Making a decision to travel To help decide whether or not to fly, think about your own medical history and any increased risks that you may have. The following questions may also help you in making your decision: Why do you want to travel at this particular time? Is your travel necessary? How long is your journey?Will this increase your risk of medical problems? How many weeks pregnant will you be when you travel and when you return? Your chance of going into labour is higher the further you are in pregnancy. It is also important to remember that having a miscarriage, whether you travel or not, is common (one in five) in the first three months of pregnancy. What are the medical facilities at your destination in the event of an unexpected complication with your pregnancy? Have you had all the relevant immunisations and/or medication for the country you are travelling to? Have you checked with your doctor how these affect your pregnancy? Does your travel insurance cover pregnancy and/or care for your newborn baby if you give birth unexpectedly?

There is huge variation among airlines and travel insurance policies so it worth checking before you decide to fly.

When traveling by car, remember the following: Wear your seat belt even if your car has an air bag. Strap the lower belt across your lower lap/upper thighs. Run the shoulder belt between your breastsand up over your shoulder, not over your abdomen. Remove any excess slack in the seat belt. Proper use of an air bag is important regardless of whether you are pregnant. If you are sitting in front of an air bag, slide the seat as far back as possible, and tilt the seat back slightly to increase the distance between your chest and the air bag [to 10 in. (25 cm) or more.

Take bathroom breaks and short walks at least every 2 hours on long trips to increase the blood circulation in your legs and reduce bladder pressure

Train do not have any restrictions for pregnant travellers. But, railways authorities suggest that pregnant passengers check with their doctor before travelling.

One must not carry heavy luggage Pregnant women should not carry or lift any heavy objects, so if you are traveling alone it is better you pack light. Pick a suitcase with wheels or a stroller to make it easy for you to drag your belongings or better still hire a porter. Try as much as possible not to travel alone as unforeseen complications may arise which only a friend, family member or companion would be able to handle.

Be before time Trains can get unpredictable! It is always better to be before time to catch a train in order to minimize any confusion and to avoid the crowd. Reaching before time will help you settle down comfortably.

Exercise caution When you are traveling by rail you would need to be extra cautious while boarding and alighting especially on the footboard.

Take a lower berth If you traveling by train during pregnancy, it is always better to book a lower berth as not only it aids in easy movement but also reduces any risk of a fall. Mention your choice of seat during reservation or you may take help of concerned railway officer on duty to arrange a convenient seat. You can also request your fellow passengers to swap their seats with you. Booking a seat along the corridor will also help in frequent movement without disturbing others

. Move around Trains have enough space in the alley or corridor to provide you with some exercise. So get up often and move around to stretch your body and relax sore muscles. But while you are moving around make sure you hold on to the rails or seat backs for support. Sitting exercises such as rotating your ankles, wiggling your toes and gently flexing your calf muscles will also help as stretching exercises.

Washroom visits There are only a few washrooms in a train and that too are small in size. You need to be careful about maintaining your balance as the train’s rocking movement especially in the bathroom can make you disoriented. Always hold on to some kind of support and wash your hands after visiting a bathroom especially a public toilet.

Will flying harm me or my baby? If your pregnancy is straightforward, flying is not harmful for you or your baby: If you have a straightforward pregnancy and are healthy, there is no evidence that the changes in air pressure and/or the decrease in humidity have a harmful effect on you or your baby.There is no evidence that flying will cause miscarriage, early labour or your waters to break. Anyone who flies is exposed to a slight increase in radiation. Occasional flights are not considered to present a risk to you or your baby

When is the safest time to fly during pregnancy?

When you are pregnant, the safest time to fly is: Before 37 weeks, if you are carrying one baby. From 37 weeks of pregnancy you could go into labour at any time, which is why many women choose not to fly after this time. Before 32 weeks, if you are carrying an uncomplicated twin pregnancy. Most airlines do not allow women to fly after 37 weeks. It is important that you check with your airline before flying. It may also be more difficult to get travel insurance after 37 weeks.2 Am I at increased risk of problems if I travel by air

Some pregnant women may experience discomfort during flying. You may have: Swelling of your legs due to fluid retention (oedema) nasal. Congestion/problems with your ears – during pregnancy you are more likely to have a blocked nose and, combined with this, the changes in air pressure in the plane can also cause you to experience problems in your ears. Pregnancy sickness – if you experience motion sickness during the flight, it can make your sickness worse. Deep vein thrombosis (DVT) A DVT is a blood clot that forms in your leg or pelvis. If it travels to your lungs (pulmonary embolism) it can be life threatening. When you are pregnant and for up to six weeks after the birth of your baby, you have a higher risk of developing a DVT compared with women who are not pregnant. There is an increased risk of developing a DVT while flying, due to sitting for a prolonged length of time.The risk of a DVT increases with the length of the flight. Your risk is also increased if you have additional risk factors such as a previous DVT or you are overweight.

What can I do to reduce the risk of a DVT? If you are taking a short haul flight (less than four hours), it is unlikely that you will need to take any special measures. Your midwife or doctor should give you an individual risk assessment for venous thrombosis and advice for your own situation. To minimise the risk of a DVT on a medium or a long haul flight (over four hours), you should:

Wear loose clothing and comfortable shoes.

Try to get an aisle seat and take regular walks around the plane. Do in-seat exercises every 30 minutes or so – the airline should give you information on these. Have cups of water at regular intervals throughout your flight. Cut down on drinks that contain alcohol or caffeine (coffee, fizzy drinks). Wear graduated elastic compression stockings –your doctor needs to provide the correct size and type for you as they are different from standard flight socks. If you have other risk factors for a DVT, regardless of the length of your flight, you may be advised to have heparin injections. These will thin your blood and help prevent a DVT. A heparin injection should be taken on the day of the flight and daily for a few days afterwards. For security reasons, you will need a letter from your doctor to enable you to carry these injections onto the plane. Low-dose aspirin does not appear to reduce the risk of a DVT but you should continue to take it if it has been prescribed for another reason.

Are there circumstances when I may be advised not to fly? A medical condition or health problem can complicate your pregnancy and put you and your baby at risk. For this reason, if any of the following apply, you may be advised not to fly: You are at increased risk of going into labour before your due date. You have severe anaemia. This is when the level of red blood cells in your blood is lower than normal. Red blood cells contain the iron-rich pigment haemoglobin, which carries oxygen around your body. You have sickle cell disease (a condition which affects red blood cells) and you have recently had a sickle crisis. You have recently had significant vaginal bleeding. You have a serious condition affecting your lungs or heart that makes it very difficult for you to breathe. It is important that you discuss any health issues or pregnancy complications with your doctor before you fly. If have an increased chance of miscarriage or ectopic pregnancy, ask for an ultrasound scan for reassurance before you fly. Be aware that the unexpected can happen while travelling which could delay your return home. Some airlines may not allow you to fly if you have fractured a bone, have a middle ear or a sinus infection or have recently had surgery to your abdomen that involved your bowel, such as having your appendix removed.

Will I have to go through a security scanner? You will have to go through the normal security checks before flying. This is not considered to be a risk to you or your baby.

Can I wear a seatbelt? You must wear a seatbelt. You should ensure the strap of your seatbelt is reasonably tightly fastened across the top of your thighs and then under your bump. Ask the cabin crew if you need a seatbelt extension.