Research your destination
People and animals in different parts of the world can carry diseases that are foreign to our bodies. Because of these differences, some countries require that people be vaccinated before they travel there so they will be immune to certain diseases. Find out which are needed for the countries you plan to visit through the Centers for Disease Control's Web site. Also check on those that are required to get back into the United States. If you have not already received one of the necessary vaccines, it's not recommended that you receive it during pregnancy.


Talk to your doctor
Before you even plan your trip, discuss your medical condition and your destination with your doctor. Some overseas destinations are not considered safe for pregnant women. If you and your doctor have agreed on your destination, find out about all the steps you should take before departing, such as having a full checkup or getting started on a prescription. Also get a copy of your medical record to take with you.


Learn about foreign medical care
Regardless of your destination, it's important to find a doctor to contact in case of an emergency. And the odds are that your doctor won't have anyone to recommend if you're traveling overseas. Find out where medical facilities and doctors are in the countries you plan to visit. If possible, contact these hospitals before you go to find a doctor who speaks English. Also speak with your insurance company to inform them of your trip and find out what medical visits or procedures would be covered.


Prepare for unsafe food and water
Travel in other countries brings you in contact with diseases that are not common in the United States. Natives of a country are used to the organisms found in the food and water, but the same organisms can make a visitor ill. As a rule, it is recommended that pregnant women avoid tap water and undercooked meat while visiting another country. There may be some countries or American resorts where this is not the case, so speak with your doctor about it if you have any doubts. Here are some ways to avoid unsafe food and water:
- Drink only bottled water, bottled or canned soft drinks, hot tea or broth. Iodine used to purify water may not be safe for pregnant women.
- Don't use ice in your drinks and don't use glasses that could have been washed in tap water. Drink out of the bottle or use paper cups.
- Avoid fresh fruits and vegetables unless they have been cooked or can be peeled.
- Stay away from raw or lightly cooked meat. It can contain organisms that cause toxoplasmosis. This disease may injure the fetus.
- Make sure the milk you drink has been pasteurized.

Eating or drinking these unsafe organisms can cause traveler's diarrhea -- which may be a minor nuisance to someone who is not pregnant, but is a greater concern for pregnant women. If you do get diarrhea, drink plenty of fluids. Do not take any medication without checking with a doctor first. A doctor can arrange for medication that is safe for use during pregnancy.


Travel Safety in Mid-Pregnancy (Week 21)

Head for the hills or the beach or the big city! This is the best time in your pregnancy to take a trip. Miscarriage isn't much of a risk now, your morning sickness has probably ended, and you're still small enough to get around easily. Use these travel tips to make the most of your last vacation (at least for a while) without night feedings, diaper bags, or a babysitter:

* Move around. The riskiest thing about travel during pregnancy is the possibility of getting a blood clot, and travel often requires long hours of sitting in a plane, bus, train, or car, which increases that risk. Get up and walk around every hour or so. Avoid crossing your legs, and if you have varicose veins or swelling problems, consider wearing support hose.
* Take your most comfortable shoes and clothing. Support hose are especially important if you're going to be sitting in cars, planes, or trains for long periods of time.
* Head off dehydration by drinking extra fluids (choose water rather than caffeinated beverages, which can contribute to dehydration), breathing steam from a cup of hot water, and using an over-the-counter saline nasal spray.
* Most airlines allow pregnant women to travel until the 36th week of pregnancy, though expectant mothers at risk for premature labor or who have placental abnormalities should avoid flying.
* Forget those multicity tours. Opt for a single destination and a pace that allows you to get off your feet in the middle of each day.
* Choose a cool climate over a hot one, now that your metabolism is in high gear, or at least be sure your hotel has air-conditioning and you can stay out of the sun.
* Beat jet lag by avoiding new time zones or start switching time zones before you leave. Switch to local time when you arrive.
* Take your good habits with you. Pack your prenatal vitamins and stick to a healthy eating plan. Continue to exercise daily.
* Lift luggage carefully: Stand alongside your suitcase, bend at your knees, grasp the handle, and straighten up. Better yet, have your partner or the bellboy carry it.
* If you have a problem with swollen ankles, wear loose-fitting shoes. Rotate your ankles and elevate your feet to improve circulation.
* Get the name of a local obstetrician and carry it with you. Also carry your medical records and insurance card.
* Check with your health insurer to find out if you're covered for health problems that occur while you're traveling and determine whether you need your insurer's approval before receiving care.
* Pick a safe destination. Now is not the time to travel to countries with unsafe drinking water, high rates of infectious diseases, or civil unrest. If you must travel to a foreign country where vaccinations are recommended by the Centers for Disease Control, check with your health care provider to weigh the risk of every vaccination against the risk of getting the disease at this point in your pregnancy.
* Don't drink the water or swim in it if you're in a country where water standards are questionable. If you're in a region where the water poses hazards, don't eat raw or unpeeled fruits and vegetables.
* When you drive, wear a lap belt and shoulder harness. The lap belt should strap beneath your abdomen, and the shoulder belt should be snug without cutting into your shoulder or neck.
* Bring extra pillows and socks no matter how you travel. They'll come in handy for comforting your back and feet.


Traveling Late in Pregnancy (Week 36)

It's best to stay home during your third trimester. If you have to travel, keep these guidelines in mind.

Think twice before you hop on a plane during these last few weeks of pregnancy. It's best to stay close to home. If you go into labor, you'll be close enough to the hospital to get there in time.

Airlines may not allow you to fly close to your due date. Some airline requires a doctor's certificate if you want to fly within seven days of your due date, and you will be forbidden to board the plane if you are in labor. Some requires any woman in her 9th month of pregnancy to present a certificate from an obstetrician, signed within the previous 72 hours, deeming her to be physically fit for flying.

Airlines clearly do not want women giving birth on their planes.

If you must travel, take a copy of your medical record and your doctor's contact information with you in case you do go into labor. Have the name and phone number of a local obstetrician handy and know where the nearest hospital is and how to get there in a hurry.

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