The primary concern I have for pregnant women who wish to travel is that, if you deliver away from Melbourne, the risks to your and your baby are greater:
- You will need to find a new hospital and a new doctor, neither of whom will have a record of your history.
- If you deliver even slightly prematurely, you are not permitted to travel until the newborn is the equivalent of 40 weeks gestation.
- It is very difficult to get travel insurance to cover you for pregnancy after around 24-26 weeks internationally, or 34-36 weeks domestically.
- The costs for an international delivery can be as high as $1 million, and are rarely covered by insurance
It is for these reasons that I do not recommend pregnant women fly internationally from around 24 weeks, and domestically after around 34 weeks.If you do need to fly, the airlines will require a letter from me authorising you to fly (either internationally or interstate) after 20 weeks gestation. Please contact me to discuss this.
Travel and illness:
In some countries, hygiene standards may not be as stringent as they are in Australia, and the risk of infection (and thus complications) is substantially higher.
- Everyone knows about ‘Bali Belly’, but it can occur in many countries and can result in premature labour or other complications.
- When travelling, avoid salads, ice, water (including bottled water unless you can be certain you are the one who broke the seal) or anything else that may have been rinsed in water.
- Also try not to eat food of which you cannot guarantee the safety.
It is important to understand how drugs are classified according to their safety in pregnancy. In Australia drugs are categorised as A, B, C, D or X according to their safety in pregnancy.
Category A drugs have been taken by a large number of pregnant women for many years with no evidence of any adverse effects on the fetus ever having been reported.
Category B drugs, likewise, have never been shown to have any adverse effects but have only been taken by a limited number of pregnant women.
Category C drugs have been known to have effects on the fetus but these are not necessarily effects that may be harmful nor particularly relevant during the first trimester. For instance, it is best to avoid sleeping tablets late in the third trimester but they have no effects in the first trimester and therefore are safe to take.
Category D and Category X drugs are known to cause fetal malformations and must never be taken in pregnancy.
You can be assured that if I ever prescribe a drug for the treatment of any condition in pregnancy that I am perfectly comfortable with it’s safety. I will never prescribe a category D or X medication; almost always I will prescribe Category A and sometimes Category B drugs. If I ever prescribe a Category C drug I will explain why it is safe for you to use at that time but not safe to use later in pregnancy.
Nevertheless, I understand that there is a great reluctance for any women to take any medication in pregnancy and this is completely understandable. However, there are times when the benefits of taking medication outweighs any potential risk but it is always up to you.