Tips for Traveling While Pregnant or With Baby This Holiday Season

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Are you planning on traveling this holiday season? For many of us, this feels like the first, best opportunity to see loved ones after almost two years of the coronavirus pandemic and lockdowns. Here are some tips for flying or taking car rides while pregnant and with your newborn. 

No matter where you are traveling, consider getting vaccinated for COVID-19 if you are not already. USA Today recently reported that only 18% of pregnant people in the United States are vaccinated against COVID-19. The Centers for Disease Control, American College of Obstetricians and Gynecologists (ACOG), and World Health Organization all recommend the COVID vaccine even during pregnancy. The benefits of the vaccine far outweigh the risks. 

Flying During Pregnancy

The American College of Obstetricians and Gynecologists (ACOG) write that during healthy pregnancies, “occasional air travel is almost always safe.” Most domestic airlines allow pregnant people to fly until about 36 weeks of pregnancy, but international airlines may have different cut-offs. You should always consult with your healthcare provider and the airline before booking any travel. 

If you do choose to fly while pregnant this holiday season, you can do a number of things to make the flight more comfortable. First, book and aisle seat if possible. This way, you can get up and walk around more easily. Sitting for more than four hours increases your risk of deep vein thrombosis (DVT), a blood clot that forms in your leg and can cause pulmonary embolism (when the blood clot gets stuck in your lung). Even when you are sitting, you can move your feet, toes, and legs to keep up circulation. 

You should also wear the seatbelt low across your hips, below the belly and avoid carbonated drinks. All domestic flights currently require masks during travel, and you should consider wearing an N95 or surgical mask, which offer the most protection against airborne pathogens like coronavirus. To stay hydrated, drink water. 

Taking Long Car Rides During Pregnancy 

Like flying, taking long car rides during pregnancy might feel uncomfortable. Wear loose-fitting clothing and layers that can be taken off or put on. You should also be drinking water and eating regular meals. Usually when we drive we want to get there as soon as possible, but remember to stop to use the bathroom and stretch your legs. Sitting in the car for extended amounts of time increases the risk of DVT and can just be uncomfortable. 

Even though a few hours-long car ride might not seem as noteworthy as flying somewhere, remember to speak to your care providers about where and how you are traveling. They may want to offer additional advice to keep you and baby safe. 

Flying with Newborn Baby

You should speak with your baby’s care provider before deciding to go on a flight. As uncomfortable as flying can be for us, it can be especially bad for newborns. Because their immune systems are still developing and planes are by nature crowded spaces, babies might be more susceptible to picking up a virus during a flight. 

The cabin pressure changes may also hurt baby’s ears. If you are traveling, let baby suck on something during takeoff and landing. And while we don’t always notice how loud a plane is, the engines and air circulation can be very loud for a baby’s new ears. Consider noise-cancelling headphones to protect their hearing. 

The level of oxygen inside an aircraft is also lower, and while this might be fine for some babies, talk to your doctor about any of baby’s heart or lung issues. 

And, although baby is allowed to be in your lap during the flight, best practice would be to purchase a seat for baby and to properly install their infant car seat (double checking for FAA approval). This gives you the mobility to get up and move around as well as a familiar place for baby to sleep. It also is by far, the safest way for baby to fly. 

Finally, make sure that you have everything your baby might need during the flight in an easily-accessible carry-on bag. 

Car Rides With a Newborn 

First, make sure that your car seat is properly installed [link to blog]. Like flying, you should also have everything baby needs in an easily-accessible bag. You or your partner may want to sit in the back seat with baby.

Before you leave, consider when and where you’ll be making stops along the way. Think about when your baby usually eats and where the best place to stop might be. Because of COVID, you may want to stop at a rest stop or picnic area rather than a restaurant. 

Am I actually going into labor?

Although the conventional knowledge is that people are pregnant for nine months (which would be 36 weeks), most babies are actually born between 38 and 42 weeks. This means that you can think of a “due month” rather than a specific date. In fact, less than 5% of babies are born on their due date. But this date range can present a problem: how do you know if you are actually going into labor? Here are four ways to know if you are going into labor. 

You experience 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! A change in emotions and becoming more sensitive, bursts of nesting energy, new or unusual cravings can signal your body is getting ready for labor. You may also have physical changes. These include feeling “crampy” or having backaches, increased vaginal discharge, loss of mucus plug (especially blood-tinged mucus), and 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. 

It always happens in movies: water spills on the floor and the character knows their baby is coming. In real life, only occasionally does your water break ahead of contractions. For the vast majority of people, contractions will follow within 12-24 hours. 

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

Pre-labor 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 labor. Your cervix will shift forward to align with the birth canal, soften or ripen, thin (or efface) and THEN finally dilate. 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. 

5 Things You Should Know About Pregnancy and the COVID Vaccines

If you are pregnant right now or trying to become pregnant, you might be asking yourself, “Should I get a COVID-19 vaccine?” or “Should I get a booster?” Pregnant women are often excluded from drug and clinical trials because the potential risk is often too high, and this was this case with the COVID vaccine trials. According to an article published last year in the New York Times, “Scientists have accumulated a small but steadily growing body of evidence that the vaccines are safe and effective during pregnancy.” Boosters  At Doulas of Baltimore, we encourage you to make decisions regarding your pregnancy and birth that make you feel comfortable and are grounded in the best information available. Here are 5 things you should know about pregnancy and the COVID vaccines (as of January 2022). 

Pregnant women have an increased risk of severe disease after a COVID-19 infection. 

In a study conducted in 2020, Centers for Disease Control (CDC) researchers analyzed data on 1.3 million women ages 15-44 who were diagnosed with SARS-CoV-2, the virus that causes COVID-19. They found that, “pregnant women were at increased risk for severe COVID-19–associated illness.” Pregnant women were more likely to be admitted to the ICU and receive invasive ventilation. Although they are not sure why this is, they speculate it could be because your body is working harder when you are pregnant– including “increased heart rate and oxygen consumption, decreased lung capacity, a shift away from cell-mediated immunity.” Another study found that pregnant women who contracted COVID were at an increased risk for preterm birth. 

A COVID vaccine booster is safe for pregnant people.

If you received your first two shots of the vaccine before you were pregnant, you may now be wondering if you should be get a booster shot. Doctors are now recommending that people who are pregnant get the booster or third shot of a vaccine if they are eligible. Because pregnant people have an increased risk of severe disease if they get COVID, it is important to keep yourself as protected as possible. Dr. Brian Brimmage of the University of North Carolina health system says that,“Obviously, a pregnant woman getting seriously ill with COVID is dangerous for her and her baby.”

A recent study shows the Pfizer and Moderna vaccines produce an immune response in pregnant and lactating women. 

Although pregnant women had this higher risk of severe disease, they were not included in any of the clinical trials for vaccines conducted last year. However, when the vaccine rollout started, some of the healthcare workers who received the vaccine were unknowingly pregnant at the time. Researchers could then track and monitor those women, and additional studies began specifically enrolling pregnant women. 

The CDC now writes that you can receive the COVID-19 vaccine if you are pregnant. In a study of 103 women, researchers found that the Pfizer and Moderna vaccines gave women an immune response (meaning the vaccine did what it was supposed to) and antibodies to COVID-19 were present in breast milk and cord blood. 

When administered during pregnancy, the Pfizer and Moderna vaccines do not damage the placenta. 

An early conspiracy theory regarding the COVID vaccines and pregnancy involved the idea that it might damage the placenta. A study just published in Obstetrics and Gynecology found that COVID “vaccination was not associated with placental histopathologic lesions,” meaning it did not damage the placenta. 

STAT news now reports that, “Three of the leading professional organizations focused on pregnancy and fertility — the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, and the Society for Maternal Fetal Medicine — all recommend that pregnant people get vaccinated, as well as those considering pregnancy.”

Protect yourself against COVID-19. 

If you don’t want to get the vaccine right now, the CDC recommends taking steps to reduce your risk of contracting COVID. This includes all the key recommendations from the last year: wearing a mask, avoiding crowds, not spending time indoors with poor ventilation, washing your hands, and keeping physical distance. 

At Doulas of Baltimore, we support the decisions that you make during pregnancy, without judgement. This blog post is not intended as medical advice, but provides some information about the latest research and commentary from the government and professional organizations regarding the efficacy and safety of COVID vaccines on pregnant women. As with all of your pregnancy and birth decisions, you should consult with your doctor before making any decisions about receiving a COVID-19 vaccine.

Pregnant & Worried about COVID-19?

Are you pregnant and worried about how COVID-19 will affect your pregnancy care and birth? We have been reading all we can. Of course, the available information is new and constantly changing. 

Our goal is to provide you with solid resources so that you can have answers you are looking for while cutting out all the extra static.

As of now (3/21/2020), we have located two informative pieces that cover a lot of expectant parents’ concerns:

Please let us know what questions you have and share with us any links or information that you have found particularly helpful. 

As for Doulas of Baltimore, we have moved to virtual childbirth classes and virtual birth doula support. Our in-home postpartum support is on a brief pause as our doulas and clients get through a minimum of 14 days of social isolation and then schedule in person support of a case by case basis. **

We know the services and resources we offer are needed, in this time more than ever, and want to ensure that we continue to deliver professional, consistent support to the expectant and new families in the Baltimore area. This will not look like you had been imaging but together we can help relieve some of your worries.

** UPDATE 04/01/2020: We have redesigned our services to meet the current needs of expectant and new families during this time. We are now offering three separate options for doula support during this time of social distancing – Pregnancy Support, Virtual Birth Support, and Newborn Care Support. More information is available on our Virtual Doula Support page.

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, 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 damsel 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. Unless you work in the airline industry, you will 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 your arms up, move your back, and flex your calves and feet.

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 that could restrict it earlier. 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:  And 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, and you need to get home now, you will 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!