Whether your idea of travel is hiking through the Amazon, flopping down on a chaise lounge on a white sand beach, or going on a business trip, if you're pregnant, you should take a few extra precautions to keep your trip worry free. Here are some points to consider.

Bungee jumping and scaling Mount Everest are obviously out of the picture. You should also refrain from downhill skiing -- and any other physical activity that could cause a blow to your stomach. Skip scuba diving. It puts your baby at risk for decompression syndrome, a dangerous condition in which excess nitrogen forms bubbles in the blood.

Hot-tubbing may be relaxing on vacation, but it's not recommended for pregnant women. One study in the American Journal of Epidemiology found that women who took hot-tub soaks in their first trimester doubled their risk of miscarriage. You also might want to cancel plans to visit an area that regularly has outbreaks of malaria, food-borne infections, or any disease that requires travelers to obtain live vaccines. It's best to stay away from destinations that do not have modern medical care, in case of an emergency.

Pregnant women should also avoid countries with contaminated drinking water and poor sanitation. Such conditions are ideal breeding grounds for hepatitis E. This newly recognized virus, which affects the liver, is mild and clears up on its own in most people. But for unknown reasons, about 15 to 25 percent of pregnant women who get hepatitis E lose their babies, according to the Centers for Disease Control and Prevention (CDC).

Outbreaks of hepatitis E have occurred in parts of Afghanistan, Bangladesh, Burma, China, India, Indonesia, Kazakhstan, Kyrgyzstan, Malaysia, Mexico, Mongolia, Nepal, Pakistan, Tajikistan, Turkmenistan, Uzbekistan, the Middle East, Northern Africa, and sub-Saharan Africa.

Phyllis Kozarsky, professor of medicine at Emory University in Atlanta and chief of travelers' health at the CDC warns that you can't get a vaccine to prevent hepatitis E, which is transmitted through contaminated food and water.

"It makes it incredibly important that pregnant women be overly meticulous about what they eat and drink," Kozarsky says.

Once you've determined that your desired destination is relatively risk free, you still need to determine when it's safest to travel. If you're healthy and your doctor allows you to travel, you can fly until week 36 of pregnancy, according to the American College of Obstetrics and Gynecology (ACOG). Generally, the second trimester is the safest, because women are less prone to miscarriage, which presents the greatest risk in the first trimester, or preterm labor, which occurs toward the end of pregnancy, according to both the CDC and ACOG. Although most U.S. airlines will allow you to travel on domestic flights until your 36th week, the cutoff for international flights is usually 32 to 35 weeks, depending on the airline. Check with your airline before flying.

You should check to see what your health insurance covers before traveling outside of your local area or abroad, advises Kozarsky. Not every plan will cover all expenses if you have an emergency when you go out of state or even to a local hospital that is outside of your health plan.

"In most situations medical insurance doesn't cover you overseas, and if you deliver overseas, it doesn't pay for the neonatal charges, even if you purchase supplemental insurance for yourself," she says. If you do buy supplemental insurance, find out what medical care would be available to you in case of an emergency during your trip. You may want to know the location of a hospital near where you will stay, just in case a problem arises.

Here are a few more good tips for a worry-free and comfortable trip :

•If possible, travel with a companion who can assist you should you have any medical problems.

•Make sure you're current on immunizations and have received any necessary vaccines that are safe for pregnant women.

•Carry your medical records with you, including lab reports and expected date of delivery.

•Get a referral from your doctor for an obstetric gynecologist or medical group at your destination.

•In case of an emergency that might leave you in need of a transfusion, make sure your destination is a place where blood is screened for HIV and hepatitis

•Avoid soft cheese, unpasteurized milk or cheese, and deli meats that are served less than steaming hot, because of the risk of listeriosis, a bacteria-caused illness that can do serious harm to your baby.

•Make sure that meat is well cooked to avoid the parasites that cause toxoplasmosis, an infection that can result in birth defects.

•Avoid eating unwashed vegetables and prepared salads. Raw vegetables and meat are sources of toxic bacteria such as salmonella and E. coli.

•If you are going to an underdeveloped country, bring rehydration packets to mix with purified water to treat dehydration. These packets are available in many foreign countries as well.

•Bring topical medication for vaginal yeast infection. Yeast infections are more common during pregnancy, especially if you're going to the tropics.

•In your carry-on bag for air travel, bring support hosiery to prevent swelling in your feet and legs, acetaminophen for minor pain, and extra snacks and water.

•Reserve an aisle seat to give you more room to stretch your legs and greater ease in getting up out of your seat.

•To prevent blood clots, a risk for all air travelers, make sure you stroll up and down the aisle every hour and frequently flex and extend your ankles to improve circulation.

•While seated, fasten the seatbelt across your pelvis.

•Drink plenty of liquids during the flight. Dehydration can slow down blood flow in the placenta and put you at greater risk for a blood clot.

-- Laurie Udesky is a freelance writer who lives in San Francisco.

Further Resources

Centers for Disease Control and Prevention http://www.cdc.gov/travel

American College of Obstetrics and Gynecology http://www.acog.org

References

First published February 3, 2005
Last updated April 3, 2008
Copyright © 2005 Consumer Health Interactive

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