What Not to Do When You're Traveling for Two

The holidays are near, which for many means imminent travel. And if you're pregnant, that could complicate matters. First and foremost, stay comfortable and use common sense -- and always check with your physician. For women with normal, healthy pregnancies, here are some rules to follow on the road. (Women with high-risk pregnancies need to think along different lines and take extra precautions.)

-- Jennifer Ramo

· Don't travel too early -- or too late. One of the crucial decisions to make when planning your pre-baby trip is when you'll take it. And while there is nothing inherently dangerous about traveling while pregnant, you do want to make sure that you minimize your risk of problems and discomfort along the way. Timing the trip well can be crucial for safety and comfort reasons.

"It is pretty universal that if you have a choice in the matter, the middle trimester is the best time to travel," says Dale Carroll, a Michigan obstetrician certified in travel medicine and the founder of the Web site Pregnant Traveler ( http://www.pregnanttraveler.com/ ). That's the trimester with the least number of complications and the one in which women tend to feel the best. The risk of miscarriage lowers dramatically from the first trimester to the second, and your belly will not be as unwieldy as it will be in the third. And if you go into premature labor in the final trimester, you want to be as close to your own obstetrician as possible.

· Don't take too long a trip. Whether on a plane, train or automobile, pregnant women should think twice before signing up for a long journey. The inactivity that usually accompanies long trips can lead to deep vein thrombosis, a dangerous, potentially fatal condition in which a blood clot forms in a vein deep in the body with the potential to break off and travel to the brain or lungs. Carroll recommends walking around and drinking plenty of water during a long flight. "Basically, pregnant women are more apt to get blood clots. I always tell people to keep hydrated and keep moving."

If you're driving, be sure to schedule frequent pit stops for food, drink and bathroom breaks. If it's a long trip, wear loose clothing and bring a pillow or anything else that helps you relax. Safety concerns aside, you will feel more refreshed and ready to enjoy your vacation if you stay comfortable on the way there.

· Don't travel too far from help. One of the keys to planning a trip while pregnant is to make sure that if you have an emergency you will not be too far from medical care. Lewis Townsend, an obstetrician and gynecologist in Bethesda, says that if you do get in trouble while away, there is little your physician can do for you besides tell you to go to the emergency room.

Physicians vary in their comfort with diagnosing their pregnant patients over the phone. Townsend recommends that the first thing you do when you choose your destination is identify the nearest ER. The Web site http://www.allianzworldwidecare.com/ , operated by health insurance provider Allianz Worldwide Care, has an international hospital finder and explanations of the health care available in countries worldwide.

· Don't travel too near a disease zone. Tempting as a trip to an exotic location sounds, Townsend says that pregnant women "don't want to travel to areas of high disease or epidemic." Not only do mothers-to-be want to avoid getting the disease itself, but the preventive care or ensuing treatment could be dangerous. For instance, Townsend says, vaccinations or other preventive medications such as antimalarial pills are not recommended while pregnant.

· Know the restrictions. Carroll says his traveling patients are often surprised to discover that airlines and cruise ships have restrictions as to when pregnant women can travel. Usually, they find out when they are boarding the plane or the cruise ship and are refused entry.

Most airlines have similar rules prohibiting travel for women after a certain stage of pregnancy. American Airlines ( http://www.aa.com/ ), for example, requires a medical certificate if the pregnant traveler wishes to travel within a month of her delivery date, while Continental Airlines ( http://www.continental.com/ ) requires medical certification only if the due date is within one week of travel.

Cruise lines also differ in their rules. Carnival Cruise Lines ( http://www.carnival.com/ ) prohibits travel after 27 weeks of pregnancy, while Crystal Cruises ( http://www.crystalcruises.com/ ) bans travel if you have been pregnant for more than 24 weeks.

Check with individual carriers and cruise lines for their rules.

· Be sensible. "No trekking," Townsend says. No bungee jumping, no scuba diving, no rock climbing and no activity that might endanger either the baby or the mother. While it may be appealing to do an athletic vacation while you feel strong and healthy, keep in mind that your body is different. Your balance is not the same, and you may not be in the same athletic condition as you were. Most important, you are now carrying a very delicate package.

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More information: Your obstetrician is always the first source for information, but there are several sources on the Web offering help and advice for pregnant travelers. The Centers for Disease Control and Prevention ( http://www.cdc.gov/travel/spec_needs.htm ) has additional information on traveling while pregnant as well as on international travel with children. The American College of Obstetricians and Gynecologists has an excellent pamphlet, "Travel During Pregnancy," available on its Web site (go to http://www.acog.org/ and plug "travel" into the search engine). The American Pregnancy Association ( http://www.americanpregnancy.org/ ) also offers information on the topic as well as a toll-free hotline (800-672-2296).