Traveling for Two: Advice for Pregnant Vacationers

Schlepping bags through an airport and long car rides in an automobile are not the most memorable aspects of anyone's vacation -- and if you already happen to be carrying a little extra baggage these days because you're pregnant, those memories may be all you will remember unless you plan your trip well.

But experts say pregnant travelers need not be detained from vacations and other travel plans. "Up to 24 weeks into the pregnancy, if the mother is doing well she can do all sorts of traveling," says Marcos Pupkin, MD, chair of obstetrics-gynecology at Mercy Medical Center in Baltimore.

But the closer to delivery time, the less advisable travel becomes. And complications of any kind indicate the need to see a doctor before traveling, Pupkin says.

"Anytime the patient is having contractions, low abdominal pain that could mean contractions, or bleeding from the uterus, traveling should be avoided," he tells WebMD.

Whether traveling by plane or car, pregnant women are apt to be sitting for long periods. "For a four- or five-hour drive I would advise pregnant women to get out of the car every hour and a half and walk for one minute," Pupkin says. "The same is true for flying. Keep your legs working once per hour and walk in the corridor of the plane. This becomes even more important as you get to the third trimester."

And Pupkin offers a tip to pregnant women traveling in the passenger seat of a car or in a plane: Place a small box on the floor where you can elevate your feet slightly above the ground. "You don't want the back of your legs compressed all the time," he says. "That closes off circulation returning from the feet."

But comfort for mom and baby is not the only concern for pregnant women taking to the highways. In a nation that reported more than 40,000 traffic fatalities in 2000, buckling up and driving sanely is a must when one of your passengers is a fetus.

Mark Pearlman, MD, reports that of nearly four million deliveries every year, about 7% are complicated by trauma, and about two-thirds of those are related to motor vehicle accidents. That can amount to 250,000 traffic accidents involving pregnant women every year, says Pearlman, who is vice chair and professor of obstetrics-gynecology at the University of Michigan Health Systems.

pproximately 2% of car crashes involving a pregnant woman -- or about 2,500 accidents -- will result in an adverse outcome for the pregnancy, he says, so "regardless of the severity of the traffic accident, pregnant mothers involved in a crash should be seen by a doctor right away."

Pearlman tells WebMD that years of specialized research looking at how traffic fatalities occur among pregnant travelers has shown that what is true for the general population is true for mom and her fetus: Seat belts and air bags work.

"Seat belts are protective not only for the mother but also separately for the fetus," he tells WebMD. "When we looked at crashes of similar speed and similar injury to the mom, proper use of seat belts separately protected the fetus. If you had two moms in similar crashes, the one who was wearing the seat belt would be more likely to have a good fetal outcome."

The same goes for air bags. "It appears that when women are in a car crash in which an air bag deploys, it does not result in an increase in fetal injury and may add an additional protection," Pearlman tells WebMD.

Since most air bags are housed in the steering wheel, Pearlman advises pregnant women behind the wheel to adjust the wheel so that it is aimed at the chest. "That is where the air bag will function best, and it won't deploy right over the abdomen," he says.

The American College of Obstetrics and Gynecology, or ACOG, cautions that seat belts worn too loosely or too high on the abdomen can cause broken ribs or injury to the abdomen. The lap belt should be placed under the abdomen and across the upper thighs so that it fits as snugly and comfortably as possible, ACOG recommends.

The shoulder belt should be placed between the breasts and across the shoulder. Never slip the shoulder belt off your shoulders, the group says.

The organization also offers the following general recommendations to pregnant women traveling by car or plane:

Wear comfortable shoes, support stockings, and clothing that doesn't bind. Choose natural fabrics like cotton or wool that absorb sweat.

Take some crackers, juice or other light snacks to prevent nausea.

Do not take motion-sickness pills or laxatives without consulting with a doctor.

ACOG also offers the following specific recommendations for pregnant flyers:

Try to get an aisle seat so that you can walk around and get to the bathroom easily. The front of the plane often has a smoother ride. A seat just behind the wall that divides first class and coach has extra leg room.

The cabin can be both hot and cold even on a short flight. Wear a few layers of light clothing that will allow you to bundle up or remove a layer or two.

Eat lightly to avoid being sick. Because the air in the cabin is dry, drink plenty of fluids.