What to expect when traveling in each trimester of pregnancy
So you're pregnant? Congrats! It's an exciting time but also one in which many aspects of your life will begin to change, including travel. While you'll quickly need to understand the airline industry's rules for flying while pregnant, there are some more personal tips I'd like to share with you based on my experience traveling throughout the first, second and third trimesters of both of my pregnancies.
A few truths about pregnancy
Picky, starving moms need to travel with snacks
I didn't know I was pregnant when I took the first flight of my second pregnancy. I was on a mileage run from Houston to Los Angeles, and by the time we landed, I was super tired, kinda grumpy and oh-my-so-hungry.
Then began a mad search for food. Luckily, Counter Burger was open and serving up sweet potato fries and burgers. Out of habit, I went for the veggie burger but I quickly regretted my decision, which left me far from satisfied with ground-up veggie mush.
In the early stages of pregnancy, your normal travel habits of going a little hungry for a while, or making due with what's around, may not work well.
Throughout your pregnancy, travel with water to stay hydrated and snacks to stave off hunger pangs and keep you going through travel delays. If you're feeling particularly food sensitive, research the food options at your destination ahead of time. I virtually lived on chicken noodle soup for a whole week early in my pregnancy and then, for a couple of days, all I wanted were hush puppies. I know how to get those items at home but when you are on the road, you either need to do more research or be more flexible -- which is sometimes easier said than done.
Research and make choices about inflight radiation and other risks
I'm not an expert, but because I fly often, I have given some thought to inflight radiation exposure, especially during the early stages of pregnancy.
For pregnant flight attendants and pilots, the Federal Aviation Administration recommends a limit of 1 mSv during pregnancy, with no more than 0.5 mSv per month. I don't fly as much as an airline employee, but it doesn't take much research to learn that the amount of radiation you (and your gestating baby) are exposed to in the air varies dramatically from route to route. The highest-level routes are typically longer, higher-altitude polar routes. Here's some information from NASA about polar flights and radiation.
Every expectant mother should discuss the risks of flying during pregnancy with her doctor before getting on a plane. For me, nine months was a tiny moment in my traveling life, so I was OK adjusting my behavior a bit out of an abundance of caution. However, I didn't adjust to the point of never leaving my house. We still flew when I was pregnant, but I was judicious about when and where I would fly.
Check your health insurance policy
If you aren't familiar with your medical insurance coverage for when you travel, brush up on those facts now. Look at in-network and out-of-network benefits, as well as coverage for procedures for medical emergencies in other countries, if relevant. Most likely, if you do have coverage for treatment in other countries, you will still be on the hook to pay for your care up front and then submit for reimbursement from your health insurer. Plan accordingly and plan for the unexpected. If your baby decides to arrive early, for instance, check to make sure your insurance would cover possible extended and expensive care in an intensive care unit in a hospital away from your home.
Be sure to check what your health insurance coverage provides if you deliver at another facility later in your pregnancy. I once had an insurance plan that specifically did not cover out-of-network deliveries after 36 weeks, so that is something you would want to know before venturing away from home late in pregnancy.
Consider travel insurance
Trip insurance can be helpful if you are traveling while pregnant. Read the plan's fine print to determine what might be covered and whether you are covered if you already knew you were pregnant when you purchased the plan. Typically, a normal pregnancy or normal delivery would not be covered but if there are unexpected complications with the pregnancy, then related trip-cancellation or trip-interruption coverage may kick in on certain plans in certain situations.
Here are some articles that will help you brush up on your travel insurance knowledge:
- The best travel insurance policies and providers
- What is independent travel insurance and when is it worth it?
- When to buy travel insurance versus when to rely on credit card protections
- Is credit card travel insurance sufficient on its own?
- Why I buy travel insurance
Traveling in the first trimester
Traveling in the first trimester can range from "no big deal" to "I think I'm going to die from misery right this very instant." Symptoms in early pregnancy can vary widely and can change by the day. A flight in your first trimester may be no different from any other flight you've ever taken or it may feel like you are flying with the worst hangover of your life.
Unless you are very high risk or have other extenuating medical issues, your doctor will probably give you the green light to travel in early pregnancy. Feeling extra tired, nauseous and queasy doesn't make for the perfect travel experience, so here are some tips to make travel easier:
Pick an aisle seat and move about the cabin
When you do hit the skies early on, choose a seat where you will be the most comfortable, likely an aisle seat so you can get to the restroom easily. I also recommend getting up to walk around and stretch your legs. (Here are tips for credit cards that will defeat basic economy and let you get a seat assignment in advance.)
Room service come to the rescue
In my first trimester of my second pregnancy, I went on a trip with my daughter and parents to New York City to see the Macy's Thanksgiving Day Parade and I was met with another challenge. I was at the point in my pregnancy when I needed food immediately upon waking or I was going to get queasy. Since I was staying in a hotel room with my young daughter, this meant room service. I also had granola bars and fruit on hand, but that was not enough to really do the trick some mornings. Had my husband been there, he could have gone in search of a warm bagel and juice, but since he wasn't on this trip, we had to improvise. Thanks goodness Marriott elite status helped defray the cost of most of the breakfast!
Take it easy when you need to
Once you are further along in your pregnancy and you actually look pregnant, you will sometimes get a little sympathy or, at least, empathy while traveling. Strangers may offer to help with your bag and people may have more patience with you if you're moving slowly. However, in the first trimester nobody can tell you are pregnant, and no one is going to feel sorry for you. If you act queasy on the plane, you will pretty much be treated like you have Ebola, and any other issue or ailment will pretty much not interest anyone. I once told the flight attendant I was pregnant when she was giving me the eye about looking queasy.
Take care of yourself, don't overdo it and know when to say enough is enough. You may be used to very busy travel days, but now find yourself needing a nap during your first trimester, and that's OK. Listen to your body and adjust accordingly.
Traveling in the second trimester
You have probably heard that the second trimester is generally the easiest of the three trimesters for most expecting moms. You usually aren't as sick and or as tired as in the first trimester, and you aren't as large, uncomfortable and exhausted as in the third trimester. From roughly weeks 13 to 27 of a pregnancy, your activity and comfort levels are often good, and this means that it can be a great time to travel. Couples that like to take "babymoons" (one last couples trip before the baby arrives) often try to schedule them in the second trimester.
The beginning and end of the second trimester are quite different
You will probably enter the second trimester not really looking pregnant, and end it looking quite different. This means that you may feel very different at the beginning and end of the second trimester. The second trimester is when lots of belly growing happens and this can mean that some types of travel will be more uncomfortable toward the end of these few months of pregnancy than at the beginning.
Consider where you are comfortable traveling
A very personal and important decision to make during the second trimester is to determine if there are certain restrictions you will place on yourself in terms of where you're comfortable traveling. Some types of travel will ban women from traveling during the second trimester. For example, many cruise lines will not allow a woman to book a cruise if she will enter her 24th week of pregnancy (or later) while on the voyage.
Royal Caribbean's policy bars pregnant women from sailing at and after the 24th week. It was developed in concert with the Cruise Lines International Association endorsement of the American College of Emergency Physicians Health Care Guidelines for Cruise Ship Medical Facilities.
Many consider unborn fetuses to be viable if born beginning around 24 weeks (though that age threshold is getting earlier and earlier). This means that a baby born at 24 weeks gestation would have anywhere from a 50% to 70% chance of survival outside the womb if (and only if) there is immediate access to advanced medical care. A cruise ship clearly doesn't have an advanced neonatal care unit on board, so presumably the policy is related to why cruise lines draw the line for pregnant passengers.
I personally draw the line for travel at 23 or 24 weeks when talking about destinations that don't have the same level of advanced medical care as the United States -- or long flights or a flight path that could hinder prompt access to advanced medical care if I happened to unexpectedly go into labor. The Maldives is an example of somewhere I would not want to travel in this instance because there would be significant delays in obtaining medical care on these remote islands.
Plan big, but not too big
The second trimester is a great time to squeeze in a pre-baby trip or two since you will probably feel relatively like to your pre-pregnant self much of the time. We went to Aruba when I was 14 weeks pregnant and it was a fantastic trip. I had lots of energy and a normal appetite. Flying was not uncomfortable because my belly was still pretty small and the only real adjustment was to make sure I had a somewhat larger bathing suit before the trip.
At 23 weeks, I traveled to Spain and still felt pretty energetic and "normal." I will admit that the flight in economy wasn't super comfortable since I did have a belly that was hindering curling up in positions that usually help me sleep on the plane, but our time on the ground in Spain wasn't really impacted at all by the pregnancy other than missing out on the Spanish wine.
The great thing about both of those trips was that they were at my own pace. This meant that if I didn't feel like doing much one afternoon, I could take it easy. Even though you may feel great in the second trimester, you can still tire more quickly than normal, so be sure to limit your vacation activities to those you can manage. There are also activities that some doctors might advise against by the second trimester like thrill rides, scuba diving or horseback riding, so double-check any restrictions before planning more adventurous outings.
Traveling in the third trimester
Pregnancy isn't an illness or disease. For many families, it's just a normal phase in a woman's life before a new baby joins the family. Assuming things are going well, it's not a time when you have to cancel all travel. However, once the third trimester rolls around, travel can get a more complicated and does eventually have to stop.
The beginning and end of the third trimester are quite different
Changes come even more quickly in the third trimester. You enter the third trimester about 28 weeks pregnant and end it with a newborn. This means that types of travel that are possible at 27 and 28 weeks pregnant may be inadvisable, or even prohibited, at 37 and 38 weeks pregnant.
Select destinations and activities carefully
In the final months of pregnancy, some activities are probably going to be more comfortable and enjoyable than others. For example, swimming and spa time may be exactly what you need.
I give strong preference to visiting beach and resort destinations in the final trimester. Trust me when I say that few activities are as comfortable in the third trimester as floating in the water! We went to The Phoenician (a Marriott property) in Scottsdale, Arizona, when I was about 31 weeks pregnant and even with my big belly, it was the perfect mix of spa, swimming and fun activities for our 5 year old before both our lives changed.
You are going to get uncomfortable
Maybe this isn't universal and there are some magical creatures out there who never feel uncomfortable during pregnancy, but every mom I know eventually hit a point in her pregnancy when she wasn't comfortable. For many, this means that sitting for an extended time in a small airline seat, standing in long lines or trekking around in the heat to explore a city all day eventually become pretty miserable activities.
No one can tell you when you will hit that point, but it will likely happen in the third trimester. For me, my back started giving me a bunch of trouble at around week 30 or 31. I was incredibly grateful there were no more flights scheduled during that pregnancy beyond that point.
If you are going to fly during the later weeks of your third trimester and have the ability to secure a more comfortable seat up front, or at least one with extra legroom so you can stretch out, it may well be a good investment in your comfort. I brought a tennis ball with me when I flew so I could give myself a bit of a "back massage" against the airplane seat.
Bring your own pillows
Sleep becomes a challenge in the third trimester for many women and a pillow fort of sorts becomes a necessity to get some good shut-eye. Many pregnant moms find that using some sort of body pillow or pillow arrangement helps to keep their bellies supported and comfortable at night. You can't assume that the hotel will have similar pillows, so bring your own if they become essential to good rest in your third trimester. I had no shame in hauling my pillow fort with me on our last road trip at eight months pregnant.
See if you are allowed to fly
Even if your doctor OKs it, many airlines have rules about women flying in the third trimester. Check out airline rules for traveling while pregnant for complete details, but generally speaking, most U.S. airlines don't have many flight restrictions until the last month of pregnancy. However, many international airlines do have restrictions and documentation requirements beginning at 28 weeks. If you are pregnant with more than one baby, the restrictions kick in even earlier.
Decide when to stop traveling
I'm all for traveling while pregnant but, realistically, most women will want to stop traveling at some point in the third trimester. I would imagine by about 36 or 37 weeks, most women will probably decide to stay closer to home. I went on a road trip about three hours from home at 35 weeks and then called it quits for the rest of the pregnancy. There's still a whole new world of travel waiting once a new baby joins the family.
There is usually no reason to stop traveling when you're expecting. During my last pregnancy, I went on 12 trips, 28 flights, visited four countries and I'm very glad I had the opportunity to stay that active. I'm also glad that I grounded myself from flight after 31 weeks and from road trips at 35 weeks because those were the right decisions for my comfort level.