Ponder this before taking a babymoon
You are more at risk of malaria if you are pregnant, and it can pose risks to both you and your baby.
We are living in a time where travel is the norm. It is becoming easier to nip off to some exotic sunny destination for even just a few days, something I am sure our predecessors would have found hard to believe.
As a pretty fearful flyer, I am often reminding myself that flying is one of the safest modes of transport, but there are still risks, especially when you are pregnant. Given that more couples are actually choosing pregnancy as a time to go overseas ( something called a ‘‘babymoon’’ I am told), it seems timely to outline some of the dos and don’ts:
❚ Always check with your doctor and midwife before booking any trip. They will give you information about the possible risks to your pregnancy, as well as find the most up-to-date facts about potential health risks in the country you are planning to visit.
❚ Avoid travel in the last few weeks if you possibly can. This is largely because from around 36-37 weeks’ gestation you can go into labour at any time (and I would imagine the average woman’s ‘‘birth plan’’ doesn’t involve one of those tiny airplane toilets and a young cabin attendant).
Flying doesn’t seem to increase the likelihood of going into labour, but I wouldn’t be risking it unless I had no choice. Lots of airlines restrict flights beyond 28 weeks’ gestation, so check with your travel agent before booking anything – it would be gutting to turn up at the check-in desk only to be turned away again.
❚ Consider avoiding travel in the first trimester – around one in five pregnancies sadly ends in miscarriage, and the likelihood is far greater in the first 12 weeks of pregnancy. This risk doesn’t increase if you go on a plane, but if you are unlucky to have a miscarriage you may wish to be at home, close to the support and health providers you know. Some countries have fantastic healthcare, and would be able to offer you all the options you would have back here, but that is certainly not the case for many of our most popular destinations, including many of the Pacific islands. From around 13 weeks, the miscarriage rate is much lower, so planning a trip in the middle part of your pregnancy is the ideal time.
❚ Always take a copy or summary of your medical notes with you. If you become unwell or something goes wrong with your pregnancy, this information will be important. This includes things like your blood type, current medications and any underlying medical conditions you may have had in the past.
❚ Make sure you check all the vaccinations required for the area you want to travel to, and that this information is up to date. There may be vaccinations that you can’t have while pregnant, and depending on the level of risk in a particular country this may affect your choice of destination. An alternative to this, if you are a real planner, is to have your travel shots before you get pregnant – many of them last for several years so can give you protection throughout your pregnancy and afterwards.
❚ Consider the risk of malaria – not such an issue in the Pacific, but if you are travelling further afield to Asia, Africa or Central Southern America, you should specifically talk to your doctor or a travel specialist about this. You are more at risk of malaria if you are pregnant, and it can pose risks to you and your baby. Ideally avoid these areas if you can, but if this isn’t possible talk to your doctor about what prevention medication may be safe for you.
❚ Avoid mosquitoes. Easier said than done, but mosquitoes can transmit not only malaria but also the Zika virus and other diseases. Zika is present in large parts of the Pacific as well as other parts of the world, and can have devastating effects in pregnancy, leading to late miscarriage and abnormalities in brain development.
There is no medication or vaccine available to prevent infection, so taking all precautions to avoid being bitten is the best you can do. This includes wearing long clothes that cover your arms and legs from dawn until dusk, sleeping under a mosquito net, avoiding lakes and rivers where mosquitoes are most prevalent, and using a repellent that is specifically recommended for pregnancy.
❚ Move around on the flight and drink plenty of fluid. All pregnant women have a higher risk of blood clots known as deep vein thromboses. This risk is much greater when you fly, especially if your flight is more than four hours duration.
Get up and walk around, do calf and thigh exercises, and ensure you are well hydrated. If you have specific risks (ie, you or your family have had clots before, or you are very overweight) it is worth checking with your doctor about prevention injections known as heparin that can be given before travel if needed.
❚ Check your travel insurance – many countries won’t have free healthcare available, and if you aren’t insured for complications that could arise in pregnancy the costs can be astronomical. Read the small print and talk to an experienced travel agent.
❚ Lastly, when you get there try to avoid anything that might increase your risk of food poisoning. Gastroenteritis can affect your baby, so I would recommend drinking bottled water if you are unsure, and ordering things that carry lower risk (freshly prepared, and cooked thoroughly).
Despite this extensive list, don’t be put off – just plan wisely and ahead of time. And remember that we live in one of the most beautiful countries in the world… a trip to the golden beaches of the far north, or the mountains of the south, is likely to be a safer option.
❚ Dr Cathy Stephenson is a GP and mother of three.