Unravelling the restrictions, precautions and risks associated with taking a flight while pregnant
If you’re pregnant and thinking about booking an overseas holiday or visiting family abroad, advice given to expectant mothers can differ from doctor to doctor, as well as from airline to airline. There are also additional things to be considered, such as pre-existing conditions, multiple pregnancies and the health care available in the country of arrival.
“It’s not advisable to fly after 37 weeks of pregnancy in a single pregnancy and after 32 weeks if you are carrying twins,” says Dr Shruti Garg Indoriya, a specialist obstetrician and gynaecologist at Dubai London Clinic. “All airlines have their ‘fit to fly’ rules for pregnant women, which need to be confirmed before travel, and they will require a travel certificate from their doctor after 28 weeks of pregnancy.”
While there are many medical reasons restricting travel in a pregnant woman’s third trimester, other factors to consider include complications, energy levels and comfort. Dr Shachi Joshi, a specialist in obstetrics and gynaecology at Dubai’s Medcare Medical Centre, says: “In most cases, pregnant women can travel safely until 36 weeks of pregnancy. But travel may not be recommended for women who have pregnancy complications, such as recent vaginal bleeding, severe sickle cell disease or lung problems.
“The best time to travel is mid-pregnancy, from 14 to 28 weeks. During these weeks, your energy has returned, morning sickness is improved or gone, and you are still able to get around easily. After 28 weeks, it may be harder to move around or sit for a long time.”
One of the main risks of flying while pregnant is going into early labour mid-air. There are many instances of women giving birth on planes. In May 2019, a woman on a flight from Riyadh to Manila went into labour, causing the pilot to decide on an emergency landing in Hyderabad, India. Last September, passenger Hiyam Nasr Naji Daaban gave birth on EgyptAir flight MS777 from Cairo to London. The pilot diverted the flight to Munich, Germany, and the airline offered the baby girl free flights for life.
“Any pregnant woman has a small chance of going into labour early or for her water to break early,” says Joshi. “This probability increases once the woman has completed 36 weeks. If this happens to you on a flight, there is no guarantee that other passengers or crew members will be trained and experienced to help you give birth safely.”
Premature birth is a concern, but more often, restrictions are based on the risk of developing a condition or exacerbating those that are pre-existing. “There is a risk of deep vein thrombosis on long-distance flights that are more than four hours,” says Indoriya.
“High-risk pregnancy conditions such as placenta previa, pre-eclampsia or twin pregnancies can have complications during the flight, which can’t be managed during travel and can risk the mother’s and the baby’s lives.”
Most airlines follow the same lines and time constraints, however, rules can differ, so you should check with your carrier before you fly. Etihad Airways does not require a medical certificate until a woman reaches 28 weeks for single or multiple pregnancies, for example. From weeks 29 to 36, a medical certificate is required to fly, while travel is not permitted past week 37 for single pregnancies. For multiple pregnancies, a medical certificate is required from weeks 29 to 32, with travel not permitted after week 33.
On Emirates, pregnant women can fly up to 29 weeks without a medical certificate, but require one after week 29. Travel is restricted at week
Premature birth is a concern and so is the risk of developing a condition or exacerbating those that are pre-existing
36 for single pregnancies and week 32 for multiple pregnancies.
There are plenty of ways pregnant women can maintain comfort in the air, as well as minimise the risks associated with flying. “Dress comfortably in loose clothing and comfortable shoes,” suggests Joshi. “Try to get an aisle seat, take regular walks around the plane and do in-seat exercises every 30 minutes or so.”
Joshi also advises drinking plenty of water, keeping your seat belt on at all times in case of turbulence – “the belt should sit low on your hip bones, below your belly” – and wearing compression socks to prevent DVT. Importantly, avoid lifting heavy luggage.
“Staff and airline personnel are available to assist with lugging those heavy bags around so you don’t have to,” she says. “Let your airline know in advance if you need assistance with your luggage or getting to the gate.”
While staying healthy in the air is important, it’s also worth being aware of the healthcare options available to you at your destination. “Women need to have travel insurance and be sure there are suitable health services available at the destination in case of an emergency,” says Indoriya. “You should also carry all your medical records in case you need to see a doctor at the destination.”