Pregnancy

Once a pregnant woman has decided to travel, a number of issues need to be considered before her departure:

• An intrauterine pregnancy should be confirmed by a clinician and ectopic pregnancy excluded before beginning any travel.
• General health insurance policies may or may not provide coverage of pregnancy-related problems while abroad. Pregnant travelers should inquire about what their health insurance policies cover and, if needed, obtain a supplemental policy for their trip. Many supplemental travel insurance policies and prepaid medical evacuation insurance policies do not cover pregnancy-related problems, so this issue should be clarified before obtaining a policy.
• Check medical facilities at the destination. For a woman in the last trimester, medical facilities should be able to manage complications of pregnancy, toxemia, cesarean sections, and premature or ill neonates.
• Determine beforehand whether prenatal care will be required while abroad and who will provide it. The pregnant traveler should make sure she does not miss prenatal visits requiring specific timing.
• Determine beforehand whether blood is routinely screened for HIV and hepatitis B and C at the destination. Pregnant travelers should consider the safety of blood transfusions, if needed, when making plans for international travel. The pregnant traveler should also be advised to know her blood type, and Rh-negative pregnant women should receive anti-D immune globulin (a plasma-derived product) prophylactically at about 28 weeks’ gestation. The immune globulin dose should be repeated after delivery if the infant is Rh positive.
• Determine if the traveler risks influenza on this trip, and recommend influenza vaccine accordingly.
• Determine whether the prevalence of tuberculosis (TB) is high in the destination region and whether the planned itinerary will put the traveler at risk for TB. If exposure to TB is determined to be a risk, the pregnant traveler should receive skin testing before and after travel