Air travel is an integral part of modern life. Whether for business, pleasure, or simple convenience, more than a million people fly through U.S. air space every day. If you're pregnant, however, there are a few things to consider before you step onto that plane. Knowing when it's okay to fly and how to avoid potential health risks can help you have a safe, enjoyable flight.

If you're healthy and have your doctor's approval, you can fly until the 36th week of pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG). However, airlines may have different policies, so it's best to check the rules before you buy your ticket. Some airlines may only allow international travel up to 32 to 35 weeks, and some may require you to provide medical forms before you fly.

The safest time to travel is during your second trimester, according to ACOG. By your second trimester, your pregnancy is well established and you'll probably be feeling your best. Most miscarriages occur during the first trimester, so it's generally unwise to travel then. The last trimester brings its own risks -- like premature labor, high blood pressure, and other complications.

Women who have any of the following conditions should not fly while they are pregnant:

•Severe anemia

•Sickle cell disease or trait

•History of blood clots

•Placental abnormalities

•Risk of premature labor

•Pregnancy-induced hypertension

•Poorly controlled diabetes

If you're pregnant and not healthy, you may want to postpone traveling long distances, advises Dr. Phyllis Kozarsky, professor of medicine at Emory University and Chief of Travelers' Health at the CDC. "Women who have any kind of underlying chronic disease should think twice or three times about traveling outside of their immediate area," she says.

As long as your doctor anticipates a risk-free pregnancy, you're in no danger from changes in an airplane's cabin pressure. Lengthy commercial flights usually maintain an altitude between 39,000 and 41,000 feet, although the internal cabin pressure is kept at the equivalent of no more than 8,000 feet. While it's true that you react differently to changes in cabin pressure when you're pregnant, your body has a remarkable capacity to adapt. At the cabin pressure equivalent of 8,000 feet, for example, the average person breathes 26 percent less oxygen than at sea level. To compensate for the lack of oxygen, your heart rate and blood pressure increase temporarily.

Even healthy pregnant women can find air travel a bit of a challenge. Remember, all the aches and discomforts you have on the ground, like leg cramps, indigestion, constipation, and heartburn, can accompany you on the plane as well. Here are some ways to make air travel less stressful and more comfortable.

•Bring support hosiery to prevent swelling in your feet and legs, acetaminophen for minor pain, extra snacks, and water to drink during the flight.

•Reserve an aisle seat to give yourself more room to stretch your legs and make it easier to get in and out of your seat.

•To reduce the risk of blood clots, stroll up and down the aisle every hour and flex and extend your ankles to improve circulation. Of course, a full bladder may work as an unintended aid in getting you moving.

•Drink plenty of liquids during the flight. Dehydration can slow down blood flow in the placenta and put you at greater risk for a blood clot.

•To help prevent discomfort, avoid eating or drinking gas-producing foods before your flight, because trapped gases expand at higher altitudes.

•If you suffer from nausea, ask your doctor to prescribe an antiemetic medication that's safe and will reduce the nausea or need to vomit.

•If traveling abroad, check that your health insurance will cover you. Purchase a supplemental travel insurance policy if necessary.

•If you'll require routine prenatal care at your destination, know what health care facilities are available before you go.

•Travel with a companion if at all possible.

•Finally, whether the airline requires it or not, it's a good idea to carry documentation with you that lists your due date.

If you've checked with your doctor and planned your flight properly, you should be able to relax and enjoy your trip. But just to be on the safe side, it's a good idea to know what to watch for in case something goes wrong. Seek immediate medical attention for any of the following:

•Bleeding

•Vaginal discharge, including passing tissue or clots

•Abdominal pain or cramps

•Contractions

•Ruptured membranes

•Headaches, visual problems, or excessive leg swelling or pain

-- Laurie Udesky is an award-winning health reporter and a frequent contributor to Consumer Health Interactive.

References

First published August 2, 2005
Last updated April 8, 2008
Copyright © 2005 Consumer Health Interactive

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