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July 04, 2022 11 min read
Editors note: This guide has been updated with the latest information.
During pregnancy, seemingly harmless things like eating deli meat and cleaning your cat's litter box are suddenly off-limits, along with more obvious restrictions on sports like skiing and scuba diving.
But what about "grey area" activities like flying in an airplane?
There's no single set of guidelines governing air travel during pregnancy and every airline has different restrictions, timelines and requirements. Some airlines may also require a medical certificate from a primary attending doctor or midwife for air travel during the final months of pregnancy, though even that varies, with U.S. airlines typically offering more flexibility than international carriers.
In the absence of clear guidelines, TPG turned to Dr. Nithya Gopal, a board-certified OB-GYN physician and the Director of OB-GYN services at Viva Eve in New York City, for her expert recommendations on safe air travel during pregnancy.
Here's what she had to say:
There is no evidence of adverse pregnancy outcomes due to flying, according to Dr. Gopal.
"The general consensus is that it is safest to fly in the first and second trimesters," Dr. Gopal told The Points Guy. "While the first and third trimesters tend to be when the most obstetric emergencies are going to happen, I personally become more cautious with my patients after 32 weeks because of the increased risk for premature labor and the possibility of needing urgent medical attention when you are in the sky."
The most important thing you can do, no matter how far along you are in your pregnancy, is to consult with your healthcare provider before flying.
"Any time you are planning to fly during pregnancy, you should be having that conversation," Dr. Gopal said. Your provider will be familiar with any safety precautions you should take to ensure a safe and healthy flight.
The airline you are flying may have its own cutoff, so you will want to confirm with it beforehand whether you will be allowed to fly if you are in (or nearing) your third trimester. We've included a chart below that outlines the rules for most major airline carriers.
When you factor in morning sickness and general pregnancy discomfort with the increased risk for blood clots that all fliers need to be aware of, flying during pregnancy can be uncomfortable even when it is deemed safe.
Dr. Gopal shared her recommendations for addressing these common issues when you take to the (baby-) friendly skies during pregnancy. Her number one tip for staying comfortable while in flight is to wear compression socks to help maintain blood flow and reduce swelling in the legs.
In addition, "I also tell my patients to get up and move at least every hour when they are on the plane," Dr. Gopal said.
To prevent clotting, "some doctors may also prescribe a low-dose aspirin," she added. "It isn't something that is recommended by the American College of Obstetricians and Gynecologists (ACOG), but it isn't harmful, either."
If it's nausea or acid reflux that ail you, there are medications generally considered safe that you can take to alleviate your symptoms. These would be the same ones prescribed by your doctor for morning sickness, so speak with your provider before your flight to ensure you have what you need at the ready.
Dr. Gopal also advises wearing loose, unrestrictive clothing (along with your seatbelt, or course) and drinking extra fluids to counteract the pressurized air in the cabin and keep you hydrated.
"Over-the-counter Gas-X may also help with bloating that can happen as a result of the pressurized air," Dr. Gopal said.
Even if your pregnancy is considered low-risk, it's always a smart idea to speak with your healthcare provider before flying. "There are a number of potential risks that go along with flying during pregnancy and those risks can change from week to week and month to month, so it's important to have that honest conversation with your doctor," Dr. Gopal said.
There are certain pregnancy conditions that may make flying more risky or unadvisable. If you are hypertensive, asthmatic or prone to clotting disorders, it's even more critical to speak with your doctor before flying.
Airline policies differ, but if you need documentation, it never hurts to include enough detail to satisfy the most stringent airline requirements.
"As with many things related to air travel, it's better to be safe than sorry," Dr. Gopal said. "It's definitely worth it, and sometimes necessary, to have medical documentation from your provider's office."
A thorough medical certificate or waiver should state:
Additionally, the certificate should be:
Carry this certificate with you on your flight. Some airlines won't ask to see it, but others will. Some airlines also may have their own documentation requirements. See the chart below to find out which airlines require it.
| Airline | Before 28 weeks | Between 29-36 weeks | After 37 weeks (33 weeks if pregnant with multiples) |
|---|---|---|---|
| Air Canada | No restrictions. | No restrictions. | Travel not permitted. |
| Air France | No restrictions. | No restrictions. | No restrictions. |
| Alaska Airlines | No restrictions. | No restrictions. | No restrictions. |
| American Airlines | No restrictions. | Travel permitted; requires medical certificate beginning 4 weeks before your due date. | For international travel, or travel over water, clearance from a special assistance coordinator is required, as well as a medical certificate dated within 48 hours of departure date. |
For domestic flights under 5 hours, travel within 7 days of due date or 7 days after birth requires special permission from an American Airlines special assistance coordinator.
Medical clearance required for mothers traveling within 7 days after birth.
Infants are not permitted to travel within 48 hours after birth, and require medical clearance between 3-7 days after birth.
Infants are not permitted to travel within 7 days of birth without necessity, and only with prior medical clearance.
Medical certificate recommended.
Uncomplicated multiple pregnancy permitted to travel with medical certificate until the 32nd week.
Original certificate must be presented to airline at check-in; the other two copies must be kept on hand during travel.
For flights shorter than four hours, travel is not permitted after 40 weeks of pregnancy (36 weeks if pregnant with multiples), or within 48 hours of normal vaginal delivery.
Even though it may be deemed safe, flying during pregnancy can be uncomfortable — and it is perfectly acceptable to implement your own cutoff for flying with your baby bump in tow. The majority of the time, though, flying is perfectly safe during pregnancy, providing that you follow the guidelines of the airline and your healthcare provider.Read on to learn more about traveling before, during and after pregnancy:
Additional reporting by Katherine Fan and Tarah Chieffi.
