Your "little" sister has just called to say that she's getting married and they've set the date for exactly six months from today. They're planning the ultimate romantic wedding on a beach in the Caribbean, and in between tears she asks you to be her matron of honor. You both scream with excitement and suddenly you remember the positive pregnancy test that you had last week. Oh no — what to do?

Despite what your grandmother told you about pregnancy "in her day," traveling during pregnancy is quite safe as long as you use common sense, discuss it with your doctor or midwife, and follow a few widely accepted guidelines. Precautions to be taken depend upon your stage of pregnancy, your method of travel, and the intended destination. Traveling during your second trimester, the middle three months, is usually the best in terms of your physical comfort and the risk of miscarriage or labor. It's also the time when the morning sickness may have stopped, and your size doesn't diminish your comfort and energy levels.

It's always best to discuss your plans well ahead of time with your physician or midwife, who may strongly caution you against any type of travel if you have had any signs of miscarriage or high-risk complications in this or previous pregnancies. When given the okay to go, it's a good idea to carry some proof of your due date, especially if traveling by air as most airlines will only allow you to travel up to 35 weeks of pregnancy. Be sure to check when making flight plans to avoid last minute disappointment. Sometimes travel can't be avoided, so if it's late in the pregnancy ask for a copy of your prenatal record, in case you have a problem or go into labor at your destination. In this case, it's also best to ask for a refferal to a hospital or physician in this locale before you depart.

Travel by car, while certainly the most common, requires a few preventative measures. Always wear a seat belt with the lap belt applied across the hips, not over the abdomen. It's important to take frequent stops along the way to empty your bladder and to exercise your legs. Stop the car, go to the bathroom, and walk a few steps at least every hour. While in the car, don't sit on your legs; keep them uncrossed and get your blood circulating by contracting and relaxing the leg muscles and by wiggling your toes.

Always drink plenty of water. During pregnancy it's important to be well hydrated to maintain enough oxygen for the baby. Water is best for you, followed by fruit juices. Avoid carbonated soda which fills you up with gas and gives you empty calories. If your travel includes a foreign country, you should drink only bottled water because the vomiting and diarrhea caused by contaminated water can quickly lead to dehydration. Most medications normally given in this instance are not safe during pregnancy.

Commercial transportation, including train travel, can be quite safe and comfortable during pregnancy. While on the train it would again be important to get up and stretch your legs at least every hour or two. Take a bathroom break even if you don't feel the urge. Get assistance from the bellman to lift your luggage into the overhead rack since heavy lifting should be avoided at all costs. While it's quite common for some train travel to occur without a pre-arranged ticket, it may be wise to pay a little extra for a guaranteed seat, especially if you'll be on a well-traveled route.

As previously mentioned, airplane travel will be limited by your weeks of pregnancy. Moms-to-be are frequently concerned about the effect of cabin pressure changes on the baby. Just like you, the baby is easily able to adjust to the changes, so it's completely safe. As soon as you check in, ask if a bulkhead seat is available. These seats have more room to stretch your legs. If this is not possible, at least get an aisle seat.

Be sure to wear your seat belt across your hips, and as long as you're on a smooth flight, you should get up, walk around the cabin and go to the bathroom.

If you're considering international travel, be sure that the country has appropriate facilities and doctors to care for pregnant women. Many countries require immunizations which cannot be given to pregnant women. It is not recommended that pregnant women travel to countries where malaria is common. Even though the pregnant woman can take some medications that protect against malaria, you may still get the disease, which can have devastating consequences for the baby. Be careful to avoid some foods, as it may be common in some countries to consume raw or undercooked meats and unpasteurized milk and cheese products.

Feeling overwhelmed by now? Don't be, it's really quite simple. Use your head, check with your doctor or midwife and most importantly, sit back and enjoy yourself!

About the Author:

Mary McTigue, RNC, MA, Director of Maternal Child Health at Trinitas Hospital in Elizabeth, New Jersey. She also serves in a national leadership position for AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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Copyright © 2001 Mary McTigue, All Rights Reserved Reprinted with Permission