Traveling While Pregnant
According to the American College of Obstetrics and Gynecology, the safest time for a pregnant woman to travel is during the second trimester (18 to 24 weeks) when there is the least danger of experiencing premature labor. A pregnant traveler should discuss her travel plans and itinerary with her obstetrician prior to travel. Before she goes she should have a complete physical with appropriate lab tests to determine the health of the pregnancy. Discuss gestational age, risk of miscarriage, and premature labor with the obstetrician, and make sure all vaccinations are completed prior to travel.
Air Travel During Pregnancy
Air travel is safe for most healthy pregnant women, though each airline has a different restriction or regulation concerning pregnant fliers (See below for information on relative contraindications to international travel during pregnancy). Always consult your obstetrician and your specific airline prior to travel. International travel is usually permitted up to the 32nd week although it is considered safe to fly up to the 36th week for single fetus pregnancies, 32nd week for twins, and the 20th week for triplets. Always carry a note from your doctor that details your medical history and your expected date of delivery.
A woman should walk every half hour during a smooth flight and flex her calf muscles frequently to prevent Deep Venous Thrombosis. Always fasten your seat belt at the pelvic level.
Below is a list of possible complications of pregnancy that should be discussed with your obstetrician prior to travel:
  • History of miscarriage
  • Incompetent cervix
  • History of ectopic pregnancy
  • History of premature labor
  • History of or existing placental abnormalities
  • Vaginal bleeding
  • Multiple gestations (twins, triplets, etc.)
  • History of toxemia, high blood pressure, or diabetes with any pregnancy
  • First time pregnancy at age 35 years or older, or 15 years or younger
  • Valve disease of the heart
  • Severe anemia
  • History of Deep Venous Thrombosis, Pulmonary Embolism, or active Thrombophlebitis
  • Travel to high altitudes
Note: If you are pregnant and considering travel to a region that is considered high risk for endemic infectious disease, we highly recommend that you postpone your trip until after delivery.
Malaria, Pregnancy and Nursing
Malaria in pregnancy carries significant risk for both the mother and the fetus. Pregnant women are advised to avoid travel to high-risk areas of malaria. Because no anti-malarial agent is 100 percent effective, if a pregnant woman does travel to these areas, she is advised to protect herself against insect bites. Although malaria is considered to be prevalent throughout many parts of Mexico it is not considered a problem in major resort areas. The same cannot be said for more rural destinations and we advise that pregnant women stay within major tourist areas.
Additional Guidelines for Pregnant or Nursing Women
  • You may use house sprays or coils that contain pyrethrum if insects are a problem.
  • Insect repellents containing N, N-diethylmetatoluamide (DEET) (<35%) are recommended for adults, but pregnant women should use them sparingly.
  • Nursing mothers should carefully wash repellents off their hands and breast skin prior to handling infants.
  • Chloroquine has been used for malaria prevention for decades with no documented increase in birth defects.
  • Nursing mothers are advised to take the usual adult dose of anti-malarial appropriate for the country they will visit. The amount of medication in breast milk will not protect the infant from malaria. Therefore, the breast-feeding child needs his or her own preventative medications.

(TD - Traveler's Diarrhea) If you are considering travel during pregnancy, recognize that you will have to exercise dietary vigilance. Pregnant women are advised not to use preventive antibiotics for TD or drink iodine-treated water. Furthermore, the dehydration and electrolyte imbalances that may be a result of Traveler's Diarrhea may have serious consequences for you and the baby. Drink only bottled water, even when brushing your teeth. Eat only well-cooked meats and pasteurized dairy products, and avoid raw fruits and vegetables that you have not personally peeled and prepared.

Oral re-hydration is the main strategy of TD therapy. Bismuth subsalicylate (Pepto-Bismol) is not recommended during pregnancy because of the possible risks of fetal bleeding from salicylates and birth defects from Bismuth. You may use the combination of Kaolin and Pectin, but you should only use loperamide (Lomotil) after consulting with a physician.
Self-treating TD with antibiotics should only be considered when reliable medical attention is not available; many antibiotics that are commonly used for treating diarrhea are not safe in pregnancy. You may take ampicillin or amoxicillin if you are not allergic to penicillin, but many bacteria may be resistant. Cephalosporin drugs such as Cefuroxime, are generally safe and effective against many strains of salmonella and shigella.
Very useful tip to consider
Antibiotics are regulated by the government and are NOT sold in Mexican pharmacies without the prescription of a registered physician so if you need to take them you may wish to bring some extra dose from home. While in Mexico if you need medical attention there are several first class hospitals in Cancun.
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