obstetrics and flying

Last edited 08/2019 and last reviewed 01/2023

  • bleeding or pain during the first trimester - any symptoms that may suggest miscarriage or ectopic pregnancy are contraindications to air travel

  • gestation
    • in general, airlines allow air travel until 36 weeks gestation - however flying is advised against after 32 weeks of pregnancy (1)
      • many airlines restrict travel beyond the end of the 36th week, or 32 nd week for twins and other multiple births (1)

  • reduced placental respiratory reserve - if there is a risk of reduced placental respiratory reserve (e.g. uncorrrected anaemia, intrauterine growth retardation) then the patient should be advised against flying. Oxygen is required if this group of patients fly.

Notes:

  • these are only guidelines and each airline has its own regulations and medical standards

  • there have been no case reports that have shown harm to the fetus if the mother travels briefly to high altitude during pregnancy. However most authorities recommend pregnant women stay below 3,658 metres (12,000 feet)

  • a pregnant traveller should be advised to know her blood type and ensure she has valid travel insurance and that the policy covers a newborn should delivery take place

  • NICE state that:
    • pregnant women should be informed that long-haul air travel is associated with an increased risk of venous thrombosis, although whether or not there is additional risk during pregnancy is unclear. In the general population, wearing correctly fitted compression stockings is effective at reducing the risk

  • commercial aircraft environment is not generally considered hazardous to the normal pregnancy. At a normal cabin altitude the maternal haemoglobin remains 90% saturated and because of the favourable properties of foetal haemoglobin (HbF) including increased oxygen carrying potential plus increased foetal hematocrit and the Bohr effect, foetal PaO2 changes very little (4)

  • most airlines require a certificate after 28 weeks, confirming that the pregnancy is progressing normally, that there are no complications and the expected date of delivery. In specific individual circumstances, an airline may allow some discretion.

Reference:

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flying