By Dr Nikhil Datar
Six months pregnant, Nimi was at my clinic for a routine check-up. She was doing well. She asked with excitement, “Doctor, we are planning a babymoon. Can I go by air?” Harish, her husband, who is a tech guy, quickly brushed it off saying, “No. That is unsafe.” He had concerns about the exposure to cosmic rays, radiation, air pressure during the flight and of course the vibrations caused by air turbulence.
So here are the answers to most common questions regarding the air travel during pregnancy:
Does air travel increase the chance of miscarriage or push you into labour?
There is no scientific evidence to say that air travel increases the chance of miscarriage or labour.
Why do airlines restrict air travel after 34 weeks then?
Most airlines have their own policy on air travel during pregnancy and restrict pregnant women close to term (34 to 36 weeks and beyond) from boarding the flight. Basically, the closer you are to term, higher are the chances that labour could start. Thus, the airlines simply want to minimise the chance of the aircraft returning or needing to deviate from the route in case the passenger on board goes in labour. But air travel per se does not push pregnant woman into labour.
Are the scanners at the airport safe?
Yes. There is no evidence to suggest that pregnant woman should avoid scanners.
Does one get exposed to radiation during air travel?
At higher altitudes, the atmosphere is thin. Thus, one does get exposed to cosmic rays and radiation from the sun. The dose is so miniscule that it does not cause any harm to the foetus.
However, if a pregnant woman is likely to undertake air travel too frequently, say if she is a pilot or an air-hostess, then she needs to be concerned about this.
Should seatbelts be used during travel?
Yes. They are safe. If you need an extension, do call for it.
What are the common problems that a pregnant woman may experience during air travel?
Some pregnant women may experience discomfort during flying. This is mainly due to prolonged hours of sitting and changes in the air pressure and humidity. You may have:
Swelling of your legs due to fluid retention (oedema).
Nasal congestion/problems with your ears.
Pregnancy sickness: If you experience motion sickness during the flight, it can make your sickness worse.
Deep vein thrombosis (DVT): This a rare but dreadful complication. When blood clots are formed in the deep veins of legs or pelvis it is called as DVT. If the clot it travels to the lungs (pulmonary embolism), it can be life threatening. During pregnancy, the blood develops a tendency towards easy clot formation. Thus, when you are pregnant and for up to six weeks after the birth of your baby, you have a higher risk of developing a DVT compared with women who are not pregnant. Prolonged sitting in one position in the flight causes the blood to clot.
The risk is higher if you are obese, a smoker and have other medical conditions that cause clotting tendencies.
What can I do to reduce the risk of DVT?
If you are taking a short haul flight (less than four hours), it is unlikely that you will need to take any special measures. To minimise the risk of DVT on a medium or a long haul flight (over four hours) following things can be done:
- Wear loose clothing and comfortable shoes.
- Try to get an aisle seat and take regular walks around the plane.
- Do stretching exercises every 30 minutes or so.
- Have water at regular intervals throughout your flight and keep yourself hydrated.
- Cut down on drinks that contain alcohol or caffeine (coffee, fizzy drinks).
- Wear graduated elastic compression stockings or do calf exercises in the seat.
Are there any medicines that can help?
Medicines have to be taken as per the doctor’s advice only. They are required in rare situations. When you are at a high risk for DVT, you may be advised to have heparin injections. These will thin your blood and help prevent DVT. For security reasons, you will need a letter from your doctor to enable you to carry these injections onto the plane. Low-dose aspirin does not appear to reduce the risk of a DVT but you should continue to take it if it has been prescribed for another reason.
Finally, how can we take the decision for air travel?
Air travel is pretty safe during pregnancy. Here are few questions that may help you in making your decision:
- Why do you want to fly at this particular time?
- How long is your flight? Will this increase your risk of medical problems?
- How many weeks pregnant will you be when you travel and when you return?
- What are the medical facilities at your destination in the event of an unexpected complication with your pregnancy?
- Have you had all the relevant immunisations and/or medication for the country you are travelling to? Have you checked with your doctor how these affect your pregnancy?
- Does your travel insurance cover pregnancy and/or care for your newborn baby if you give birth unexpectedly?
- How are you going to ensure that you get hygienic food and water at the destination?
Before you embark on the air journey do ensure that:
- Your case papers are with you.
- Your medications are with you.
- Common medications for common problems are with you.
- You have travel insurance (especially for foreign travel).
(The writer is Senior Gynaecologist & Medical Director, Cloudnine Hospital Mumbai, Malad.)