (well-controlled)
• Children and adolescents
• Chronic obstructive pulmonary disease (mild)
• Coronary artery disease (following revascularization)
• Diabetes mellitus
• Hypertension (controlled)
• Neoplastic diseases
• Obesity (Class 1/Class 2) 2
• Obstructive sleep apnea (mild/ moderate)
• Pregnancy (low-risk)
• Psychiatric disorders (stable)
• Seizure disorder (controlled)
• Angina (stable)
• Arrhythmias (poorly controlled)
• Chronic obstructive pulmonary disease (moderate)
• Coronary artery disease (nonrevascularized)
• Cystic fibrosis (FEV1 30%–50% predicted)
• Heart failure (compensated)
• Hypertension (poorly controlled)v Infants <6 weeks old
• Obesity (Class 3) 3
• Obstructive sleep apnea (severe)
• Pulmonary hypertension (mild)
• Radial keratotomy surgery
• Seizure disorder (poorly controlled)
• Sickle cell trait
• Angina (unstable)
• Asthma (unstable, poorly controlled)
• Cerebral space–occupying lesions
• Cerebral vascular aneurysms or arteriovenous malformations (untreated, high-risk)
• Chronic obstructive pulmonary disease (severe/very severe)
• Cystic fibrosis (FEV1 <30% predicted)
• Heart failure (decompensated)
• Myocardial infarction or stroke (<90 days before ascent)
• Pregnancy (high-risk)
• Pulmonary hypertension (pulmonary artery systolic pressure >60 mm Hg)
• Sickle cell anemia

Abbreviations: : FEV1, forced expiratory volume in 1 second

1 Travelers with these conditions most often require consultation with a physician experienced in high-altitude medicine and a comprehensive management plan.

2 Class 1 obesity: Body Mass Index (BMI) of 30 to <35; Class 2 obesity: BMI of 35 to <40

3 Class 3 obesity: BMI of ≥40.

Diabetes Mellitus

Travelers with diabetes can travel safely to high elevations, but they must be accustomed to exercise if participating in strenuous activities at elevation and carefully monitor their blood glucose. Diabetic ketoacidosis can be triggered by altitude illness and can be more difficult to treat in people taking acetazolamide. Not all glucose meters read accurately at high elevations.

Obstructive Sleep Apnea

Travelers with sleep disordered breathing who are planning high-elevation travel should receive acetazolamide. Those with mild to moderate OSA who are not hypoxic at home might do well without a continuous positive airway pressure (CPAP) device, while those with severe OSA should be advised to avoid high-elevation travel unless they receive supplemental oxygen in addition to their CPAP. Oral appliances for OSA can be useful adjuncts when electrical power is unavailable.

There are no studies or case reports describing fetal harm among people who briefly travel to high elevations during their pregnancy. Nevertheless, clinicians might be prudent to recommend that pregnant people do not stay at sleeping elevations >10,000 ft (≈3,050 m). Travel to high elevations during pregnancy warrants confirmation of good maternal health and verification of a low-risk gestation. Advise pregnant travelers of the dangers of having a pregnancy complication in remote, mountainous terrain.

Radial Keratotomy

Most people do not have visual problems at high elevations. At very high elevations, however, some people who have had radial keratotomy procedures might develop acute farsightedness and be unable to care for themselves. LASIK and other newer procedures may produce only minor visual disturbances at high elevations.

The following authors contributed to the previous version of this chapter: Peter H. Hackett, David R. Shlim

Bibliography

Bartsch P, Swenson ER. Acute high-altitude illnesses. N Engl J Med. 2013;369(17):1666–7. 

Hackett PH, Luks AM, Lawley JS, Roach RC. High-altitude medicine and pathophysiology. In: Auerbach PS, editor. Wilderness medicine, 7th edition. Philadelphia: Elsevier; 2017. pp. 8–28. 

Hackett PH, Roach RC. High altitude cerebral edema. High Alt Med Biol. 2004;5(2):136–46. 

Luks AM, Auerbach PS, Freer L, Grissom CK, Keyes LE, McIntosh SE, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness Environ Med. 2019;30(4S):S3–18. 

Luks AM, Hackett PH. High altitude and preexisting medical conditions. In: Auerbach PS, editor. Wilderness medicine, 7th edition. Philadelphia: Elsevier; 2017. pp. 29–39. 

Luks AM, Hackett PH. Medical conditions and high-altitude travel. N Engl J Med. 2022;386(4):364–73. 

Luks AM, Swenson ER.Medication and dosage considerations in the prophylaxis and treatment of high-altitude illness. Chest. 2008;133(3):744–55. 

Meier D, Collet TH, Locatelli I, Cornuz J, Kayser B, Simel DL, Sartori C. Does this patient have acute mountain sickness? The rational clinical examination systematic review. JAMA. 2017;318(18):1810–19. 

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Woolcott OO. The Lake Louise Acute Mountain Sickness score: still a headache. High Alt Med Biol. 2021;22(4):351–2.

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Abortion rights activist with Kentucky ties to campaign for President Joe Biden, Kamala Harris

Hadley Duvall, a Kentucky native, is sharing her story with the world and advocating for reproductive and abortion rights as part of President Joe Biden and Vice President Kamala Harris' re-election campaign.

The 22-year-old, originally from Owensboro, first gained national attention when appearing in a video for Gov. Andy Beshear's re-election campaign last fall, but shared her story publicly amidst the overturn of Roe v. Wade in 2022 with strict abortion bans in Kentucky.

At 12 years old, Duvall said, she found out she was pregnant with her stepfather's child after enduring a decade of abuse. Although she had a miscarriage, she "would have" gone through with her decision to terminate the pregnancy, as it was legal, according to an Instagram post on her account. Today, abortions are illegal in the Bluegrass State unless experiencing a medical emergency.

Here's what we know about Duvall's activism career.

Kentucky native comes forward as rape survivor after overturn of Roe v. Wade

Shortly after the Supreme Court overturned Roe v. Wade in June of 2022, Duvall, of Owensboro, Kentucky, shared her story with the world. According to a post on Instagram, Duvall became pregnant at age 12 after being raped by her stepfather. She experienced a decade of abuse from him and wrote she was "lucky this only happened once," referring to her pregnancy and miscarriage.

"The father figure in my life had planted his child in me at the age of 12. I wasn't even a teenager yet. Thankfully, I had my CHOICE," she wrote. "I never had to go through with my decision, but I would have. I couldn't imagine not having that choice. & if you can look at a CHILD & tell them they have to carry their parent's child, you are sick."

Duvall graduated from Owensboro High School before playing collegiate soccer at Midway University. She graduated in May with a psychology degree with hopes of helping children of incarcerated individuals or those in recovery.

Hadley Duvall appears in Gov. Andy Beshear's re-election campaign in 2023

Duvall appeared in Gov. Andy Beshear's, D-Ky, re-election campaign ahead of November 2023 in opposition to Daniel Cameron, former Attorney General of Kentucky.

"Anyone who believes there should be no exceptions for rape and incest could never understand what it's like to stand in my shoes," Duvall said. "This is to you, Daniel Cameron. To tell a 12-year-old girl she must have the baby of her stepfather who raper her is unthinkable."

She continued, "I'm speaking out because women and girls need to have options. Daniel Cameron would give us none."

'Hadley's Law' challenges Kentucky abortion bans

Duvall continued to advocate for women in similar positions to her own by working with Louisville Democratic Senator David Yates on Senate Bill 99, often referred to as "Hadley's Law." As previously reported by The Courier Journal, the bill would've made some changes to Kentucky's strict abortion bans if passed, allowing for more protections over a woman's choice in instances of rape, incest or when maternal health is in question.

The bill failed to pass during legislative sessions.

▶ 'Hadley's Law': Bill calls for rape, incest exceptions to Kentucky abortion ban

▶ Louisville Democrat tries unusual maneuver on last-minute abortion-ban exceptions bill

Hadley Duvall publishes opinion piece with The Courier Journal

An opinion piece from Duvall was published by The Courier Journal on June 21. Read it below.

▶ Hadley Duvall: Women deserve abortion access. Kentucky laws mean rape victims like me have no options.

Hadley Duvall campaigns for President Joe Biden, Vice President Kamala Harris

Ahead of the 2024 November election, Duvall is campaigning in support of abortion and reproductive rights, making a recent appearance on MSNBC with Vice President Kamala Harris.

"It would mean the unimaginable. It would mean that they have no options. Not even women and girls, but you know, women with nonviable pregnancies, wanted nonviable pregnancies that are killing these women. It will mean no traveling to another state. It will be no options based on where you live," Duvall said. "It will just be one rule for everybody and that will be no abortions and that is a very very dangerous world for women. Not only young girls but all women."

She also appeared on an episode of "Unapologetically Woman" in March, sharing more about her journey, including backlash received by classmates and others on social media.

"Some people at my school have shared that they don't agree with what I stand for. They haven't shared that to me, they've shared that on social media, and that's okay. I still walk the same halls, I still do the same thing I did every single day, I still go to sleep every single night," she said. "I just want those people to consider themselves blessed to not ever have been in this position, whether it was their sister, their mother, their daughter, whoever it may be, I'm just glad they've never had someone faced with that decision."

She continued, saying while she has feelings about comments she's received, it doesn't stack up to the love she has for women and girls experiencing a similar situation.

"We're human. We all get our feelings hurt and I think it's important to embrace that. I'm not made of steel, I'm very much real, I have feelings," Duvall said. "I see what people say about me on social media but my truth and my love for the girl I used to be and for the girls that are like who I used to be or the women going through that, that's stronger than the hurt that I feel when these people, who don't even know who I am, say these crazy things."