In the absence of obstetric or medical complications, occasional air travel during pregnancy is generally safe, according to the American College of Obstetrics and Gynecology (ACOG). Like other travelers, pregnant women should use seat belts while seated.
Most commercial airlines allow pregnant women to fly up to 36 weeks of gestation, with some restrictions on international flights.
ACOG does not recommend air travel for pregnant women with medical or obstetric conditions that may be exacerbated by flight or that could require emergency care. It advises checking flight durations when planning travel and know that the most common obstetric emergencies occur in the first and third trimesters.
Once aboard a flight, conditions including changes in cabin pressure and low humidity, coupled with the physiologic changes of pregnancy, do result in adaptations, including increased heart rate and blood pressure, reports ACOG. And those traveling on long-haul flights face the risks associated with immobilization and low cabin humidity. This can cause issues such as lower extremity edema and venous thrombotic events.
ACOG recommends preventive measures to minimize these risks, including the use of support stockings, regular movement of the lower extremities, avoiding wearing restrictive clothing ad regular hydration. It also advises against consuming gas-producing foods or drinks before a flight.
Other ways for pregnant women to be comfortable on their flights include: booking a bulkhead seat for more legroom; reserve an aisle seat for easy access to lavatories and to walk; elevate your legs on a carry-on bag to avoid swelling and cramps; and wear a layered, comfortable outfit for changing cabin temperatures.
Airlines around the world have different rules and regulations on when and how long pregnant women can fly. Below are the policies for the top 25 airlines from around the world.
The French flag carrier requires pregnant women to have a medical certificate for travel beyond 36 weeks. it recommends avoiding travel in the final month of pregnancy, as well as during the first seven days after delivery. The airline does not require medical clearance, but recommends expecting mothers seek their doctor's opinion before traveling.
India’s flag carrier allows expectant mothers in good health to fly up to and including their 32nd week of pregnancy. After 32 weeks, if the pregnancy is anticipated to be a normal delivery, an expectant mother will be accepted for travel up to the 35th week. But a medical certificate confirming the mother is fit to travel is required by an attending obstetrician. In case of the pregnancy beyond 35 weeks, a passenger may be accepted for transportation only on urgent or compassionate grounds, with the authority of the Executive Director - Medical Services, after filling out the airline’s MEDIF form.
Cases of multiple and complicated pregnancy should not be accepted after the 32nd week in the case of pregnancy with twins, triplets etc. and cases where a mother experienced a difficult and complicated delivery in the past.
The country's flag carrier allows women pregnant with twins to fly up to the end of their 31st week. For single, uncomplicated pregnancies and clearance from a doctor or midwife women can take flights more than five hours up to the end of their 35th week. For flights under five hours, it's up to the end of the 37th week. The airline recommends that women past their 28th week carry a letter from a doctor or midwife that says you are fit for travel, confirming your pregnancy dates and that there are no complications.
The airline's medical team must offer clearance for women experiencing the following: a complicated pregnancy, such as placenta previa or bleeding; a multiple pregnancy; a history of premature labor; or have begun the early stages of labor.
Italy's flag carrier has no travel restrictions for expectant mothers during the first eight months of pregnancy. But if traveling within the last four weeks of pregnancy, expecting multiple births, or having a complicated pregnancy, medical clearance is required. Completion of a Medical Information Form, MEDIF, prior to travel and signed by both the passenger and doctor is required. The form is available for download from Alitalia's site.
Alitalia advises pregnant not to fly seven days prior to and seven days after giving birth, or if there is a risk of a premature birth or other complications. It will make staff available to escort pregnant women from the airport check-in counter to the boarding gate. Staff onboard the flight will help stow carry-on luggage. Seats can be pre-assigned and women cannot sit in an exit row.
The Japanese carrier requires women within 15 to 28 days of their due date to fill out and carry a medical information form. Women within 14 days of their due date are required to have a medical form and travel with a doctor. The form must indicate there are no complications of pregnancy, that the passenger has no health problems preventing them from flying and the due date. It must be completed by a doctor and submitted no more than seven days prior to departure.
The Fort Worth-based carrier has different rules for international and domestic flights. If a due date is within four weeks of a flight, you must provide a doctor’s certificate stating that you’ve been recently examined and you’re fit to fly. For domestic flights under five hours, pregnant women won’t be permitted to travel within seven days (before and after) their delivery date. Those who need travel within this time frame will need approval from a physician and help from a special assistance coordinator. The pregnant woman's physician will be required to fill out a passenger medical form before a flight. A special assistance coordinator will send the form directly to your physician.
Clearance from a special assistance coordinator is required for international travel or travel over water. Within four weeks of a due date also requires a physician's note stating that you’ve been examined within the past 48 hours and you’re fit to fly. And seven days before or after delivery also requires a passenger medical form to be completed by your physician.
The U.K. carrier does not allow pregnant women to fly after the end of the 36th week if you are pregnant with one baby or the end of the 32nd week if you are pregnant with more than one baby. After 28 weeks, expecting mothers must carry a confirmation from a doctor or midwife, such as a letter or certificate, in addition to your pregnancy record. It should be written within seven days prior to travel and confirm your approximate due date, that you're fit to travel and that there are no complications with your pregnancy.
Hong Kong's flag carrier requires that women with pregnancies after 28 weeks carry a medical certificate, dated within 10 days of travel that states the following:
- single or multiple pregnancy
- estimated week of pregnancy
- expected due date
- certifying you are in good health and the pregnancy is progressing normally, without complications
- that you are fit to travel
The airline accepts pregnant women with uncomplicated single pregnancies to travel up to 36 weeks and uncomplicated multiple pregnancies up to 32 weeks.
The Atlanta-based carrier does not impose restrictions on flying for pregnant women, so a medical certificate is not required to travel. But the airline will not waive ticket change fees and penalties for pregnancy. The airline recommends that those flying after their eight month should check with their doctor to be sure travel is not restricted.
The UK-based No restrictions for pregnant passengers traveling up to the 27th week of pregnancy. But a doctor's certificate is required if an expectant mother is traveling between the 28th and 35th week of pregnancy. The certificate must be issued by a doctor or midwife, and must be dated within five days of the outbound travel date. No travel is permitted beyond the 36th week of pregnancy.
Pregnant women can travel up to their 28th week without a medical certificate. After that, they are required to have a certificate or letter signed by a qualified doctor or midwife that states whether the pregnancy is single or multiple, is progressing without complications, includes an estimated due date, that you are in good health and there's no known reason to prevent you from flying.
This Abu Dhabi-based carrier allows women with single or multiple children to travel during the first 28 weeks of pregnancy without a medical certificate. For single pregnancies between 29 and 36 weeks, a medical certificate is required. After 37 weeks, pregnant women will not be allowed to travel. For multiple pregnancies, a certificate is required between the 29th and 32nd week; after that, women will not be allowed to travel.
The medical certificate must include the following:
- Be issued and signed by a doctor or midwife
- Written on a clinic/hospital letterhead and/or stamped by the doctor or midwife
- State that the guest is fit to fly
- State if the pregnancy is single or multiple
- State the number of weeks of pregnancy and the Expected Date of Delivery
- Easily understood and written in Arabic or English. Other languages are accepted but must be verified by Etihad Airways' check-in staff
The original medical certificate shall be accepted for the whole journey (originating, return and stopover flights), provided the above validity criteria is met for each sector. And it is valid for three weeks from the date of issue.
The New York-based carrier does not allow pregnant customers expecting to deliver within seven days to travel unless they provide a doctor's certificate dated no more than 72 hours prior to departure stating that the woman is physically fit for air travel to and from the destinations requested on the date of the flight and that the estimated date of delivery is after the date of the last flight.
The Dutch flag carrier recommends pregnant mothers not fly after the 36th week, along with the first week following delivery. For those expecting more than one baby, the carrier recommends consulting with a physician first. If you have had complications, you always need to have permission to fly from your physician.
Expectant mothers with complication-free pregnancies can fly on the German flag carrier until the end of the 36th week of pregnancy or up to four weeks before their expected due date without a medical certificate from a gynecologist. But the airline recommends that pregnant women beyond the 28th week have a current letter from a gynecologist that includes confirmation that the pregnancy is progressing without complications and the expected due date. The doctor should expressly state that the patient’s pregnancy does not prevent her from flying.
Because of the increased risk of thrombosis during pregnancy, the airline does recommend that expectant mothers wear compression stockings while flying.
The Malaysian flag carrier requires medical clearance for expectant mothers approaching 35 weeks for international travel or 36 weeks for domestic travel. If medical clearance is required, the MEDIF application form should be completed by a doctor and submitted to the airline through its ticketing offices or travel agents at least five working days before traveling.
An expectant mother who is in normal health and with no pregnancy complications will be allowed to fly without medical clearance after filling out an EMIS form. Pregnant women may be accepted for travel if they are not beyond 35 weeks if they fill out a part one of the EMIS form. Those between 24 and 32 weeks of pregnancy will have to fill out EMIS Form Part 2. And if the expectant mother is below 21 years of age, the consent in writing of the husband, parent or guardian must be secured. For expectant mothers beyond 32 weeks of pregnancy, EMIS Part 3 must be accomplished by the Flight Surgeon or Company Physician, who shall issue the clearance for travel
On Australia's flag carrier for flights longer than four hours, women can fly up to the end of the 36th week for single pregnancies and the end of the 32nd week for multiple pregnancies. For flights under four hours, women can travel up to the end of the 40th week for single pregnancies and the end of the 36th week for multiple pregnancies. The carrier requires medical clearance if there are pregnancy complications or it's not a routine pregnancy. After the 28th week, women are required to have a certificate or letter from a registered medical practitioner or registered midwife confirming the delivery date, whether it's a single or multiple pregnancy and that the pregnancy is routine.
No doctor's note is required for women traveling through their 28th week of pregnancy. Expectant mothers can fly between week 29 and week 32 with a doctor's note and a pregnancy with no complications. Those with multiple births will need a doctor's note and a Medical Information Form (Medif). Between weeks 33 and 35, women will need a doctor's note and a Medif. The airline does not accept women in their 36th week and beyond.
The low-cost Irish carrier allows expectant mothers to fly up to their 28th week of pregnancy. After that, the airline requires women to have a ‘fit to fly’ letter from their midwife or doctor. For an uncomplicated single pregnancy, travel is not permitted beyond the end of the 36th week of pregnancy, while the cut-off for an uncomplicated twins, triplets etc. is 32 weeks.
For uncomplicated single pregnancies, the carrier restricts expectant mothers from travelling beyond the 36th week of pregnancy; for uncomplicated multiple pregnancies, the restriction is the 32nd week.
For uncomplicated single pregnancies between 29 weeks and 36 weeks, expectant mothers must provide a medical certificate stating the following: (1) fitness to travel, (2) number of weeks of pregnancy and (3) estimated date of delivery. The certificate should be dated within ten days of the date of the first flight exceeding 28 weeks of pregnancy. This certificate will have to be presented at check-in when requested.
The Dallas-based carrier advises expectant mothers at any stage of pregnancy should consult with their physicians prior to air travel. The airline recommends against air travel beginning at the 38th week of pregnancy. It warns that in some cases, traveling by air has been known to cause complications or premature labor. Depending on their physical condition, strength, and agility, pregnant women may, in some cases, be asked not to sit in the emergency exit row.
Turkey's flag carrier allows mothers pregnant with one child to travel between the 28th and 35th week if they have a doctor's report that includes the phrase, “There is no particular reason for the patient not to fly.” For women pregnant with more then one baby, the travel cut-off is the 31st week with a doctor's report. The report has to be no more than seven days from the travel date.
Any woman in the first eight months of pregnancy will be allowed to travel on the Chicago-based carrier without medical documentation. An expectant mother traveling during the ninth month of pregnancy must have the original and two copies of an obstetrician’s certificate, which must be dated within 72 hours of a flight’s departure. The original certificate should be submitted to a United representative at check-in.
The London-based airline allows travel without restrictions until the 28th week of pregnancy provided that it's free from complications. The carrier asks pregnant mothers to inform its Special Assistance department so they can offer appropriate inflight health advice. Between the 28th and 36th weeks of pregnancy, a doctor's or midwife's certificate is required, stating that the passenger is safe for travel and the expected due date (32 weeks if carrying multiples in an uncomplicated pregnancy). Beyond the 36th week of pregnancy, travel is only permitted for medical/compassionate reasons and the pregnant passenger is required to be accompanied by a medical escort. This travel is subject to the approval of a Virgin Atlantic doctor.