What are the guidelines for flying during pregnancy?

Guidelines for Flying During Pregnancy

Most pregnant women without complications can safely fly up to 36 weeks of gestation for domestic flights and 35 weeks for international flights. 1, 2

General Safety Recommendations

• The second trimester (13-26 weeks) is considered the safest time for air travel during pregnancy, as the risk of spontaneous abortion and preterm labor is lowest during this period 2
• Commercial air travel is not contraindicated for healthy pregnant women with uncomplicated pregnancies 1, 3
• Pregnant women should continuously use their seat belts while seated to minimize risk of trauma from unexpected air turbulence 1

Timing Restrictions

• Most airlines allow pregnant women to fly up to:
  • 36 weeks of gestation for domestic flights 1, 2
  • 35 weeks of gestation for international flights 2
• Women at significant risk for preterm labor or with placental abnormalities should avoid air travel altogether 1

Physiological Considerations

• In-flight environmental conditions (low cabin humidity, changes in cabin pressure) combined with pregnancy-related physiological changes may cause maternal adaptations that could have transient effects on the fetus 1
• Flying does not pose a risk of fetal hypoxia unless the fetal oxygen supply is already impaired at ground level due to an underlying maternal condition 2
• Pregnant women with medical problems that may be exacerbated by a hypoxic environment should be prescribed supplemental oxygen during air travel 1

Risk Mitigation Strategies

• To reduce risk of deep vein thrombosis (DVT), which is increased during pregnancy and air travel:
  • Wear compression stockings 3
  • Stay hydrated 1
  • Perform frequent leg exercises 1
  • Walk in the aisle periodically when it's safe to do so 1
• Pregnant women should take precautions to ease in-flight discomfort, such as:
  • Choosing an aisle seat for easier access to the restroom 1
  • Wearing loose, comfortable clothing 1
  • Bringing snacks and staying well-hydrated 1

Special Considerations

• Pregnant women should familiarize themselves with the healthcare system at their destination and develop an emergency plan for contacting healthcare providers if needed 3
• Those with underlying medical conditions should consult with their obstetrician before embarking on long-distance travel 3
• Although rare, there have been case reports of placental abruption during air travel, though a direct causal relationship has not been established 4

High-Altitude Considerations

• Altitudes up to 2,500 meters (8,200 feet) generally pose no problem for pregnant women 2
• When traveling to high altitudes, pregnant women should:
  • Allow sufficient time to acclimatize 2
  • Keep physical exertion to a minimum 2
  • Avoid scuba diving, which is contraindicated during pregnancy 2

Research on Fetal Response to Air Travel

• Studies examining fetal movement during transatlantic flights in the third trimester have shown that most fetuses (63%) experience no change in movement patterns during the flight itself 5
• Transient changes in cardiotocographic tracings during the third trimester have been reported following air travel, but these do not appear to have long-term significance 3