Traveling While Pregnant: What Is and Isn’t Allowed

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Today a fellow BoardingArea blogger, Angelina from Just Another Points Traveler, did an interesting guest post for another family friendly blog that I like, InACents.com.  The topic of the day was traveling while pregnant, and most specifically the policy that many cruise lines have to not allow a pregnant woman to cruise beginning in their 24th week of pregnancy.  Just Another Points Traveler is due to give birth to her first little traveler any day (yay!), so it was great to get her take on traveling while pregnant.  I love to read anything related to family travel that I come across, so I’m very glad this topic is being discussed.

The point of view of her post was that the rule that many cruise lines have, including Disney Cruises, to not allow any woman who will hit her 24th week of pregnancy or beyond while at sea to board was that she was “shocked that such a “family-friendly” company would have such policy in place”.  I love hearing different opinions on important topics, but I have to respectfully disagree.

Even though many women may not really even look that pregnant yet at 24 weeks (though I did!), cutting off travel for pregnant women on a cruise at 24 weeks is likely not an arbitrary date pulled from a hat. As I am sure most parents (and probably many non-parents) reading this already know, the 24th week of pregnancy is sometimes referred to as reaching “viability” for the unborn baby.  More or less, this is about the age where if the child is born prematurely it has a shot at survival, if (and only if) immediate and quality NICU care is available.  The road for a child born at 24 weeks will not be quick, easy or certain, but there is a decent shot at a relatively normal life with the appropriate medical support.

22 weeks pregnant

22 weeks pregnant with Little C

However, if a woman in her 24th, 26th, 28th week, etc. were to suddenly have complications and potentially deliver at sea, that baby would not have the same shot at survival.  I am not a “cruiser”, but I do know that cruise ships do not have the same levels of medical support available that you would find in an advanced hospital.  To be clear, I did not stop traveling when I was pregnant.  I went to Yellowstone early on, I went to Vegas, went to the beach, I even flew a 40 minute flight about a month before I was due to get to a funeral (doc and I decided a 40 minute flight was better than 4 hours in the car each way).  I wasn’t a mom-to-be that always stuck close to home, but I know I would never be able to live with myself if I chose to voluntarily travel somewhere that didn’t have the best medical care possible relatively close by and something happened, especially once I reached the point in my pregnancy where my unborn child might be able to live if they were born.

24 weeks pregnant

Anniversary dinner in Vegas at 24 weeks pregnant with C

Everyone is different, but for me, certainly passed 24 weeks that would mean no time in the middle of the ocean, in a country that didn’t have hospitals at least up to par with the US, or to remote locations that were hours away from the nearest hospital.  If I were to have a second child, I wouldn’t just sit on my couch for 9 months waiting for my baby to be born (unless I was put on bed-rest), but the deciding factor in where I would and would not go would be where is safe for my baby, not where I thought would be fun for me.  I love to travel, but I’m 100% fine with crossing certain kinds of trips and destinations off the list for a few months to ensure the best possible outcome for my child.  I’m not a person that lives in fear, but the reality is you never know when a “normal” pregnancy will turn into a very early delivery.  I’ve just seen it happen to too many of my friends.

Enjoying my lemonade pregnant at Disney World

Enjoying my lemonade pregnant in “Germany” at Disney World

If you are curious about the policies that a few airlines have regarding traveling while pregnant, here is a sampling.  As you will see, the US based airlines in general have more lax policies than the international airlines sampled.

United Airlines:

Passengers traveling in their ninth month of pregnancy must have an obstetrician’s certificate dated within 24 to 72 hours prior to their flight departure.

American Airlines:
For domestic flights under five hours, travel is not permitted within seven days before and after your delivery date. If you should need to travel within seven days before or after delivery, a medical certificate is required as well as clearance from our Special Assistance Coordinators.  For international travel or any flights over the water, travel is not advised within 30 days of the due date, unless you are examined by an obstetrician within 48 hours of outbound departure and certified in writing as medically stable for flight. Travel within 10 days of the due date for International travel must have clearance from our Special Assistance Coordinators. Travel within 7 days after delivery requires clearance as well.

Southwest Airlines:

Female Customers at any stage of pregnancy should consult with their physicians prior to air travel. Southwest Airlines recommends against air travel beginning at the 38th week of pregnancy. Depending on their physical condition, strength, and agility, pregnant women may, in some cases, be asked not to sit in the emergency exit row.

Lufthansa:

Expectant mothers with complication-free pregnancies can fly with Lufthansa 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. However, we recommend that expectant mothers beyond the 28th week of their pregnancies carry a current letter from a physician which includes the following:

  • confirmation that the pregnancy is progressing without complications
  • the expected due date
  • the doctor should expressly state that the patient’s pregnancy does not prevent her from flying.

Singapore Airlines:

For uncomplicated single pregnancies, we restrict expectant mothers from travelling beyond the 36th week of pregnancy (calculated based on the expected date of delivery).  For uncomplicated multiple pregnancies, we restrict expectant mothers from travelling beyond the 32nd week of pregnancy (calculated based on the expected date of delivery).  For uncomplicated single pregnancies between 29 weeks and 36 weeks of pregnancy, expectant mothers are required to 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.

For uncomplicated multiple pregnancies, you need to present the medical certificate if you are travelling between the 29th and 32nd week of pregnancy (calculated based on the expected date of delivery).  You need not present any medical certificate if you are travelling within the 28th week of pregnancy (calculated based on the expected date of delivery). But if any of your return flight exceeds 28 weeks of pregnancy, you will need to present a medical certificate.

It makes perfect sense to me that a cruise line would not accept a pregnant woman past 24 weeks as a passenger, but I know that not everyone shares that sentiment.  What are your thoughts about traveling while pregnant?  Where would you/did you go, and where would you not go?

Comments

  1. With my first pregnancy, I traveled every week for work (either a short flight or train between DC and NYC) up until about 36 weeks and never had any challenges. I also took a trip to Thailand and Malaysia at 18 weeks and Germany at 20 weeks – we were in first/business class for most legs but one leg was in coach and I would not recommend that when pregnant if you can avoid it! I had a lot of swelling following the flight given I couldn’t stretch out or elevate my legs. With my second, I didn’t travel nearly as much since I worked primarily from home, and just took a few trips back and forth to either NYC or CA from DC. I was definitely more cautious with my second and didn’t want to travel internationally after about 18-20 weeks in the event something were to happen… agree you want to be near a good NICU. Of course I was overdue with both of mine so this was never an issue!

  2. I don’t agree with the cruise line policies, mostly because they are overly broad.

    Ban TATL/TPAC/Alaska after 24 weeks? Sure. But why ban anything in the Caribbean; you’re no further away from competent medical care than on a YYZ-HKG flight and they generally allow those up until 36 weeks. I can see requiring a medical fitness certificate, but if you’re having a healthy, regular pregnancy I see no reason to have an outright ban on simple 3-7 day cruises.

  3. Ryan, I’m not a cruise expert, but I would think that a medical evac on a cruise would be more time consuming to get to a suitable hospital than diverting a flight, though both would be horrible outcomes. Can you imagine being in premature labor and being helicoptered in a basket off a cruise ship? Ugh! A flight is also a few hours long, and a cruise is days long so that risk equation changes some I guess purely based on duration.

    In a perfect would we wouldn’t need bans on things like this as people would just make good decisions, but I’m betting the cruise ban is in place because folks didn’t make good decisions and it had a poor outcome.

  4. I’m betting the ban is in place because people made reasonable decisions, it had a poor outcome (because sometimes horrible things happen), and then somebody sued somebody else…
    I find the cruise ban kind of offensive, even though I’ve never been on a cruise and have no imminent plans to do so.
    We all have completely different levels of comfort, but to impose one approach on everyone is pretty over the top. Like when I read what you said about, “I would never be able to live with myself if I chose to voluntarily travel somewhere that didn’t have the best medical care possible relatively close by and something happened…” it makes my skin crawl… not because that shouldn’t be your choice, because someone feeling that way about her own pregnancy is absolutely fine and reasonable. It’s when that kind of idea gets imposed on other people that if a woman doesn’t eliminate every possible micro-risk that she should feel responsible for something happening to her baby.
    Not trying to jump on you here (and also, hopefully not trying to invite a backlash against myself), but I think that in America we are really overly paranoid about risks during pregnancy, and always to the end of putting the responsibility and blame on the mom.
    Very helpful list about the official policies, though! 🙂

  5. Jamie, no backlash coming from me for sure. I’ve found that virtually anything to do with pregnancy and child raising is potentially controversial and touchy. However, I certainly don’t view traveling where there isn’t adequate medical care while 24+ weeks pregnant a micro-risk. I personally consider that a very easily avoided real risk. Obviously not everyone feels that way, and that’s okay. There’s lots of things that can happen in life that we have no control over, but my own view is it makes sense to eliminate the easy unnecessary risks that you do have control over…especially when it comes to a child. For me that includes being pickier about where to travel the last few months of pregnancy, for others it may mean something else.

    Thanks for sharing your thoughts!

  6. I don’t see why this is controversial. Cruise ships have very limited medical facilities and a cruise ship doctor would not be able to do much, if anything, to save a mother and baby that went into early labor. A medical evacuation by helicopter is not an ideal and can take far more time that one might have in an emergency. Travel by plane or car and you are rarely that far from adequate medical care. Is taking a cruise really worth the risk when you can mostly visit the same places by plane, car and/or short boat ride?

  7. As Emily E said, cruise ships are covering their a$$ as they do not have medical facilities to cover this if something where to happen. They also want to reduce airlifting if possible. Of course, a pregnant women can go as they can just say they are not pregnant but they are agreeing to the acknowledgment that services might not be available if something were to happen.

  8. This is a good conversation and I posted the same thing on Just Another Points Traveler. People in life have different risk tolerances. If the baby was born on land or on a boat the baby is premature nonetheless. It would have happened either way. I know the dissenting opinion would be Disney has costs and helicopters would fly in, food borne illnesses etc etc I am aware of the risks. People live their lives with restrictions they either self impose or are imposed by society. Find your own truths whatever they may be. 24 weeks is a risk we are willing to take. If Disney said 20 weeks or 30 weeks I am sure they would have convinced many people to observe the rules and then this conversation would have been about their 20 week policy or 30 week policy. I prefer to police myself and live the way that feels right. 24 weeks on a disney cruise feels wrong. Maybe my opinion is subjective but I prefer to have a subjective opinion than an opinion that I feel may not be my own aka “just listening to a policy and agreeing with it”. Rules will change and this one I think may be amended over time. Before this rule there was no 24 week rule. There was no conversation about this before the rule was enacted.

  9. Emily, I agree.
    Deals, if they aren’t really showing I’m sure they probably could board without issue. Though if you look pregnant they could ask for a doctors note verifying you aren’t yet 24 weeks…I bet that is a touchy conversation though if you aren’t OBVIOUSLY pregnant. 😉
    Mr. Points Traveler, congrats on your upcoming new addition! Great to have a soon-to-be-dad weigh in. I 100% agree we all have our own risk tolerances. I’m sure some things that I thought were okay in pregnancy are on the no-no list for others. I don’t actually think 24 weeks is new to Disney though. I did a little digging today and saw discussions about this dating back quite a while. I’m clearly not a doctor, but I also don’t think 24 weeks is arbitrary. It is exactly the time that a baby is potentially viable outside the womb, and when medical intervention could be the difference between life and death for the baby. I can’t swear that is why that cut-off was selected, but it makes sense to me. You are 100% right a baby can be born prematurely whether home on the couch or in the middle of the ocean, but the chances of survival for both the baby (and potentially the mom depending on the situation) are much different in those two situations.

    Great discussion though and so glad you and Mrs. Points Traveler will have a nice full term baby!

  10. Thanks for the congratulations. I am not referring to it being new or it being arbitrary. Just the fact that it wasn’t a conversation before the policy. And trust me, at one time it didn’t exist. I am sure they have facts to justify their position like any position and like any good money making organization if they don’t have the facts they will create them. If they didn’t have facts it would arbitrary and Disney would not do that. Positions are buttressed by facts and stories and numbers but can changed and once changed they will justify with other facts and figures etc.

    What happens if a mother gets on the ship at 23.5 weeks and has the kid? Should Disney change their policy if that frequently happens? Then we’ll be having a conversation about 23 weeks. I can’t remark on survival rate. It makes logical sense if you compare a women sitting on a couch vs. a cruise ship but I can easily change the odds by commenting on a different environment- their are numerous ones so I won’t even comment on this. I am sure every reader with an imagination can come up with situation whereby being on a cruise ship would be better.

  11. We actually had this happen to us last year as we were taking a family trip with 16 of us. We had booked a cruise and then found out about the pregnancy clause. My daughter-in-law would have been over the 24 week period (and it is not at the start of the cruise, but you must not be 24 weeks by the time the cruise ends. What we found out is that you have to have a letter from your doctor telling the cruise line when your due date is. My DIL’s daughter had no problem letting her cruise but she did not want to ask him to lie on the letter and say she was less than 24 weeks pregnant.

    I do understand the policy. We have talked about evacuation but what about if it was needed during bad weather? What about if you were in Haiti? You would then have to pay quit a bit of money to be sent back to the USA or another country for quality care? I’m sure if would have to be a private medical plane, etc. Just my two cents worth.

  12. I’m so glad you posted the airline examples on here, I definitely think that there is a misconception on what airline policies are (and in fact most let you travel up to your due date, or the week before, at least domestically – http://passportsandpushchairs.com/flyingwhilepregnant/)

    I think the cruises have a valid point, and while I traveled extensively with both my pregnancies, domestically and internationally, I always was in places that I was comfortable having my babies at if it happened that way. Fortunately, or maybe not, I went 15 days late with both 🙂

  13. I’d be fine with an “I understand the risks” type of disclaimer, and maybe even a doctor note saying it’s ok, but to across the board exclude women 24 wks+ pregnant is harsh.
    I’m just saying that perhaps this cruise is very important to you. Maybe it’s a big birthday trip for your grandma. Maybe it’s the only time in years you will see a lot of people in your family. Missing that should be your decision on behalf of you and your baby, and going to it should be your decision as well.
    Ideally a family would have the time and flexibility to make the decision that, hey, this time let’s go somewhere with easier access to medical facilities. But given how far in advance a trip like this is probably booked, that flexibility probably isn’t there for most people.
    Interesting discussion, and good point about 24 weeks being an important date.
    We lived in the UK when each of our daughters was born. I wanted to come back to the US for a visit during the summer while I was pregnant with my first, but didn’t. I had a hard time finding travel medical insurance that would cover me at that stage of pregnancy (around 5 mo IIRC), so we skipped it. It was primarily a money issue rather than safety since it was an uneventful pregnancy and a visit to a country with good medical care. But still it wouldn’t have been a good situation to be in the US with uncertainties about medical coverage and have something come up, especially with your first. Maybe if there had been some kind of event going on that was very important to me I might have taken the trip anyway. Who knows.

  14. Wanted to just add in some info for those who want to book a big trip but want to hedge their bets in case they become pregnant and can’t go…that is a covered reason to cancel a trip on some trip insurance plans, like this one. https://www.travelinsured.com/agency/31270/info/trip-cancellation-interruption

    I don’t normally get trip insurance, but it could make sense if you are booking a cruise and think you may be 24+ weeks pregnant by the time it happens and can’t go.

  15. I flew internationally up until 32 weeks with no issues – *but*, I had no complications, and no reasons not to fly. I understand why the airlines and cruise lines do that, but it’s also very annoying. I did a half marathon at 26 weeks – 2 weeks past the 24wk cutoff for the cruise line. I think it’s a decision that should be made in consultation with your doctor.

  16. I think it has everything to do with a mother’s own comfort level and risk tolerance. And also whether she is having a healthy, low risk pregnancy without complications.

    With my first pregnancy, I flew for the last time (Denver to Hawaii) at 34 weeks, which is about my maximum for comfort reasons. I have no desire to fly past that point, but it’s not a safety thing, it’s a comfort thing.

    With my second pregnancy, I traveled internationally for the last time (Germany) at 26 weeks, “domestically” by air for the last time (Puerto Rico) at 33 weeks, and took a domestic road trip (Denver to Mt. Rushmore) at 36 weeks, all with a toddler in tow.

    I have no regrets, and plan to travel the same way again if we’re ever so blessed.

  17. Just to add… the remotest place I have ever traveled while pregnant was to Easter Island when 17 weeks with my first. We did have a long discussion about the lack of services, but determined that if something were to go wrong at that stage of pregnancy, there was probably very little anyone could do about it anyway. Thankfully all went well and we now have a rambunctious 2.5 year old. But these are the risk assessments one must do.

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