Aida Zabidi
There was a recent article making the rounds on the Internet about Air Asia’s refusal to let a pregnant woman fly due to her advanced pregnancy. I read it with some interest, because too often people seem to forget that pregnancy is a special state in itself. 

In general, the American College of Obstetrics and Gynaecologists do not impose healthy pregnant women with no pregnancy related complications from flying, however they do suggest that women do not fly after more than 36 weeks of pregnancy. 

Note the clause ‘healthy pregnant women with no pregnancy related complications’. Different airlines do impose different guidelines towards their clients, and it is an airline’s every right to do so in the interest of their passengers, and of course, to protect the business from a medicolegal perspective. 

This is when it becomes important to discuss with a doctor if you are planning to take a flight at any point in the pregnancy. Any patient with complications of pregnancy such as gestational diabetes, placenta praevia, hypertension and mothers with a potential risk of premature delivery will not be encouraged to fly. 

Doctors talk a lot about risk, because there is no certainty about the outcomes of harm. There is no saying that being able to fly on an airline will cause any harm, or cause a miscarriage of the pregnancy. There are too many factors about any pregnancy that can affect the outcome, and it is because of this that we can only advise our patients regarding the possible risks. 

During the first trimester, the risk of miscarriage is high, and a lot of women experience morning sickness. Make sure you have an aisle seat with available vomit bags! There is a higher risk of miscarriage, but it is difficult to say if flying increases that risk.

Generally the second trimester, which is between 12-23 weeks, is the safest period to fly – the risk of miscarriage and premature labour tend to be lower. However, with longer flights there is a general risk throughout the population to get a deep vein thrombosis, and this risk is higher in pregnant women due to a naturally increased coagulable state. This can be dealt with by taking short walks throughout the flight, or using TED stockings, which are compressive stockings that help with the circulation in your legs. 

It is suggested to wear the seatbelt underneath the abdomen and for pregnant women to wear their seatbelt at all times due to the unpredictable nature of turbulence. General advice such as keeping hydrated and avoiding caffeinated drinks is especially relevant to pregnant women as well. 

After 36 weeks, things become trickier due to the increased possibility of premature labour, and doctors might be less reluctant to allow these women to fly. No one wants to deal with the possibility of a woman giving birth mid-air, and this risk of premature labour increases with the longer flights. 

If there is a possibility of taking an airplane at this time, please in the very least make sure to have your antenatal records available and please buy travel insurance! 

While I sympathize with the woman who was not allowed to get on the plane due to her pregnancy, I do believe it is every individual’s responsibility to check the airline guidelines before deciding to take a flight, and to discuss with their doctors regarding the safety of flying in their pregnant state. 

I believe Air Asia’s policy is not to allow anyone over 35 weeks pregnant to fly, and between 28-34 weeks, passengers are required to have an approved medical certificate from their doctor.The woman was apparently allowed to fly the next day after having obtained said certificate.
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