uk travel advice pregnancy

Travelling in pregnancy

With the proper precautions such as travel insurance, most women can travel safely well into their pregnancy.

Wherever you go, find out what healthcare facilities are at your destination in case you need urgent medical attention. It's a good idea to take your maternity medical records (sometimes called handheld notes) with you so you can give doctors the relevant information if necessary.

Find out more about getting healthcare abroad .

Make sure your travel insurance covers you for any eventuality, such as pregnancy-related medical care during labour, premature birth and the cost of changing the date of your return trip if you go into labour .

When to travel in pregnancy

Some women prefer not to travel in the first 12 weeks of pregnancy because of  nausea and vomiting and feeling very tired during these early stages. The risk of  miscarriage is also higher in the first 3 months, whether you're travelling or not.

Travelling in the final months of pregnancy can be tiring and uncomfortable. So, many women find the best time to travel or take a holiday is in mid-pregnancy, between 4 and 6 months.

Flying in pregnancy

Flying isn't harmful to you or your baby, but discuss any health issues or pregnancy complications with your midwife or doctor before you fly.

The chance of going into labour is naturally higher after  37 weeks (around 32 weeks if you're carrying twins), and some airlines won't let you fly towards the end of your pregnancy. Check with the airline for their policy on this.

After week 28 of pregnancy, the airline may ask for a letter from your doctor or midwife confirming your due date, and that you are not at risk of complications. You may have to pay for the letter and wait several weeks before you get it.

Long-distance travel (longer than 4 hours) carries a small risk of blood clots (deep vein thrombosis (DVT)) . If you fly, drink plenty of water and move about regularly – every 30 minutes or so. You can buy a pair of graduated compression or support stockings from the pharmacy, which will help reduce leg swelling.

Travel vaccinations when you're pregnant

Most vaccines that use live bacteria or viruses aren't recommended during pregnancy because of concerns that they could harm the baby in the womb.

However, some live travel vaccines may be considered during pregnancy if the risk of infection outweighs the risk of live vaccination. Ask your GP or midwife for advice about specific travel vaccinations. Non-live (inactivated) vaccines are safe to use in pregnancy.

Malaria tablets

Some anti-malaria tablets aren't safe to take in pregnancy so ask your GP for advice.

Zika virus is mainly spread by mosquitoes found in some parts of the world. For most people it's mild and not harmful, but can cause problems if you're pregnant.

If you are pregnant, 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
• the Caribbean
• the Pacific islands

Check before you travel

It's important to check the risk for the country you're going to before you travel.

Find out more about the Zika virus risk in specific countries on the Travel Health Pro website

Car travel in pregnancy

It's best to avoid long car journeys if you're pregnant. However, if it can't be avoided, make sure you stop regularly and get out of the car to stretch and move around.

You can also do some exercises in the car (when you're not driving), such as flexing and rotating your feet and wiggling your toes. This will keep the blood flowing through your legs and reduce any stiffness and discomfort. Wearing compression stockings while on long car journeys (more than 4 hours) can also increase the blood flow in your legs and help prevent blood clots.

Tiredness and dizziness are common during pregnancy so it's important on car journeys to drink regularly and eat natural, energy-giving foods, such as fruit and nuts.

Keep the air circulating in the car and wear your seatbelt with the cross strap between your breasts and the lap strap across your pelvis under your bump, not across your bump.

Road accidents are among the most common causes of injury in pregnant women. If you have to make a long trip, don't travel on your own. You could also share the driving with your companion.

Sailing in pregnancy

Ferry companies have their own restrictions and may refuse to carry heavily pregnant women (often beyond 32 weeks on standard crossings and 28 weeks on high-speed crossings ). Check the ferry company's policy before you book.

For longer boat trips, such as cruises, find out if there are onboard facilities to deal with pregnancy and medical services at the docking ports.

Food and drink abroad in pregnancy

Take care to avoid food- and water-borne conditions, such as stomach upsets and travellers' diarrhoea . Some medicines for treating stomach upsets and travellers' diarrhoea aren't suitable during pregnancy.

Always check if tap water is safe to drink. If in doubt, drink bottled water. If you get ill, keep hydrated and continue eating for the health of your baby, even if you're not hungry.

Find out about a healthy diet in pregnancy , and foods to avoid in pregnancy .

Page last reviewed: 17 August 2022 Next review due: 17 August 2025

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• General Travel Health Advice

Advice for Pregnant Travellers

Disease risks, maternity notes and medical care, travel insurance, vaccinations, malaria prevention.

Pregnancy creates an altered state of health which requires practical consideration before travel. In the first instance travel plans should be discussed with your GP, practice nurse, midwife or obstetrician, ideally before booking and well in advance of your intended departure date.

Fluctuating hormone levels and the psychological impact of pregnancy, as regards changing routines and responsibilities, may adversely affect your capacity to cope with the stressful nature of travel. It is therefore worth considering if you will have access to sufficient emotional and physical support during travel.

Many diseases have more severe consequences in pregnancy, with significant risk to both mother and unborn baby. For example, malaria in pregnancy is harmful to both you and your unborn baby with an increased risk of severe illness or death for both. Consequently, where possible, you should avoid all non-essential travel to tropical destinations during pregnancy, in particular those with a risk of diseases such as malaria , zika virus or yellow fever .

The association between infection with zika virus and birth defects means that non-essential travel to areas with ongoing high risk of zika virus transmission should be postponed by women who are pregnant or planning pregnancy. For further information see our zika virus  page.

Take a copy of your hand held maternity notes in case you need medical care during travel; include information about any pre-existing medical conditions and your blood group.

Carefully consider your intended destinations prior to booking, find out about:

• availability and standard of medical care
• existing health risks in the destination countries
• any other travel warnings.

The Foreign, Commonwealth and Development Office (FCDO) website provides advice on the availability of medical treatment and facilities alongside any travel warnings on an individual country basis.

It is essential that all your early pregnancy examinations are carried out prior to travel in order to rule out potential complications. If travelling after 28 weeks of pregnancy, it is important to ensure that available medical facilities at the destination are suitable to manage complications of pregnancy such as pre-eclampsia and caesarean section.

Be aware that blood supplies may not be safe in some destinations; this can increase the risks of blood borne infections such as hepatitis B , C and HIV .

Misunderstandings due to language barriers or cultural problems could make communication and therefore diagnosis and treatment of any illness more difficult than it would be at home.

Ensure that your travel insurance policy covers both you and your unborn child, and if delivery should occur during travel, that your newborn is insured.

Failure to notify your travel insurance provider that you are pregnant is likely to invalidate your insurance policy.

Additionally, it should be remembered that insurance policies are only as good as the medical facilities available.

Please see our travel insurance page for further information.

Air travel is generally considered safe in uncomplicated pregnancy. However, it is important to discuss your fitness to fly with your GP, practice nurse, midwife or obstetrician before departure.

Be aware that policies vary between each airline but generally:

• Most commercial airlines accept pregnant travellers up to 36 weeks if single pregnancy or up to 32 weeks if a multiple pregnancy. This is because labour is more likely after 37 weeks, or around 32 weeks if carrying an uncomplicated twin pregnancy.
• Some airlines require written documentation from your practice nurse, midwife or obstetrician. This is to confirm you are in good health, that your pregnancy is uncomplicated and your due date.
• Flying during the first 12 weeks of pregnancy may be considered risky as miscarriage is more common during this early stage. Additionally, at this stage pregnant travellers may be suffering from pregnancy induced nausea and fatigue which could make travelling uncomfortable.
• You may be at greater risk of deep vein thrombosis (DVT) during pregnancy and the postpartum period; please refer to our Deep Vein Thrombosis page for further information.

The Royal College of Obstetricians and Gynaecologists have produced an advice leaflet for pregnant women planning to undertake air travel: Air Travel and Pregnancy

Pregnancy does not prevent you from receiving vaccines that can protect the health of you and your unborn baby.

A general rule is that most recommended vaccines can be used if the risk of infection is substantial and if there are serious consequences of infection. However, a careful risk versus benefit analysis is needed for every individual, and the decision on whether to vaccinate should be made in conjunction with an appropriately qualified health care professional.

Inactivated Vaccines in Pregnancy

Inactivated vaccines cannot replicate which means they cannot cause disease in either the mother or her unborn baby. Most inactivated vaccines can be used if the risk of disease is considered high.

Live Vaccines in Pregnancy

The risk of the disease versus the benefit of administering any live vaccine during pregnancy requires expert consideration and expert advice should be sought. This is due to a theoretical concern that vaccinating pregnant women with live vaccines, such as: measles, mumps, rubella, chicken pox (varicella) and yellow fever, could potentially infect the unborn baby. Consequently, live vaccines are usually avoided during pregnancy. However, the use of live vaccines in pregnancy may be appropriate if travel is unavoidable and the risk of the disease is high.

Malaria in pregnancy is associated with miscarriage, premature delivery, low birth weight, severe illness or death, affecting both the mother and unborn baby. Consequently, you should avoid all non-essential travel to known malaria risk areas during your pregnancy.

If travel to a malaria area is unavoidable then it is important that you seek expert advice. In the first instance contact your GP for advice, however, be aware that they may refer you to a specialist travel medicine service.

Mosquito bite avoidance is essential in the prevention of malaria. Pregnant women are more attractive to mosquitoes and should therefore be particularly careful to avoid mosquito bites.

For further information please see our mosquito bite avoidance page.

Malaria Medication in Pregnancy

If antimalarial tablets are recommended then you should seek expert advice about which malaria tablets are safest for you to take.

The choice of malaria tablets will largely be determined by your destination, stage of pregnancy and any other pre-existing medical conditions you may have.

Malaria tablets should always be used in combination with mosquito bite avoidance .

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• Disease Prevention Advice

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Is it safe to fly while pregnant? Your complete guide

What you should – and shouldn’t – do on the plane and how late in your pregnancy you can fly: we answer the key questions.

Is flying while pregnant safe?

T he short answer to this question is yes, says Dr Victoria Wakefield , a paediatric registrar with an interest in family medicine, who also works for Hello Juno , an app offering specialist healthcare advice for pregnant women and parents. “However, many women feel uncomfortable flying in their first trimester because they’re nauseous or tired — and because the risk of miscarriage is higher during the first 12 weeks of pregnancy,” she says.

You’ll also want to give thought to the standard of healthcare on offer in the country you’re travelling to, in the event that you need urgent medical attention. “Similarly, in your third trimester it’s worth considering the possibility of going into labour on your flight,” says Dr Wakefield. “And if you’re going somewhere exotic — is that a place you’d feel comfortable having your baby? If the answer is no, then don’t go.” The best time to travel tends to be in mid-pregnancy, from four to six months.

Main photo: with consideration, it’s safe to fly abroad while you’re pregnant (Alamy)

How many weeks pregnant can you be to travel on a plane?

There’s no medical line on this topic, so it’s up to the carrier you’re travelling with. Typically, the majority of airlines (and ferry operators) will say up to 32 or 36 weeks — at 37 weeks you’re full-term, so giving birth becomes a very real possibility. “Most airlines will want a letter from your doctor, obstetrician or midwife after 28 weeks, confirming your due date and saying that you’re fit to fly and haven’t got a high chance of going into early labour,” says Dr Wakefield. Be sure to check the policy of the company you’re booking with, before you buy your tickets.

Does it make a difference if I’m carrying twins?

Those expecting twins have a higher risk of going into early labour after 32 weeks, but the same guidelines apply as for those carrying one child — you’ll need something in writing from your midwife or doctor after 28 weeks, and to check the policy of your airline. “It’s all about your own preference and risk-benefit ratio,” says Dr Wakefield. “You may not have had any issues or pregnancy complications so far, but you need to think about where you’re going, whether you need to go there and — if you do, and go into early labour — how that is going to affect you and your plans.” Those expecting more than one child should also read their travel insurance policy carefully, to ensure they’ll be covered if holidaying after a certain number of weeks gestation.

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Should i go on long-haul holidays when pregnant.

Anyone taking a long-haul flight — four hours or more — has a slightly higher risk of deep vein thrombosis or DVT: a blood clot in a vein, usually the leg. If you’re in the second or third trimester you need to add that to the small additional risk of blood clots that comes with pregnancy. “If you’re pregnant you’ve basically got a massive watermelon sat on the blood vessels that drain your legs, so it’s important to make a real effort to minimise your risk of developing DVT,” says Dr Wakefield. Happily, this can be done with a few simple precautions during your journey (see below).

Is there anything I should do/not do on the plane?

The NHS advises moving frequently — every 30 minutes or so — and making sure you’re drinking plenty of water. You can also buy a pair of graduated compression or support stockings, to help keep your blood flow moving. “During my second pregnancy I went to Ibiza for a babymoon at 30 weeks,” says Dr Wakefield. “Even though it wasn’t a long flight I took two 2 litre bottles of water with me on the plane and kept jiggling about and doing stretches, just for my peace of mind.” You should also pack your maternity notes in your hand luggage — they contain essential medical information that could make all the difference if you require emergency treatment, and if they’re in the hold there’s always a chance your luggage might go astray.

What do I need to know about travelling while pregnant during Covid?

“In the wake of the pandemic, health is much more on everyone’s radar,” says Dr Wakefield. “We all automatically ask ourselves ‘what would happen if I get sick?’.” Health anxieties are often at the forefront of our minds when expecting a baby, but pregnant women should feel reassured that — if double-vaccinated — the risk of contracting Covid while travelling is significantly reduced, as is your chance of becoming seriously ill if you do catch it. “There is a concern that if you’re on a flight and they’re recirculating air, your risk of catching it is a bit higher,” says Dr Wakefield. “However, the evidence shows that there weren’t big increases of people catching it on planes, because passengers were wearing masks.”

If you’re worried, invest in a good-quality face covering to wear during the flight — but it’s important to think about the destination, too. “If, God forbid, you did catch Covid while pregnant and became poorly, you’d want to be in a place that offered the best medical care,” says Dr Wakefield. “A system similar to that available through the NHS at home.” Those with or without health issues or pregnancy to consider should always take sensible precautions when visiting a developing country — drinking bottled water, not eating salad or taking ice in your drinks — to minimise the chance of catching a stomach bug.

Can I have travel vaccinations if I’m pregnant?

You can — but vaccines that contain live bacteria or viruses aren’t recommended during pregnancy because of concerns they might harm your baby. Examples include the MMR, oral polio or typhoid and yellow fever vaccines. That said — if, for whatever reason, you have to go to a country where you’re at risk from one of these diseases “it’s better for you to have the vaccine than take the chance of contracting the illness,” says Dr Wakefield. “So again, it’s a personal thing, but if you want to go to Mexico to sit on the beach and going there requires a live vaccination, you might want to reconsider your travel plans.”

Where’s the best place to sit on a plane when pregnant?

You may wish to think about paying extra for a seat with more legroom, to give you space to move around and stretch during the flight — especially if flying long-haul. Requesting an aisle seat or bulkhead seat is cheaper and will help you stick to a DVT-preventing regime of regular walks. It’ll also give you unfettered access to the loos — generally non-negotiable during pregnancy. Maintaining stable blood sugar can also really help with early pregnancy nausea, so in this phase perhaps position yourself near the galley, where cabin crew generally keep a ready supply of snacks.

Could airport scanners be harmful to my baby?

No, they’re perfectly safe. X-rays are not recommended during pregnancy, but whole-body airport scanners use different technology (millimetre wave imaging), to detect potentially dangerous objects that you might have concealed under your clothing. The level of radiation people are exposed to during this process is very low — less than you’d get from your smartphone — so they’re considered safe for all. You needn’t worry about the hand-held scanners sometimes used by security teams, either. X-Rays are used to scan luggage, but these machines have thick walls and lead curtains to prevent passengers being exposed to radiation.

What should I do about travel insurance — am I covered?

Getting cover for health insurance should be straightforward during the first two trimesters of pregnancy, so long as your doctor or midwife agrees that you’re medically fit to travel and your trip falls within your carrier’s specific guidelines. “Travel insurance is primarily there to cover the cost of emergency overseas medical treatment for unexpected events when you are on holiday,” said a spokesperson from the Association of British Insurers . “While pregnancy is not classed as a pre-existing condition, travellers should disclose any other existing conditions to their insurer. Normally childbirth would not be seen as an unforeseen event and would therefore not usually be covered by your travel insurance.” That said, medical treatment required after a premature birth or unforeseen emergency would usually be covered, so long as the woman had followed medical advice about her journey and stuck to the rules outlined by the airline she travelled with.

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• Advising on travel...

Advising on travel during pregnancy

• Related content
• Peer review
• Natasha L Hezelgrave , academic clinical fellow, obstetrics and gynaecology 1 ,
• Christopher J M Whitty , professor 2 ,
• Andrew H Shennan , professor of obstetrics 1 ,
• Lucy C Chappell , clinical senior lecturer 1
• 1 Division of Women’s Health, King’s College London School of Medicine, London SE1 7EH, UK
• 2 International Health, London School of Hygiene and Tropical Medicine, London, UK
• Correspondence to: L Chappell lucy.chappell{at}kcl.ac.uk
• Accepted 10 April 2011

Summary points

Travel during pregnancy may carry additional risks

The second trimester of pregnancy is considered the safest in which to travel

Air travel may carry risk of miscarriage, preterm birth, and thromboembolism

Adequacy of obstetric and neonatal care facilities at destinations is varied

Women should obtain adequate insurance and check with their airline for restrictions on travel

Communicable diseases acquired abroad may increase risks of perinatal morbidity

As travel increases, 1 the number of pregnant women who travel will probably rise. Women often ask if travel is safe in pregnancy and seek advice from a range of healthcare professionals. Travel related maternal and fetal morbidity and mortality can be completely avoided only by postponing travel until after delivery, but travel may be necessary or desirable during pregnancy.

Most women are “low risk” and can expect no problems with travel during pregnancy. However, there are particular risks to be considered with each stage of pregnancy, especially if the pregnancy is complicated by comorbidity. Medical concerns can be divided into risks of travel itself (in particular air travel), difficulties related to negotiating different healthcare systems and insurance, and specific risks of acquiring infectious diseases in particular countries. Some travel companies place restrictions on travel in pregnancy. Limited robust evidence or disseminated guidelines makes it difficult to provide definitive advice.

When asked to advise a woman regarding travel in pregnancy a careful risk assessment will help to inform the advice given. We outline an approach to considering risks associated with travel during pregnancy and discuss preparation for travel, advice on managing illness while abroad, and relevant post-travel considerations. This article is relevant to all who provide care during pregnancy, particularly general practitioners, who may be the primary source of advice for women with uncomplicated pregnancies who are considering travel.

Sources and selection criteria

We searched PubMed and the Cochrane Library using the terms “travel”, “travelling”, “flight”, and “flying” together with “pregnancy” and “antenatal”, along with other relevant search terms for specific topics. We also searched the National Institute for Health and Clinical Excellence (NICE), the Royal College of Obstetricians and Gynaecologists (RCOG), and the American Congress of Obstetricians and Gynecologists (ACOG) for published guidelines and articles yielded by reference lists.

What are usual restrictions on travel in pregnancy?

Many domestic and international airlines place restrictions on travel at advanced gestations (box 1), although guidelines vary between airlines. Women should consult their airline before flying to check individual restrictions. Some ferry operators have similar regulations to airlines, but most international train services are not restrictive.

Box 1 Typical gestation guidelines for air travel in uncomplicated pregnancies

Unlimited up to 28 weeks

After 28 weeks women should carry a letter from a doctor or midwife confirming the due date and that pregnancy is uncomplicated

Singleton pregnancies: flying usually permitted up to 36 +6 weeks*

Multiple pregnancies: flying usually permitted up to 32 +6 weeks*

*Women must inform and check with the individual airline on every occasion.

Who is at increased risk of adverse outcome and when?

No formal evidence or guidance is available on absolute contraindications to travel in pregnancy, because the decision may depend on gestation, degree of clinical compromise, and presence of pre-existing comorbid disease. However, certain women with obstetric or medical conditions should be advised against travelling (table 1 ⇓ ); this decision will need to be made on an individual basis by an obstetrician, often in conjunction with the relevant medical specialist, and will depend on the degree of potential compromise.

Indications for caution before travel

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In women who are otherwise healthy, and when travel dates are flexible, doctors are often asked if there is a “best” gestation for travel. Each trimester has specific risks and considerations.

First trimester

Although travel probably does not alter risk in women who are at increased risk of having an ectopic pregnancy or a miscarriage it will increase the difficulty (and cost) of management if either of them occurs. Women at increased risk of an ectopic pregnancy include those who have become pregnant after sterilisation or while using an intrauterine contraceptive device and those with previous ectopic pregnancy, tubal surgery, pelvic inflammatory disease, infertility, and documented tubal pathology.

A review noted that the miscarriage rate is 3-30% for women who experience vaginal bleeding in the first trimester. 2 Prospective studies quote a miscarriage rate of only 3-5% if fetal heart activity is confirmed after bleeding. 3 4

Second trimester

Pregnancy related complications, including miscarriage, are less common during the second trimester of pregnancy than in the first and the third trimester. Risks of an adverse pregnancy outcome are small and similar in nature to those described for the third trimester. The National Institute of Health and Clinical Excellence (NICE) schedule for antenatal care advises only one visit in the second trimester, after the 20-22 week anomaly ultrasound scan. 5

Third trimester

Preterm delivery (spontaneous and iatrogenic, as a result of pregnancy complications) occurs in 7-12.3% of all pregnancies, 6 7 depending on country of residence and ethnicity, but is often unpredictable. Women at increased risk of preterm delivery include those who have had a preterm birth, recurrent episodes of threatened preterm delivery, multiple pregnancy, or cervical trauma.

What are the specific risks associated with air travel?

Specific concerns have been raised about the safety of air travel during pregnancy as a result of the woman’s changing physiology and the altered environmental conditions.

Miscarriage and preterm birth

A recent meta-analysis of nine studies, mainly retrospective cohort in design, 8 reported that the risk of pregnancy loss was significantly greater in flight attendants than in controls (odds ratio 1.62, 95% confidence interval 1.29 to 2.04). Risk of preterm birth (less than 37 weeks) was also significantly higher in air passengers than in controls (1.44, 1.07 to 1.93), but not in flight attendants (1.37, 0.85 to 2.22). The authors note that studies were few in number and generally not of high methodological quality.

Venous thromboembolism (box 2)

Venous thromboembolism is 10 times more common in pregnant women than in matched non-pregnant women, and it complicates about one in a 1000 pregnancies. 9 Inherent prothrombotic endothelial changes of pregnancy and relative obstruction to venous flow by the gravid uterus contribute to this. Travel may confer further risk of thrombosis because of immobility, low oxygen tension, and low humidity, which lead to venous stasis and dehydration. 10

Box 2 Royal College of Obstetricians and Gynaecologists’ recommendations for flight deep vein thrombosis prophylaxis 10

Use aisle seat if possible to facilitate movement

Mobilise throughout flight—every 30 minutes

Avoid dehydration

Increase water intake

Limit caffeine and alcohol intake

Consider elastic compression stockings for flights longer than four hours

Consider low molecular weight heparin in the presence of additional risk factors for deep vein thrombosis (such as obesity, previous deep vein thrombosis) if not already on antenatal thromboprophylaxis

A recent cohort study reported that air travel was associated with a two to four times higher risk of a new thrombosis in non-pregnant people. 11

Exposure to radiation

Exposure to radiation at any stage in pregnancy, but particularly during fetal organogenesis, is of concern. Exposure to cosmic radiation during flight is potentially greater than on the ground. Guidelines for diagnostic imaging in pregnancy from the American Congress of Obstetricians and Gynecologists (ACOG) conclude that there is no known increase in fetal malformations or miscarriage or effects on growth at levels less than 50 mSv. 12 For comparison, the estimated cumulative background radiation per year in the United Kingdom is 2.2 mSv, a chest radiograph gives 0.1 mSv, and the radiation exposure from a 10 hour flight is estimated to be 0.05 mSv. 13 The risk of adverse effects to the fetus from radiation during a single flight is negligible, but pregnant women who are frequent fliers, and airline staff who fly, may reach levels of exposure over the recommended maximum.

Low oxygen saturation

The partial pressure of oxygen in inspired air in aeroplane cabin environments maintained by cabin pressure is usually lower than it is at sea level. Physiological adaptations to this relative reduction in inspired oxygen include an increase in heart rate, increased blood pressure, and a decrease in transcutaneously measured arterial oxygen saturation. 14 Fetal haemoglobin has a greater affinity for oxygen than does adult haemoglobin, and the fetus is able to maintain a higher oxygen saturation in this environment, which protects it during routine flight conditions. Most healthy pregnant women will have no adverse effects, but those with pre-existing cardiovascular problems, sickle cell disease, or severe anaemia (haemoglobin <80 g/L) may experience the effects of low arterial oxygen saturation. 15 A routine haemoglobin check before travel is not currently recommended, but women with known anaemia should aim to optimise their haemoglobin before they travel, and those with severe anaemia should be advised to postpone air travel.

What are the risks from communicable diseases?

Travel to many developing countries puts pregnant women at increased risk of exposure to communicable diseases that manifest more severely in pregnancy. Prophylaxis and treatment of infectious diseases may affect the fetus. Although the risks of communicable diseases should not be exaggerated, because most are rarely acquired, important examples include the following.

Travellers’ diarrhoea (box 3)

Travellers’ diarrhoea affects 10-60% of visitors to tropical and semi-tropical regions of the developing world. 16 In pregnancy, decreased gastric activity and slowed intestinal transit may result in more severe dehydration and ketosis, which may increase the risk of premature labour. 17

Box 3 Travellers’ diarrhoea 18

Meticulous care with hand washing and attention to food hygiene are needed

Use boiled or bottled water (theoretical risk with iodine water purification and fetal toxicity)

Avoid raw food (such as vegetables) not washed in a known safe water source

Most patients will respond to early and generous oral rehydration (oral rehydration salts mixed with filtered water, which is safe in pregnancy). Use a sugary drink if oral rehydration salts are not available because sugars are likely to increase water absorption

If the patient does not respond, consider treatment for atypical pathogens (such as giardia, amoeba, and cryptosporidia) after confirmed diagnosis on a stool sample; check safety of specific antibiotics in pregnancy

Early recourse to parenteral rehydration if the patient does not respond to oral fluids

Malaria in pregnancy

Malaria in pregnancy carries substantial risks to mother and baby, particularly with Plasmodium falciparum infection. Pregnant women probably have a higher risk of being bitten by mosquitoes than non-pregnant women 19 ; an increased risk of contracting malaria and dying from it 20 ; a higher likelihood of malaria related hypoglycaemia 21 ; and an increased risk of miscarriage, stillbirth, and premature labour if they develop malaria. 22 Malaria prophylaxis is not 100% effective. 10

Other infections

Hepatitis E is a faeco-oral hepatitis virus that is more likely to cause severe disease in pregnancy. There is currently no vaccine. The incidence of rubella is higher in many countries than in the United Kingdom; women who have not been vaccinated or infected in childhood are at increased risk of acquiring rubella. Acquiring HIV during pregnancy produces a high viral load, making mother to child transmission of HIV more likely. Many rarer infectious diseases ranging from typhoid to listeriosis pose a greater risk to the fetus, the mother, or both when acquired during pregnancy.

What pre-travel advice should you give after assessing risk?

Box 4 summarises the approach to risk assessment in pregnant women who are considering imminent travel.

Box 4 Assessment of a pregnant woman before travel

Assess the index pregnancy.

Has the woman considered gestation specific risks?

Are blood pressure, antenatal progress to date, and ultrasound findings normal?

Does the woman have acute symptoms or signs (vaginal bleeding, uterine activity, pain)?

Are the risks of antepartum haemorrhage, preterm labour, and pre-eclampsia low?

Check history of problems in a previous pregnancy

Have the risks of recurrence been considered?

Check pre-existing or additional medical conditions

Is acute deterioration likely during travel?

Is the woman carrying appropriate documentation?

Drugs: does the woman have sufficient supplies (including needles), has she considered the effects of crossing time zones (for example, with insulin), and can she replace supplies if necessary?

Women considering air travel

The Royal College of Obstetricians and Gynaecologists (RCOG) and the ACOG have both issued guidance on air travel in pregnancy. The ACOG states that healthy pregnant women with uncomplicated singleton pregnancies can fly safely up to 36 weeks’ gestation. 15 Similarly, the RCOG guidelines state that there is no specific risk to pregnancy associated with commercial air travel. 10 However, NICE suggests that pregnant women should be informed of the risk of venous thrombosis with long haul air travel, although it is unclear whether pregnancy confers an additional risk. 5 The RCOG recommends prophylactic measures for pregnant women against venous thrombosis (box 2), including the use of correctly fitted compression stockings, which reduce the risk of thromboembolism in the general population, 10 although no evidence exists on their effectiveness in pregnancy. Women with pre-existing cardiovascular problems, sickle cell disease, or severe anaemia should either not travel by air or they should consider supplemental oxygen if travel is unavoidable.

Women should be advised to wear a seatbelt while seated (whether travelling by aeroplane, car, or coach), strapped low under the abdomen, across the top of the thighs. 10

Women consulting early in pregnancy

The location of the pregnancy should be confirmed ultrasonographically before travel in women who are at increased risk of miscarriage or ectopic pregnancy. In the presence of any abnormal symptoms (abdominal pain, bleeding) we advise women to defer travel until the pregnancy location and viability have been confirmed with ultrasound scan and symptoms have settled. If a woman is asymptomatic, many maternity units in the UK do not offer a routine first trimester ultrasound until 11-13 weeks’ gestation, and most early pregnancy units do not offer earlier routine scans solely for those considering travelling.

Women consulting after the first trimester

The ACOG considers the second trimester to be the best time to travel. 15 Women who are at increased risk of preterm delivery should avoid long haul flights and consider the availability of maternity and neonatal care facilities. 23 Facilities for managing the preterm infant may not be optimal or covered by insurance at the destination, and such facilities are not available on an aircraft. Other serious adverse events in pregnancy (such as major antepartum haemorrhage, severe pre-eclampsia, or cord prolapse) are not common but are difficult to predict; they may be life threatening, especially in the absence of trained personnel and adequate medical facilities. Airlines carry limited resuscitation facilities and often rely on the chance availability of a doctor. Only five of 17 international airlines questioned in 2004 carried delivery kits. 24 A typical leading airline confirmed (2010) that although cabin crew undergo mandatory “pregnancy and emergency childbirth” training, the onboard medical kit contains a delivery pack, one 22 g cannula, one ampoule of ergometrine with oxytocin, and no crystalloid or colloid fluid.

Extended travel abroad and advice on travel insurance

Women should be encouraged to find out about the availability and quality of medical care at their chosen destination, including facilities for mother and baby. If they are travelling for long periods of time they should organise routine antenatal checks abroad. Women should travel with their handheld obstetric notes so that their medical details are readily available to any treating clinician, who can in turn update this information.

A survey of 138 women attending for ultrasound scan at 34 weeks’ gestation found that more than a third who had travelled during their pregnancy had done so without adequate insurance. 25 Preterm babies may not be able to be repatriated for some months, and the costs may be substantial. Any woman considering travel while pregnant should take out insurance in the event of medical problems or delivery away from home. Many insurers will cover pregnant women only until 32 weeks’ gestation, and women should obtain agreement from their insurer in writing before travel. British women travelling in Europe should get a European Health Insurance Card (EHIC) and carry it at all times; it shows that they are eligible for free or reduced cost emergency medical care but does not replace travel insurance and will not cover the cost of repatriation.

Travel to a malaria endemic country

Risks of acquiring malaria vary considerably. In many parts of sub-Saharan Africa in particular, the average person may get malaria several times a year. The RCOG advises against travel to malaria endemic zones during pregnancy. 26 If travel is unavoidable, encourage women to take chemoprophylaxis, which—although not 100% effective—carries a low risk to the fetus, especially in the second and third trimesters, compared with the much higher risks to the pregnancy associated with malarial infection if prophylaxis is not taken. The choice of chemoprophylaxis depends on specific incidence of malaria at the destination and level of drug resistance to P falciparum . We advise seeking specialist input for women in the first trimester because of the small theoretical potential for teratogenicity from antimalarial drugs that must be weighed against the substantial risk of acquiring malaria. To avoid bites pregnant women should always sleep under treated mosquito nets in a malaria endemic area and wear long clothing after dark. A low index of suspicion for a diagnosis of malaria in women who have travelled to endemic areas is vital, and given the high risk to the pregnancy urgent specialist advice is recommended for treatment.

Are travel vaccinations safe in pregnancy?

The risks of vaccination during pregnancy on the developing fetus are unclear. The Centers for Disease Control and Prevention state that there is no evidence of risk from vaccinating pregnant women with inactivated virus, bacterial vaccines, or toxoids. 27 It is advised that pregnant women avoid live vaccines, such as yellow fever, because of the small risk of contracting a disease that is potentially harmful to the fetus. 28 For yellow fever a letter from a doctor or travel centre stating why vaccination has not been given reduces the risk of pregnant women being turned away or vaccinated on arrival. Inactivated vaccines are generally considered safe, although those associated with febrile reactions (such as oral typhoid) are generally not advised unless the risk is high, because they have been linked with miscarriage. 27 Women should seek up to date information from an appropriate travel clinic about vaccination and should be encouraged to avoid disease endemic areas (table 2 ⇓ ).

Travel vaccinations in pregnancy

Considerations in the returning pregnant traveller

Routinely ask about recent travel in a pregnant woman who becomes unwell and encourage women to mention recent travel if they become ill on their return. If a travel history is given, have a low threshold for suspecting and looking for thromboembolism and infectious diseases, particularly malaria. A pregnant woman brought up in a malaria endemic area may have malarial anaemia without malaria being visible in the peripheral blood film because of placental sequestration of the malaria parasite. If travel related infection is suspected clinicians should seek specialist advice.

Unanswered questions

Is there a true increased risk of miscarriage among frequent flyers?

What is the increased risk of thromboembolic disease in women who fly during pregnancy and how can it be reduced?

Can the risk of preterm labour be predicted accurately before travel using a combination of cervical length and cervicovaginal fetal fibronectin?

Can the risk of pre-eclampsia be predicted accurately before travel using a combination of biomarkers (plasma or urine) or uterine artery Doppler velocimetry, or both?

Should the NHS bear the cost of additional investigations to support the mother’s decision to travel while pregnant?

A patient’s perspective

During my first pregnancy I travelled to Sri Lanka to be with my husband’s family who were organising a family reunion. I was 23 weeks’ pregnant and my five month scan had been fine. While I was out there I was careful about what I ate and drank but I still got travellers’ diarrhoea. I was in bed for a few days while I was away and it took me a while to get over it. I was worried about the baby but it was fine in the end. I did have insurance that covered me, but I still didn’t want to go into hospital while I was abroad.

A few years later, we were trying for our third baby and I went to Mauritius with my husband. I found out I was pregnant—about six weeks’ gestation—just before we left. While we were in Mauritius, I started to bleed. I was worried about an ectopic pregnancy or a miscarriage because I had already had a miscarriage. I didn’t know whether I should try to arrange a scan out there or fly home immediately. Eventually, the bleeding settled and we flew home at the end of the holiday. It was a very difficult time, and I wished I had known that the baby was in the right place and OK.

Additional educational resources

Resources for health professionals.

Royal College of Obstetricians and Gynaecologists. Scientific Advisory Committee opinion paper on air travel and pregnancy. www.rcog.org.uk/womens-health/clinical-guidance/air-travel-and-pregnancy

ACOG Committee on Obstetric Practice. ACOG Committee Opinion No 443. Air travel during pregnancy. Obstet Gynecol 2009;114:954-5

Royal College of Obstetricians and Gynaecologists. Malaria in pregnancy prevention guidelines. www.rcog.org.uk/prevention-malaria-pregnancy-green-top-54a

Health Protection Agency. National malaria prevention guidelines. http://www.hpa.org.uk/infections/topics_az/malaria/guidelines.htm

Centers for Disease Control and Prevention ( http://wwwnc.cdc.gov/travel/ )—Provides up to date health information for advising those who wish to travel

Medical advisory services for travellers abroad (MASTA) ( www.masta.org.uk )—Provides information on whether the travel destination is currently an endemic country:

Resources for pregnant women

Royal College of Obstetricians and Gynaecologists ( www.rcog.org.uk/air-travel-and-pregnancy-information-for-you )—Air travel and pregnancy information leaflet

ACOG ( www.acog.org/publications/patient_education/bp055.cfm )—Patient education on travel during pregnancy

British Insurance Brokers’ Association (BIBA) ( www.biba.org.uk )—Provides information on travel insurance for pregnant women

Cite this as: BMJ 2011;342:d2506

Thanks to Alan Stone, nurse adviser at British Airways.

Contributors: NLH performed the literature search and wrote the initial draft. LCC revised the first and later drafts. CJMW and AHS provided further contributions and revised subsequent drafts. All authors approved the final version. LCC is guarantor.

Funding: None received.

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could have influenced the submitted work.

Provenance and peer review: Not commissioned; externally peer reviewed.

Patient consent obtained.

• ↵ Health Protection Agency. Foreign travel-associated illness in England, Wales and Northern Ireland. 2007.
• ↵ Sotiriadis A, Papatheodorou S, Makrydimas G. Threatened miscarriage: evaluation and management. BMJ 2004 ; 329 : 152 -5. OpenUrl FREE Full Text
• ↵ Tongsong T, Srisomboon J, Wanapirak C, Sirichotiyakul S, Pongsatha S, Polsrisuthikul T. Pregnancy outcome of threatened abortion with demonstrable fetal cardiac activity: a cohort study. J Obstet Gynaecol 1995 ; 21 : 331 -5. OpenUrl PubMed
• ↵ Tannirandorn Y, Sangsawang S, Manotaya S, Uerpairojkit B, Samritpradit P, Charoenvidhya D. Fetal loss in threatened abortion after embryonic/fetal heart activity. Int J Gynaecol Obstet 2003 ; 81 : 263 -6. OpenUrl PubMed
• ↵ National Institute for Health and Clinical Excellence. Antenatal Care. Routine care for the healthy pregnant woman. 2008. www.nice.org.uk/nicemedia/pdf/CG062NICEguideline.pdf .
• ↵ Office for National Statistics. 1 in 13 live births in England and Wales are born preterm. 2007. www.statistics.gov.uk/pdfdir/preterm0507.pdf .
• ↵ Martin J, Osterman M, Sutton P. Are preterm births on the decline in the United States? Recent data from the National Vital Statistics System 2008. NCHS data brief, no 39. National Centre for Health Statistics, 2010.
• ↵ Magann EF, Chauhan SP, Dahlke JD, McKelvey SS, Watson EM, Morrison JC. Air travel and pregnancy outcomes: a review of pregnancy regulations and outcomes for passengers, flight attendants and aviators. Obstet Gynaecol Surv 2010 ; 5 : 396 -402. OpenUrl
• ↵ Rodger MA, Walker M, Wells PS. Diagnosis and treatment of venous thromboembolism in pregnancy. Best Pract Res Clin Haematol 2003 ; 16 : 279 -96. OpenUrl PubMed
• ↵ Royal College of Obstetricians and Gynaecologists. Air travel and pregnancy. Scientific Advisory Committee Paper, 2008. www.rcog.org.uk/womens-health/clinical-guidance/air-travel-and-pregnancy .
• ↵ Kuipers S, Cannegieter SC, Middeldorp S, Robyn L, Buller HR, Rosendaal FR. The absolute risk of venous thrombosis after air travel: a cohort study of 8755 employees of international organisations. PLOS Med 2007 ; 4 : 290 . OpenUrl CrossRef
• ↵ 1ACOG Committee on Obstetric Practice. ACOG Committee Opinion. Number 299. Guidelines for diagnostic imaging during pregnancy. Obstet Gynecol 2004 ; 104 : 647 -51. OpenUrl CrossRef PubMed Web of Science
• ↵ Barish R. In-flight radiation exposure during pregnancy. Obstet Gynecol 2004 ; 103 : 1326 -30. OpenUrl CrossRef PubMed Web of Science
• ↵ Huch R, Baumann H, Fallenstein E, Schneider KT, Holdener E, Huch A. Physiologic changes in pregnant women and their fetuses during jet air travel. Am J Obstet Gynecol 1986 ; 154 : 996 -1000. OpenUrl PubMed Web of Science
• ↵ ACOG Committee on Obstetric Practice. ACOG Committee Opinion No 443. Air travel during pregnancy. Obstet Gynecol 2009 ; 114 : 954 -5. OpenUrl CrossRef PubMed
• ↵ Dupont HL. Systematic review: the epidemiology and clinical features of travellers’ diarrhoea. Aliment Pharmacol Ther 2009 ; 30 : 187 -96. OpenUrl CrossRef PubMed Web of Science
• ↵ Agnew CL, Ross MG, Fujino Y, Ervin MG, Day L, Kullama LK. Maternal/fetal dehydration: prolonged effects and responses to oral rehydration. Am J Physiol 1993 ; 264 : 197 -203. OpenUrl
• ↵ Diemert D. Prevention and self-treatment of traveler’s diarrhea. Clin Microbiol Rev 2006 ; 19 : 583 -94. OpenUrl Abstract / FREE Full Text
• ↵ Barry M, Bia F. Pregnancy and travel. JAMA 1989 ; 261 : 728 -31. OpenUrl CrossRef PubMed
• ↵ Lindsay S, Ansell J, Selman C, Cox V, Hamilton K, Walraven G. Effect of pregnancy on exposure to malaria mosquitoes. Lancet 2000 ; 355 : 1972 . OpenUrl CrossRef PubMed Web of Science
• ↵ Royal College of Obstetricians and Gynaecologists. The diagnosis and treatment of malaria in pregnancy. Greentop Guideline No 54B. 2010.
• ↵ McGready R, Ashley EA, Nosten F. Malaria and the pregnant traveller. Travel Med Infect Dis 2004 ; 2 : 127 -42. OpenUrl CrossRef PubMed
• ↵ Easa D, Pelke S, Loo SW, Ash K, Shimomura G, Nakamura KT. Unexpected preterm delivery in tourists: implications for long distance travel during pregnancy. J Perinatol 1994 ; 14 : 264 -7. OpenUrl PubMed
• ↵ Breathnach F, Geoghegan T, Turner MJ. Air travel in pregnancy: the air-born study. Irish Med J 2004 ; 97 : 167 -8. OpenUrl
• ↵ Kingman C, Economides DL. Travel in pregnancy: pregnant women’s experiences and knowledge of health issues. J Travel Med 2003 ; 10 : 330 -3. OpenUrl PubMed Web of Science
• ↵ Royal College of Obstetricians and Gynaecologists. The prevention of malaria in pregnancy. Greentop Guideline No 54A. 2010.
• ↵ Centre for Disease Control and Prevention. Guidelines for vaccinating pregnant women from recommendations of the Advisory Committee on Immunization Practices (ACIP). 1998. www.cdc.gov/vaccines/pubs/preg-guide.htm .
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Tips for travelling while pregnant

Travelling while pregnant needn't be an ordeal. from picking the most suitable luggage and packing the right snacks to medical advice and travel insurance, we've got you covered..

If you're flying while pregnant, wear flat shoes and loose clothing.

1 // Fly high You can generally fly until you're 36 weeks gone (32 if carrying twins) but check with your airline. You may also need a doctor's note and your medical records beyond 28 weeks. Be prepared for morning sickness, tiredness and sinus problems to be aggravated by flying (especially in the first trimester). General advice applies when flying: wear flat shoes and loose clothing and try some light in-flight yoga. Upgrade or pre-book aisle or bulkhead seats for more space, or seats over the wings for a smoother journey.

2 // Pack with hacks Use wheelable, light luggage, and pack a travel pillow or neck support, a refillable water bottle, heartburn tablets (as this can be made worse when cramped) and a bump band for back support.

3 // Take to rail, road or water These options can be less arduous than flying but still mean sitting still for long periods, so stroll or take a break if possible, wear compression socks and do foot and leg exercises. Some ferry and cruise companies won't carry heavily pregnant women (or even those beyond 32 weeks), so check before you book. If you're taking a cruise, ask about medical facilities on board and at ports.

4 // Avoid no-go zones Pregnant women should avoid travel to areas with a high risk of Zika, or have unprotected sex with someone who's lived in or travelled to an area with the mosquito-borne virus, which can cause serious birth defects. For details of areas with a high risk, see cdc.gov.

5 // Be protected Jabs are essential — the risk of catching an infectious disease far outweighs any potential risk from vaccination. Book in with your GP at least eight weeks before travel. Your doctor or nurse can let you know about any vaccines that aren't recommended due to live bacteria. Ideally, avoid travelling to places with malaria while pregnant. If you do go, seek advice well before your departure date. Your GP can prescribe antimalarials that are safe to take during pregnancy.

6 // Get covered Take your medical notes (or copies) wherever you travel. At the time of writing, it was unclear how Brexit will affect the European Health Insurance Card (EHIC) giving health cover in the EU (see nhs.uk for updates). Nonetheless, it's important to cover all bases with an additional private travel insurance policy. Check it covers you for pregnancy (including transport and hospitalisation) and also covers the baby if you give birth during your trip.

7 // Eat and drink wisely With tiredness and dizziness common in pregnancy, especially early on, however you travel, go armed with healthy natural snacks such as fruit and nuts, and keep hydrated. At your destination, check if tap water is safe — if it isn't, stick to bottled water. If you do get sick when you're travelling, check any medicines you intend to consume are suitable during pregnancy. If you're ill, even if you're not hungry, keep hydrated and eat plainer food when your appetite returns.

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Published in the November 2018 issue of National Geographic Traveller (UK)

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• Travel and Adventure

Medical conditions and pregnancy

Travelling can be a bit daunting if you have a medical condition or are pregnant, but in most cases you don't need to do anything different. You may need to take some precautions and the information below will help you understand what you need to do.

Medical clearance – am I fit to fly?

For some medical conditions you need to get medical clearance before you can fly, for example:

• recent illness, hospitalisation, injury or surgery
• existing unstable medical condition
• need for additional oxygen or use of medical equipment on board
• travelling for medical reasons or treatment.

How to get medical clearance

Step 1: Download our medical information form   (pdf, 650kb, English only) and fill out part one.

Step 2: Ask your doctor to complete part two.

Step 3:  Email the completed form (part one and part two) to  [email protected] . Our Passenger Medical Clearance Unit (PMCU) will be able to advise if you're fit to fly. Medical forms should be despatched to the medical clearance team a minimum of 7 days prior to departure.  Contact details for our PMCU can be found below. 

Portable oxygen cylinder : If you are travelling on a short-haul European flight, and require the use of your own portable oxygen cylinder (weighing less than 5kgs) you also need to download and complete the attached form . Email the completed form to  [email protected] .    Medical forms should be despatched to the medical clearance team a minimum of 7 days prior to departure.  Contact details for our PMCU can be found below. 

We assess your fitness based on internationally accepted criteria by the World Health Organisation so we can be sure you have a safe and comfortable flight. In some cases we may need additional information, or ask you to travel with a medical escort or supplementary oxygen.

Passenger Medical Clearance Unit (PMCU)

British Airways has a dedicated Passenger Medical Clearance team who can assess your fitness to fly and advise if you'll be able to travel.

Office Opening Hours: Monday to Friday - 08:00 to 16:00, Closed - weekends and Bank Holidays

If you need to use medical equipment on board that contains batteries, there might be some restrictions. Please click the link for information regarding batteries; Liquids and Restrictions .

Travelling with other airlines

If your flight is operated by one of our airline or franchise partners, they may have different processes so please contact them directly before you travel.

Travelling when you're pregnant

We welcome expectant mothers on board our flights during most of their pregnancy. To ensure the health and wellbeing of both mother and baby on the flight, please follow our guidelines. You may not be allowed to travel from some countries without your medical documentation.

For your and your baby’s safety, you cannot fly after:

• the end of the 36th week if you are pregnant with one baby
• the end of the 32nd week if you are pregnant with more than one baby.

We recommend you carry a letter or statement from your Doctor or Midwife confirming:

• Whether your pregnancy is single or multiple.
• Your expected due date.
• There are no complications with your pregnancy.

The letter should be dated as close to your travel date as possible and covers you for your entire journey (outbound and return), provided you do not require any medical care during your trip.

It is not necessary to complete our medical form.

Travelling with a medical escort

Sometimes, even if your medical condition is serious, you can still travel, but it must be with a medical escort. We recommend you book this through a recognised medical assistance company who specialise in this type of service.

Travel insurance

Our partner, Europ Assistance, offers COVID-19 travel insurance including medical emergencies and travel disruptions.

Find out more

Travel health information

Travelling with medicines, medical supplies or medical equipment.

Here's some key information for travelling with medicines, medical supplies or medical equipment. If you have any additional questions please contact PMCU .

• Please carry any medication, including liquid medicines, or medical supplies, such as syringes, in your hand baggage (if possible in the original packaging) with a prescription or supporting letter from your doctor that confirms this medication is prescribed to you to avoid delays at security or customs.
• We cannot help you keep your medication cool. Please talk to your pharmacist about alternative options.

If you do not have this letter, you will need to pay excess baggage charges for any bags that are in addition to your baggage allowance . A visual check of your medical bags may also be carried out to check their contents. In addition, you may need this letter to assist with other countries customs and immigration departments as well as local security requirements.

• In most circumstances you can use authorised medical equipment on board, except during taxi, take-off, approach and landing. All equipment must be able to work from a battery as we cannot guarantee a power supply on board.

Food allergies

In-flight meals.

We source food from all around the world and not every country considers the same food ingredients to be potential allergens. On UK-bound flights, allergen labelling on the packaging may not reflect all the allergens listed under UK legislation.

When booking travel, customers can order a special meal . However, note that staff (including call centre staff) are unable to share personal allergen information with cabin crew. When travelling with us, you must therefore inform your cabin crew of your food allergy upon boarding your flight.

To assist with food allergies

• If you have a food allergy, we can offer a range of special meals that exclude a variety of potential allergens e.g. seafood, dairy, eggs and gluten. Information on special meals can be found here .
• You can bring your own food on board.
• Upon request and following boarding, cabin crew will be able to provide information relating to the allergens contained within the meals served. In some instances, meal packaging will also provide this information.
• To allow for cleaning and inspection of seats, customers will be able to pre-board the aircraft following presentation of a medical letter for the epinephrine/adrenaline auto-injector to staff at the gate. Customers must bring their own suitable wipes.

Please note the following

• We cannot guarantee an allergen-free cabin environment or prevent other passengers from bringing their own food on board. Meals containing tree nuts may continue to be served throughout the aircraft and tree nut based snacks may also continue to be served in other cabins of travel depending on the aircraft type. We use the recommendations of the International Air Transport Association (IATA) for allergen-sensitive passengers to make sure your flight is as comfortable as we can make it.
• We do not currently offer any special meals free from sesame, tree nuts, lupin, soya, sulphites, mustard or celery.
• For customers consuming food of their choice, not provided by the airline - we are unable to heat or refrigerate any food items you might bring with you. If you prefer to consume your own food, we suggest non-perishable food. Please also check the different quarantine laws of your transit and/or destination with respect to food types permitted into the country.

Guidance for Peanut, Tree Nut or Sesame allergy sufferers

• Our in-flight meals do not contain peanuts or peanut products. However, they may be produced at a facility that handles peanuts. We are unable to offer a peanut-free special meal.
• We do not provide a special meal option for customers with tree nut or sesame allergies.
• We cannot guarantee an allergen-free environment while travelling with us.
• Upon request, Cabin Crew will make an announcement so that other passengers are aware of your allergy. Cabin Crew will also suspend the serving of loose nut snacks in your cabin of travel.

Severe allergic reactions (anaphylaxis)

Severe allergic reactions on board are rare, but if you suffer from a severe allergy always speak to your doctor before you book to discuss potential risks and how you can minimise becoming ill on your trip.

Here are a few examples of how you can prepare:

• Your epinephrine/adrenaline auto-injector should be carried in your hand baggage. This should be accompanied by a letter from your doctor or a copy of your prescription to present to airport security personnel.
• If you have been prescribed an epinephrine/adrenaline auto-injector like Epipen, Anapen, Twinject or Jext make sure you carry this with you in your hand baggage. Take an emergency treatment plan and a letter signed by your doctor with you to minimise delays at airport security.
• Clearly label your medication to show who it should be administered to.
• You will be able to pre-board when you present your medical letter for the epinephrine/adrenaline auto-injector to staff at the gate. This will allow you to wipe down your seating area to help prevent inadvertent contact with allergen traces. Passengers must bring their own suitable wipes.
• When boarding the aircraft you must inform cabin crew of your food allergy.
• Advise cabin crew and the people seated next to you of your allergy, where you have placed the medication and what to do in an emergency. Our cabin crew can speak to people seated near to you to help explain your allergy.
• Ensure your medication is easily accessible throughout the flight, e.g. place it in the seat pocket or on you personally.
• Cabin crew are trained to recognise symptoms of anaphylaxis and administer treatment but if you are travelling with family, friends or guardians, they would be expected to treat you first.
• Wear a medi-alert bracelet.

Anaphylaxis campaign website

Spraying the cabin

We are required by the World Health Organisation (WHO) or local Health Authorities to spray the inside of the aircraft before arrival into certain destinations to prevent the risk of insects spreading highly dangerous diseases, such as malaria and dengue fever.

On routes where we are required to spray, cabin crew will advise that spraying is about to take place. This will give you the opportunity to cover your eyes and nose if you wish. The spray clears from the aircraft in a few minutes.

Contents of the insecticides

The sprays contain synthetic pyrethroids, which are widely used. The World Health Organisation (WHO) assesses the safety of insecticides and recommends the use of the following synthetic pyrethroids:

• Phenothrin, which has lethal effects on domestic insect pests. It is used against mosquitoes, houseflies and cockroaches.
• Permethrin, which is a broad spectrum insecticide used against a variety of pests.

For flights to Australia, the aircraft must be sprayed prior to departure from Singapore with a Permethrin insecticide spray.

British Airways flights that require disinsection

If your diabetes is stable you can fly with no restrictions, however you need to take care that you look after yourself during your trip.

• If you are crossing time zones make sure you know how to manage your insulin regime throughout the trip.
• You should carry your insulin in your hand baggage otherwise it may freeze in the hold.
• Your insulin should be in the original packaging, easily identifiable and accessible during the flight.
• Always carry a prescription or supporting letter from your doctor to avoid delays at security or customs.

Carriage of newborn and babies

Newborn with no medical complications.

Normal Term :  British Airways is able to carry new born babies born at normal term (40 weeks) with no medical complications once they are 48 hours old. However, we recommend waiting until they are one week old. These children need no prior medical clearance.

Premature Infants : British Airways is able to carry premature infants born at more than 37 weeks gestation, with no medical complications, once they have reached the normal delivery date (40 weeks) plus one week. These infants need no prior medical clearance.

Premature newborn and ex-premature infants

Children born at less than 37 weeks gestation that were born with no medical complications can be considered for carriage once they have reached normal term (40 weeks) plus one week, but they will require medical clearance until they reach 12 months old.

Children born at less than 37 weeks gestation that were born with any respiratory complications (e.g. neonatal chronic lung disease / bronchopulmonary dysplasia etc) cannot be considered for carriage until they have reached normal delivery date (40 weeks) plus 6 months. From normal term plus 6 months old until they reach their first birthday, they will require medical clearance.

In both cases please contact PMCU prior to booking.

Babies with medical conditions

Babies with any significant condition, such as cardiac disease, or any other condition requiring medical support, e.g. oxygen, medication, treatment during flight, should be discussed with PMCU prior to booking.

Please download the medical information form (pdf, 650kb, English only) and fill out.

Flying after an illness or an operation

You need to be very careful if you're considering flying after an operation or illness. Please speak to your doctor before making a booking to confirm they're happy for you to fly.

The below details are a guide to the minimum time you must leave before you can travel and also whether you need to tell us about your condition. If you're in doubt, please contact our PMCU team .

Travel vaccinations

Please check if you need any travel vaccinations for your destination before you travel. You can find more information about your country of travel and any medical information on the IATA Travel Centre .

In the UK, our preferred travel partner for health services is MASTA (Medical Advisory Services for Travellers Abroad). They have the largest network of travel clinics across the UK and offer expert travel medicine advice and treatment, including a comprehensive immunisation service and a wide range of anti-malarial drugs.

MASTA website

BA Travel Clinics vaccination records

If you were vaccinated at one of our BA Travel Clinics before they closed in August 2006 and need a letter confirming your vaccination or a duplicate certificate of your Yellow Fever vaccination, please write to British Airways Health Services (see below address). Please note that we can only trace back vaccination information as far as 2002.

Please provide the following information:

British Airways Health Services - Travel Clinic records British Airways Plc Waterside (HMAG) PO Box 365 Harmondsworth UB7 0GB

Travellers' thrombosis (DVT)

Traveller’s thrombosis or Deep Venous Thrombosis (DVT) is a blood clot that forms in a vein, usually in the lower legs. Research has confirmed that if you are sitting in an aircraft, car, bus or train for more than four hours the risk of a blood clot forming may increase.

Factors increasing the risk of DVT include:

• being over the age of 40
• suffering previously from DVT or a pulmonary embolism or someone in your close family suffering from it
• use of oestrogen-therapy, oral contraceptives ('the Pill') or hormone-replacement therapy (HRT)
• recent surgery or trauma, particularly to the abdomen, pelvic region or legs
• some inherited blood-clotting abnormalities and other blood disorders.

If you think any of the factors above may affect you, seek medical advice before travelling. Your doctor may advise that compression stockings or anti-coagulant medication can help to avoid the possibility of DVT.

You can reduce the risk of DVT by:

• drinking normal amounts of fluid
• avoiding alcohol and caffeine
• avoiding smoking
• avoiding crossing your legs when you’re sitting down
• taking a walk around the cabin regularly
• standing in your seat area and stretching your arms and legs
• doing regular foot and leg exercises during the flight
• wearing loose-fitting, comfortable clothes when you’re travelling.

If you recently had a DVT:

If you recently had a DVT but have been discharged from hospital and your condition is resolved you should be fit to fly. Please contact PMCU to advise if you need to get medical clearance.

Broken bone

Communicable and contagious diseases.

The following illnesses can be contagious, we’ve put together some guidance on when you can travel.

In-flight oxygen

Short haul flights.

(including connecting flights to and from long haul segments)

Customers requiring therapeutic oxygen on short haul flights will be required to make their own provisions for all short haul segments of their itinerary. Acceptable therapeutic oxygen provisions are outlined below. Customers need to obtain medical clearance for approval of their own therapeutic oxygen provisions. Medical forms should be despatched to the medical clearance team a minimum of 7 days prior to departure.

Acceptable therapeutic oxygen provisions:

Portable Oxygen Concentrators

• Customers may bring a FAA approved portable oxygen concentrator (for more information please visit the FAA website https://www.faa.gov ).
• Customers must have sufficient battery provision for 150% of the flight duration (accounting for unexpected delays).
• Customers need to obtain medical clearance in advance to bring a portable oxygen concentrator. Medical forms should be despatched to the medical clearance team a minimum of 7 days prior to departure. 
• If your reservation is booked through British Airways but is operated by another airline, please check their own criteria for accepting portable oxygen concentrators on-board.

Oxygen Cylinders

• Customers may bring oxygen cylinders, providing they are manufactured specifically for the purposes of containing and transporting oxygen.
• Each cylinder and its contents must not exceed 5kgs in weight.
• Only one customer per flight will be permitted to bring their own oxygen cylinders on board.
• British Airways Health Services will advise on the volume of oxygen customers should bring during the medical clearance process.
• Cylinders, valves and regulators, where fitted, must be protected from damage that could result in inadvertent release of the contents.
• Liquid oxygen and oxygen generators are forbidden on board the aircraft.
• Customers need to obtain medical clearance in advance to bring their own oxygen cylinders. Medical forms should be despatched to the medical clearance team a minimum of 7 days prior to departure.

Long haul flights

We can only provide in-flight therapeutic oxygen to one person on board so if you need to use oxygen you must book it in advance. It's important to contact the Passenger Medical Clearance Unit to check availability prior to booking your flights. Please note we cannot provide oxygen on the ground at an airport.

On board our Airbus A380 and Boeing 787 aircraft we offer the Avia Technique Pulse dose cylinder: Oxygen is provided ‘on demand’ and your Doctor will need to confirm that you can use this.

There is no charge for in-flight therapeutic oxygen.

If therapeutic oxygen is required, you will need medical clearance to fly. Please allow the medical clearance team 48 hours to process your request. Medical forms should be sent to the team a minimum of 7 days prior to departure.

Disposal of used medical supplies

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Pregnancy travel: how to decide where to go

Travel in the first trimester: rest and relaxation

Travel in the second trimester: have a beach break, travel in the third trimester: pamper break, where not to go in pregnancy.

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10 top tips for pregnant travellers

Pampering pregnancy holidays

Dads: pregnancy timeline

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Tips for travelling while pregnant

Dec 16, 2019 • 8 min read

With a few pragmatic adjustments, pregnancy needn't clip your travelling wings © Tim Robberts / Digital Vision / Getty Images

Being a guidebook author and a journalist, I travel a lot for work. And for leisure; I didn’t get this job by accident. So when I became pregnant, I thought I’d make some adjustments but it never crossed my mind to stop travelling altogether.  During my first pregnancy, I travelled to Côte d’Ivoire , Brazil and France , the latter on numerous occasions, including two extended research trips for Lonely Planet’s France guidebook. And it was all a breeze. In fact, with hindsight, travelling with a bump turned out to be much easier than with babies and toddlers, so my advice to future parents is make the most of it!

Disclaimer: I am fit, healthy and enjoyed a (single) trouble-free pregnancy. Were it not the case, I wouldn’t have been able to do as much. But provided you are well too, there is no reason why you should hang up your rucksack and put your passport on sabbatical until baby is old enough to fly. Overall, I found that a little planning and some minor concessions (many of which I had to make at home anyway) were all that was needed for a great trip.

Formalities

Health check: Every woman and pregnancy is different so check with your doctor or midwife that they’re happy for you to travel (mine were very supportive). They’ll also be able to advise on medications you can or can’t take and what to do about immunisations and other disease prevention (more on that in a moment).

Insurance:  Policy provisions can vary depending on where you live, so it's important to check the fine print. The Association of British Insurers (ABI) recommends that you shop around to find the policy best suited to your needs and has an online tool to help you choose. Broadly speaking however, if you're European travelling in Europe, most policies will cover you if you’re enjoying a trouble-free pregnancy (as with every condition, you’ll be covered for unexpected events, not routine appointments). Just take your medical notes with you, should anything happen. But in Australia, for example, no insurance provider will cover a pregnant woman past 32 weeks (19 weeks for multiple pregnancies). Contact your insurer before you set off; travelling without insurance could be extremely costly if you were to go into labour early while abroad.

Flying: Many airlines put restrictions on pregnant women in their third trimester and the restrictions vary depending on whether you are flying long or short haul. Check the requirements before you book. In Europe, as a rule, the cut-off point is 36 weeks for a single pregnancy, 32 for twins/triplets. Once you’re past 28 weeks, some carriers ask for a letter from your doctor or midwife confirming your due date and that there are no complications with the pregnancy. Otherwise, the usual advice applies – drink plenty of fluids, move often and wear compression socks (pregnant women have a slightly higher risk of DVT, especially on long-haul flights).

Ferries and cruises:  Ferry companies tend to be fairly accommodating, usually allowing pregnant women to travel well into their third trimester (restrictions vary but 32 to 38 weeks is common, sometimes with a letter from your doctor or your midwife). Cruise companies are much more restrictive however, due to lengthy periods at sea: the cut-off point is 24 weeks. Some river cruise operators lift these restrictions due to the proximity to land but this isn’t universal. Make sure you check with the operator before booking.

Malaria, zika and dengue fever prevention

This is the most delicate topic I had to deal with. Health professionals advise pregnant women not to travel to malaria-prevalent areas because pregnancy reduces the body’s immunity to the disease. If you must go, your options for prophylaxis will be more limited than usual: some drugs cannot be taken at all during pregnancy; others can only be prescribed during the last six months; others still only work on some strains of the disease (and therefore only in certain areas/countries).

As a rule, I take prophylaxis if travelling to a malaria-prevalent area such as Côte d’Ivoire (I know some travellers don’t, but that’s a debate for another article). Unfortunately, there was nothing I could take last time around, so I decided instead to go all out on prevention.

The powerful insect repellent DEET is not recommended in the first three months of pregnancy; talk to a trained medical professional about other options. Covering yourself up is key: I wore long sleeves, long trousers and closed shoes and decided to have dinner indoors in the evening rather than on balmy terraces. I also slept in an air-conditioned room; even better would have been a mosquito net on the bed, although these were surprisingly scarce in Abidjan ’s mid-range hotels. I also bought Avon Skin So Soft, having heard that it worked wonders (it is actually a moisturiser). Its properties are not scientifically proven but anecdotal evidence is plentiful, so I thought I’d give it a try. The strategy worked for me: I left Côte d’Ivoire after four days without a single bite.

In Brazil, it was dengue, not malaria, I had to think about. This was before a zika virus outbreak swept through the Americas in 2015; travellers to central and south America (and a number of other countries) will now have to worry about both, but zika in particular because of the birth defects it can cause. The US Center for Disease Control (CDC) has comprehensive information on zika, including travel advice and a map of zika prevalence and outbreaks. The CDC’s recommendation is that pregnant women and couples looking to conceive should consult a healthcare professional about the risks of travelling to areas that have reported zika transmission in the past. The ABI notes that travel insurance is likely to pay a claim if you had booked a trip to a zika-prevalent area before finding out you are pregnant or if you’d booked a trip somewhere that was subsequently declared at risk with zika.

Dengue and zika are transmitted by the same species of mosquito, the Aedes, which bites during the day as well as at night. Zika can also be sexually transmitted. There is no vaccine or prophylaxis available for either disease so prevention is key. In Brazil, I applied the same bite prevention strategy as in Côte d’Ivoire for malaria. I did get a few bites over our two-week holiday, but then I’m not sure they were mosquitoes…

There are other diseases or health concerns you may have to think about before travelling, including immunisation - whatever the issue, do speak to your doctor about it so that you can make an informed decision.

Food and drink

I’ve found the food and drink restrictions of pregnancy to be my biggest frustration (if this were Twitter, I would add #firstworldproblems). I am a real foodie and cocktails are my guiltiest pleasure – having to forego unpasteurised cheese and charcuterie (cured meats) in France and caipirinhas in Brazil was akin to punishment.

On the plus side, I found people to be endlessly accommodating. In Corsica , I had waiters running back to their kitchens to check which, if any, of their cheeses were made with pasteurised milk; in Brazil, friends plied me with plates of specially well-cooked barbecued meat; and in the south of France, a restaurant made a fuss of preparing me a non-alcoholic aperitif.

Apart from these few restrictions, I followed the same precautions as usual to minimise the risks of food poisoning: filtered or bottled water if tap water is unsafe; piping hot food; salads from places you trust. I also carried snacks (cereal bars, dried fruit or bananas) to stave off the munchies (a pregnancy novelty).

OK, so perhaps you’ll have to swap canyoning for a trek and postpone your diving course until after the baby is born, but on the whole, I found that being pregnant did not stop me from enjoying an active trip. During my research for the France guidebook, I did several hikes in Corsica and the Riviera, cycled around Nice and kayaked off Île Rousse. In Brazil, swimming, snorkelling and hiking on Ilha Grande were among the highlights of my holiday.

The only time I felt uncomfortable was on a dreadful road in Parque Nacional do Itatiaia in Brazil. Knowing we’d have to do the same in reverse the next day, I decided to walk the worst stretch instead. As with health precautions, check with your doctor or midwife if in doubt about any activity.

It may be stating the obvious but wearing comfortable clothes is essential. I wore all my usual clothes until I was about three months pregnant and regretted not having invested in a pair of maternity trousers somewhere into the 2000km I drove for my France research (plan B was unbutton and unzip the jeans while driving – not terribly glamorous).

I got it right in Brazil, however: one pair of maternity jeans, a pair of linen cropped maternity trousers, baggy low-waist shorts and plenty of dresses. Maxi/long dresses were a dream; the short dress-cum-leggings combo also worked a treat (a thicker version of the latter would be perfect for winter/colder climes).

For swimwear, think about how comfortable you will be showing your bump: ‘tankinis’ and one-piece swimming suits are great alternatives to bikinis. And if you're going somewhere cold, make sure that whatever coat you take zips over the bump – no one wants a draughty tummy.

Cultural issues

If you are showing, be prepared for people touching your bump, even strangers, especially in Mediterranean or Latin cultures. You may also encounter some disapproval about you travelling. On the other hand, you’re likely to be shown unexpected kindness and attention: we received our first baby presents in Brazil from people we had only just met.

You might also like:

Baby travel: why and where you should head afield with your infant   How to pack for travel with kids   Family adventure destinations 

Article first published in July 2014, and last updated by Emilie Filou in December 2019

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This article was first published July 2014 and updated December 2019

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Zika virus infection and pregnancy

Last updated: 27 February 2019

This guideline provides information for healthcare professionals on Zika virus infection in pregnancy, developed by the RCOG, Royal College of Midwives, Public Health England and Health Protection Scotland.

The guideline is updated on a regular basis as new data becomes available.

The guideline covers:

• Epidemiology
• Transmission
• Congenital Zika virus syndrome
• Travel advice for pregnant women and couples planning pregnancy
• Recommendations for pregnant women and those planning pregnancy
• Perinatal outcomes
• Information for women

Related information

• Zika virus (ZIKV): clinical and travel guidance collection on  GOV.UK
• Testing algorithm for the Zika virus in pregnancy guidelines  
• Further patient information on the  NHS Choices  website  
• Advice for travellers including pregnant women on the National Travel Health Network and Centre ( NaTHNaC ) website    
• Health advice for women returning from areas with active Zika virus transmission on  GOV.UK

This page was last reviewed 17 June 2016.

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Pregnant Travelers

Pregnant travelers can generally travel safely with appropriate preparation. But they should avoid some destinations, including those with risk of Zika and malaria. Learn more about traveling during pregnancy and steps you can take to keep you and your baby healthy.

Before Travel

Before you book a cruise or air travel, check the airlines or cruise operator policies for pregnant women. Some airlines will let you fly until 36 weeks, but others may have an earlier cutoff. Cruises may not allow you to travel after 24–28 weeks of pregnancy, and you may need to have a note from your doctor stating you are fit to travel.

Zika and Malaria

Zika can cause severe birth defects. The Zika virus is spread through mosquito bites and sex. If you are pregnant, do not travel to  areas with risk of Zika . If you must travel to an area with Zika, use  insect repellent  and take other steps to avoid bug bites. If you have a sex partner who lives in or has traveled to an area with Zika, you should use condoms for the rest of your pregnancy.

Pregnant travelers should avoid travel to areas with malaria, as it can be more severe in pregnant women. Malaria increases the risk for serious pregnancy problems, including premature birth, miscarriage, and stillbirth. If you must travel to an area with malaria, talk to your doctor about taking malaria prevention medicine. Malaria is spread by mosquitoes, so use  insect repellent and take other steps to avoid bug bites.

Make an appointment with your healthcare provider or a travel health specialist  that takes place at least one month before you leave. They can help you get destination-specific vaccines, medicines, and information. Discussing your health concerns, itinerary, and planned activities with your provider allows them to give more specific advice and recommendations.

Plan for the unexpected. It is important to plan for unexpected events as much as possible. Doing so can help you get quality health care or avoid being stranded at a destination. A few steps you can take to plan for unexpected events are to  get travel insurance ,    learn where to get health care during travel ,  pack a travel health kit ,  and  enroll in the Department of State’s STEP .

Be sure your healthcare policy covers pregnancy and neonatal complications while overseas. If it doesn’t get travel health insurance that covers those items. Consider getting medical evacuation insurance too.

Recognize signs and symptoms that require immediate medical attention, including pelvic or abdominal pain, bleeding, contractions, symptoms of preeclampsia (unusual swelling, severe headaches, nausea and vomiting, and vision changes), and dehydration.

Prepare a  travel health kit . Pregnant travelers may want to include in your kit prescription medications, hemorrhoid cream, antiemetic drugs, antacids, prenatal vitamins, medication for vaginitis or yeast infection, and support hose, in addition to the items recommended for all travelers.

During Travel

Your feet may become swollen on a long flight, so wear comfortable shoes and loose clothing and try to walk around every hour or so. Sitting for a long time, like on long flight, increases your chances of getting blood clots, or deep vein thrombosis. Pregnant women are also more likely to get blood clots. To reduce your risk of a blood clot, your doctor may recommend compression stockings or leg exercises you can do in your seat. Also, see CDC’s Blood Clots During Travel page for more tips on how to avoid blood clots during travel.

Choose safe food and drink. Contaminated food or drinks can cause travelers’ diarrhea and other diseases and disrupt your travel. Travelers to low or middle income destinations are especially at risk. Generally, foods served hot are usually safe to eat as well as dry and packaged foods. Bottled, canned, and hot drinks are usually safe to drink. Learn more about how to choose safer  food and drinks  to prevent getting sick.

Pregnant women should not use bismuth subsalicylate, which is in Pepto-Bismol and Kaopectate. Travelers to low or middle income  destinations  are more likely to get sick from food or drinks. Iodine tablets for water purification should not be used since they can harm thyroid development of the fetus.

After Travel

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider immediately, and tell them about your travel. Avoid contact with other people while you are sick.

More Information

CDC Yellow Book: Pregnant Travelers

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Travel Advice for Pregnant Women

Going on holiday is an enjoyable experience that many people look forward to; however, when you’re pregnant rules and regulations can present nasty surprises if you haven’t done your research. There may be restrictions on when and where you can travel, as well as certain conditions applied to you.

Restrictions

Before you even book your holiday, you need to find out if there will be any restrictions imposed if you travel when pregnant. For example, some airlines will let you fly anywhere at any point in your pregnancy, whereas others have slightly stricter rules. Most airlines will allow you to fly up to 36 weeks (if you and the baby are healthy), however if you’re carrying multiple babies this is usually reduced to 32 weeks, and if you’ve had problems with previous pregnancies this could be reduced further. Similarly, cruise ships may stop pregnant women travelling at the later stages of pregnancy, particularly in the last couple of weeks.

Airlines may allow you to fly up to 36 weeks, but after 27 weeks they will usually require a letter from your doctor or midwife. This letter will have to state your due date and whether you are safe to fly, as well as highlight that the chance of you going into labour mid-flight is unlikely.

When it comes to travel insurance, you need to be aware that companies may have different rules about pregnancy and travel. Pregnancy is not an ‘illness’, it is a natural and wonderful experience for any woman, however travelling later in pregnancy can put you and your child at a greater risk of medical complications, therefore most insurers will limit cover for travel after a certain point (just like an airline). Furthermore, although you shouldn’t need to declare your pregnancy to your insurer, you will need to declare any issues linked to your pregnancy, for example if you have high blood pressure.

Personal Choice

It’s worth bearing in mind that your feelings on travelling may change as your pregnancy progresses. A trip that you planned when you were only eight weeks pregnant may not seem quite as appealing once you reach 28 weeks. As your bump grows larger, you may find some things are uncomfortable and the familiarity of home could seem like a nicer option. During the first few weeks of pregnancy, you may experience various unpleasant symptoms including nausea and sickness. This also tends to put some women off of travelling or embarking on long journeys.

During the earlier days of your pregnancy, most insurers and travel operators are more than happy to allow you to travel almost anywhere. If you’re planning a trip to a far-flung destination, however, you may have to consider inoculations, and some of these are not recommended or even suitable during pregnancy, so give this careful consideration before you travel. You will also need to consult a doctor to find out what is safe for you to take, for example anything from malaria medication to travel sickness tablets could be unsafe for pregnant women.

When you do book a trip anywhere, be sure to do lots of research and read through every detail of the policy to ensure that you are covered for everything you need. If anything changes between booking your trip and actually going on it, inform your insurer and holiday operator. Listen to your body throughout your pregnancy as this can often give you the best indications when it comes to making decisions about travelling.

For more information on quality pregnancy travel insurance, visit our dedicated pregnancy page or if you would like further help with travelling while pregnant, please   read our complete pregnancy travel guide here .

Safe travels!

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Trying for a baby

Diet and lifestyle are important when you are trying for a baby and during pregnancy. Being a healthy weight may increase your chances of becoming pregnant and reduces the chances of complications.   

A healthy, varied diet based on starchy foods (including wholegrain varieties), with plenty of fruit and vegetables and some lean meat, fish, eggs and other sources of protein , and low-fat dairy products is important for good health throughout life. When you want to become pregnant, it is even more important that you follow a healthy, balanced diet to get all the nutrients you need.

What is a healthy weight?

A body mass index (BMI) of between 18.5 and 25 is considered healthy. You can calculate your BMI here :  

Women who have too little body fat are more likely to have irregular periods or no periods at all, which can affect your ability to conceive.   

If you have suffered, or are suffering, from an eating disorder, gaining weight might be hard for you to manage. If this is the case, tell your doctor that putting on weight may raise difficult feelings for you. Extra support, such as counselling from a mental health professional, can help you cope with the challenges around eating healthily before and during your pregnancy.  

Having too much body fat can lower fertility, and women with excess body fat may not ovulate normally. Women with a BMI over 30 should seek advice from a health professional to help reduce weight before becoming pregnant.  

Very low-calorie diets and those that exclude a wide variety of foods or a whole food group, should be avoided as they can result in low intakes of important nutrients.   

If you are concerned about your weight in pregnancy, seek advice from your doctor or midwife.  

What is a healthy weight during pregnancy?

Weight gain varies greatly in pregnancy. Most pregnant women gain between 10kg and 12.5kg (22lb to 28lb) putting on most of the weight after week 20.

Gaining too much weight can increase your risk of complications, including gestational diabetes, pre-eclampsia (high blood pressure) and the need for a caesarean delivery.  

Dieting during pregnancy is not recommended as it may harm your baby’s health.    

Eating for two?

Energy requirements during the first and second trimester are no different to normal as your body makes some adaptations to help reduce the extra energy it might otherwise need.

In the last 12 weeks of pregnancy, you do need a little extra energy – about 200kcal more per day.

Good sources of extra calories include steamed vegetables, egg noodles, a small handful of unsalted nuts, porridge with a spoonful of raisins, or wholegrain toast with peanut better.  

Morning sickness

Morning sickness is a normal part of pregnancy; it usually settles in the second trimester and is unlikely to cause longer-term problems.  

Some women find eating carbohydrate-rich foods helps reduce nausea and eating small amounts throughout the day may also help. There is some evidence that ginger products, such as fresh ginger or ginger teas, help reduce nausea and vomiting in pregnancy.

Try to replace the fluids that are lost when you are sick.  

Some women experience severe nausea and vomiting during pregnancy (‘hyperemesis gravidarum’) and should consult their doctor or midwife. 

Breastfeeding

For breastfeeding women, losing weight by eating healthily and taking regular exercise will not affect the quantity or quality of their milk. 

Women who exclusively breastfeed may require extra calories, but your body will also use up the fat stored during pregnancy for this exact purpose.  

Exclusively breastfeeding is linked to greater weight loss after pregnancy and breastfeeding for a longer period is associated with a healthier BMI in the long term. Breastfeeding has important health benefits for mother and baby, including supporting your baby’s immune system. 

Nutrition during pregnancy

Pregnancy is a special time and one when many women think about their diet. What you eat can affect the health of your baby, so it is important to eat healthy, balanced and varied diet when you are pregnant. 

Choose a diet with 

• meals based on   starchy foods  (choosing wholegrain varieties or potatoes with their skins on)  
• at least five potions of a variety of fruit and vegetables every day 
• beans and other pulses, fish, eggs, lean meat and other   proteins   (like tofu or Quorn)  
• milk, yogurt and cheese (or fortified dairy alternatives).  
• limited foods and drinks that are high in   fat  and  sugar .   

Beside all the nutrients you get from a   healthy, varied diet, some  vitamins and minerals  are especially important for the development of your baby. 

Important nutrients for pregnancy

Dietary advice for women who are trying for a baby is mostly the same as for other adults, but there are some top tips that women who want to become pregnant should follow.

This vitamin is particularly important before and during the first 12 weeks of pregnancy, when extra folic acid reduces the risk of baby neural tube defects (such as spina bifida). Folate – the natural form of folic acid - is found in green leafy vegetables , wholegrains and wholegrain bread , nuts , peas , beetroot , oranges and berries , and a supplement of 400 µg (micrograms) per day is recommended for most women in pregnancy.    

If you have a family history of neural tube defects, are taking anti-epileptic medication, or are diabetic, speak to your doctor as you may need a higher dose.  

It's common for women to develop iron deficiency during pregnancy. This is because your body needs extra iron to ensure your baby has a sufficient blood supply and receives necessary oxygen and nutrients.  

Try to build up your iron stores when you’re trying to become pregnant by eating a balanced diet including food containing iron, such as red meat, poultry and fish, beans, dark green leafy vegetables, nuts and wholegrains .   

Vitamin C helps us absorb iron from plant sources. Try adding foods or drinks that are high in vitamin C (like peppers, tomatoes or a small glass of orange juice) to meals, to help increase your iron uptake.  

As well as being a good source of vitamin D, oily fish is rich in omega-3 fatty acids , and this type of fat is needed for the development of your baby’s brain and eyes.

Try to eat at least one portion (140g, cooked weight) of oily fish per week but limit fish but no more than two portions per week as some fish, including salmon, sea bass, sea bream, turbot, halibut and brown crab meat can be harmful if consumed in large amounts.   

If you are trying for a baby or are pregnant, avoid eating shark, swordfish and marlin, and more than four cans of tuna, or two fresh tuna steaks, a week. These fish can contain more mercury than other kinds of fish, which may harm your baby’s nervous system.  

Women are also advised to avoid ready-to-eat cold-smoked or cured fish products as they can present a risk of listeria.  

Vitamin D helps your body absorb calcium from your diet, which is important for healthy bones for you and your baby.  

Low levels of vitamin D are common in UK women, especially in winter. Women with darker skin and women who spend little time exposed to sunlight are most at risk of vitamin D deficiency.  

Oily fish is a good source of vitamin D and eating oily fish once a week (such as salmon, trout, mackerel, sardines, pilchards and herring) can make a useful contribution to your vitamin D intake. Vitamin D is also found in eggs and is added to some breakfast cereals and spreads.  

Because vitamin D is found only in a small number of foods, everyone, including pregnant and breastfeeding women, and women trying for a baby, should consider taking a daily supplement containing 10µg of vitamin D at least during the winter months. You may qualify for free vitamins via the government’s Healthy Start scheme . 

Do not take more than 100µg of vitamin D per day, as this could be harmful.  

Foods to avoid in pregnancy

Which foods and drinks do I need to avoid when I'm pregnant, and why?

It is important to eat a healthy, balanced diet when you are pregnant, not only to help your baby grow healthily and give them the best start in life but also to help you feel your best too.

Some foods are best avoided in pregnancy, however.   

Soft cheese

Avoid soft cheeses with white rinds such as brie, camembert and others with a similar rind, including goats' cheese with a rind (sometimes known as chèvre)  

Also, avoid soft, blue-veined cheeses such as Danish blue, gorgonzola and Roquefort  

These cheeses can contain listeria bacteria that cause listeriosis. Listeriosis is an infection that can cause flu-like symptoms. Although listeriosis is extremely serious in pregnancy, it is very rare.  

Unpasteurised milk or cream

Pasteurisation is a heat treatment process to kill bacteria and prevent food poisoning.  

Unpasteurised or ‘raw’ milk and cream (from cows’, goats’ or sheep) are often sold at farmers markets and farm shops. They may contain harmful bacteria that could cause food poisoning and should be avoided.

These products must carry an on-pack warning in England and Wales. The sale of raw milk is banned in Scotland.   

Including raw cured meats, for example Parma ham (prosciutto), chorizo, pepperoni and salami  

Many cold meats such as salami, pepperoni, chorizo and Parma ham, are cured and fermented but not cooked, and there is a risk they contain toxoplasmosis-causing parasites.

Freezing for four days or more makes the meat safer to eat, as does cooking (pepperoni on a pizza, for example).   

Other things to avoid or limit

Large amounts of vitamin A can harm your unborn baby and may cause conditions such as spina bifida.  

Avoid supplements that contain vitamin A (including fish liver oil) and liver or liver products, such as pâté, which are high in vitamin A.

You can speak to your doctor or midwife for more information.   

Caffeine is found in coffee, tea, chocolate, sports/energy drinks, some soft drinks and some cold and flu remedies. It has been linked to an increased risk of your baby not growing as well as expected, so limit your caffeine intake when trying for a baby and while pregnant , to less than 200mg per day . This is roughly the amount in two mugs of instant coffee or two and a half cups of tea.   

Energy drinks are legally required to declare a high caffeine content and are not recommended for children or pregnant or breast-feeding women.    

The advice from the UK Chief Medical Officers’ is that, if you are pregnant or planning to become pregnant, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum.  

Drinking in pregnancy can lead to long-term harm to the baby , with the more you drink the greater the risk.  

The risk of harm to the baby is likely to be low if you have drunk only small amounts of alcohol before you knew you were pregnant or during pregnancy.   

If you who find out that you are pregnant after already having drunk during early pregnancy, avoid further drinking but be aware that it is unlikely in most cases that your baby has been affected.  

Calcium for growth and development

Calcium is important for the growth and development of your baby’s bones and helps to maintain your bones as well.    Milk, cheese and yogurt are a good source of calcium so try to include low-fat versions in your diet.

Pregnant women are advised to avoid unpasteurised semi-hard and soft cheeses (unless cooked until steaming hot), all mould-ripened soft cheeses with a white coating on the outside, such as brie, camembert and chèvre (unless cooked until steaming hot), blue cheeses such as Danish Blue, Gorgonzola and Roquefort (unless cooked until steaming hot) and any unpasteurised milk or cream.  

Alternative sources of calcium include   

• fortified plant-based milks and yogurts  
• calcium-fortified breakfast cereals (check the label)  
• some leafy green vegetables (such as kale, rocket and watercress)   
• almonds, Brazil nuts, hazelnuts and sesame seeds  
• bread that is not wholegrain (which are legally required to be fortified).   

Water is needed to produce the fluid surrounding your baby and to help increase your blood volume, so it’s important to stay hydrated during pregnancy.   

Signs of dehydration include dark urine, dizziness, headaches, tiredness or a dry mouth .   

What (not) to drink

Tap water is a good choice, but all non-alcoholic drinks can count towards your fluid intake, including milk, fruit and vegetable juices, smoothies and hot drinks.

Keep your caffeine below 200mg per day during pregnancy. A mug of instant coffee, for example, has about 100mg of caffeine, filter coffee about 140mg, and a mug of tea about 75mg. Bear in mind that green tea has caffeine.   

Sugary drinks

There is a greater risk of tooth decay and gum disease in pregnancy, so limit sugary and acidic drinks as fizzy soft drinks, sweetened iced teas, juices and smoothies, to mealtimes only.    

Vegetarian and vegan diets during pregnancy

Mums-to-be can get all the nutrients that you and your baby need from a vegetarian or vegan diet as long as care is taken to replace important nutrients found in animal foods.  

Like any healthy diet, include:  

• wholegrain or higher fibre options like wholewheat pasta, wholegrain breakfast cereals, brown rice, or potatoes with their skins;   
• at least five of a variety of fruit and vegetables , fresh, frozen or tinned. A 150ml glass of  unsweetened fruit or vegetable juice counts as one portion, or  
• protein-rich foods , like tofu, beans, lentils and chickpeas, nuts, and eggs (for those who include them in their diet) milk, cheese and yogurt, or fortified plant-based alternatives  

How to replace nutrients found in animal foods

Vitamin B12 is important for the normal development of your baby and helps the body to release the energy from the food you eat.  

Vitamin B12 is found naturally in meat, dairy products and eggs); the only reliable sources of vitamin B12 for a vegan diet are fortified foods .

These include vitamin B12-fortified yeast extract ( Marmite ), vitamin B12-fortified dairy-free alternatives (such as soya, oat and almond dairy-free alternative drinks or vegan spreads) and vitamin B12-fortified breakfast cereals.

Always check the label.   

Riboflavin (vitamin B2) is important for the normal development of your baby and is found in meat, dairy products and eggs, and in some plant-based foods, including  

• some nuts (such as almonds) and seeds 
• yeast extract (Marmite) (especially fortified varieties) 
• riboflavin-fortified dairy alternatives (such as soya, oat and almond-based drinks) 
• riboflavin-fortified breakfast cereals (check the label) 

Selenium supports our immune system and protects our cells from damage.  

Levels of selenium vary depending on the soil in which plant foods are grown, but good sources include 

• some nuts and seeds, especially Brazil nuts, cashew nuts and sunflower seeds 
• some breakfast cereals, such as puffed wheat cereal, shredded wheat and cornflakes 
• seeded and wheatgerm bread 

Iodine is important for your baby's brain development and your requirements for iodine increase during pregnancy.  

Good sources of iodine include fish, eggs, milk and milk products. Vegans are at risk of iodine deficiency as plant-based sources are limited and you may want to consider foods fortified with iodine such as plant-based drinks such as soya or oat (check the label).  

Ramadan and pregnancy

If you are a Muslim woman who is   pregnant, or is planning to become pregnant, you may be wondering whether you should still fast during Ramadan.

Islamic law gives permission for pregnant and breastfeeding women to opt out of fasting if she fears that it will harm her health or the health of her baby.

Find out more on our pages on Ramadan and pregnancy .

Physical activity in pregnancy FAQs

Can exercise help me while pregnant?

It is well known that regular physical activity can help to reduce the risk amongst other things of high blood pressure and type 2 diabetes.

In pregnancy, being active can also help reduce varicose veins, swelling in the feet and legs and improve lower back pain, and there is some evidence to suggest that women who exercise during pregnancy have shorter labours and fewer delivery complications than those who do not.  

What if I did no exercise before becoming pregnant?

If you have not been used to exercise, start gradually with 10 minute bouts of moderate exercise, building up to a total of 150 minutes, spread throughout the week. 

‘Moderate’ activity is any activity that makes you breathe faster but still be able to hold a conversation.   

Pregnancy can affect your ability to do physical activity and as a general rule, if you feel uncomfortable, stop and seek advice from your doctor or midwife, and always consult with them before embarking on a new exercise regime. There is helpful information here . 

What sports can't I do while pregnant?

To avoid hitting your bump, refrain from contact sports and sports that risks falls such as:

• horse-riding
• ice skating

Also, avoid scuba diving as the change in pressure may not be good for your baby and a void exertion at high altitudes (over 2500m) until you have acclimatised, which may take a few days.  

Is it too hot to exercise?

Do not exercise in hot humid conditions, as you are more likely to get too hot during exercise when you are pregnant, which can be dangerous for your baby.  

Keep well hydrated during exercise. Make sure you drink before, during and after exercise.  

Where next?

A healthy balanced diet

Read about the importance of a balanced diet, the recommended food groups and current healthy eating guidelines.

Nutrition for babies

In this section, you can learn about feeding your baby and looking after yourself after birth, as well as when, what and how to introduce solid foods to your baby’s diet when the time comes.

Eating healthily on a budget

The rise in food, energy and fuel prices will affect many of us having less to spend on food shopping.

Did you find this page useful?

We'd love to hear your feedback. If you would like a response, please contact us. Please note that advice provided on our website about nutrition and health is general in nature. We do not provide any individualised advice on prevention, treatment and management for patients or their family members.

NEWS... BUT NOT AS YOU KNOW IT

Is it safe to travel to Iceland? UK travel advice after latest volcanic eruption

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A volcano in southwestern  Iceland  has erupted yet again, following former eruptions from the Fagradalsfjall volcano .

A state of emergency has been declared after fast lava flows in Iceland’s Reykjanes Peninsula were spotted, after the volcano erupted without warning.

Fast moving lava has already reached the eastern side of the small evacuated town of Grindavik, which was initially evacuated late last year due to similar eruption activity.

Pools of lava gathering near the town’s defences have sparked concern, although the lava streams appear to be slowing, according to local authorities.

But the new eruption has worried travellers who were planning on spending time in the icy country, with visitors concerned that their flights from the UK may be cancelled in light of the seismic activity.

Here is the latest travel advice issued by the government for those planning to fly to the country.

Is it safe to travel to Iceland?

Yes, it is still safe to travel to Iceland , but travellers are urged to check government websites for warnings if the situation changes.

The UK Government posted on its website: ‘Recently there have been a series of volcanic eruptions on the Reykjanes peninsula in south-west Iceland, the latest occurring on 16 March.

‘These have affected the town of Grindavik and area to the north of it. All roads to Grindavik and the surrounding area are closed and you should stay away from this area. Keflavik International Airport and the road to it is unaffected and operating normally.

‘The capital city, Reykjavik, and the rest of Iceland is not impacted by the eruptions. The likelihood of further eruptions in this location remains high.

‘You should monitor local media for updates and follow the authorities’ advice on travel to the area.’

Are flights still going to Iceland?

Flights to and from Keflavik are generally running without a hitch at the moment.

‘The principal information on the eruption can be found on the  website of the Civil Protection Department  and the  website of the Icelandic Meteorological Office .’

But those travelling will be warned that major tourist attractions, including the Blue Lagoon, have shut.

The Blue Lagoon, one of Iceland’s most famous geothermal spas, has announced it will remain closed through March 17.

Get in touch with our news team by emailing us at [email protected] .

For more stories like this, check our news page .

MORE : Iceland’s most powerful volcano eruption yet triggers state of emergency

MORE : Iceland’s Blue Lagoon evacuated because volcano is about to erupt

MORE : There are 14 supervolcanoes – that we know of. What will happen if one erupts?

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