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Eeyore

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Tuesday, June 3rd 2008, 10:49am

PREGNANCY & TRAVEL - FREQUENTLY ASKED QUESTIONS

I'm pregnant - when is it safe to travel?

As a general rule, it should be safe for you to travel when pregnant. If you are planning to travel by plane, you will need to check with your airline and insurance company beforehand. For more information, see 'when is it safe to travel by plane' below.

You may decide to avoid travelling if you have previously had a miscarriage, ectopic pregnancy or premature labour. If you have high blood pressure or diabetes or are expecting a multiple birth, you should seek advice from your GP regarding travelling.


I'm pregnant - when is it safe to travel by plane?

After 12 and before 25 weeks is generally the safest time to travel. This is called the second trimester. The first trimester (up to 12 weeks) is when you may be suffering morning sickness. There is also an increased risk of miscarriage during this time.

** However, there is no current evidence to support any link between flying and increased risk of miscarriage **

After 25 weeks (third trimester) there is a risk of an increase in blood pressure as well as the chance of giving birth prematurely due to stressful conditions or illness. Every pregnancy is different, so it is advisable to discuss any concerns with your doctor.

Check with your airline and insurance company that they will allow you to travel when pregnant. After 24 weeks, the airline may request a letter from your GP stating your expected delivery date. All airline policies vary, but as a general rule you should be allowed to travel until 28 weeks of pregnancy, or 36 weeks for a short-haul (less than four hours) flight.

Women who have a high-risk pregnancy or a known health condition that could cause complications may not be allowed to fly in the last four weeks of pregnancy. Remember to take into account the date of your return journey and how this may affect travel plans.

When flying, drink plenty of bottled water, with no ice (as the air humidity is very low), sit in an aisle seat, move about a lot and wear compression stockings to avoid developing blood clots. (Symptoms of blood clots include swelling, pain, tenderness and redness especially at the back of the leg below the knee.)

Wear loose clothing, comfortable shoes, and adjust your seatbelt low over your pelvis.


Can I get travel insurance during pregnancy?

Some insurance companies do not cover pregnancy, especially the last four weeks of pregnancy (when you may go into labour at any time), so it is best to check before you travel.

You may need a letter (or 'pre-travel health statement') from your GP that says your pregnancy is not high risk (i.e. you do not have any known health conditions that could lead to serious complications before, during or after the birth).

Some insurance companies will not cover any medical expenses relating to the birth or post birth care - you should check this before you travel


What medication should I travel with if I am pregnant?

In terms of medication, pregnant women should travel with:

• a safe insect repellent,
• paracetamol,
• sachets of oral rehydration powder,
• sun cream,
• tablets for constipation and diarrhoea, andmedication for existing conditions, for example, asthma.
• Drink plenty of bottled water as your body temperature is higher than normal during pregnancy.

Generally, you should avoid taking any unnecessary drugs while you are pregnant, but there are certain types of travel sickness and heartburn tablets that are safe to use in pregnancy. Your pharmacist, GP or midwife will be able to advise you.


Can I have vaccinations during pregnancy?

Not all vaccines have been declared safe to be given during pregnancy. Therefore, if you are pregnant, it is best to avoid travelling to any destination where you will need vaccinating beforehand, because there is a slight risk to your baby from vaccines, especially live vaccines (MMR, yellow fever, BCG, typhoid). However, if you cannot avoid the trip you should get vaccinated because, as a general rule, the disease will probably be more harmful to your baby than the vaccination.

Vaccination guidelines differ between countries, so it is best to check with your GP who will weigh up the risks and benefits of each vaccine. Your GP will probably advise you to get vaccinated against a particular disease if there is a high risk of catching it on your trip.

If you are planning to become pregnant, make sure that your routine vaccinations are up-to-date. This is particularly important for rubella, which can be dangerous to the baby if the virus is caught during pregnancy.

Pregnant women are especially susceptible to malaria. Malaria is a very serious disease that can result in serious illness or death of you and your baby. Malaria is most common in tropical countries but is spreading to other parts of the world including Switzerland and the United States. Try to avoid travelling to malarial areas while you are pregnant. If you cannot postpone or cancel your trip, preventative treatment is available. Be very careful to avoid being bitten by insects, and use a mosquito repellent specifically recommended for use in pregnancy.


Can I take anti-malaria medication if I’m pregnant or trying for a baby?

If you are pregnant, ideally you should avoid travelling to a place where malaria is present. If your trip cannot be avoided, you should consult your GP before taking any anti-malaria medication.

If you are not pregnant and due to travel to a place where malaria is present, you should delay trying for a baby while you are taking anti-malaria medication. With some medication, you may have to make sure that you do not get pregnant for three months after you stop taking it.

Malaria and pregnancyMalaria is a serious illness, particularly for pregnant women. It can result in severe illness or death. Both the mother and unborn baby can be affected.

Malaria is caused by a parasitic germ that lives in mosquitoes. It's passed to people through mosquito bites. The illness is most common in tropical countries but it's spreading to other parts of the world, including Switzerland and the United States. Each year, over 2,000 people in the UK get malaria, after catching it while abroad. About nine people in the UK die each year from malaria.

Taking anti-malaria medication while pregnantIf you are pregnant and cannot postpone or cancel your trip, you should seek your GP's advice about taking medication to help prevent malaria. Some courses of medication need to be started before you travel, so you should seek advice well before your departure date.

The type of medication will depend on the country you visit, because malaria germs vary between different parts of the world. Sometimes the germs are resistant to medication. Your GP will have up-to-date information about the most effective anti-malaria medication for your destination.

Some anti-malaria medicines have been taken safely during pregnancy for many years, while others should be avoided. For example, it's recommended that the anti-malaria medication mefloquine should be avoided during the first 12 weeks of pregnancy. And medications such as doxycycline and atovaquone/proguanil are unsuitable for use at any time during pregnancy.

If you use a mosquito repellent on your skin, choose one specifically recommended for use in pregnancy.

Your GP will advise which, if any, anti-malaria medication is appropriate for you and your circumstances. If medication is recommended for you, remember to take it regularly and exactly as prescribed. Your GP may also recommend that you take folic acid supplements with your medication.

Can I try for a baby while taking anti-malaria medication?

If you are not pregnant, you should use contraception to avoid becoming pregnant while you are taking anti-malaria medication.

If you take the anti-malaria medication doxycycline while using combined hormonal contraception, the effectiveness of your contraception may be reduced. This applies whether you are using combined hormonal contraceptive patches or pills. You should use other methods of contraception, such as condoms, while your protection remains reduced.

If you are taking the anti-malaria medication mefloquine, you should avoid becoming pregnant for at least three months after you have taken the last dose.

If you are trying for a baby, speak with your GP before you take any anti-malaria medication.

What if I take anti-malaria medication and then find out I'm pregnant?

If you find out you're pregnant within three months of taking anti-malaria medication, you should contact your GP as soon as possible for advice.

If you are abroad, you should get advice from a healthcare professional in the area that you are staying. You can also contact the Department of Health for advice on +44 (0)20 7210 4850 (9am-5pm, Monday-Friday UK time).


I'm pregnant - what documents do I need to take when travelling?

As well as a pre-travel health statement from your GP, you should take with you your antenatal medical records and your European Health Insurance Card (EHIC) if applicable. Also make a note of your blood group, if you know it.


I'm pregnant - what if I need to see a doctor while I'm away?

Before you travel, check the availability and standards of medical facilities at your destination. It is worth remembering that the medical staff may not speak English very well. Make sure they are aware you are pregnant. If you go into labour while you are away you may need a blood transfusion, therefore it is advisable to check if the country you are travelling to routinely screens blood donations for HIV and Hepatitis B.

Watch for and report any symptoms such as:

• abdominal pain or tightenings,
• persistent or severe headaches,
• vomiting,
• visual disturbances such as blurring or flashing lights before the eyes,
• sudden swelling of face/ankles/wrists/fingers,
• back pain, or
• vaginal bleeding.


I’m pregnant - how do I keep cool during hot weather?

When you're pregnant, it can be difficult to keep cool in hot weather. You may be adjusting to the changes in your size and your body, finding it hard to sleep at night, and very hot weather can be the last straw. Try our tips for preventing meltdown in the heatwave.

Keep out of the sun to avoid overheating and sunburn, and wear loose fitting, cotton clothing. When you're applying suncream, you may find that your skin is more prone to irritation during pregnancy. Try a brand formulated for sensitive skin instead.

Heat rash (also called prickly heat) - which develops when you become overheated and sweaty - is made up of lots of small pink spots, which may be itchy. Stay out of the sun for a day or so until it settles down, and follow our advice for keeping cool. If it doesn't clear up within a couple of days, phone NHS Direct for advice on 0845 4647 or see your GP to check that the rash doesn't indicate anything more serious.

Buy a fan to use indoors. Small hand-held fans can also be very useful. Invest in a cooling leg gel for mums-to-be, and take regular breaks to sit with your feet up in front of the fan.

Keep bedroom curtains/blinds closed during the day to try to keep the room a little cooler.

Drink plenty of fluids to prevent dehydration. This is important, as your body needs more fluid than usual when you're pregnant, and even more so in hot weather.

One of the signs of dehydration is a headache. However, if you are suffering from a persistent headache that continues despite drinking plenty of fluids, and you also have other symptoms such as:

• sudden swelling of the hands, feet, ankles, or face
• blurred vision
• vomiting or
• abdominal pain

See your GP or midwife for an urgent blood pressure and urine check. These symptoms could indicate pre-eclampsia (a potentially serious condition usually occurring after 20 weeks of pregnancy). If you are experiencing sudden breathing difficulties along with sudden swelling, visit your nearest A&E department urgently.

Avoid soft whipped ice creams (e.g. from ice cream vans and fast food restaurants) as they can contain bugs such as salmonella if the equipment is not kept clean. Have a refreshing fruit juice lolly instead. Homemade ice cream made with raw eggs should also be avoided, but standard packaged ice cream is fine and will even help to keep your calcium levels up!

Fill a washing-up bowl or small paddling pool with water, and sit in the shade with your feet in the water. At the end of the day, a cool shower or bath can be soothing and may help you to get a more restful night's sleep.

Rivka

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Reg: Oct 11th 2005

Location: Yorkshire

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Monday, July 28th 2008, 7:17am

Just bumping this as the summer seems to have finally arrived




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