Air Travel During Pregnancy: avoiding the unexpected

The headline could have easily been from TV drama or sitcom, but was very real: Infant born at 35,000 feet.

Aida Alamillo was as surprised as anyone that she went into labor en route to Boston. At 35 weeks, she was cleared to fly and within the airline guidelines for flying while pregnant.  Her son, as many babies do, had other plans and he was born mid-flight. Thankfully everything went well due to three nurse passengers and mom and baby are both doing well in a San Francisco hospital.

Aida and Kevin are lucky. Being so far away from medical care, many complications could have emerged that would have been challenging to handle on an airplane. This is one of the reasons most airlines and the American College of ObGyn don’t advise travelling past 36 weeks, or in the last month of pregnancy. Aida was within those guidelines but barely.

So, what should you do if pregnant and needing to travel near term?

1. Talk to your Ob/Gyn and make sure it truly makes sense to travel so close to term.  While 36 weeks is a general ball park for ceasing travel, your Ob/Gyn may have an earlier cut off based on your history.

2. Consider the “what ifs”. What if you go into labor early, on a train, boat, car or plane? Will you be near a hospital or 911 services? If not, perhaps you can travel earlier or delay your trip.

3. Know the airline guidelines for travel while pregnant.

This headline got me wondering about medical emergencies inflight and how they are typically handled. From what I could find in reports and studies, the data about inflight medical emergencies is spotty at best. It appears that births are quite rare but other emergencies such as heart attacks, panic attacks, fainting, asthma, are not.  Given this information, I would have expected airlines today would train personell on how best to handle these situations should they occur. As it turns out, that’s not the case.

According to a recent JAMA article, the reality of how airlines handle medical emergencies is quite different from what most of us would have predicted.

If a medical emergency does occur, there are many obstacles to handling it including the availability of the flight crew and emergency medical kit. As noted in JAMA article:

“Other reports have recounted physicians having challenging experiences with in-flight medical emergencies. Like physicians in these other reports, these physicians faced challenges in providing care: the physical space was difficult to work in, the emergency medical kit was not immediately available for use, the physicians were unfamiliar with its contents, and the flight attendants were absent for much of the episode.”

The article goes on to further note an issue with flight attendant medical emergency training:

“Judging from events such as the emergency landing on the Hudson River, as well as other incidents, flight attendants are well trained in emergency landings and evacuations. Because of improved aviation safety, most individual flight attendants will never experience an emergency landing or evacuation during their careers. By contrast, in-flight medical emergencies occur frequently. Yet the kinds of approaches that have improved flight safety have not been extended to providing optimal care for passengers who become acutely ill while on board airplanes.”

The best advice for safe air travel in general is to know your own health history and to consult your primary care physician if you have any questions about whether air travel is safe for you. And, if you are pregnant, recognize that babies don’t check calendars. When it’s time, it’s time…even if your physician said it was ok to travel, the baby may truly have another plan in mind!

 

 

 

 

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