Sunday, March 31, 2013

Flying When Pregnant - A Definitive Guide


A case in Dublin Airport, Ireland, in August 2011 brought the issue of flying when pregnant into the media. Nigerian asylum seeker Olayinka Ijaware who had miscarried at 8 weeks was due to be deported and the Rotunda Hospital had discharged her with a letter stating that if she was actively bleeding from the vagina that she would be unfit for air travel. Although this case relates to a woman who had already suffered a miscarriage it gives us the opportunity to examine the subject of flying when pregnant in more detail.

What are the risks of flying when pregnant?

The risks of air travel during pregnancy are deep-vein thrombosis, miscarriage and premature birth.

Also bear in mind that the British Medical Journal highlights the fact that there is a limit on robust evidence which makes it difficult for healthcare professionals to provide definitive advice.

So to clarify, there are various generic guidelines but given that air travel and pregnancy is a relatively new topic the British Medical Journal (BMJ) states that the only way to completely avoid the risks is by postponing air travel. The BMJ does also state that air travel may either be necessary or desirable in pregnancy.

The majority of pregnancies are low risk and if you fall into this category the general guidelines below should apply to you. However please note that these are guidelines only and you should always consult your own healthcare provider.

Air travel during pregnancy has some generic guidelines such as:
1. The second trimester (18-24 weeks) is considered to be the safest time to fly when pregnant. It is during this time that most women should be feeling at their best and that there is generally the lowest risk of miscarrying or premature labour.

2. If you feel that you will want fly during pregnancy then before making your final decision consider the destination you are planning to fly to. Is it well equipped medically if you had a need?

3. Are you considering flying to a destination where there are specific risks of acquiring infectious diseases? Infectious diseases acquired abroad may increase risks of perinatal morbidity.

4. If this is the case you may wish to reconsider the destination or if it is necessary to fly there you should definitely consult with your healthcare provider.

5. Check out the airlines policies on flying when pregnant, as these differ from airline to airline.

6. Buy the most suitable insurance cover for your journey.

If you do fly:
1. Ask for an aisle seat with extra legroom when possible.

2. If you are flying when pregnant then wear clothing which does not restrict movement and is loose and comfortable.

3. Make sure you drink a lot of fluids when flying while pregnant.

4. Every half an hour you should get up and walk around a bit if possible.

5. While sitting-be aware of flexing your feet and stretching your legs to keep the circulation healthy.

6. Do circulatory exercises as detailed usually in the flight magazine and wear compression socks (flight socks).

7. Fasten your safety belt across the tops of the thighs so that it rests under your stomach.

Flying When Pregnant-Potential Medical Concerns
Medical professionals will potentially be concerned about the method of travel-air travel as well as the destination, healthcare facilities there and adequate insurance coverage.

The doctor will want to assess the fitness of his pregnant patient to fly and will focus on blood pressure readings and ultrasound pregnancy scans findings.

The doctor will analyse if the woman is at an increased risk of miscarriage, premature labour, pre-delivery haemorrhage or pre-eclampsia. He/she will also assess if the woman has any pre-existing conditions such as asthma or diabetes.

Is There Any Evidence Of Risk Of Miscarriage When Flying During Pregnancy?
At the time of writing there has been no evidence to date which would suggest that flying when pregnant increases the risk of miscarriage. However there are studies which reveal that female flight attendants do have a higher miscarriage rate than the rate of their peers.

Even though there is no evidence to point towards a heightened risk of miscarriage when flying during pregnancy; if a miscarriage were to occur it would be more difficult to manage it.

Flying When Pregnant Conclusion
Consider the destination, healthcare facilities, the stage of pregnancy you intend to fly during, and consult with your healthcare practitioner who will take into account your medical history, pregnancy scans and your travel destination. One last point is that kind of a worst case scenario-but if you were not able to return home for some reason this would mean you would need to spend the remainder of your pregnancy away from home.

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