A patient came to the consultation of María de la Calle, director of the Medical Section of Obstetrics of the La Paz Hospital and professor of the Faculty of Medicine of the Autonomous University of Madrid. She was in an advanced stage of pregnancy and wanted to know if she could move with her family to southern Spain. “The first thing I do in these cases is measure the cervix, it is a predictor of childbirth,” the doctor says on the phone. Above 25 millimeters it leaves a certain margin; below, the possibility that the woman will give birth in the following month increases. He measured and advised against escape. The patient had her baby four days later.
The first advice for a pregnant woman who wants to travel is to contact her gynecologist. He or she will tell you what you should do and what not to do, depending on your specific circumstances: whether it is a twin pregnancy, whether it was produced with assisted reproductive techniques, whether you have a history of miscarriage, or whether you have had bruising or bleeding.
“I went to my gynecologist with an entire page full of doubts,” smiles María José Muñoz, author of the blog Los Viajes de Pepa, over a video call. Her pregnancy was going well. “I had no nausea and felt very energetic,” he recalls.
The second quarter: the best for an escape
According to De la Calle, the second trimester (week 14 to week 30) is the best for travel. The possible risks of bleeding or miscarriage have already passed and the pregnancy has not yet entered the final stage. “In the third trimester we are more cautious again, as the uterus is very distended, there may be contractions and there is a greater risk of the water breaking,” she warns.
The plane is not the problem
There is a fairly widespread hoax that pregnant women cannot get on a plane. “They can do it perfectly, their amniotic sac won’t rupture or anything like that,” clarifies De La Calle. The problem here, as in any other means of transport, is the time of immobility, especially on transoceanic flights. “There is a greater risk of blood clots forming, so we advise them to get up and walk around occasionally; some are also prescribed heparin,” he explains.
The same thing happens on the train, where the instruction is to walk between the carriages, or in the car, where the rule is to stop every now and then to stretch your legs. De La Calle, by the way, suggests avoiding bumpy roads full of potholes.
Muñoz flew to Budapest in her second trimester of pregnancy. Airlines usually require a medical certificate from week 28 and directly prevent you from flying from week 35 or 36 (a little less if it is a twin pregnancy). “Each company applies its own rules; you need to check them carefully when purchasing your ticket,” says the travel expert.
Specific insurance
There is specific travel insurance for pregnant women, which Muñoz invites you to take out. They cover medical expenses and hospitalization in the event of complications in the destination (abortion, premature birth) and, if necessary, medical repatriation. Some involve canceling the trip for medical reasons related to pregnancy. The blogger encourages you to compare different policies and, very importantly, check the maximum week of gestation covered by each (may vary).
Where to travel?
“If you haven’t traveled to Africa yet, don’t wait until you get pregnant to do so!” urges Muñoz, who offers travel advice to expectant mothers on her blog. “It is advisable that the destination has adequate healthcare in case of need,” he specifies. Personally he advocates starting from local tourism, “to chase away fears”, and gradually increasing the kilometers of distance. “Spain is perfect to get to know,” he declares.
Contraindicated vaccines
“The first thing is to see what kind of infections there are in the destination place and what vaccinations or medications are needed,” says De la Calle. Some vaccines, such as the one against yellow fever, are contraindicated during pregnancy. And hydroxychloroquine (used as a prophylactic to prevent malaria) must be administered “with precautions”, he reveals. The gynecologist considers malaria (which causes miscarriages and premature births) and the Zika, dengue and chikungunya viruses, linked to malformations of the fetus’s brain, to be particularly dangerous. The three viruses, endemic in areas of Latin America and the Caribbean, Southeast Asia and Africa, belong to the same family and are transmitted by the same type of mosquito. In those areas, long sleeves and trousers and repellent with DEET (diethyltoluamide) are recommended.
Active tourism with common sense
“Walking is a wonderful activity and, in nature, even more so,” says De la Calle. But without excesses, and with common sense. “Without jumping cliffs,” he says. It is also not recommended to walk at a faster pace than your body allows. “We must listen to our body and pay attention to it,” Muñoz intervenes. It is healthy for the gynecologist to take it as something fun, without trying to break any records. “You should drink plenty of water, wear appropriate footwear and stop if your stomach feels hard,” he asks.
General tips
“Pregnancy is not a disease, but your body is not the same either,” warns María de la Calle, head of the Medical Section of Obstetrics at La Paz Hospital. Breathing capacity decreases, the possibility of hypotension increases and the increase in body temperature is directly proportional to the risk of suffering from heat stroke. The center of gravity also varies, making it easier to lose balance.
Here are some tips to counteract risks and inconveniences during a trip:
- Stay hydrated and use a high-factor sunscreen to avoid the appearance of blemishes.
- Find out about the water quality of the destination country and, if necessary, drink bottled water. Avoid raw cured meats and don’t eat raw fruit or vegetables unless you can ensure they have been properly washed. These are recommendations to prevent toxoplasmosis, which can affect the fetus.
- Move regularly during the trip.
- Discover the nearest hospital centers and medical treatments in the destination country.
