Parents-to-be often wonder if it is safe to travel or live in India when pregnant. Before deciding on this it is helpful to understand the level of Risk during different times in the Pregnancy, and then set this alongside your travel plans. Your doctor or obstetrician will probably be able to advise you, and if you are going with a company or agency their medical adviser may have guidelines.

HOW SAFE IS TRAVEL DURING PREGNANCY? – IN GENERAL

Simple traveling during pregnancy carries small additional risks owing to the greater likelihood of fever, dehydration, accidents, and distance from good health care when away from home.

• If you do have to travel in the first three months, try to arrange at least one antenatal appointment before going abroad, at which time you can discuss any concerns you have with your doctor. You may just be able to fit in your first scan.
• The middle three months are generally the best time to undertake a journey. In this way, you can complete basic antenatal investigations, including blood tests and scans, before you leave, and be in place for any problems that may arise towards the end of the pregnancy.
• You should think carefully before traveling if you have a medical condition that adds to the risk of pregnancy. This would include heart disease, diabetes, significant anemia, asthma or chronic lung disease, previous venous thrombosis, or pelvic infection.
• You have had a problem in a previous pregnancy. This would include a previous actual or threatened miscarriage, ectopic pregnancy, or known complication of childbirth. Rhesus incompatibility or raised blood pressure. Include any other condition that caused you to have extra appointments or treatment in your last pregnancy.

SAFETY OF LIVING IN INDIA WHEN YOU ARE PREGNANT

This will vary greatly depending on the part and exact location you live. Although in cities, especially in metropolitan cities overseas pregnancies will pass without difficulty, if problems do arise or tragedy does occur you will want the reassurance that you made an informed choice based on the knowledge of possible risks. It is therefore worth considering what the commonest risks are:

Miscarriage – There is no such risk in India, but if you live outside of the city or in some rural areas you need to take care of it. If you do have a miscarriage and continue to bleed, medical facilities such as those of Dilatation and Curettage are available in hospitals. However, finding an exact blood group is quite a task in suburbs in India.

Malaria – You need to take care of mosquitoes, especially malaria and dengue. Malignant malaria can increase your risk of anemia, premature labor, miscarriage, and stillbirth. A severe attack could put your life at risk, especially if you have not been taking antimalarial. The baby may be born with malaria. 

Hepatitis E – This form of hepatitis is spread like hepatitis A. In India and Nepal, it is quite common. I don’t yet have a very accurate idea of just how widespread it is. If you are in a country where it is known to be common or there is reliable evidence that it is about, take even more care than usual with food and water hygiene.

Medicines – Many medicines, including most treatments for diarrhea, bowel infections, and worms are best avoided in pregnancy, meaning you may need to delay treatment until the baby is born. A bewildering number of drugs are available in India, either by prescription or over the counter. You should only take medicine if it is essential and you have checked it is harmless to the baby.

Premature Labor – You need to take care of safe blood for the mother and extra support for a premature baby. You can minimize health risks during pregnancy by trying to set up an ordered lifestyle, taking regular exercise, and allowing more time than usual for rest, relaxation, and routine tasks. Avoid high-altitude trekking, scuba diving, horse riding, and skiing.

SAFETY OF HAVING A DELIVERY IN INDIA

There is potentially a greater danger of complications at the time of delivery in India unless you are within access to a known center of excellence.  You will need to make an informed choice, not through the romantic haze of optimism but based on a cool look at what would happen in the worst scenario.

• A maternity unit, easily accessible at all times of the day or night and at all seasons, with 24-hour cover from an experienced doctor able to carry out forceps and vacuum deliveries and Caesarean sections.
• High standard of hygiene, fully trained midwives, and the guaranteed use of sterile instruments.
• The ready availability of safe blood from a trusted donor with the same or a compatible blood group.
• Resuscitation facilities for the newborn.
• The absence of any serious pregnancy-related problems in this or previous pregnancies, including Rhesus incompatibility.
• A personality that can cope with the added risks and anxieties of having a delivery away from your home country, with its high-tech back-up and family support.
• A partner or family member who can give practical support at the time of delivery, including overseeing travel arrangements.

AIR FLIGHT & PREGNANCY

Most international flights will be unwilling to carry a passenger known to be 35 weeks pregnant or beyond, but many domestic flights make a cut-off point at 36 weeks. Check the exact regulations with the airline concerned and leave a margin of two weeks in case of last-minute changes of plan or cancellations. It’s worth having a medical certificate giving the expected date of delivery, especially if flying near the airline’s cut-off point or if you are about to give birth!

Air travel is generally safe in pregnancy. Make sure you keep your fluid intake up and avoid alcohol. Your feet may swell more than normal. To prevent clots in the legs walk around at least once every hour and avoid sitting in a cramped position. Eat a fiber-rich diet throughout pregnancy, especially at the time of air travel.

Check the details of your travel insurance as most policies will not cover delivery or complications of pregnancy.