Traveling While Pregnant: Trimester-by-Trimester Safety Guide

Can You Travel While Pregnant? Yes, With Planning

The short answer is that most healthy pregnant women can travel safely through the end of their second trimester and often into the early third trimester. The American College of Obstetricians and Gynecologists (ACOG) considers the safest time to travel during pregnancy to be between 14 and 28 weeks (second trimester), when the risk of common pregnancy complications is lowest and you are past the worst of the first-trimester nausea but not yet at the stage where airlines restrict your travel.

That said, travel during pregnancy is not one-size-fits-all. It depends on your specific health situation, your destination, your mode of transportation, and your tolerance for risk. This guide covers every practical consideration, organized by trimester, with specific airline policies, insurance guidance, and safety information to help you make informed decisions.

Important disclaimer: This guide provides general travel information for educational purposes. It does not replace medical advice. Discuss your specific travel plans with your OB-GYN or midwife before booking any trip during pregnancy.

First Trimester Travel (Weeks 1-13)

The Reality

The first trimester is the period of greatest risk for miscarriage (approximately 10-15% of recognized pregnancies end in miscarriage, with the vast majority occurring in the first 12 weeks). It is also the trimester when most women experience the worst nausea, fatigue, and food aversions.

Is It Safe to Travel?

For most healthy pregnancies, first-trimester travel does not increase the risk of complications. The miscarriage risk exists whether you are at home or abroad. However, some women prefer to avoid travel during this period because:

• Nausea and vomiting make long flights and car rides miserable
• Fatigue limits how much you can do and enjoy
• Food aversions are hard to manage in unfamiliar food environments
• Emotional preference to stay near their OB-GYN during the highest-risk weeks

If You Do Travel in the First Trimester

• Carry anti-nausea remedies: Ginger chews, Sea-Bands (acupressure wristbands), vitamin B6 (25 mg, three times daily, approved for pregnancy nausea), and prescription ondansetron (Zofran) if your doctor approves
• Eat small, frequent meals rather than large ones. Crackers, plain bread, and bananas tend to be well-tolerated.
• Stay hydrated. Dehydration worsens nausea.
• Carry copies of your prenatal records including blood type, and your OB's contact information
• Know the location of the nearest hospital at your destination

Airline Policies: First Trimester

No airline restricts first-trimester travel. You do not need a doctor's letter or any special documentation. Standard booking and boarding procedures apply.

Second Trimester Travel (Weeks 14-27)

The Sweet Spot

The second trimester is universally considered the best time for travel during pregnancy. Reasons:

• Nausea typically subsides by week 14-16
• Energy levels rebound after the first-trimester fatigue
• Risk of miscarriage drops significantly
• Risk of preterm labor is low (preterm labor risk increases primarily after 28-32 weeks)
• You are physically comfortable enough to walk, fly, and explore
• No airline restrictions apply until later in the third trimester

Travel Recommendations for the Second Trimester

This is the time to take that trip you have been planning. Whether it is a babymoon beach vacation, a European city break, or a domestic road trip, weeks 16-26 offer the best combination of comfort and safety.

• Flying is safe for uncomplicated pregnancies. ACOG has no restrictions on flying during the second trimester.
• Hydrate more than usual on flights. Pregnant women are already at higher risk for dehydration.
• Wear compression stockings. Pregnancy increases the risk of deep vein thrombosis (DVT), and flying compounds that risk. Compression socks (15-20 mmHg) should be worn on any flight over 4 hours.
• Book an aisle seat for easy restroom access. You will need to urinate more frequently.
• Walk the cabin every 60-90 minutes to reduce DVT risk.
• Wear your seatbelt below your belly, across your hips, at all times when seated.

Airline Policies: Second Trimester

No major airline restricts travel during the second trimester. No documentation is required. Some airlines may ask about your due date during check-in if you appear visibly pregnant, but there are no formal policies until later.

Third Trimester Travel (Weeks 28-40)

When Travel Gets Complicated

The third trimester introduces real restrictions because the risk of preterm labor increases and airlines want to avoid deliveries at 35,000 feet. This is also when you become physically less comfortable: back pain, swollen feet, frequent urination, and general fatigue make long travel days genuinely difficult.

Airline Cutoff Policies by Carrier

Every airline has a specific cutoff after which they restrict or prohibit pregnant travelers from flying. Here are the policies for major carriers:

Airline	Domestic Policy	International Policy	Doctor's Letter Required
American Airlines	No restriction through 36 weeks	No restriction through 36 weeks	Not formally required, but recommended after 28 weeks
Delta Air Lines	Restricted after 36 weeks	Restricted after 36 weeks	Recommended after 28 weeks; required for clearance after 36 weeks
United Airlines	No specific restriction	No specific restriction	Recommended after 36 weeks
Southwest Airlines	Travel permitted throughout pregnancy	N/A (domestic only)	Not required but recommended after 36 weeks
British Airways	Not permitted after 36 weeks (single), 32 weeks (multiple)	Same	Letter required after 28 weeks confirming fitness to fly
Lufthansa	Not permitted after 36 weeks (single), 28 weeks (multiple)	Same	Medical certificate required after 36 weeks
Emirates	Not permitted after 36 weeks (single), 32 weeks (multiple)	Same	Medical letter required after 29 weeks
Singapore Airlines	Not permitted after 36 weeks (single), 32 weeks (multiple)	Same	Medical certificate required after 28 weeks
Qantas	Not permitted after 36 weeks (single), 32 weeks (multiple)	Same	Medical clearance after 28 weeks
Japan Airlines	Not permitted after 36 weeks	Same	Medical certificate within 7 days of departure required after 28 weeks
Ryanair	Not permitted after 36 weeks	Same	Fit-to-fly letter required after 28 weeks

Key takeaways:

• Most airlines restrict travel after week 36 for single pregnancies and week 32 for multiple pregnancies (twins, triplets)
• Doctor's letters are typically required after week 28 for international flights. The letter should be dated within 7-10 days of your departure and should state your expected due date, confirm a single/multiple pregnancy, and certify you are fit to fly.
• Always check the specific airline's policy before booking, as policies can change
• If you look heavily pregnant, you may be asked about your due date at check-in regardless of the official policy. Having a doctor's letter prevents delays.

Doctor's Letter: What It Should Include

Ask your OB-GYN for a letter on letterhead that includes:

1. Your full name and date of birth
2. Your expected due date
3. Confirmation that the pregnancy is single or multiple
4. Statement that you are fit to fly and have no pregnancy complications
5. Confirmation that no delivery is expected within the next 7 days (or however many days until your return flight)
6. Doctor's name, medical license number, and contact information
7. Date of the letter (must be within 7-10 days of travel for most airlines)

Travel Insurance During Pregnancy

Standard travel insurance policies have significant exclusions for pregnancy-related events. Understanding what is and is not covered is critical.

What Standard Travel Insurance Typically Covers

• Complications of pregnancy that are unexpected and arise during the trip (such as emergency preeclampsia or ectopic pregnancy)
• Trip cancellation if your doctor certifies you are too ill to travel (some policies cover this; read the fine print)

What Standard Travel Insurance Typically Does NOT Cover

• Routine prenatal care during the trip
• Normal delivery (if you go into labor while traveling)
• Any pregnancy-related event after a certain week (commonly week 28 or 32, depending on the policy)
• Pre-existing pregnancy may be excluded entirely if the policy has a pre-existing condition exclusion and you purchased the insurance after becoming pregnant
• Newborn care for the baby if delivered during the trip

Insurance Providers With Better Pregnancy Coverage

• Allianz Travel Insurance: Covers complications of pregnancy as an unforeseen medical emergency. Excludes routine delivery and prenatal care. No specific week cutoff in most plans.
• World Nomads: Covers unexpected pregnancy complications for trips purchased before 26 weeks of pregnancy. Does not cover after 26 weeks.
• IMG Global: iTravelInsured plans cover emergency pregnancy complications with no specific week restriction in some plans. Read the policy carefully.
• Battleface: Some plans cover pregnancy complications through the entire pregnancy. One of the more generous options.

Always read the Certificate of Insurance (the full policy document, not just the summary) to understand the pregnancy exclusions for your specific plan.

CFAR (Cancel for Any Reason) Insurance

If you want maximum flexibility, consider a Cancel for Any Reason policy. If your pregnancy progresses into a complicated situation and you need to cancel your trip for any reason (including doctor's orders, personal discomfort, or anxiety), CFAR policies typically reimburse 50-75% of your prepaid trip costs. CFAR must usually be purchased within 14-21 days of your initial trip deposit.

Zika Virus and Pregnancy

Zika virus is transmitted by Aedes mosquitoes and can cause severe birth defects (microcephaly) when contracted during pregnancy. The CDC recommends that pregnant women avoid travel to areas with active Zika transmission.

Current Zika Risk Areas (Check CDC for Updates)

As of the latest CDC guidance, areas with Zika risk include parts of:

• Central America: Honduras, Guatemala, El Salvador, Nicaragua, Belize
• Caribbean: Most islands, including Jamaica, Dominican Republic, Puerto Rico, US Virgin Islands, Trinidad and Tobago
• South America: Brazil, Colombia, Venezuela, Ecuador, Suriname, French Guiana
• Southeast Asia: Parts of Thailand, Vietnam, Philippines, Indonesia, Cambodia
• Pacific Islands: Fiji, Samoa, Tonga
• Sub-Saharan Africa: Multiple countries

Important notes:

• Zika risk levels change over time. Always check the CDC's Zika Travel Information page (cdc.gov/zika) within 2 weeks of your departure for the most current advisories.
• Zika can also be transmitted sexually. If your partner travels to a Zika area, the CDC recommends using protection or abstaining for at least 3 months after the partner's return.
• There is no vaccine for Zika. The only prevention is avoiding mosquito bites and avoiding travel to affected areas.

Altitude Restrictions During Pregnancy

High altitude (above 2,500 meters / 8,200 feet) reduces oxygen availability, which can affect both mother and fetus. ACOG recommends caution with high-altitude travel during pregnancy.

Guidelines

• Below 2,500 meters (8,200 feet): Generally safe for uncomplicated pregnancies. This includes most major cities: Mexico City (2,240m), Bogota (2,640m -- slightly above threshold), Denver (1,609m), Cusco (3,400m -- above threshold).
• 2,500 to 3,500 meters (8,200 to 11,500 feet): Travel with caution. Acclimatize gradually (1-2 days). Avoid strenuous exertion. Discuss with your OB-GYN.
• Above 3,500 meters (11,500 feet): Generally not recommended during pregnancy. This eliminates destinations like Cusco, La Paz (3,640m), and many Himalayan treks.

Symptoms to watch for at altitude:

• Severe headache
• Shortness of breath at rest
• Decreased fetal movement (in later pregnancy)
• Dizziness or confusion

If any of these occur, descend to a lower altitude immediately and seek medical attention.

Airplane cabins are pressurized to the equivalent of 5,000-8,000 feet (1,500-2,400 meters), which is generally safe for pregnant women. This is below the concerning threshold.

Food and Water Safety

Foodborne illness during pregnancy carries heightened risks because certain infections (listeria, toxoplasmosis, salmonella) can harm the fetus.

Foods to Avoid While Traveling Pregnant

• Raw or undercooked seafood: Sushi, ceviche, raw oysters, rare tuna
• Unpasteurized dairy: Soft cheeses (brie, camembert, queso fresco) unless confirmed pasteurized
• Deli meats and pate: Risk of listeria contamination unless heated to steaming
• Raw or runny eggs: Common in some international dishes (tiramisu, hollandaise, mayonnaise in some countries is made with raw eggs)
• Tap water in countries where it is not safe for general travelers. Use bottled water for drinking and brushing teeth. Avoid ice unless confirmed from purified water.
• Street food in developing countries unless cooked fresh at high temperatures in front of you

Safe Eating Strategy Abroad

• Eat hot, cooked food served fresh
• Peel your own fruit rather than eating pre-cut fruit
• Drink sealed bottled water or water you have purified yourself
• Choose busy restaurants with high food turnover (reduces time food sits)
• Carry snacks from home or reliable sources for moments when safe food is not available
• Bring prenatal vitamins to supplement potentially uneven nutrition while traveling

Safe Destinations for Pregnant Travelers

The best destinations for pregnant travelers combine good healthcare access, food and water safety, low disease risk, and manageable physical demands.

Top Picks

• Western Europe (UK, France, Italy, Spain, Scandinavia): Excellent healthcare, safe food and water, good infrastructure. Avoid high-altitude Alpine destinations above 2,500m.
• Canada: World-class healthcare, clean water, minimal disease risk
• Japan: Exceptional food safety standards, clean environment, excellent hospitals. Tokyo has several English-speaking hospitals.
• Australia and New Zealand: High healthcare quality, safe food and water, no Zika risk
• Hawaii: US-based healthcare, tropical experience without international travel complications
• Singapore: Top-tier hospitals, extremely clean, no Zika risk in the city

Destinations to Avoid During Pregnancy

• Active Zika zones (see list above)
• Countries requiring live vaccines: Yellow Fever vaccine is a live vaccine and generally not recommended during pregnancy unless the risk of infection outweighs the vaccine risk. This effectively eliminates some Sub-Saharan African countries that require Yellow Fever vaccination.
• Remote locations far from medical facilities (backcountry camping, remote islands, developing countries with limited hospital access)
• Very high altitude destinations (above 2,500m) without medical clearance
• Countries with ongoing outbreaks of diseases dangerous in pregnancy (check the CDC and WHO travel notices)

What to Pack for Pregnant Travel

In addition to your normal travel packing, include:

Medical Documents

• Copy of prenatal records (blood type, test results, ultrasound findings)
• Doctor's fit-to-fly letter (if traveling after 28 weeks)
• Health insurance cards (primary and travel insurance)
• OB-GYN's phone number and after-hours line
• List of local hospitals at your destination with emergency department addresses
• Prescription medications in original containers

Comfort Items

• Pregnancy pillow or wedge: A small inflatable wedge ($15) provides support for sleeping on your side in hotel beds
• Compression socks: 15-20 mmHg for flights and long days of walking
• Belly support band: Reduces lower back pain during walking-heavy days. Gabrialla brand ($25-$40) is widely recommended.
• Comfortable, supportive shoes: Feet swell during pregnancy, especially in heat. Bring shoes a half-size larger than normal. Birkenstocks and supportive sneakers are good choices.
• Loose, breathable clothing: Stick with lightweight, stretchy fabrics
• Large water bottle: Hydration needs increase significantly during pregnancy

Medical Kit Additions

• Prenatal vitamins (enough for entire trip plus extras)
• Approved anti-nausea medication (vitamin B6, ginger supplements, prescription as approved by your doctor)
• Antacid (Tums is pregnancy-safe for heartburn, which worsens in second and third trimesters)
• Stool softener (Colace/docusate sodium, pregnancy-safe; constipation is common during pregnancy and worsens with travel)
• Hemorrhoid cream (preparation H; travel constipation combined with pregnancy makes this common)
• Acetaminophen (Tylenol; the only OTC pain reliever generally considered safe during pregnancy. Ibuprofen and aspirin should be avoided.)
• DEET-based insect repellent (DEET is considered safe during pregnancy by the CDC and EPA when used as directed; concentrations up to 30% are recommended)
• Sunscreen SPF 50+ (pregnancy increases skin sensitivity to sun; melasma/pregnancy mask risk increases with sun exposure)

When to Avoid Travel Entirely

Your OB-GYN may advise against travel if you have any of the following conditions:

• Preeclampsia or risk factors for preeclampsia
• Cervical insufficiency or cerclage placement
• Preterm labor in current or previous pregnancy
• Placenta previa (after 28 weeks)
• Premature rupture of membranes
• Multiple pregnancy (twins or more) after 28 weeks
• Poorly controlled gestational diabetes
• Significant vaginal bleeding

If any of these apply, follow your doctor's guidance regarding travel restrictions.

Road Trips While Pregnant

Driving during pregnancy is safe with modifications:

• Seatbelt positioning: Lap belt below the belly across the hips; shoulder belt between the breasts and to the side of the belly. Never place the lap belt across the belly.
• Stop every 1-2 hours to walk, stretch, and use the restroom
• Keep snacks and water accessible to prevent nausea and dehydration
• Move the seat back as your belly grows to maintain distance from the steering wheel (at least 10 inches between the steering wheel and your breastbone)
• Limit driving stretches to 5-6 hours per day to manage fatigue

Plan Your Babymoon With TripGenie

The babymoon (a pre-baby vacation, typically during the second trimester) is your last chance for a while to travel as a couple without diapers, bottles, and strollers. TripGenie can help you plan a relaxing, pregnancy-appropriate itinerary at a safe destination. Whether it is a beach resort in Hawaii, a slow-paced tour of Tuscany, or a weekend in a mountain spa, TripGenie builds day-by-day plans so you can focus on enjoying this special time.

Trimester Travel Summary

Factor	First Trimester	Second Trimester	Third Trimester
Safety	Safe for uncomplicated pregnancies	Safest period for travel	Safe until 36 weeks with precautions
Comfort	Nausea, fatigue	Best comfort level	Increasing discomfort
Airline restrictions	None	None	Most airlines restrict after 36 weeks; letters required after 28 weeks
Best for	Short, low-key trips	Major trips and babymoons	Nearby, short trips with medical access
Recommended distance	Domestic or short international	Any safe destination	Stay within 2-3 hours of your delivery hospital after 34 weeks

Final Checklist for Pregnant Travel

• Discussed travel plans with OB-GYN and received clearance
• Checked airline policies for your specific gestational age
• Obtained doctor's letter (if traveling after 28 weeks)
• Purchased travel insurance with pregnancy complication coverage
• Verified destination safety (Zika, altitude, food safety, healthcare access)
• Located hospitals at your destination with emergency obstetric services
• Packed prenatal vitamins, medical records, and comfort items
• Planned hydration and movement strategies for flights and drives
• Confirmed food safety practices for your destination
• Set up communication with OB-GYN for telemedicine if needed

Traveling while pregnant is not about eliminating all risk. It is about understanding the specific risks, minimizing them with preparation, and making informed choices about what works for your body and your pregnancy. With the right planning, a pre-baby trip can be one of the most memorable experiences of this chapter of your life.