Flying when pregnant
Flying when pregnant Image Credit: Shutterstock

Dubai-based Ijaz Ummar and his seven-month-pregnant wife Jasleena were left stunned at their narrow escape, for she was slated to be on the Air India Express flight that crashed at Kozhikode on Friday evening, leaving at least 18 passengers and crew members dead.

Ummar said he was in the office when Jasleena called him to say that she needed a fitness certificate to board the flight. "There was a delay in getting that since it was a Friday and, despite our efforts, it could not be obtained," he said.

Consequently, Jasleena's trip was postponed and the couple did not think any more about it until they began receiving frantic calls from their relatives in their hometown of Kozhikode in the evening.

"Everyone was asking if she was on the flight. We had failed to inform relatives that her trip was postponed," Ummar said.

Jasleena said both of them are still in shock after watching the news of the crash on TV.

"We feel sad seeing all the visuals. While we are thanking God, we are also praying for all those who are suffering. We do not know what to say and how to express our feelings," she said.

In the wake of the accident, there are still many questions as the community reels from this tragedy. Jasleena and Ummar can only count their blessings at the narrow escape, which potentially saved Jasleena and their unborn baby - their first child, which they are expecting after five years of trying.

But what is the fitness certificate that may have inadvertently saved Jasleena and why do pregnant women need one?

What is a Fit-to-fly certificate?

Different airlines have different timelines but, generally speaking, if you are travelling at any point around your third trimester (from 28 weeks onwards) you will be required to show a fit-to-fly certificate to your airline before being allowed to board the plane.

This is a medical certificate or letter written on a clinic or hospital letterhead paper and / or stamped and signed by your obstetrician that mentions:

  • The number of weeks pregnant you are on the date when you wish to fly
  • The number of weeks pregnant you are on the date you will return (if applicable)
  • Your expected due date
  • Whether it is a single or multiples pregnancy
  • A declaration from your doctor stating that your pregnancy is uncomplicated and you are medically fit to fly

“A Fit to Fly certificate during pregnancy is a certificate for the treating doctor to state that the patient is fit to travel and has no risk factors that may affect her and her foetus during the travel,” says Dr. Sonia Chaudhary, Specialist obstetrics & gynaecology, Medcare Women & Children Hospital. “This is a requirement from the airlines for expectant mothers.”

If you have any heightened risk factors, such as being pregnant with multiples or gestational diabetes, it may be harder to obtain one and you may need to have a more thorough check from your doctor before they can sign it.

Why do pregnant women need a fit-to-fly certificate?

“If the expectant mother has any condition like a history of bleeding, history of preterm delivery, high blood pressure, or sickle cell disease then it’s especially important that she is checked to ensure she is medically fit to fly,” says Dr Chaudhary. “These conditions put the mother and the foetus at risk due to the air pressure change in the plane, hence for the safety of the mother and the foetus it is always advised to be checked over first in order to get a certificate to travel.”

In order to get your certificate you have to visit your doctor, says Dr Chaudhary. “Your doctor will examine you and review your antenatal record. After examining if there are no complicating factors the doctor will issue this certificate.” However you need to ensure that you time your medical visit right: “The certificate is valid only for 48 hours. The best time to travel for expectant mothers is between 14th week and the 28th week of pregnancy.”

During the time of COVID-19 pregnant women may be less eager to fly anywhere, although Dr Chadhary says that it is still relatively straight forward to get the fit-to-fly certificate if you do need to travel: “During the pandemic if it is necessary to travel, to get a certificate is not as challenging provided the patient is completely aware about all the safety measures and precautions that she has to take. The patient should also be aware about all details with regards to the quarantine period at her destination.”

You may not be accepted on your flight if you travel without one, especially if you are visibly pregnant (although most airlines do not require documentation if you are 27 weeks’ pregnant or less).

When you need a fit-to-fly certificate

According to Skyscanner, some of the UAE’s most popular airlines have the following policies for pregnant women:

• Etihad Airways allow women to travel during the first 28 weeks of pregnancy without a medical certificate.

• At Emirates Airlines, traveling after the 36th week is not allowed, unless with special permission from the Medical Department of the airlines.

• Air Arabia allows travel until 35 weeks, if the expectant woman provides a medical certificate indicating the number of weeks of her pregnancy.

• Flydubai allows normal travel of expectant mothers until the end of 28 weeks. Travelling after 28 weeks is not allowed, unless with an official medical report sufficient to Flydubai.

Other pointers to remember when flying while pregnant:

Be COVID cautious

Pregnant women are potentially at a higher risk of more severe forms of COVID-19, so ensure that you are following all of the usual precautions to the letter. This means wearing your mask at all times (including and especially in the restroom), washing your hands with soap and water or sanitizing gel frequently, and being careful not to touch your face. “When you sit down, immediately sanitise everything that you are likely to touch…..twice (i.e. TV screen, handsets, tray stable, arm rest, overhead cabin crew call buttons). Everything you can!” says Dr Richard Jones, Family Medicine doctor at Mediclinic. “This is probably where people pick up most coughs and colds.” Other advice includes directing the air vent over yourself to create a ‘cone of protection’ against any airborned germs, as well as keeping nasal passages moisturized (through saline sprays and keeping hydrated) to help them combat any infection. Some people even recommend dabbing petroleum jelly on your nostrils to keep your nose moisturized and prevent infection.

Walk the cabin

No matter the flight length, it’s good to get up from your seat for a bit as there is an increased risk of getting blood clots during pregnancy. Every half hour during the flight stand up and walk, or flex and extend your legs to prevent swelling of the feet and to improve blood circulation. But be sure to, “Wear shoes to the toilet or if you are walking around the cabin,” warns Dr Richard Jones. “The carpets are full of germs.”

Wear a pair of compression socks

Ask your OB/GYN or midwife about elastic compression socks for your flight. When pregnant, slower circulation increases the chance of blood clots and these will help. However it is important that they fit you properly or they can restrict blood flow even more, so it’s best to buy a pair with the advice of your doctor.

Sit comfortably

If you can afford the luxury of flying in business class or premium economy then do it. If not, try to select an extra-legroom seat before your flight. You could even just ask the flight staff if they can make some accommodations for you. If a seat with extra legroom is unavailable, the second best option would be to get an aisle seat.

Drink water – lots of it

It’s important to drink lots of water when pregnant and you’re much more likely to get dehydrated when travelling on planes. Firstly, stay hydrated while waiting to get on the plane, then buy a large bottle of water to take on the flight with you so you’re not at the mercy of the airline's food and beverage service.

Avoid lifting heavy bags

When you arrive at the airport, staff and airline personnel are available to assist you at every stage of your journey, so ask for help. Alert your airline if you need assistance with your luggage when boarding or when travelling to your flight.