Flying During Pregnancy: Air Travel Through the Trimesters

Be it for work trips or baby moons, flying during pregnancy presents a whole new world of details to consider. Walking through security and radiation exposure, the risk for increased swelling, and remaining well hydrated, are all concerns for pregnant people who use air travel at any stage of pregnancy. Here are some specific tips and additional things to consider before you plan and pack.

Flying during pregnancy and the TSA:

If you have concerns about going through TSA’s security scanners because of exposure to x-rays, we’ve got good news. Their scanners do not use x-ray, but instead, use non-ionizing electromagnetic waves that get reflected off the body. They are considered perfectly safe for all passengers. However, you can still opt out of the scanner, and ask for a pat down instead. A female TSA agent will perform the search, and you can continue to your gate.

Also, you can ask for as much help for lifting, and getting through the line as you need. No one is labeling you a person in distress. Instead, how about a savvy flyer who knows what resources are available for use!

1st Trimester

Compression stockings/socks: can help reduce swelling of your lower extremities, and promote blood flow.
Nausea remedies: The change in elevation may cause internal gasses to expand, making your tummy even more vulnerable to sickness. Try having easy to digest foods, like crackers, available in your carry on to nibble throughout the flight. Some find relief from peppermint or ginger candies.

Radiation Exposure: there is some evidence that extreme exposure to radiation between the 8th and 15th week of pregnancy may affect IQ, but the level of inflight radiation is low. There is little risk for the average traveler, but it is something to be aware.

No one will feel bad for you: One of the hardest parts is the lack of empathy you will garner from most people. You will be tired, and everything will feel harder, and most people do not have external signs they are expecting.

2nd Trimester

In the second trimester, most are generally feeling better than they were in the 1st trimester, with more energy restored. At the beginning of your 2nd trimester, you may still not have any noticeable physical changes, whereas when you finish the 2nd trimester, you will most likely have grown considerably. See compression socks above.

Snacks: While you may start to feel less nauseous, you will want to continue to carry snacks and water.
Getting up and moving while in flight will help with overall discomfort in your back, hips, and legs. If you are not permitted to stand or walk, try to stretch as best you can.

Airline Policy: Some more significant things to consider are your airline’s policies on traveling while pregnant, and possibly restricting yourself on destinations. Most pregnancies are considered viable after 24 weeks, so in the event of an unplanned birth, consider if the place you will travel to have the medical resources to support you and your babe until you are well enough to go home.

3rd Trimester

Check with Your Doctor: With all air travel, talking with your doctor is recommended, but in the 3rd trimester, it is especially important. Most physicians discuss limiting air travel at week 36, but your specific pregnancy may have particular needs. If you are traveling between weeks 28- 36, be ready for lots of restroom breaks, low back pain, and fatigue creeping back in. To help with all that:

Bring a pillow: Not a neck pillow. A real pillow. Having the ability to support your body in various ways on flights may seem like a luxury. If you can have get an aisle seat (even better if there is extra leg room), we recommend it. You won’t have to maneuver around as many for your trips to the restroom, and if the seatbelt sign goes off, merely standing and swaying will be a comfort.

Travel Insurance: Consider getting travel insurance during pregnancy. In the event you need to get home quickly you can make arrangements without the additional pain of a hefty bill, or make cancellations should they be necessary.

Panty liners: it may have happened before the 3rd trimester, but you may be surprised by a small release of urine when you cough or sneeze. The pressure your bladder and pelvic floor are under in the 3rd trimester make minor incontinence a very common occurrence. Having extra protection is much more comfortable than needing to bring a complete change of clothes.

Whatever trimester you are in, you can stay safer and more comfortable while flying during pregnancy!

RSV Vaccine during Pregnancy | The Evidence

We all want to keep our newborn babies safe. When looking at common illnesses, RSV is a frequent concern amongst new parents. The latest recommendation? Recieve the RSV Vaccine during pregnancy. If your doctor has made this suggestion you may be curious how it works. Let’s take a look at what RSV is and what you can do before your baby is even born to protect them from it.

What Is Respiratory Syncytial Virus (RSV)?

Respiratory syncytial virus (RSV) is a leading cause of hospitalization in infants, responsible for 58,000–80,000 annual hospitalizations in children under 5 in the U.S. Babies under 6 months are especially vulnerable, as RSV can lead to severe lung infections like bronchiolitis and pneumonia. We’ve done a deep dive on the specifics of RSV in babies, you can check that out here!

It’s important to remember that while RSV is dangerous for infants and the immunocompromised, it can present as a common cold in healthy individuals. This means even if someone’s only symptom is a runny nose, they could spread the illness.

How does getting the RSV vaccine during pregnancy work?

The Abrysvo vaccine, approved by the FDA and recommended by the CDC, is given to pregnant individuals between 32 and 36 weeks of gestation. It works by transferring protective antibodies to the fetus, providing passive immunity that shields infants during their most vulnerable early months.

A baby rests peacefully in their mother's arms.

Is it safe and effective?

Yes! Clinical trials show impressive results:

81.8% efficacy against severe RSV within the first 90 days of life.
69.4% efficacy through 6 months of age.

Safety data from over 7,000 participants revealed no significant risks to pregnant individuals or babies. The most commonly seen side effects are mild such as injection site pain or fatigue and they were reported to be short-lived.

What else should I know about the RSV Vaccine during Pregnancy?

Timing: CDC recommends vaccination at 32–36 weeks, ideally before RSV season (typically fall/winter).

Who should get it? Most pregnancies without contraindications. This could be something such as an allergy to the vaccine’s components.

Alternative option: For those unable to receive the vaccine, there is an option that can be given to infants post-birth.

The American Academy of Pediatrics (AAP) and World Health Organization (WHO) endorse RSV vaccination during pregnancy as a safe, effective way to reduce infant complications due to RSV.

Take Action

The most important thing you can do when considering healthcare decisions is to talk to your trusted healthcare provider. You can practice using the BRAIN acronym during your prenatal visit by asking the following questions:

Benefits – What are the benefits of recieving the RSV vaccine during pregnancy?
Risks – What are the known risks? What are the risks of RSV to a newborn?
Alternatives – What alternatives do I have?
Intuition – What am I feeling now that I know the science-based answers to my questions?
Nothing – What happens if I do nothing about RSV?

By vaccinating during pregnancy, you’re offering your baby a strong first defense against a potentially serious illness.

More Reading

Center for Disease Control (CDC)

World Health Organization (WHO)

American College of Obstetrics and Gynecologists (ACOG)

 

Am I actually going into labor?

One of the most searched topics during pregnancy? “Am I actually going into labor?”

Although the conventional knowledge says that pregnancy lasts nine months (which would be 36 weeks), most babies are actually born between 38 and 42 weeks. This means that you can think of your due date as more of a “due month” rather than a specific date. In fact, less than 5% of babies are born on their due date. This date range can present a problem, though: how do you know if you are actually ready to meet your baby? Here are four surefire ways to know if you are going into labor.

You’re experiencing certain physical and emotional changes. 

There are specific physical and emotional changes we hear from clients that make your doula double check her birth bag and put her running shoes by the door! We often see a change in emotions and becoming more sensitive. Bursts of nesting energy and new or unusual cravings can also signal your body is getting ready to give birth. Physical changes may also occur.

These may include:

  • feeling “crampy” or having backaches
  • increased vaginal discharge
  • loss of mucus plug (especially blood-tinged mucus)
  • softer, more frequent bowel movements.

Be in tune with your body and emotions, and communicate those changes with your care providers as you get closer to your due month.  

You’re having uterine contractions. 

Uterine contractions are the first sign of going into labor for most people. But how do you know the difference between uterine contractions and Braxton Hicks or false labor contractions? Uterine contractions are regular and consistent; they get steadily closer, stronger, longer and do not lessen with rest, movement, eating or drinking. You may have contractions before you are in labor. But if they are not causing your cervix to change, you are not in labor. See our blog post on latent labor for more on those contractions.

Your water breaks. 

You’ve seen it in movies and on tv shows: water spills on the floor and the character suddenly knows their baby is coming. In reality, only occasionally does your water break ahead of contractions. Typically the other signs we’ve outlined will happen for hours or even days prior to your water breaking. Ir this is your first sign, the vast majority of people will experience contractions that follow within 12-24 hours. 

Your cervix is not a crystal ball and it can’t tell you if labor is imminent.

Cervical exams are not necessarily an indication of when labor will begin. There are a number of cervical changes that have to take place ahead of dilation, the number measured in centimeters that we all associate with how close the baby is to being born.

Your cervix will go through these changes:

  • shift forward to align with the birth canal
  • soften or ripen
  • thin (or efface)
  • The final step is dilation.

These changes may be evaluated by your care provider during a cervical exam once you head to the hospital in order to determine if you are in labor.

To learn more about childbirth and the stages of labor, sign up for our Complete Childbirth Education class or Birth Basics. 

Group B Strep: What is GBS?

If you’re pregnant it’s likely you’ve heard of Group B Strep (GBS), probably as one of the required tests for pregnant individuals. What is it and why does it matter? While GBS is common, (1 in 4 pregnant individuals have it present!) if left untreated it can pose serious health risks. Today we’re taking a look at what GBS is, treatments and testing, and the bottom line so you can make informed and empowered decisions for you and your baby.

What Is Group B Strep (GBS)?

GBS is a common bacterium (Streptococcus agalactiae) that naturally exists and is typically harmless in adults. It resides in the digestive, urinary, and reproductive systems. While the bacteria may be present (colonization) it often doesn’t lead to infection.

If a bacteria has colonized, it simply exists. It’s when it gets out of control that it can cause infection in the body. Even if one is asymptomatic, infection could be present and is very dangerous for newborns which is why testing is so important. An estimated 20-25% of pregnant individuals have GBS present.

Remember: levels can vary over time.

Why Is Group B Strep a Concern During Pregnancy?

Risks to the Pregnant Person:
Those who have GBS present generally are unaffected. Rarely, they can encounter complications such as Urinary Tract Infections (UTIs), infection of the amniotic fluid or infection of the uterus once the baby has arrived. 

Risks to the Baby:
The risks of GBS are generally for the baby. Transmission of the bacteria to the baby during childbirth can lead to early-onset (first week) or late-onset (weeks 1–3) disease. Complications from contracting this bacteria include sepsis, pneumonia, meningitis, long-term disabilities, or even mortality.

Though this can sound scary, please keep in mind that these are rare complications, only affecting 1 or 2 babies out of 100 if the laboring person doesn’t receive antibiotics during labor. Though rare, it’s vital to understand the facts.

Risk Factors for Transmission:
Your baby may be at a higher risk for contracting GBS if you experience preterm labor, prolonged rupture of membranes (greater than 18 hours), a fever during labor, or a prior GBS-positive baby. Your baby is also at risk if you test positive on your routine GBS testing.

How Is GBS Tested for in the United States?

The United States takes a broad approach to testing using a Universal Testing model that requires a routine vaginal/rectal swab at 36–38 weeks. This will typically be done at your OBGYN or Midwife’s office. This swab is then cultured and evaluated to determine if GBS bacteria are present. If yes, the results will be communicated to you along with options for treating and intervention.

This testing is done between 36-38 weeks to ensure accuracy (remember, this bacteria varies in levels present) and avoid overuse of antibiotics.

Urine testing can also detect GBS earlier in pregnancy. Typically a positive result won’t prompt any action by your care provider but if heavy colonization is indicated, this could require antibiotics during pregnancy.

You might be surprised to find that countries around the world vary in their approaches. Canada, for instance, aligns with the US perspective of Universal Testing whereas Nordic countries such as Sweden and EU countries such as the UK prefer a Risk-Based approach where testing is only done if requested or indicated. Regardless, it’s important to ask questions and follow the recommendations of your trusted healthcare provider.

What Are the Options If I Test Positive for GBS?

Intrapartum Antibiotics:
The gold standard for care is IV penicillin administered during labor at least 4 hours before delivery. This helps ensure efficacy of the antibiotic prior to baby passing through the birth canal. The timing is important!

Special Scenarios:
If labor is rapid it can limit the efficacy of the antibiotics. Antibiotics will still be given but baby will likely be monitored more closely. In the event of a Cesarean section delivery, antibiotics won’t be needed if labor hasn’t begun and your water hasn’t broken.

What Else Should I Know About Group B Strep?

Prevention Strategies: There are no preventative measures that can be taken to eliminate GBS bacteria in the body. This bacteria occurs naturally. Once detected, prompt antibiotic treatment reduces neonatal risk by ~80%.

Newborn Care: It’s important to monitor the baby for fever, lethargy (difficult to wake), or breathing struggles. These can all be signs of infection and should be addressed as soon as possible by a medical provider. The baby’s pediatrician should be the first call. Antibiotics are the standard treatment.

Postpartum Care: Mind the birthing person’s temperature and symptoms alongside baby’s, paying attention to any changes and seeking care if they’re noted.

Emotional Support: Addressing parental anxiety and connecting with support groups.

Future Pregnancies: Retesting will be required for all subsequent pregnancies, however, a positive test isn’t a guarantee. Group B Strep can be a transient bacteria that recedes, eliminating the risk to the birthing person and their baby.

Are There Myths About GBS?

Yes! There are many myths about GBS that can feel scary or leave you feeling confused. The main ones are:

GBS is not a sexually transmitted infection. It is a naturally-occurring bacteria that exists within the body and a common one, at that.

Antibiotics during labor do not harm the baby. While it is true that the antibiotics could have a small impact on baby’s microbiome, these effects have not been studied at length. Preliminary studies with limited data suggest that the impact is short-term and the effects can be mitigated to some degree by choosing to breast or chestfeed.

Positive status doesn’t guarantee infant infection! Even if you do test positive and aren’t able to recieve antibiotics quickly the number of newborns that get sick from GBS are few. While the illness is a very serious one and shouldn’t be taken lightly, it is still rare.

No proven remedies are known to exist besides antibiotics during labor. There are many online suggestions such as Hibiclens or Garlic to change the bacteria levels. There are no scientific studies to prove any of the alternatives work to keep your baby safe.

Wrapping it all up

If you’ve found yourself here because you have tested positive for GBS, don’t panic. Remember, GBS is a bacteria that naturally exists within the body. There is nothing you could do that would change that. If you test positive for GBS at your routine screening, remember that it is manageable with proactive care.

Antibiotics reduce both neonatal and postpartum risks for baby and parent and can be simply administered during labor.

As with everything, remember to ask questions and follow the guidance of your medical care provider. With early intervention, proper treatment, and consistent care you and your baby will not experience any ill effects from GBS.

The Changes Your Body Experiences After Birth

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We spend nine months getting ready for baby to arrive–both physically and emotionally. But the actual birth experience portion of your journey is relatively short. After birth, your body continues to change for many months. Here are some of the changes you can expect in the moments, weeks, and months after birth. 

What will I experience immediately after birth?

Immediately after birth, a care provider may place baby directly on your chest. This skin-to-skin contact helps regulate baby’s body temperature and calms baby. But it can also help your uterus contract to reduce bleeding. Bleeding may still be taking place from where the placenta was attached to the uterus or from any tears. A care provider might provide medication to slow or stop that bleeding, perform a uterine massage, or stitch the perineum. You might also shake, have contractions, feel weak, or be sore (you did just work very hard). 

How long does it take to recover from childbirth?

How long it takes to physically recover from childbirth depends on what happened during birth as well as the birthing person’s activity level. If you had tearing, an episiotomy, excessive blood loss, or a cesarean birth, it may take you longer to recover. In the days and weeks following birth, your body will feel different. You may be exhausted, bloated, and sore. The change in hormones can cause mood swings, sweating or hair loss. Pregnancy and childbirth also stretches ligaments and muscles, so your abdominal and pelvic floor muscles take time to tighten back up. If you had a c-section, remember that it is major surgery. You shouldn’t lift or over-exert yourself. Take the time you need to recover, listen to your body and be gentle with yourself

What are the emotional changes I’ll experience after birth?

Our brains are a part of our bodies, and the physical changes to our brains can alter our emotions. The change in hormones that happens in the postpartum period can make you feel happy, excited, positive, overwhelmed, sad, possessive, or disappointed. These are all normal. Making a plan for how family and friends (link to last blow) can help reduce stress. Prolonged and severe depression can also happen after childbirth, and if you (or your support network) are worried about a Postpartum Mood Disorder (PMDD) or Post-traumatic Stress Disorder (PTSD), talk to your care provider. 

What physical changes are not normal?

If you have any physical or emotional changes that concern you, talk to your care provider. They can help you determine what is normal and what isn’t. You should also talk to your care provider if you have vomiting, flu-like symptoms, fever, heavy bleeding, difficulty urinating, leg pain, vaginal itching, dizziness, shortness of breath, or racing heart. 

Can I recover more quickly after childbirth? 

The most important thing to do after giving birth is listen to your care provider. They can help you understand what you went through and how long it will take to recover. Make sure you prioritize your needs for rest, nutrition, and mental health. Many women feel physically recovered from childbirth around 6 weeks, but for most, it may take longer. 

A postpartum doula can provide education and support, and assist with newborn care, breastfeeding support, or anything else that can help ease the transition when a new baby arrives.