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Is it safe to fly during pregnancy?

Generally, air travel before 36 weeks of pregnancy is considered safe for people who aren't dealing with any pregnancy problems. Still, if you're pregnant, it's a good idea to talk with your health care provider before you fly.

Your provider might suggest that you not fly if you have certain pregnancy complications that could get worse because of air travel or that could require emergency care. Examples include a history of miscarriage or vaginal bleeding, severe anemia, and high blood pressure or diabetes that's not well controlled. If you had preeclampsia during a previous pregnancy — a condition that causes high blood pressure and extra protein in urine — flying may not be advised. The same is true if you're pregnant with twins or other multiples.

Tell your provider how far you are flying, as the length of the flight might make a difference. Also, be aware that some airlines may not allow pregnant people on international flights. Check with your airline before you make travel arrangements.

After 36 weeks of pregnancy, your health care provider may advise against flying. And some airlines don't allow pregnant people to fly after 36 weeks. The airline also may require a letter from your health care provider that states how far along in your pregnancy you are and whether flying is advised.

If your health care provider says it's okay for you to fly, and your plans are flexible, the best time to travel by air might be during the second trimester. The risks of common pregnancy emergencies are lowest during that time.

When you fly:

• Buckle up. During the trip, keep your seatbelt fastened when you are seated, and secure it under your belly.
• Drink plenty of fluids. Low humidity in the airplane could cause you to become dehydrated.
• Avoid gassy foods and drinks before you fly. Gases expand during flight, and that could make you uncomfortable. Examples of foods and drinks to avoid include broccoli and carbonated soda.
• Think about medical care. Plan for how you'll get obstetric care during your trip if you need it. Bring copies of your medical information in case you need care while you're away.

Blood clots

Air travel can raise the risk for blood clots in the legs, a condition called venous thrombosis. The risk is higher for pregnant people. Moving your legs may help prevent this problem. Take a walk up and down the aisle every hour during the flight. If you must remain seated, flex and extend your ankles from time to time. In general, it's best to avoid tightfitting clothing, as that can hinder blood flow. Wearing compression stockings can help with blood circulation during a long flight.

Radiation exposure linked to air travel at high altitudes isn't thought to be a problem for most people who fly during pregnancy. But pilots, flight attendants and others who fly often might be exposed to a level of radiation that raises concerns during pregnancy. If you must fly frequently during your pregnancy, talk about it with your health care provider.

Mary Marnach, M.D.

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• Allergy medications during pregnancy
• AskMayoExpert. Health considerations for air travelers: Pregnancy considerations. Mayo Clinic; 2022.
• Air Travel During Pregnancy: ACOG Practice Bulletin No. 746. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/08/air-travel-during-pregnancy. Accessed Dec. 1, 2022.
• Ram S, et al. Air travel during pregnancy and the risk of venous thrombosis. American Journal of Obstetrics and Gynecology. 2022; doi:10.1016/j.ajogmf.2022.100751.

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Home / Pregnancy / Why do miscarriages happen?

Why do miscarriages happen?

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For many people, the sudden end of a pregnancy gives rise to a thousand thoughts and feelings. Suddenly, you’re not sure what this means about your body or your ability to have a healthy pregnancy, and you certainly aren’t sure what might happen next. Of the questions that patients ask me, the first is almost always, “Why did this happen to me?”

A person having a miscarriage joins a club that they never intended to sign up for. This club is full of amazing people from all different walks of life who are bonded together by this similar experience. Everyone’s miscarriage journey is different, but you and the others that came before you all experience the physical and emotional loss of a pregnancy ending.

This is a bigger club than you realize. Around 1 in 4 recognized pregnancies ends in a miscarriage — and it may be as many as half the pregnancies, since many people miscarry before they realize they are pregnant. At those rates, about a quarter of women will experience a miscarriage during their lifetimes.

This means you absolutely know at least one person who has had a miscarriage, even if no one has told you they’ve had one. Miscarriages happen to people in every country and every situation in life. Healthy or sick. Young or old. Happy or sad or unsure about the pregnancy. There are risk factors for miscarriages, but it’s important to know that most pregnancy losses happen to completely healthy people.

Here are the most common risk factors for pregnancy loss:

Who you are:

• Age.  Being over 35 or having a male partner over 40.
• Weight.  Being underweight or overweight is associated with miscarriage, but it’s unclear if weight itself directly increases the risk.

What you do:

• Lifestyle factors.  Smoking 10 cigarettes or more a day, drinking alcohol, or using nonprescribed substances, particularly cocaine.
• Exposure to radiation and toxic substances.  Having a job that exposes you to toxins, like pesticides, heavy metals (lead, mercury, arsenic), solvents (toluene and benzene), ionizing radiation and some chemotherapy agents.
• Extensive lifting at work.  Regularly lifting over 220 pounds a day. If your job or workplace poses a risk to you during pregnancy, your doctor can write a letter to your employer. Your employer should make accommodations for you.

Pregnancy complications:

• Multiple gestation.  Twins, triplets, or more.
• Pregnant with an IUD in place.  Intrauterine devices (IUDs) are highly effective forms of birth control, but if the device fails, the pregnancy is at a higher risk of loss.
• Invasive pregnancy testing.  Chorionic villus sampling (CVS) and amniocentesis tests to determine if the baby is healthy can uncommonly cause miscarriage.
• Infections.  Rubella, chickenpox, foodborne infections (listeriosis, salmonellosis).
• High-velocity trauma,  like a serious motor vehicle accident or major fall; or low-velocity trauma, like getting hit in the belly during a low-speed motor vehicle accident in the second or third trimester.

Unclear associations, due to poor or conflicting data:

• Night shift work.  Some studies (but not all) have shown that working a night shift affects long-term health and increases the risk of miscarriage.
• Taking medication.  Certain drugs, including oral medication used to treat a yeast infection, may increase early miscarriage risk. Ask your doctor if there are drugs or supplements you shouldn’t take while pregnant.

The average person who wants to be pregnant and have more than one child may be pregnant many times in a lifetime. The odds are actually higher that you’re going to have at least one miscarriage than that you won’t have any. It’s especially sad when a miscarriage happens in a first pregnancy because of all the doubts it might raise. But you’re no more or less likely to have bad luck on your first pregnancy than your fourth.

There are also plenty of things that do not cause a miscarriage. Here’s a short but by no means definitive list:

Exercise, heavy lifting or physical exertion Don’t worry about the fact that you vacuumed your house, moved a few heavy boxes, or lifted your niece or nephew. Even if you have a job that involves lifting mattresses or pushing heavy carts. Even if you bench-pressed 150 pounds on a few occasions or ran a marathon (which is amazing). No amount of typical physical activity can cause a miscarriage.

Working There’s no link between miscarriage and full-time employment, standing more than six hours a day, or an average amount of lifting. While some jobs may be associated with a higher risk, it’s unlikely your job had anything to do with your miscarriage.

Screen time Working at a computer all day or spending a lot of time on your social media accounts is not associated with miscarriage. The electromagnetic fields from computer screens are weak. While staring at a screen all day may not be good for your eyesight or your relationships, it doesn’t threaten your pregnancy.

Air travel Cabin pressurization isn’t associated with higher miscarriage risk. However, if you do fly while you’re pregnant, be sure to regularly get up and walk the aisle to prevent blood clots in your legs. Pregnancy does increase your risk of those.

Frights There are myths about a shock or fright causing a miscarriage. That’s not true, either. Enjoy all the horror movies you want.

Sex I don’t care how vigorous the sex was, how athletic or in what position. In fact, I hope all those things were superfun. No amount of sex (or an orgasm, with or without intercourse) can disrupt your pregnancy.

Caffeine Moderate caffeine consumption (2 cups of coffee or 3 to 5 cans of soda a day) is OK while pregnant.

Tampons Tampons stay in your vagina and go nowhere near the baby inside the uterus.

Hormonal birth control Hormonal contraception doesn’t fundamentally change your ovaries, your eggs or your uterus, and it has no impact on the health of your pregnancies. While the injection can delay your periods from returning for up to a year, you’ll still be able to have a healthy pregnancy once the hormonal effects wear off. If your hormonal birth control failed and you became pregnant while using it, there is no increased risk of miscarriage.

An intrauterine device (IUD) Similarly, having used an IUD in the past doesn’t increase your risk of miscarriage. The only association with an IUD and miscarriage is in the rare instances when you become pregnant with an IUD in place. These pregnancies have a high risk of miscarriage, especially if the IUD is not removed.

A past abortion It isn’t uncommon for people to feel that their decisions about past pregnancies are the reason for a present-day miscarriage. Medically, a past abortion — even if you’ve had more than one — has no impact on your pregnancies in the future. You made the best decision for yourself that you could at the time, and an abortion does not damage your uterus so that you can’t get pregnant again. The universe is not sending you a message.

Morning sickness My patients have asked me if their babies were nutritionally deprived because they were nauseous all the time and couldn’t eat or were vomiting throughout the day. No matter how much you vomited or how little you ate, morning sickness does not lead to miscarriage. In fact, it’s associated with high pregnancy hormone levels that tend to indicate healthier pregnancies.

A flu shot The effects of flu vaccines on pregnancies have been heavily researched. Despite what you may have heard, getting the flu vaccine during pregnancy is not only safe, but also highly recommended. If you were to get the flu while pregnant, you would have a higher risk of serious illness — and even death — than getting the flu at any other time. Getting the flu vaccine won’t cause a miscarriage and will keep you and your baby safe, both before and after birth.

Bottom line: You did nothing wrong. You did nothing to make this happen.

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What Experts Want You To Know About Flying In The 1st Trimester

When it comes to air travel, there are unspoken rules — especially when you have kids. Hi, man in row 23. I feel your stare. Flying etiquette looks different for everyone — some people say live and let live, while others start huffing and puffing the moment someone’s arm hair brushes theirs. But what about when you are newly pregnant? Navigating the early weeks of pregnancy comes with a lot of questions, let alone doing it while aboard the friendly skies. Like, can flying during the first trimester cause a miscarriage ?

“Travel during the first trimester is safe, but women should be aware that the overall risk of miscarriage is greatest during the first trimester, so if she happens to miscarry, she may blame it on air travel,” Dr. Rebecca C. Brightman, a NYC-based OB-GYN and assistant clinical professor at the Icahn School of Medicine at Mount Sinai, tells Romper in an email interview.

Dr. Salli Tazuke , the co-founder and co-medical director of Colorado Center for Reproductive Medicine in San Francisco explains the roots of the concern, pointing at speculation over whether or not flying can cause miscarriage due to lower oxygen tension or exposure to atmospheric radiation . But she says, while there is some limited observation that flight attendants have slightly higher miscarriage rates, this has not been confirmed.

“If your pregnancy is straightforward, then flying is not thought to be harmful for you or your baby,” she says.

Tazuke says there are a few precautions pregnant women should take when flying , however, including hydrating properly (dehydration can cause cramping) and moving around on the plane to avoid deep vein thrombosis.

Once a heartbeat is seen on ultrasound at about six or seven weeks, Brightman says “ the risk of miscarriage does decline significantly , making travel less anxiety provoking.” She does caution, however, that women who are considered a high-risk for miscarriage or who have had a history of miscarriage, may want to put off first trimester travel plans until they receive the "go ahead" from their healthcare provider.

Now when it comes to the last month of pregnancy, it's a different story, says Dr. Allison Hill, OB-GYN and co-author of The Mommy Docs’ Ultimate Guide to Pregnancy and Birth.

"Most airlines won’t let you travel in the last month of pregnancy, but that’s just because they don’t want people going into labor on the airplane," she says. "Being at altitude in a pressurized cabin is not dangerous in itself."

Of course, if you are flying with me, then the rules are simple — I get the window seat.

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Flying when pregnant: what you need to know

Read time 6 minutes

If you’re feeling unsure about whether you can hop on that plane when you’re expecting, here’s the info.

Can I fly at one, two or three months pregnant (first trimester)?

Yes, there is no evidence that flying causes miscarriage (RCOG, 2015) . Yet as this is the riskiest time for miscarriage , just be aware that no medical help will be available if that does happen. You also might feel nauseous and exhausted, so that’s something to think about too.

Can I fly at four, five or six months pregnant (second trimester)?

Good news if you’re thinking of going away in the second trimester: it’s considered the safest time to fly (Hezelgrave et al, 2011) . That’s mainly because the risk of pregnancy-related complications, including miscarriage, is lower during the second trimester than in the first and third (Hezelgrave et al, 2011) .

Can I fly at seven, eight or nine months pregnant (third trimester)?

It’s fine to fly in the third trimester but you’re advised to do it before 37 weeks, or before 32 weeks in an uncomplicated twin pregnancy . That’s because you could go into labour any time after those dates (RCOG, 2015) .

Do still check with your specific airline before you fly though. Many airlines have restrictions on travel in advanced pregnancy (Hezelgrave et al, 2011) .

Flying when pregnant: the worries and concerns

First of all, you should know that flying is not considered harmful to you or your baby if you’re having a straightforward pregnancy.

You might feel a bit uncomfortable flying at certain stages of pregnancy. For example, you might have swollen legs, pregnancy sickness , nasal congestion (more common during pregnancy) or ear problems during pressure changes due to this congestion (RCOG, 2015) .

A change in air pressure or a decrease in humidity won’t cause your baby any harm. There is also no evidence to suggest that flying causes miscarriages, early labour or waters to break (RCOG, 2015) . If you have any health issues or pregnancy complications, discuss it with your GP or midwife before you decide to fly. They might advise you not to fly if you have:

• severe anaemia
• sickle cell disease
• significant vaginal bleeding
• a serious heart or lung condition that makes it difficult to breathe
• increased risk of going into labour before the due date
• increased chance of miscarriage or ectopic pregnancy  (request an ultrasound before flying)
• previous history of ectopic pregnancy, pelvic inflammatory disease, infertility and documented tubal pathology.

(Hezelgrave et al, 2011; RCOG, 2015)

Deep vein thrombosis (DVT) when pregnant and flying

A DVT  is a blood clot that develops in a deep vein in your leg or pelvis. It’s dangerous if a DVT travels to your lungs and causes a pulmonary embolism.

The risk of DVT increases when you’re flying and with longer flights because you are sitting down for a long time. You’re also at a higher risk of developing a DVT when you are pregnant and for up to six weeks after you give birth (RCOG, 2015) . Risk factors like a previous history of DVT and a high BMI can further increase your chance of developing a DVT.

Your doctor or midwife will be able to check your risk of developing DVT and advise you about flying.

How to reduce your risk of DVT

You can reduce your risk of DVT by:

• wearing loose clothing and comfy shoes
• getting an aisle seat and going for regular walks around the plane
• doing in-seat exercises every 30 minutes (ask your GP about how to do these)
• drinking plenty of water
• avoiding drinks containing alcohol and caffeine
• wearing graduated elastic compression stockings to help reduce leg swelling.

(RCOG, 2015; NHS Choices, 2016)

Flying when pregnant: general tips

• Take your hand-held pregnancy notes.
• Carry any medication in your hand luggage.
• Carry any documents confirming your due date and (if needed) that you are fit to travel. If you are 28 weeks pregnant or more, the airline you are travelling with might ask for a letter from your midwife or doctor stating your due date, that you’re in good health, have no complications and have a straightforward pregnancy.
• Carry your travel insurance documents with you too or make sure you have access to them if they’re on email.
• Carry your European Health Insurance Card (EHIC) with you if you are travelling to Europe. You can apply online for one for free .
• Seatbelt wise, it’s recommended that you strap your seatbelt reasonably tightly across the top of your thighs and then under your bump. If you need a seatbelt extension, ask cabin crew.

Travel vaccinations when pregnant – are they safe?

There’s no evidence of risk from vaccinations that contain inactivated virus, bacterial vaccines or toxoids when you’re pregnant (CDC, 2017) . However, avoid live vaccines like yellow fever because of the risk of contracting a disease that might harm your developing baby (Hezelgrave et al, 2011) .

If you need advice on specific travel vaccinations, contact your doctor or midwife. Some anti-malarial tablets are not safe to be taken during pregnancy, so consult your GP or midwife about those too (NHS Choices, 2016) .

This page was last reviewed in May 2018.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

CDC. (2017) Guidelines for vaccinating pregnant women. Available from: https://www.cdc.gov/vaccines/pregnancy/hcp/guidelines.html [Accessed 11th May 2018]

Hezelgrave NL, Shennan AH, Chappell LC. (2011) Advising on travel during pregnancy. BMJ.342. Available from: https://www.bmj.com/content/342/bmj.d2506.long [Accessed 11th May 2018]

NHS Choices. (2016) Travelling in pregnancy. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/travel-pregnant/#car-travel-in-pregnancy [Accessed 11th May 2018]

RCOG. (2015) Air travel and pregnancy. Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/air-travel-pregnancy.pdf [Accessed 11th May 2018]

Rodger MA, Walker M, Wells PS. (2003) Diagnosis and treatment of venous thromboembolism in pregnancy. Best Pract Res Clin Haematol. 16:279-296. Available from:  https://www.ncbi.nlm.nih.gov/pubmed/12763492 [Accessed 11th May 2018]

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Risk of Flying During Pregnancy and Miscarriage

T here is some connection between flying frequently as flight attendant and miscarriages

Recent studies have shown a slightly increased risk of miscarriage  among flight attendants, possibly due to cosmic radiation, work during sleep hours, and high physical job demands. However, m iscarriage  risk was not increased among flight attendants compared with teachers.

Spontaneous abortion or miscarriage is a very common problem regardless of occupation or activity. In the first month of pregnancy about half of the fertilized eggs do not survive, most because of lethal chromosome abnormalities. Once a woman misses her period and knows she is pregnant, 15% of the embryos miscarry naturally.

There are about 24 known medical problems that are responsible for pregnancy losses. Smoking and drinking increase the risk, as does thyroid disease and diabetes. The radiation exposures in flight are too low to contribute to the risk of abortion and the oxygen levels in a pressurized cabin are more than adequate for the mother and fetus.

Stress may be a factor, but it will vary with the individual. Studies performed in female flight attendants, show that  m iscarriage  risk was not increased among flight attendants compared with teachers.

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What Does and Doesn't Cause a Miscarriage

Can stress cause a miscarriage? What about sex, exercise, or certain foods? We spoke with experts about what causes a miscarriage—and what doesn't.

What Causes Miscarriage

The most common causes of miscarriage.

• What Doesn't Cause Miscarriage
• Is Miscarriage Ever the Pregnant Person's Fault?

Miscarriage is common. In fact, it's estimated that as many as 26% of all pregnancies end in miscarriage with the likelihood increasing with advancing age. While common, there is still a lot that people don't know about what causes a miscarriage. "Much misinformation is shared among women or passed down from older generations," says Jonathan Schaffir, M.D. , an assistant professor of obstetrics and gynecology at Ohio State University College of Medicine.

While most miscarriages are caused by things that are beyond the pregnant person's control like chromosomal abnormalities and underlying health conditions, many people continue to worry about inadvertently causing a miscarriage. Here's what you should know about what causes a miscarriage—and what does not.

The majority of miscarriages, especially in the first trimester, are caused by chromosomal abnormalities in the developing embryo or fertilized egg, explains the American College of Obstetricians and Gynecologists (ACOG). Beyond chromosomal abnormalities, there are other known causes of miscarriage.

Known Causes of Miscarriage

Known causes of miscarriage include:

• Chromosomal abnormalities
• Genetic factors
• Certain health conditions
• Hormonal disorders

Drug and alcohol use

• Uterine abnormalities
• Cervical abnormalities

Despite all that's known about what can cause miscarriage, there is still a lot that experts don't know. Even after a fertility evaluation for pregnancy loss, up to 50% of miscarriages are attributed to unknown causes.

Because the majority of people who conceive again after experiencing a miscarriage go on to have a healthy pregnancy, it's common to remain in the dark about what caused the miscarriage. Things may look a little different when you're dealing with recurrent miscarriage (two or more back-to-back pregnancy losses), at which point a health care provider may be more likely to recommend doing some testing to pinpoint a possible cause and determine the best course of action.

While it may be hard to pinpoint an exact reason behind a pregnancy loss, here's what experts do know about the most common causes of miscarriage and some of the factors that may increase a person's risk of having one.

Chromosomal abnormalities in the fetus

Research suggests that at least 50% of first-trimester miscarriages are caused by chromosomal abnormalities in the fetus.

"When the chromosomes of the egg and those of the sperm fuse to form an embryo, they usually pair up correctly," says Henry Lerner, M.D., an OB-GYN at Newton-Wellesley Hospital in Newton, Massachusetts. "But sometimes they get scrambled; if they're paired incorrectly, the embryo stops developing."

Chromosomal abnormalities don't mean that anything's wrong with the parents or their genes , and because chromosomal abnormalities in embryos are often random, one-time events, they're unlikely to happen again.

Certain health conditions in the pregnant person

Certain health conditions can cause miscarriage, especially those that restrict blood flow to the uterus. Chronic conditions that are associated with a higher risk of miscarriage include hypertension, diabetes, thyroid disease, lupus, and heart disease. Hormone-related disorders and autoimmune disorders like antiphospholipid syndrome (APS) have also been linked to miscarriage. Certain types of uterine infections and sexually transmitted infections (STIs) can also play a role.

Problems with the uterus or cervix such as fibroids and cervical insufficiency (when the cervix dilates too soon during pregnancy) can also lead to miscarriage.

Other health-related factors include certain medical procedures such as amniocentesis and chorionic villus sampling (CVS), which carry a very small risk of miscarriage (one of the reasons why these procedures are reserved for cases where the benefits outweigh the risks).

Caffeine is one drug that comes up a lot in the context of pregnancy. Let's be clear: One daily cup coffee during pregnancy is perfectly fine. It's when caffeine consumption gets higher that there may be a risk.

Much of the conversation about caffeine and miscarriage is based on a 2008 study that found that people who consumed 200 milligrams or more of caffeine a day had twice the miscarriage risk as those who didn't have any.

Since then, additional studies have demonstrated a connection between excessive caffeine consumption and miscarriage, but there isn't consensus about the nature and strength of the connection. The official stance of the ACOG is that it's safe for pregnant people to drink up to 200 milligrams of coffee per day, which is the amount of caffeine in about two 8-ounce cups of regular coffee.

While the research about caffeine and miscarriage risk is incomplete, the evidence is clear that drug and alcohol use can lead to miscarriage. "Exposing a fetus to large amounts of these chemicals on a regular basis can cause miscarriage because they have a poisonous effect on all those developing cells," says Dr. Schaffir. Substances that can lead to miscarriage include alcohol, illicit drugs, nicotine and tobacco products, and even certain prescription medications.

Researchers note that the risk of stillbirth is raised by 1.8 to 2.8 times with tobacco use, 2.3 times with marijuana use, 2.2 times with stimulants or prescription drug use, and even 2.1 times greater risk of miscarriage from passive exposure to tobacco.

What Doesn't Cause Miscarriage

While we know what things can cause or increase the risk of miscarriage, there are still plenty of myths surrounding miscarriage. We asked Dr. Schaffir to debunk some major misconceptions about miscarriages.

"It's important for [people] to understand that these are just old wives' tales—and not only are they not true but in some cases, believing them can affect your health and well-being," he says. Here are four things that don't cause a miscarriage.

Moderate exercise

Exercising or picking up a (reasonably) heavy object—such as a grocery bag, a toddler, or the like—are extremely unlikely to cause a miscarriage. In fact, the ACOG notes that exercise during pregnancy, with your doctor's approval, can have benefits during pregnancy.

That's because exercise reduces stress, relieves aches and pains, lowers your risk of pregnancy-related conditions like gestational diabetes, gestational hypertension, and preeclampsia, improves your overall fitness, and even builds up stamina for labor. As long as you're continuing exercises that you did pre-pregnancy and not suddenly taking on Olympic weightlifting, exercise during pregnancy is perfectly safe.

Everyday stress

While some studies on stress and miscarriage are conflicting, Dr. Schaffir says that everyday tension or anxiety—such as tight deadlines at work or worrying about what labor will be like—have not been linked to pregnancy loss. What's more, no studies have ever linked excessive bad moods to miscarriage, Dr. Schaffir adds.

Things get murky when dealing with major stress, though. "We're talking big things, like the death of a spouse or parent," he explains, and even then, the link is not well established. Plus, pregnant people who are under extreme stress may be more likely to smoke, drink, or do drugs to cope, which can also affect their risk of miscarrying.

Food that's properly cooked

While foods themselves don't cause miscarriage, certain foods come with higher risks of food-borne illnesses like listeriosis (an infection caused by the bacteria Listeria monocytogenes ).

The Food and Drug Administration (FDA) explains that cases of listeriosis and other food-borne illnesses have been linked to miscarriage and pregnancy complications, which is why experts recommend avoiding certain foods during pregnancy. For instance, pregnant people should avoid raw meat and fish, unpasteurized cheeses, and deli meat, all of which carry a higher risk of food-borne illness.

In general, all kinds of sex and sex acts including the use of sex toys are considered safe during pregnancy. The fetus is protected not only by amniotic fluid but also by the powerful muscles of the uterine walls. As long as the pregnancy is low risk, the fetus is developing on a typical track, and there are no concerns about pre-term labor or other complications, sex during pregnancy is likely safe. If you're concerned, however, don't hesitate to ask a health care provider.

Is Miscarriage Ever the Pregnant Person's Fault?

The vast majority of miscarriages occur because of chance chromosomal or genetic abnormalities in the embryo or fetus or, less commonly, hormonal imbalances or problems with the uterus or placenta, says Dr. Schaffir. These factors are nothing that a pregnant person has control over. It's natural for people experiencing loss to try to explain it in some way, even if that means blaming themselves. "But all [people] need to know that most of the time, a miscarriage is completely random," he says.

Dr. Schaffir adds that if you eventually want to try again, odds are you will conceive and have a healthy pregnancy. Of course, that being said, if you have any concerns, have had two or more losses in a row, or are over the age of 35, it's always a good idea to speak with a doctor who can help you plan your next steps.

Key Takeaways

The majority of miscarriages are caused by chromosomal abnormalities, which cannot be predicted or prevented. Most people who have had a miscarriage are able to conceive again and have a healthy pregnancy. If you experience repeated miscarriages or have any underlying health conditions, it's best to speak to a doctor about making a plan for pregnancy.

Miscarriage . Stat Pearls . 2022.

Early Pregnancy Loss . The American College of Obstetricians and Gynecologists. 2018.

Chromosomal instability in first trimester miscarriage: a common cause of pregnancy loss? . TP Translational Pediatrics . 2018.

Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study . American Journal of Obstetrics and Gynecology . 2008.

Relationship between maternal caffeine and coffee intake and pregnancy loss: A grading of recommendations assessment, development, and evaluation-assessed, dose-response meta-analysis of observational studies . Frontiers in Nutrition . 2022.

Association between stillbirth and illicit drug use and smoking during pregnancy . Obstetrics & Gynecology . 2014.

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Can Travel Cause Miscarriage

Traveling during pregnancy is a common concern for many expectant mothers, as potential risks and uncertainties arise. In this article, we explore the question: can travel cause miscarriage? We will examine various factors such as modes of transportation, duration, and precautionary measures to provide you with a comprehensive understanding of traveling safely during pregnancy. So, if you’re curious about the effects of travel on the well-being of both you and your baby, read on to gain valuable insights and put your mind at ease.

Table of Contents

Factors to Consider

When it comes to traveling during pregnancy, concerns about miscarriage can be a source of worry and confusion. However, it is important to understand that travel alone may not directly cause a miscarriage. There are various factors to consider in order to determine the potential risks and precautions to take when traveling while pregnant.

Understanding Miscarriages

Miscarriage, also known as spontaneous abortion, is the loss of a pregnancy before the 20th week. It is a common occurrence, with about 10-20% of known pregnancies ending in miscarriage. Miscarriages can happen due to many reasons, such as genetic abnormalities, hormone imbalances, uterine abnormalities, and maternal health issues. It is crucial to recognize that most miscarriages are not caused by external factors like travel, and are instead a result of biological processes.

Potential Risks of Travel During Pregnancy

While travel itself may not directly cause a miscarriage, there are certain risks associated with traveling while pregnant. It is essential to assess these risks and take appropriate precautions to ensure the safety and well-being of both you and your baby.

1. Mode of Transportation

The mode of transportation you choose for your journey plays a significant role in determining the potential risks. Air travel is generally considered safe for pregnant women, especially during the second trimester. However, it is advisable to check with your healthcare provider and the airline for any specific guidelines or restrictions. Long drives or train rides may be physically demanding and increase the risk of discomfort, fatigue, and potentially harmful situations such as accidents. Proper planning and taking breaks at regular intervals can help mitigate these risks.

2. Length of the Journey

The duration of your journey is another factor to consider. Prolonged travel, especially if it involves long hours of sitting or physical exertion, can put unnecessary strain on your body and potentially compromise your well-being. It is crucial to listen to your body and take breaks as needed to stretch, move around, and relieve any discomfort.

3. Destination and Accessibility to Healthcare

The destination you plan to travel to also plays a significant role in determining the potential risks. Being in a remote or less accessible location may limit your access to necessary healthcare in case of an emergency. It is important to research and ensure that adequate medical facilities are available in the area you are traveling to, should any complications arise.

4. Physical Discomfort and Stress

Traveling while pregnant can lead to physical discomfort, including backaches, swollen feet, and increased fatigue. Additionally, the stress and anxiety associated with travel, such as navigating through unfamiliar places or dealing with delays, can further exacerbate these discomforts. Maintaining a comfortable posture, wearing loose and comfortable clothing, and practicing relaxation techniques like deep breathing and meditation can help alleviate physical discomfort and manage stress levels.

5. Exposure to Environmental Hazards

During your travels, you may be exposed to various environmental hazards that can potentially impact your pregnancy. Factors like extreme temperatures, high altitudes, certain chemicals, infectious diseases, and radiation should be taken into consideration. It is important to research your destination and take necessary precautions to minimize exposure to such risks.

6. Medical Conditions and Complications

If you have pre-existing medical conditions or complications during your pregnancy, it is essential to consult with your healthcare provider before embarking on any travel plans. Conditions such as gestational diabetes, hypertension, and placental abnormalities may require additional precautions or restrictions when it comes to traveling. Your healthcare provider can provide personalized advice based on your specific situation.

Precautions to Take Before Traveling

To ensure a safe and comfortable journey, it is important to take certain precautions before traveling during pregnancy.

1. Consultation with a Healthcare Provider

Before making any travel plans, it is crucial to consult with your healthcare provider. They will be able to evaluate your specific situation, address any concerns, and provide personalized advice. They may also recommend certain medical tests to ensure that you and your baby are in good health to travel.

2. Timing of the Trip

Choosing the right time to travel during pregnancy is important. The second trimester, which is usually between weeks 14 and 28, is often considered the safest period for travel. During this time, the risk of miscarriage is lower, morning sickness has often subsided, and the energy levels are typically higher. However, every pregnancy is unique, and it is essential to consult with your healthcare provider to determine the ideal timing for your trip.

3. Packing Essentials

When preparing for your journey, it is essential to pack the necessary essentials for a comfortable and safe trip. This may include loose and comfortable clothing, comfortable shoes, any prescribed medications, prenatal vitamins, medical records, and insurance information. It is also advisable to carry a copy of your healthcare provider’s contact information and any necessary documentation related to your pregnancy.

4. Stay Hydrated and Rested

During travel, it is crucial to prioritize hydration and rest. Proper hydration helps maintain healthy blood flow and prevents dehydration, which can lead to discomfort and potential complications. Adequate rest helps reduce fatigue and ensures overall well-being. Make sure to drink plenty of water and take regular breaks to rest and rejuvenate.

5. Manage Stress Levels

Traveling can be a stressful experience, and managing stress is particularly important during pregnancy. Engaging in activities that promote relaxation, such as gentle exercises, mindfulness, or listening to calming music, can help alleviate stress. It may also be beneficial to plan your itinerary in a way that allows for flexibility and minimizes time constraints, reducing unnecessary pressure and stress.

While travel alone may not directly cause a miscarriage, it is important for pregnant women to consider the potential risks and take necessary precautions to ensure a safe journey. Factors such as mode of transportation, length of the journey, destination, physical discomfort, exposure to environmental hazards, and medical conditions need to be evaluated and addressed. By consulting with a healthcare provider, timing the trip appropriately, and taking necessary precautions, pregnant women can enjoy their travels while prioritizing their health and the well-being of their baby. Remember to listen to your body, stay hydrated, get plenty of rest, and manage stress levels to make the journey as comfortable as possible.

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Can flying cause miscarriage: precautions to take

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Table of contents

True or false: flying can cause a miscarriage, when is the safest time to fly during your pregnancy tips to fly safely, can you fly at seven, eight or nine months pregnant (third trimester), what are the risks associated with flying while pregnant, how to reduce your risk of dvt while flying when pregnant, are there any circumstances when flying is not advised during pregnancy, commercial medical escort- a cost-effective solution for a safe flight, air ambulances – your safest way to fly while being pregnant, contact us for a free quote now.

Many aviation health experts and healthcare specialists agree that pregnant women and their unborn children face no particular risks when flying commercially. However, this statement only applies to healthy pregnancies. What about pregnant women who have underlying medical conditions? Is it dangerous for them to fly? Can it result in a miscarriage? This article helps unravel the true from the false when it comes to air travel and pregnancy .

Can flying cause miscarriage: the top things to know when flying when pregnant

• There is no concrete evidence that flying endangers the fetus or the expectant mother's health in case of a normal pregnancy. Furthermore, there is no evidence that flying causes miscarriages, premature labor, or uterine rupture.
• Expectant mothers may find flying uncomfortable during certain stages of their pregnancy. Because of the pressure changes caused by this congestion, they may experience pregnancy sickness, swollen legs, nasal congestion, or ear pain.
• Women who are considered high-risk for miscarriage or have a history of miscarriage should postpone first-trimester travel plans until they receive the "all clear" from their ob-gyn.

Is the tropical sun beckoning you and your baby bump? Getting on a plane and flying for hours on end is generally considered more of a nuisance than a health risk. However, when it comes to a woman traveling for two, the stakes are a little higher.

For decades, scientists have speculated that long-haul flights may increase the risk of complications and miscarriage during pregnancy, arguing that increased exposure to radiation, low oxygen levels , and other conditions aboard some aircraft may harm a developing fetus. A few recent studies have investigated the claim, but none have been able to confirm it.

So, what is the answer to the question, “Can flying cause miscarriage”? If you have a normal pregnancy, then the most common answer is ‘No, flying will not cause a miscarriage’. However, the situation is different if you have complications or are a higher risk of miscarriage. Get the advise of your doctor before flying.

According to an extensive study on air travel and pregnancy, published in 2015 by the Royal College of Obstetricians and Gynecologists of the United Kingdom, “flying does not endanger the health of the fetus or the expectant mother. There is also no evidence that flying causes miscarriages, early labor, or uterine rupture.”

Air travel is the safest mode of transportation for pregnant women, according to the research. A change in humidity or air pressure will not harm the baby. Similarly, a slight increase in radiation during infrequent flights is not considered hazardous to either the mother or her child. This, however, only applies to healthy women who are carrying a normal pregnancy .

At certain stages of their pregnancy, expectant mothers may find flying uncomfortable. For example, they may experience pregnancy sickness, swollen legs, nasal congestion, or ear pain because of the pressure changes caused by this congestion.

Can you fly at one, two or three months pregnant (first trimester)?

There is no evidence that flying causes miscarriage during the first trimester, even though the fetus is most vulnerable until after the 12th week of pregnancy.

Caution: If a complication arises during your flight, keep in mind that there will be no on-board medical assistance available.

1 st month: There are no obvious physical changes or actual physiological disruptions at this stage, so you can travel without putting your child's development at risk.

2 nd month: Air travel is not contraindicated, but keep in mind that flying during this stage of pregnancy is not always pleasant and can be stressful. Symptoms such as heartburn, bloating, heavy fatigue, and nausea tend to increase tenfold during the flight.

3 rd month: Flying is not a problem at this stage of pregnancy. However, nausea and vomiting are common during the third month, which can worsen with altitude and make flying uncomfortable. Furthermore, your uterus, which has grown to the size of a grapefruit, presses against your bladder, increasing the frequency with which you must urinate.

It is important to note that while the risk of miscarriage is higher during the first trimester of pregnancy, the plane has no effect on this.

Can you fly at four, five or six months pregnant (second trimester)?

If you're planning a trip during your second trimester, you're in luck - it's considered the safest time to fly. This is primarily because the second trimester has a lower risk of pregnancy-related complications , including miscarriage, than the first and third trimesters.

4 th month: Usually, at this point in your pregnancy, you are feeling less tired, less nauseous, and vomiting is a distant memory. This is an excellent time to fly! Stay hydrated, stretch your legs every hour , and sit comfortably in your seat to enjoy the flight.

5 th month: Your fetus is always moving! The only disadvantage is that their sleeping hours may differ from yours or from your flight schedule. Consider booking a seat with lots of legroom . Sleep is essential whenever there is a chance to relax.

6 th month: Pregnant women can travel by air without restriction. However, from the 23rd week onwards, expectant mothers are prone to hot flashes and excessive sweating. Remember to dress comfortably in light and loose clothing . Make regular round trips between the front and back of the aircraft during the flight to stretch your legs and increase blood circulation.

It is safe to fly during the third trimester, but you should avoid doing so after 37 weeks, or 32 weeks in the case of an uncomplicated twin pregnancy . This is because you could go into labor at any time after those dates.

Important: Always check with your airline before flying. Many airlines place restrictions on pregnant women traveling after 28 weeks.

7 th month: The baby will be unaffected by the trip. Before booking airline tickets, purchase health and repatriation insurance as a precaution. Fasten your seat belt under your abdomen. Place a cushion between the lower belt strap and your baby bump to avoid pressure on the uterus . Sit in your seat with your legs extended, so you can move your ankles and toes. Try to walk as much as possible during the flight.

8 th month: Your child is all set to point the tip of his nose. If you want to fly at this point in your pregnancy, consult with your doctor or midwife to ensure you'll be able to do so.

9 th month: The World Health Organization (WHO) advises pregnant women not to fly after the 36th week of pregnancy, or 4 weeks before the due date . Because labor can start at any time during the last few weeks, it is best to avoid traveling during this time.

Did you know that? Flying at the end of a pregnancy is not advised, not because of an increased risk of water ruptures at altitude, but because the delivery may be triggered prematurely.

A deep vein thrombosis (DVT) is a blood clot that forms in your leg or pelvis. It can be fatal if it travels to your heart ( heart attack ) or your lungs (pulmonary embolism).

Because of the prolonged sitting, there is an increased risk of developing a DVT while flying. The risk of DVT also increases as the flight lengthens . If you have additional risk factors, such as a previous DVT or being overweight, your risk is heightened.

Caution: When you are pregnant and for up to 6 weeks after your baby is born, you are at a higher risk of developing a DVT than other women. Your doctor or midwife can assess your personal risk of developing DVT and advise you on flying.

It is unlikely that you will need to take any special precautions if you are flying for less than four hours. To reduce the risk of DVT on a medium or long-haul flight (more than four hours), you should:

• Avoid alcohol and caffeine-containing beverages;
• Invest in graduated elastic compression stockings;
• Dress comfortably. Wear loose clothing and comfortable shoes;
• Drink plenty of water at regular intervals throughout your flight;
• Try to get an aisle seat and walk around the plane every 30 minutes or so. Do in-seat exercises every 30 minutes or so.

Once a heartbeat is detected on ultrasound at around 6 or 7 weeks of a pregnancy, the risk of miscarriage decreases significantly, making travel less stressful. Women who are considered high-risk for miscarriage or who have a history of miscarriage, on the other hand, may want to postpone first-trimester travel plans until they receive the "all clear" from their ob-gyn.

A medical condition or health issue can complicate your pregnancy and endanger both you and your baby. As a result, if any of the following apply, you should avoid flying:

• You have severe anemia ;
• You have sickle cell disease;
• You have an increased chance of miscarriage;
• You have recently had significant vaginal bleeding;
• You are at increased risk of going into labor before your due date;
• You have a previous history of ectopic pregnancy (request an ultrasound before flying), pelvic inflammatory disease or documented tubal pathology
• You have a serious condition affecting your lungs or heart that makes it very difficult for you to breathe;

Did you know that? Flying is not recommended for patients suffering from serious lung conditions such as COPD , pneumonia , or pneumothorax .

With decades of experience providing air ambulance services, we can handle the most complex and critical cases while also providing the safest and most cost-effective solution for transporting expecting mothers safely to their destination.

To that end, we offer commercial medical escort services for patients who don't need a full air ambulance but still need medical supervision while flying commercially. When the patient is fit to fly , these services are available for all domestic and international commercial flights.

We can assist the patient and their family schedule an appropriate commercial flight, purchase tickets, arrange ground transportation, and file the necessary paperwork with the airlines.

The patient will be accompanied on the commercial flight by a member of our highly skilled medical crew who has received extensive training in altitude and physiology, as well as safety in that environment.

If you or a loved one is interested in a medical escort, please contact us right away!

Since our inception, we have been providing air medical transportation to patients, ranging from basic intra-state air ambulance transports to international medical flights . We specialize in transporting patients with the same level of care as a hospital ICU to and from hospitals, rehabilitation centers, specialized care facilities, and private residences.

Our medically configured ambulance jets are equipped with cutting-edge medical technology, and our medical flight teams have the most advanced training and experience in treating pregnant women . Each air medical transport has, at least, a two-person crew that includes a critical care trained flight doctor and a flight paramedic or pregnancy-related therapist.

We recognize that selecting an ambulance service can be a difficult and perplexing decision. We are dedicated to treating our patients like members of our own family. We will manage and organize all aspects of transportation. Our crews will accompany the patient from the time they are picked up until they arrive at their destination with our bedside-to-bedside service.

The benefits of chartering an ambulance jet with us include:

• Medically configured medical jets ;
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• Ground transportation on both ends;
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Are you looking for an air ambulance service to arrange a long-distance patient transportation? Please get in touch with our multilingual team so we can advise you on the best mode of transportation for your needs. Our helpful experts will respond as soon as possible to provide you with a free, non-binding quick estimate for your trip.

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Can Falling During Pregnancy Cause a Miscarriage?

• Early Pregnancy
• Later in Pregnancy

It is one of those conventions you may have seen in movies: A pregnant woman falls down a flight of stairs and ends up in critical condition. But, are situations like this merely cinematic drama, or can miscarriages really happen after a fall?

The simple answer is that, yes, trauma can lead to the unfortunate loss of pregnancy. The actual risk is largely influenced by the stage of pregnancy and the severity of the accident.

The female body is built to withstand a certain amount of bumps and bruises when carrying an embryo or fetus. However, certain circumstances or conditions increase the likelihood of miscarriage (loss within the first 20 weeks) or stillbirth  (loss after the first 20 weeks) following an injury .

A Fall in Early Pregnancy

Generally speaking, a fall during the first trimester is not as likely to lead to miscarriage. During the first trimester, the uterus has a thick wall and is protected by the bones in the pelvic girdle. In the second trimester, a high volume of amniotic fluid surrounds the baby, offering added protection as well.  

Falling Later in Pregnancy

As pregnancy progresses, the uterus stretches and grows larger in size. By the third trimester, the uterus has a thin wall and the baby is positioned in a prominent area. Blunt trauma in the third trimester is more likely to cause a placental abruption  (where the placental lining is separated from the uterus).  

Unfortunately, falling is more common in the third trimester. As your belly grows, your center of gravity shifts forward, making it harder to stay balanced. Pregnancy hormones, specifically the hormone relaxin, can also make you feel unsteady on your feet.

Relaxin is produced by the body to relax the ligaments in the pelvis and to soften and widen the cervix in preparation for delivery. As a result, joints are looser during pregnancy, increasing the chance of falling.

The Severity of the Fall

How hard you fall will impact how much damage is felt by you and your baby. Injuries in pregnancy may be classified as minor or major. Although minor injuries are less severe, they are also much more common. Nine out of 10 injuries reported by pregnant women are considered minor. Still, these minor injuries represent 60% to 70% of the total fetal losses associated with trauma.  

Minor trauma does not involve the abdomen, and the patient doesn't experience pain, loss of fluid, vaginal bleeding, or a reduction in fetal movement. By contrast, major trauma involves the abdomen along with strong forces, including deceleration, shearing, or rapid compression (all of which would more likely occur in a car accident, not a fall).

What to Do If You Fall During Pregnancy

If you are pregnant and experience a fall or other minor injury, call your doctor to assess the potential harm. Even if you don't think your injury was a big deal, you're better off being safe than sorry, especially in the latter stages of pregnancy.

If you have abdominal or back pain, cramping, dizziness, are experiencing contractions, or have any vaginal discharge or bleeding , call your doctor immediately and go straight to the emergency room.

Under no circumstance should you wait to report an injury if you notice decreased fetal movement . An evaluation will need to be made using an ultrasound, external fetal monitoring (EFM), or other diagnostic and imaging techniques.

A Word From Verywell

Accidents during pregnancy can be unsettling, to say the least. Try to keep in mind that in the vast majority of cases, both you and your baby will be fine. Talk to your doctor right away, even after a minor injury, for peace of mind and to ensure that you receive a proper evaluation in a timely manner.

Murphy NJ, Quinlan JD. Trauma in pregnancy: Assessment, management, and prevention . Am Fam Physician . 2014;90(10):717-22.

By Krissi Danielsson Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. 

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Can flying cause a miscarriage? Tips for a smooth pregnancy

Travelling with a healthy pregnancy is possible. However, flying can cause a miscarriage in case of complications. Check out how to fly safely when pregnant.

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Table of contents

Flying can cause a miscarriage: a myth or reality, the dangers of dvt for pregnant women while flying, when not to fly to prevent a miscarriage, what to do in case of a complication abroad during your pregnancy, flying whilst pregnant: travelling via an air ambulance for pregnant women, added benefits of travelling on an air ambulance for pregnant women, contact us for an air ambulance.

The number of precautions that pregnant women need to take when carrying a baby can be overwhelming for some. Rightly so since two lives are at risk. To ease the mind of those having travel plans, we explore the popular belief that flying may cause a miscarriage.

Debunking the myth that flying can cause a miscarriage

Looking at the risks of a miscarriage when flying, this article will explore whether it is safe for pregnant women to fly in case of an uncomplicated pregnancy. However, a pregnancy being unpredictable, there are certain precautions that must be taken and flying commercially is not recommended in case of complications. In all cases, a flight via an air ambulance is almost always possible, especially thanks to advanced safety technology.

An expectant mother cannot be blamed if she is worried about flying during her pregnancy. With the number of claims flying around left and right, there are bound to be confusion and concerns, the main one being whether ‘flying may cause a miscarriage?’

What are the factors inherently connected to flying that lead to the claim that flying can cause a miscarriage?

• The lower air pressure and oxygen level in the plane cabin
• The cosmic radiation during high altitudes flights

Nonetheless, researchers and health professionals point out that there is no evidence demonstrating that changes in air pressure prevent oxygen from reaching the fetus or cause harm to the baby . Similarly, radiation from occasional flights poses no risk to mothers and their baby.

As Sarah Reynolds, consultant obstetrician and gynaecologist at the Bedford Hospital NHS Trust advanced, “If your pregnancy has no complications then there's no reason why you can't travel safely, as long as you take the right precautions”.

However, there are certain risks in case of complications during the pregnancy and if the appropriate precautions are not taken .

The most common risk to pregnant women when flying is Deep Vein Thrombosis (DVT). DVT is a blood clot that usually forms in your leg and pelvis and that can travel in the bloodstream in the body. A DVT becomes dangerous, even life-threatening, if the blood clot travels to your lung , causing pulmonary embolism. It may also get stuck and block the blood flow to an important organ or limb.

What expectant mothers should be aware of is that while they are pregnant and for up to six weeks after the birth of their baby, the risk of developing DVT is higher in comparison to others. This is further exacerbated by the fact that during a flight, you are seated for a prolonged amount of time. The longer the flight, the higher the risk .

Besides DVT, there are other medical conditions or complications that prevent you from flying to avoid any risk of a miscarriage.

While the act of flying in itself might not lead to a miscarriage, the combination of other risk factors might cause a serious threat. That is why your doctor would advise you against flying in case of:

• Severe anaemia
• Sickle cell disease
• Recent significant vaginal bleeding
• Breathing difficulties following a lung problem
• An ectopic pregnancy
• Increased chance of a miscarriage
• Increased risk of going into labour before your due date
• A previous history of ectopic pregnancy, inflammatory disease, infertility or tubal pathology.

The problem with flying when pregnant is that in case of a complication, there would be no medical professional, such as a doctor or a paramedic, onboard the flight to help you out . Another impediment is the lack of medical equipment which might be necessary to offer the appropriate treatment in some cases.

The possibility of a medical complication occurring during your pregnancy while you are abroad on holiday should not be eliminated. What to do in the case of high blood pressure during your holiday in Italy? What about preeclampsia?

In matters related to pregnancy, for your safety and that of your unborn baby, it is better to seek medical care immediately . After receiving emergency care, you should weigh the pros and the cons of remaining abroad. The following are questions that you should ask yourself:

• Is the quality of care available and the healthcare system better than the NHS?
• How affordable is the healthcare system? Can I afford the treatment long-term?
• Will I obtain more efficient treatment from a doctor who is familiar with my case?
• Where are my previous reports/ history related to the pregnancy?
• Will I be able to rest and recover more quickly at home?
• Are there friends and relatives to take care of me and provide moral support here?

After deliberation, if you decide to get back to the UK, can you do so on a commercial flight? In case of a complication, considering the lack of medical equipment and healthcare professionals onboard, it is better to travel via an air ambulance . Indeed, commercial airline staff are not qualified or experienced to deliver effective treatment and care.

Note: Most airline companies would not allow you onboard a commercial plane after 28 to 35 weeks for international travel, even if you do not have any complication.

Medical Repatriation UK has air ambulances that help patients travel both short and long-distances safely. These are medical planes that are equipped with the latest medical equipment and with doctors and paramedics on board.

The medical equipment is similar to that available in an Intensive Care Unit . As such, even ICU patients can travel safely, knowing that they are taken care of, in the air ambulances of Medical Repatriation UK. When it comes to pregnant women, we make sure that we equip our medical flights with the necessary equipment based on their condition . We can even have a gynecologist as our air ambulance doctor to provide the necessary specialist care and treatment.

Doctors prescribe bed rest to pregnant women to prevent complications related to the baby’s growth and other issues such as vaginal bleeding or preterm labour . Moreover, in case of a medical complication, pregnant women are advised to complete bed rest. However, the act of flying commercially can be very tiring. For instance, it involves waiting in long lines during boarding and having to reach the airport hours earlier.

Nonetheless, with air ambulances, this issue is eliminated. Pregnant women can have complete bed rest even if they are flying . With an air ambulance, there is no need to wait in line to check-in. You will enter the airport via a separate entrance and get into the air ambulance directly.

Moreover, we offer a bed-to-bed service . This involves picking you up from your hotel room/hospital and taking you to the airport. We can literally carry you to the ground ambulance in case you cannot move . The same process is applicable once you land in the UK as well.

Our air ambulances operate in any part of the world, and depending on your situation, can usually be deployed the following day of the booking process.

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Viral Infections That Increase the Risk of Miscarriage

Dr. Chelsea Hetherington, Ph.D.

With the recent COVID-19 pandemic and outbreaks of infections like monkeypox, many pregnant women and families might be concerned about viral infections that might contribute to pregnancy loss.

Unfortunately, there are several types of viruses that can increase the risk of miscarriage or stillbirth. It’s important to stay informed of virus infections that can cause pregnancy complications, as well as what you can do to reduce your risk factors for adverse pregnancy outcomes.

1. Zika Virus 

Zika virus is commonly thought to cause fetal abnormalities, like microcephaly, but researchers have recently found that it may also lead to miscarriages and stillbirths as well. Zika virus commonly spreads through mosquito bites, which is why many doctors recommend that pregnant women avoid traveling to countries where the Zika virus or other infectious diseases are prevalent.

Unfortunately, there is no vaccine or known treatment for Zika virus, making it all the more important to exercise caution in where you travel. Even if you aren’t currently pregnant, if there is a chance you could become pregnant, you should take precautions to avoid contracting the Zika virus because it can cause problems even in very early pregnancy. 

2. Parvovirus B19 

Parvovirus can cause a condition called fifth disease. Fifth disease is very mild and many people contract it in childhood without even realizing it, giving them immunity into adulthood.

Although it’s rare, the CDC reports that roughly 5% of pregnant women who contract fifth disease will have a miscarriage. Your doctor can conduct a blood test to see if you already have immunity to parvovirus from previously coming into contact with the virus.

3. Rubella 

Rubella - aka ”German Measles” is a virus that many adults are already vaccinated against through the MMR vaccine, making it a relatively uncommon virus. Rubella can cause miscarriage or birth defects if contracted in the first trimester. If you did not receive the MMR vaccine as a child and are planning to become pregnant, talk to your healthcare provider about getting vaccinated now. Your doctor can also run a blood test to check whether your body has antibodies to protect you from contracting rubella.

4. Herpes Simplex Virus 

Herpes simplex virus is a virus that’s transmitted by coming into contact with a person carrying the virus. In most cases, herpes simplex virus does not lead to miscarriage. Scientists still need to do more research to better understand how herpes simplex virus may or may not contribute to miscarriage risk.

5. Chlamydia 

Much like herpes simplex virus, chlamydia is a sexually transmitted infection that can increase the risk of pregnancy complications. In particular, chlamydia can cause an increased risk of ectopic pregnancy and miscarriage.

Although it‘s possible to have chlamydia and not show any symptoms, common symptoms of chlamydia include vaginal discharge, itching, and pain during sex or during urination. If you believe you may have contracted chlamydia, it’s important to talk to your healthcare provider about treatment options. Chlamydia is a very treatable infection that can easily clear up with a course of antibiotics.

6. Cytomegalovirus 

Cytomegalovirus - aka CMV - is a common virus that’s similar to several other common viruses, namely herpes simplex virus and chicken pox. CMV infection can stay dormant in the body for a long time, becoming active many years after infection. CMV infection is spread through bodily fluids and can be transmitted from mom to baby during vaginal childbirth. Scientists aren’t quite sure whether CMV increases the risk of miscarriage, but it can cause problems after birth. While most babies won‘t have any negative outcomes from contracting congenital CMV, some will have more negative outcomes.

7. COVID-19 

Despite a flurry of new research, there’s still a lot that we don’t know about COVID-19. One thing that researchers have found is that COVID-19 can cause problems for pregnant women, especially in the first trimester of pregnancy. One study found a relationship between early pregnancy loss and COVID-19 infection. Although more research is needed, it’s still a good idea to be up to date on COVID-19 vaccinations, which the CDC says is safe for pregnant women.

Other Infections to Avoid 

While the above conditions are all considered viruses, there are also some bacterial infections that pregnant women should avoid. There are also some viral infections that don’t lead to miscarriage, but can still cause serious congenital birth defects.

Listeria is a food-borne illness and is a leading cause of food poisoning in the United States. When a pregnant woman comes into contact with listeria, she may develop listeriosis, which can cause miscarriage, preterm birth, or stillbirth. Protect yourself against potential listeria exposure by avoiding consuming unpasteurized milk, deli meat, sushi, and soft cheeses.

Toxoplasmosis 

Toxoplasma is a bacteria that is commonly found in cat feces. Toxoplasmosis interferes with fetal development and can lead to congenital birth defects and miscarriage. If you are a cat owner, avoid changing the litter box while pregnant!

Chicken Pox 

Varicella is the virus that we commonly call chicken pox. Chicken pox is a highly contagious virus that you may contract after coming into contact with an infected person. Many people carry immunity to chicken pox either from contracting it as a child or receiving a vaccine.

Hepatitis is an inflammatory viral infection that impacts the liver. While hepatitis is not associated with a hihger risk of miscarriage, it can cause preterm birth. Hepatitis is also dangerous because it can be passed from mother to baby through the placenta.

What You Can Do to Lower Your Risk 

The best way to be prepared for potential risk is to have a better understanding of that risk. If you are immunocompromised or have other conditions that make you a high risk for any of these infections, consider talking to your healthcare provider about your concerns.

Also make sure that you’re up to date on all the necessary vaccinations, including getting your yearly flu shot. Follow your healthcare provider’s recommendations on things like medications, supplements, travel, and vaccinations. Your healthcare provider may also be able to recommend things you can do to boost your immune response to fight off infection.

You can also be sure to practice good hygiene practices throughout your pregnancy, like washing your hands regularly and cooking meat until it’s well done. Try to stay away from people who are unwell while you are pregnant, and consider wearing a mask while out in public.

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What Does a Miscarriage Look Like?

Miscarriage blood is brighter red and has larger clots than period blood

• How It Feels
• Ultrasound Imaging
• Period vs. Miscarriage Clots
• Confirming a Miscarriage
• Managing Blood Loss
• Multiple Miscarriages

Cramping or bleeding during early pregnancy may cause worry and have you wondering if what you're seeing is a miscarriage. Miscarriages early in pregnancy can cause similar symptoms to a period, including bleeding and cramping, so you may wonder how to know if you miscarried.

If you have large blood clots, it may be due to a miscarriage. Talking to your healthcare provider about your symptoms can help determine if you have had a miscarriage.

Continue reading to learn how a miscarriage looks, what occurs, and how it feels. 

Illustration by Tara Anand for Verywell Health

Appearance of Miscarriage Tissue and Bleeding

The most common sign of miscarriage is bleeding. Some bleeding during pregnancy is common, but not normal. This type of bleeding is usually light. If your bleeding is equal to or heavier than a period, you may be having a miscarriage. 

In addition to bleeding, you may notice other discharge as you wipe or in the toilet bowl that can indicate a miscarriage. These can include:

• Blood clots that are reddish and jellylike and about the size of a dime up to the size of a lemon
• Bright red blood
• Brownish discharge similar to coffee grounds, signifying dried blood
• Clear or pink fluid gushing from the vagina
• White or gray tissue that may indicate fetal remains (most noticeable between eight and 12 weeks' gestation)

A Word From Verywell

Bleeding during pregnancy doesn't always mean miscarriage so it's important to be evaluated by your healthcare provider. About 15% or more of pregnancies do result in early miscarriage and, unfortunately, the majority of the time, it's not predictable or preventable.

Beyond Appearance: How Miscarriage Feels

Most people who miscarry experience cramps. You might feel these in your stomach, or lower back. Some people experience intense cramps that are worse than period cramps, while others have very mild cramping that doesn’t compare to a period. You may also experience cramps that come in waves, similar to contractions. 

How Much Bleeding Is Normal?

Miscarriage bleeding can be heavy. However, if you are filling more than two pads per hour for two consecutive hours or are passing clots that are larger than a lemon, you should contact your healthcare provider or go to a hospital emergency room. It’s also important to see a healthcare provider if you have a fever or chills, which can indicate an infection.

Once cramping begins, it’s usually quickly followed by bleeding. Heavier bleeding typically lasts for two to four hours in most cases. After that, you will continue to bleed and spot for four to six weeks, but you won’t continue to pass large clots or tissue (if you do, reach out to your healthcare provider).

In addition to physical pain, miscarriage can trigger emotional pain. Dealing with an unexpected miscarriage can be very distressing, and some people find it helpful to have a support person nearby as they’re going through it.

How Miscarriage Looks on Ultrasound

Most people who experience miscarriage have pain and bleeding. Some people, however, have no symptoms. This is known as a missed miscarriage , and it’s believed to occur in about 3% of pregnancies (compared to about 20% of pregnancies for typical miscarriages).

Oftentimes, missed miscarriages are diagnosed when you go for a routine ultrasound. On an ultrasound, a miscarriage is clear because the embryo or fetus has no heartbeat. Also, the fetus often measures smaller than the pregnancy’s gestational age since it has stopped developing. 

If you are unsure whether you’re having a miscarriage, your healthcare provider may suggest an ultrasound to confirm whether the fetus is still developing. 

Period Blood Clots vs. Miscarriage Clots

Period clots and miscarriage clots are quite similar. Both are small clumps of blood that are often bright or dark red with a gel-like consistency. However, there are some differences, such as:

• Miscarriage clots are often larger, and may be as big as a lemon. 
• Miscarriage clots may include white or gray tissue.

In addition, during your period, you may pass clots for days. During a miscarriage, most of the tissue passes during a two- to four-hour window in which you experience the most intense bleeding.

How to Confirm If You Miscarried

The quickest way to confirm whether you miscarried is to call your healthcare provider and ask for an ultrasound. However, if you are very early in pregnancy, it may be hard to tell. That’s because the fetus’s heart doesn’t start beating until the sixth week of pregnancy, so the typical way of diagnosing miscarriage—by the lack of a heartbeat—wouldn’t work before then.  

Managing Blood Loss From Miscarriage 

Although the bleeding associated with miscarriage can seem like a lot, most people don’t need medical treatment for blood loss. However, you should see your healthcare provider or seek emergency care if you:

• Soak through more than two pads per hour
• Pass clots larger than a lemon
• Have a fever or chills
• Have intense pain
• Experience intense, prolonged sadness

Managing Emotions of Miscarriage

A miscarriage is a loss, and it’s normal to have strong emotions. You may even find yourself moving through the stages of grief and mourning . Remember, miscarriages are common and not your fault. In most cases, people go on to have healthy pregnancies. If you need mental health help, reach out to support groups and therapists. 

Multiple Miscarriages: What to Know

In most cases, people who have had multiple miscarriages will go on to have a healthy pregnancy. In fact, even if you’ve had three miscarriages in a row, there’s a 70% chance your next pregnancy will go to term.

Still, healthcare providers recommend seeking treatment after you’ve had three miscarriages (or after two if you’re 40 or older). Healthcare providers can do testing to look for possible causes of these recurrent miscarriages, and they may offer treatments that can help with future pregnancies.

Miscarriages can look and feel like a period, although they can also feel more intense and bring heavier bleeding. If you’re having a miscarriage you might notice cramping, followed by two to four hours of heavy bleeding. You’ll likely see clots and may notice gray or white tissue.

If you have an ultrasound, it will show that the fetus has no heartbeat. It also may show the fetus is smaller than expected because it has stopped developing. While the physical pain of a miscarriage usually passes within a day, the emotional pain can last much longer. It's important to take care of your mental and physical health at this time. 

Planned Parenthood. How do I know if I’m having a miscarriage?

UC Davis. What are the signs of early miscarriage?

American College of Obstetricians and Gynecologists. What happens after a miscarriage?

Pandya PP, Snijders RJ, Psara N, et al.  The prevalence of non-viable pregnancy at 10-13 weeks of gestation .  Ultrasound Obstet Gynecol . 1996;7(3):170-173. doi:10.1046/j.1469-0705.1996.07030170.

By Kelly Burch Burch is a New Hampshire-based freelance health writer with a bachelor's degree in communications from Boston University.

Traveloka Team

12 Jun 2024 - 6 min read

Is Flying Safe During Pregnancy? Essential Tips Every Mother Should Know

Flying during pregnancy can be a cause of concern for many expectant mothers. With the right knowledge and precautions, air travel can be safe and manageable. We will explore essential tips to ensure a smooth and comfortable journey for you and your baby. From understanding the best trimester for flying to packing essentials and managing potential discomfort, we've got you covered. Whether it's your first time flying while pregnant or you're a seasoned traveler, these tips will help alleviate any worries and make your trip as stress-free as possible. Ready to plan your next adventure? Trust Traveloka for easy booking of activities, flight , and hotel so you can focus on enjoying your journey with peace of mind.

Safe Air Travel During Pregnancy

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First Trimester: Flying Safely During Early Pregnancy

Early pregnancy can be a delicate time. While flying itself doesn't raise miscarriage risks, some women experience increased nausea. Discussing your travel plans with your doctor is crucial. If you get nausea, consider remedies like ginger or acupressure. Opt for an aisle seat for easier access to the restroom and pack healthy snacks to keep your blood sugar stable. Staying hydrated is important throughout pregnancy, but especially during air travel.

Second Trimester: Ideal Time for Air Travel During Pregnancy

The second trimester is often seen as the golden age for flying while pregnant. Morning sickness usually subsides, and you likely have more energy. However, it's still important to get your doctor's green light before booking your flight. Many airlines have policies restricting travel in the later stages of pregnancy, so choose one with a clear policy that aligns with your due date (usually around 36 weeks). Opt for an aisle seat with extra legroom for more comfort and stretching. Continue to drink plenty of water to avoid dehydration and wear loose-fitting clothes that allow for movement.

Third Trimester: Precautions and Considerations for Late Pregnancy Travel

As you enter the home stretch of pregnancy, airlines typically restrict travel due to potential complications. This often starts around 36 weeks for single pregnancies and maybe even earlier for multiple. There's also an increased risk of blood clots (DVT) during long flights. To fly safely in the third trimester, confirm airline restrictions well in advance. Pack a doctor's note confirming your due date and a healthy pregnancy for potential checks. Wearing compression stockings can improve circulation during the flight. Get up and move around the cabin frequently to keep blood flowing, and be prepared for potential delays or unexpected situations.

Essential Steps Before Flying During Pregnancy

Consider Timing

Timing your flight is important for your comfort and safety. The second trimester (weeks 14 to 27) is generally considered the safest and most comfortable time to fly. During this period, the risk of miscarriage is lower, and you are less likely to experience the discomforts associated with the first and third trimesters. Most airlines restrict travel after 36 weeks due to the increased risk of labor, so plan your trips accordingly.

Plan for Comfort and Safety

Ensuring your comfort and safety during the flight involves several practical steps. Wear loose, comfortable clothing and supportive footwear to help you feel at ease. Staying hydrated is crucial, so drink plenty of water before and during the flight. To reduce the risk of blood clots, make a point to walk around the cabin every hour or so and do simple leg exercises while seated. When fastening your seat belt, make sure it is positioned under your abdomen and across your hips and pelvis to avoid any pressure on your belly.

Consult with Your Healthcare Provider

Before planning any travel, it’s crucial to discuss with your healthcare provider to ensure that flying is safe for you and your baby. This step is particularly important if you have a high-risk pregnancy or any complications. Your doctor can provide personalized advice based on your medical history and current condition. Additionally, some airlines may require a letter from your doctor confirming that you are fit to fly, especially if you are in your third trimester.

Check Airline Policies

Different airlines have varying policies regarding pregnant travelers, so it’s essential to check these before booking your flight. Some airlines impose restrictions or require medical clearance after a certain number of weeks into pregnancy. To enhance your comfort during the flight, request an aisle seat, which will provide easier access to the bathroom and more room to stretch your legs.

Prepare for the Journey

Preparation is key to a smooth journey. Pack all necessary medications, a copy of your prenatal records, and easy-to-digest snacks. Knowing where medical facilities are located at your destination and along your route is also important in case of an emergency. Having a plan in place can provide peace of mind and help you manage any unexpected situations.

Insurance and Documentation

Before traveling, ensure that your travel insurance covers pregnancy-related issues. This can provide financial protection and access to necessary healthcare services while you are away. Additionally, carry your health insurance information and a copy of your prenatal records with you. These documents can be vital in case you need medical assistance during your trip.

Address Health Concerns

Addressing health concerns proactively can make your flight more comfortable. Wearing compression stockings can help with circulation and reduce swelling, a common issue during long flights. If you experience morning sickness, carry remedies to manage nausea and eat small, frequent meals. Taking these precautions can help you feel better and reduce the discomfort associated with flying while pregnant.

Tips for Comfortable Air Travel While Pregnant

1. Wear Comfortable Clothing: Opt for loose, breathable clothing to enhance your comfort during the flight. Choose fabrics like cotton or stretchy materials that allow for easy movement. Supportive footwear is also important, especially for navigating airports and during the flight. Compression socks can help improve circulation and reduce swelling in your legs and feet.

2. Choose an Aisle Seat: Selecting an aisle seat can make your flight more comfortable. It allows easier access to the restroom and more space to stretch your legs. Being able to move around more freely can help reduce discomfort and make the flight more pleasant.

3. Move Regularly: Long periods of sitting can increase the risk of blood clots, particularly during pregnancy. Aim to walk around the cabin every hour or so. While seated, do simple leg and foot exercises, such as ankle circles and flexing your feet, to promote circulation.

4. Use a Pillow for Support: Bring a small travel pillow or use the airline’s provided pillow for extra support. Placing a pillow behind your lower back can help maintain good posture and reduce back pain. A neck pillow can also make it easier to rest or sleep during the flight.

5. Eat Light and Frequent Meals: To manage nausea and maintain energy levels, eat small, light meals and snacks throughout your flight. Avoid heavy, greasy, or spicy foods that can cause indigestion or discomfort. Pack your snacks to ensure you have options that you know agree with you.

6. Carry Essential Items: Pack a small carry-on bag with essential items like medications, prenatal vitamins, and any other personal necessities. Having easy access to these items can help you manage any minor issues that arise during the flight.

7. Prepare for Emergencies: Have a plan in case of an emergency. Know where the nearest medical facilities are at your destination and along your route. Carry a list of emergency contacts, including your healthcare provider’s information, and familiarize yourself with the airline’s emergency procedures.

What to Pack When Flying During Pregnancy?

Flying during pregnancy can be safe and manageable with proper preparation and precautions. By following these essential tips, expectant mothers can ensure a more comfortable and worry-free travel experience. Remember to consult with your healthcare provider before making any travel plans, especially if you have any pregnancy complications or concerns.

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Watch CBS News

Texas man details wife's devastating miscarriage amid state's strict abortion laws: "Nobody uses the word abortion"

By Omar Villafranca , Jennifer Earl , Rachel Bailey

Updated on: June 4, 2024 / 10:52 AM EDT / CBS News

Texas radio host Ryan Hamilton's world was shattered last month when his wife told him she was suffering a miscarriage at nearly 13 weeks pregnant and the fetus no longer had a heartbeat.

But for Hamilton and his wife, the nightmare was just beginning.

Medical records reviewed by CBS News show Hamilton's wife, who asked not to be named, was treated at a Surepoint Emergency Center branch near their home in North Texas. There, doctors confirmed the fetus — their second child — had no heartbeat, according to the records. His wife was prescribed the drug misoprostol , which induces labor and is used for both miscarriages and abortions. Hamilton says doctors told them the medication may need to be repeated, so they were prescribed one refill.

Starting treatment for miscarriage

"We were told she could take a medication that would start the process to finish…to finish what had already started at home," an emotional Hamilton told CBS News correspondent Omar Villafranca in an interview for "CBS Mornings" that aired on Tuesday.

Hamilton said doctors referred to it as terminating the pregnancy.

"Nobody uses the word abortion at this point," he said. "No one has said that word."

Misoprostol is often prescribed after a miscarriage to help a woman's body expel the fetal tissue from the uterus, which could otherwise cause a potentially life-threatening infection.

Hamilton said after his wife took the first round of misoprostol, it was clear the dose of medication wasn't working, so he went to the pharmacy to get the refill so she could begin the next round of the drug.

When the second round failed, Hamilton called the Surepoint Emergency Center and explained that the medication wasn't working. His wife returned to the medical center, where Hamilton says a different doctor told her they couldn't give her another refill to continue the process.

"She goes back in and that doctor says, 'Due to the current stance, I cannot prescribe this medicine for you,'" said Hamilton, adding the only word to describe what he was feeling at that moment was "fury."

Texas abortion laws

The only explanation Hamilton could think of was that this doctor thought the current state laws in Texas prevented it. Texas bans abortions at about six weeks unless there's a medical exception for a pregnancy that threatens the mother's life or health in a way that would result in "substantial impairment of a major bodily function," according to the law .

The Texas Supreme Court recently rejected a challenge to the state's abortion ban over medical exemptions, ruling that "Texas law permits a physician to address the risk that a life-threatening condition poses before a woman suffers the consequences of that risk." Doctors convicted of providing an illegal abortion could face fines of up to $100,000 and even jail time.

Surepoint Emergency Center declined CBS News' request for comment on Hamilton's situation, citing patient confidentiality and HIPAA laws.

The couple was left devastated and confused.

"You start thinking about the women that have to drive across state lines. We've heard these stories. And you — just as a husband, you go, 'Is that what we're gonna have to do?'" Hamilton wondered.

"The doctors feel scared"

Hamilton tried to keep his composure for his wife.

"You want to panic, but you can't," he told Villafranca. "What are we going to do? Leave the baby inside her so she can get an infection? Get sepsis that can kill her?"

The pair left the Surepoint Emergency Center and drove to another hospital about an hour away, where she was evaluated for about four hours. The doctors again confirmed the tragic news that there was no fetal heartbeat. Hamilton asked CBS News to not name the second hospital.

"I think the delay is their confusion on what they're allowed to do. That's what it feels like. They feel scared. The doctors feel scared," explained Hamilton about the hours-long visit. 

Doctors told Hamilton that it wasn't enough of an emergency to perform a D&C, also known as dilation and curettage —  a surgical procedure to remove fetal tissue inside the uterus, used for both miscarriages and abortions.

According to Texas law, abortions are illegal once a fetal heartbeat is detected with exceptions for medical emergencies. The law doesn't require there to be a medical emergency to perform a D&C if there's no cardiac activity, like in Hamilton's case.

"The conversation is not what's best for my wife. The conversation is on the hospital side, 'What should we do?'" Hamilton said.

"This really happens"

The doctors opted to give Hamilton's wife a higher dose of misoprostol and sent her home for a third time. 

"People are not aware of how common miscarriages are. One out of every five pregnancies end in miscarriage. This is a common experience for women, and so it's really scary that here you have a woman going through something that's actually quite common and having such a frustrating time getting the care that she needed," CBS News medical contributor Dr. Céline Gounder, editor-at-large for public health at KFF Health News, said on "CBS Mornings."

In a statement, the hospital told CBS News it follows state and federal laws in accordance with national standards of care.

"We provide training and education to our employed providers to ensure they understand any changes to applicable laws related to patient care. Medical care for all patients is determined by the attending physician based on clinical indications. D&Cs and medications are treatments providers can use based on the patient's condition and the provider's clinical judgment. Care for miscarriage generally does not require Ethics Committee review," the hospital's statement read, in part.

Shortly after returning home, Hamilton recalled playing with his 9-month-old daughter when he noticed a missed call from his wife. He found her unconscious in the bathroom surrounded by blood. He carried her to the car and rushed to the emergency room.

"I got to the hospital, ran inside, told them what was happening. And they took her in. And you know what they said? 'Thank God, you brought her,'" he recalled angrily, adding that at one point he thought he might lose his wife.

The doctors told the couple that the third round of misoprostol was successful. Eventually, she was stable and the pair was able to return home. But the painful process of losing their child is something that will stick with them forever. 

"I want people to know that this really happens. My fear is that stories like ours will continue to get told and not believed," Hamilton said. "Everything in her life right now that she's having to do to get better is not just a reminder of the baby that we lost, it's a reminder of what they put her through, and she has to do it every day."

Omar Villafranca is a CBS News correspondent based in Dallas. He joined CBS News in 2014 as a correspondent for Newspath. Before CBS, Villafranca worked at KXAS-TV Dallas-Fort Worth, at KOTV-TV the CBS affiliate in Tulsa, Oklahoma, and at KSWO-TV in Lawton, Oklahoma.

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NJ Health Department Alerts Residents of Travel-Associated Confirmed Measles Case, Urges Individuals To Stay Up to Date on Vaccines

TRENTON, NJ – The New Jersey Department of Health (NJDOH) is alerting residents about potential exposure associated with a confirmed, travel-associated case of measles. Individuals – especially parents, guardians, health care providers, and caregivers – are urged to be aware of the symptoms of this highly contagious virus and to stay up to date with the measles, mumps, and rubella (MMR) shots.

The confirmed case is a resident of Somerset County and developed measles following travel from a country that is currently experiencing an ongoing outbreak of measles.

Measles symptoms include a high fever, cough, runny nose, watery red eyes, and a rash that usually appears between three and five days after symptoms begin. The rash usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, torso, arms, legs, and feet. Measles can also cause serious complications, such as pneumonia and encephalitis (swelling of the brain), and can lead to miscarriage in pregnant people, premature birth, or a low-birth-weight baby.

Anyone who visited the following location at the specified date and times may have been exposed to the virus:

• Location: Emergency Department, Penn Medicine Princeton Medical Center 1 Plainsboro Road, Plainsboro Township, NJ 08536
• Date & Time: June 1, 2024 between 12:00 PM (noon) and 3:30 PM  

NJDOH recommends that anyone who visited the location listed above during the specified date and times should contact a health care provider immediately to discuss potential exposure and risk of developing the illness.

Potentially exposed individuals, if infected, could develop symptoms as late as June 26, 2024 . Contact tracing is underway. As of June 5, no additional associated cases have been identified.

The virus is easily spread through the air when someone coughs or sneezes and can remain in the air for up to two hours after an infected person leaves the area. People can also get sick when they come in contact with mucus or saliva from an infected person.

NJDOH is working in collaboration with local health officials and Penn Medicine to notify people who might have been exposed and to identify additional exposures that may have occurred. Those who may have been exposed or who suspect illness should call their health care provider first before arriving at any facility so that necessary infection prevention precautions can be taken to protect other patients and staff.

Individuals at risk include those who have not been fully vaccinated or have not had measles in the past.

NJDOH encourages all residents to stay up-to-date on routine vaccinations and especially recommends that New Jersey residents planning to travel , regardless of destination, are up to date on MMR shots .

MMR vaccine, administered in two doses, is safe and the most effective way to protect against measles, mumps, and rubella. The vaccine is also effective at preventing complications caused by these highly contagious diseases.

• NJDOH Factsheet on Measles Exposure
• NJDOH Measles Information and Tips Fact Sheet
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• Centers for Disease Control and Prevention (CDC) Measles Information
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When "abortion travel" becomes a nightmare: A tale of no good choices

She wanted a baby — but her fetus had no chance of survival. how idaho's abortion laws led to devastating trauma, by nicole karlis.

Rebecca Vincen-Brown was still in her first trimester of pregnancy, in the late fall of 2022, when things started to go wrong. She had blood drawn for a standard genetic test called noninvasive prenatal testing, or NIPT, which can detect increased risks for various chromosomal disorders. The results of the test took slightly longer than normal to come back, and when they did, Vincen-Brown received a troubling phone call: The test was “inconclusive” because not enough fetal DNA was detected in her blood. 

NIPT cannot diagnose fetal disorders conclusively, but the possibilities were troubling: Her fetus might have triploidy, trisomy 13 or trisomy 18, rare and serious genetic conditions involving either an extra set of chromosomes or an extra copy of one chromosome. While the specifics vary, most infants born with these conditions will live only days or weeks, and almost none will survive to adulthood.

When Vincen-Brown and her husband first learned she was pregnant with their second child a few weeks earlier, they were “over the moon,” she said. They’d been trying to conceive for nearly a year. She went to the attic of their house in Kuna, Idaho, a small town south of Boise, and began digging out some of the favorite baby clothes that her older daughter, then two years old, had outgrown. She even started to get the nursery set up for their new arrival. (Vincen-Brown has requested that Salon not identify her husband by name or occupation.)

After that confusing test result, the mood shifted dramatically. Vincen-Brown’s care team recommended a different test, called a nuchal translucency ultrasound, which yielded normal results. But she couldn’t shake the feeling of apprehension.

“They kept giving us a little bit of hope, saying, ‘There's still a chance, we don't know for sure what's going on, but we need to do further testing,’” Vincen-Brown, who is now 32, told Salon in an extended interview. “From there we held off on getting ready for the baby. I had hope, but at the same time, in your stomach, you kind of knew something wasn't right.”

A second NIPT once again yielded inconclusive results, indicating a high risk of the same three chromosomal abnormalities. After that, Vincen-Brown elected to have an early anatomy ultrasound scan at 16 weeks of pregnancy, rather than the usual 20 weeks. On March 6, 2023, she and her husband got the kind of news all prospective parents dread.

The ultrasound had detected “several fetal abnormalities,” in Vincen-Brown’s words. The fetus’ heart and kidneys had significant defects, and the network of blood vessels in the fetal brain had not properly attached to the ventricular wall. If the infant were even born alive, she said, “swallowing, eating or anything like that outside of the womb would have been impossible.” The overall result was a “long list of things that no modern medicine could make a life out of.” 

As she would later learn, her fetus did indeed have triploidy, which appears to occur at random and is estimated to affect 1 to 3 percent of all pregnancies in the United States.

Vincen-Brown was offered two choices, both of them disheartening. “We could keep carrying the baby, which would likely lead to a miscarriage or a stillbirth, or the baby would be born full-term and shortly die after that,” she said. “Or we could get an abortion.” 

*  *  *

In June 2022, a few months before Vincen-Brown’s second pregnancy, the U.S. Supreme Court issued the now-famous decision in a case called Dobbs v. Jackson Women’s Health, which overturned the constitutional right to abortion care established nearly 50 years earlier by Roe v. Wade. After Dobbs, all states and U.S. territories could set their own laws about whether abortion would be legal and, if so, under what circumstances. 

Even the exceptions in Idaho's abortion law had to be “proven by a preponderance of the evidence” showing that physicians had provided “the best opportunity for the unborn child to survive.”

Well before that, some anti-choice Republican officials had prepared for the possible overturn of Roe by passing “trigger laws,” meaning severe restrictions or outright abortion bans that would go into effect as soon as such a decision occurred. On March 24, 2020 , Idaho Gov. Brad Little — a Republican, like every other statewide elected official — had signed S1385 , which made it a crime to conduct all abortions except in cases of documented rape or incest, or in order to prevent the mother's death. Even those exceptions had to be “proven by a preponderance of the evidence” showing that physicians had provided “the best opportunity for the unborn child to survive” in their “good faith medical judgment.” Any doctor who violated the law could face up to five years in prison and lose their medical license. 

Just before the Dobbs ruling, Idaho passed a second law that overlaps with the “trigger law” in confusing fashion. It prohibits all abortions after six weeks of gestation and allows for lawsuits against medical professionals who provide abortion services, or are suspected of doing so. It even encourages neighbors and community members to monitor pregnant people in their communities. Both laws were in effect by the time Vincen-Brown found out she was pregnant again.

After many sleepless nights and conversations with her doctors, Vincen-Brown and her husband decided they would travel to another state and terminate the pregnancy. The risks to her health, including possible miscarriage and hemorrhage, preeclampsia and the possibility of endangering future pregnancies, were just too high, they concluded.

“It was not a knee-jerk reaction, it was not a knee-jerk decision,” she said. “It was not a birth control decision. It was based on many tests.” 

Vincen-Brown’s traumatic odyssey was nowhere near over, as it turned out. Largely because of what happened next, she would later become one of several plaintiffs in a case called Adkins v. Idaho, which seeks clarification of the limited exceptions to the state's abortion laws, as well as clearer language that physicians can apply in emergency situations. Among other things, the plaintiffs are demanding that Idaho’s exceptions to its near-total abortion ban be expanded to include fatal fetal anomalies, so that no pregnant person is forced to face the discouraging options that confronted Vincen-Brown.

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According to Marc Hearron, senior counsel for U.S. litigation at the Center for Reproductive Rights, which filed the lawsuit, Idaho’s two laws restricting abortion “have conflicting language with different standards” and fail to use standard “medical terminology.” Hearron and his team are asking for a change to the legal language of the laws that would allow physicians to provide abortion care when a pregnant person has “a medical condition or complication of pregnancy,” such as a risk of infection or bleeding, that poses a severe risk to herself, the fetus or both, or when “the fetus is unlikely to survive the pregnancy and sustain life after birth.”

Although the incidence of birth defects has steadily declined since the 1970s, an estimated 2 percent of pregnancies are diagnosed with a congenital anomaly each year in the U.S. But according to KFF, 13 of the 20 states that have restrictive abortion laws or early gestational limits in effect make no exceptions for fatal fetal anomalies .

This means that many women who find themselves in the already devastating situation of having a nonviable pregnancy must either be forced to stay home and carry a nonviable pregnancy to term or travel out of state to terminate. For those who do have the resources to travel — like Vincen-Brown, or  Kate Cox, a woman from Dallas  who made national headlines — things don’t necessarily get less difficult when they cross state lines.

After several rounds of phone calls to abortion providers in neighboring states, Vincen-Brown and her husband secured an appointment several days later at a clinic in Portland, Oregon, more than 400 miles away. Her husband took time off work and they loaded up the car. Since they had no reliable child care they brought along their two-year-old daughter, who was going through potty training at the time. They tried to make the journey seem like a “normal road trip,” Vincen-Brown said, offering their daughter “lots of bribery snacks” and occasionally stopping at a park or playground to let her play on the swings. 

“We didn't want to be targeted, we didn't want to put our family at risk of any negative effects. We just didn't tell anybody what really happened, except for a few friends."

After seven hours on the road, they checked into their hotel in Portland. The next day, Vincen-Brown went to the clinic, where a physician dilated her cervix, the first stage of a normal abortion procedure. She went back to the hotel to rest, expecting to return the following day for the second part of the procedure, when the uterus is emptied. 

But when Vincen-Brown tried to fall asleep that night, she started having painful cramps that kept getting worse, and became labor contractions by midnight. The on-call doctor at the abortion clinic told her that “cramping was normal,” she said. But she had experienced labor before, and understood what was happening. 

“It just kept persisting, 30 seconds apart, 30 seconds apart, and the whole time I'm thinking to myself, I need to hold out until 8 a.m.,” when the clinic would open, she said. Around 3 o’clock in the morning, her contractions began to slow down, but the pain was exponentially worse, “the kind where you can't walk or stand up during them.” All this time, Vincen-Brown and her husband were trying not to wake their daughter, who was asleep across the room in a portable crib. 

They called the clinic’s doctor one more time. He said he could come to their hotel room if necessary, but told Vincen-Brown to keep “hanging on.” She knew she needed urgent medical care, but their car was four blocks away in a valet parking lot. She didn’t want to call 911, since her out-of-state medical insurance wouldn’t cover the cost of an ambulance and an emergency-room visit. 

After that second phone call, Vincen-Brown had a miscarriage on the bathroom floor, at around 4 a.m. Her husband gave her a fundal massage in the shower, trying to control the potentially dangerous bleeding and painful cramping. The miscarried fetus lay on the bathroom floor for another four hours, until someone from the clinic finally arrived. 

“We were just whispering, trying to be quiet, and my husband's taking phone calls in the hallway,” Vincen-Brown said. “Nothing about it was right. It was actually quite barbaric.”

The next day she went back to the clinic to finish the procedure, and then Vincen-Brown, her husband and their daughter — who had no idea what had just happened — drove another seven hours back to Idaho. Along with the shock, grief and physical and emotional trauma, she and her husband spent about $5,000 out of pocket for travel costs and the abortion procedure itself. She estimates she put 900 miles on her car.

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Looking back on this nightmarish experience, Vincen-Brown draws what many would consider a logical conclusion: All of it could have been avoided if she had access to appropriate care in Idaho. “A lot of unnecessary complications happened that could have been foregone if we stayed home,” she said.

After Vincen-Brown and her husband first got home, they didn’t tell anybody they knew what happened. Their story was partly true: She’d had a miscarriage, and later testing determined that the fetus had a fatal anomaly. 

Their semi-rural community on the southern edge of the Boise metro area, Vincen-Brown said, is “very loud” on the abortion issue. “We didn't want to be targeted, we didn't want to put our family at risk of any negative effects. We just didn't tell anybody what really happened, except for a few friends. We didn't want the judgment either.”

Jillaine St. Michel, 38, lives a few miles away from Vincen-Brown, in the same Idaho county, and became pregnant just a few months earlier. In July of 2022, she texted her husband that she had “very exciting” news. He knew what that meant: They, too, were having a second child and were elated about it. At first, everything went smoothly. At a first-trimester screening, St. Michel found out she was having another girl. At around 16 weeks of pregnancy, she announced the news on social media. When she went in for her 20-week anatomy scan, she told her husband she felt confident going alone.

St. Michel is a chiropractor who understands anatomy, and noticed during the sonogram, she said, that the fetus’ arms did not look quite right. The sonographer disappeared to talk to a specialist in the next room — and was gone for 20 minutes. Eventually, the doctor returned with a genetic counselor.

“My heart dropped,” she told Salon. “I knew something was not OK.” The doctor suggested that St. Michel call her husband, Brandon St. Michel, saying, “We've seen some really severe stuff that we want to go over with you.”

By the time her husband arrived 20 minutes later, St. Michel was in tears. The doctor told them the fetus had severe genetic and developmental conditions that impacted multiple organ systems. Because of a “caudal regression sequence,” the lower spine had not formed properly, nor had the bones of one leg. The fetus also had a cystic hygroma, a form of benign tumor that creates a high risk of miscarriage. Her pregnancy was unlikely to reach full term, the doctors said, and the infant would not survive past birth.

Doctors even asked St. Michel, she said, whether she had been exposed to toxic chemicals, because the complications of this pregnancy were so unusual. 

St. Michel and her husband asked for help finding abortion services. The only thing the doctor could do was to hand them “a sheet of paper with a list of clinics in other states.”

She too confronted a range of options, none of them promising: St. Michel could seek additional imaging or consult a specialist. She could arrange “palliative care” for the fetus, aimed at reducing the suffering of a birth process that would likely also bring death. Some people in her situation, the doctor said, would choose to terminate the pregnancy.

St. Michel and her husband had never had that conversation, they said, but at that moment they both felt sure that the last option was right for their family.

They asked for help finding abortion services and the only thing the doctor could do was to hand St. Michel “a sheet of paper with a list of clinics in other states.” The doctor told her, “I don't even know how updated this is, the laws are changing so rapidly in other places. This is the best we can do here, because it’s illegal in our state.”

Dr. Julie Lyons, a family physician who is chief of staff of St. Luke’s Wood River Medical Center in Hailey, Idaho, is another plaintiff in the case against the state. She’s familiar with those sheets of paper. It feels like physicians “are being gagged” and their “hands are being tied” when it comes to helping the patients get the resources they need, she said. 

The summer of 2023 was “especially horrific” in Idaho, Lyons said. State Attorney General Raúl Labrador — a far-right Republican and staunch supporter of Donald Trump — wrote a letter suggesting that sending a patient out of state for treatment could be considered “aiding and abetting” and could put a doctor’s medical license at risk. That sent “shock waves” through Idaho’s medical community, she said. (Salon repeatedly contacted Labrador’s office and received no response).

“I have had several patients who have had to leave the state since the abortion laws have been passed, for fatal fetal diagnoses,” Lyons said. She recalled one patient who spent three hours making phone calls to clinics, and ultimately spent more than $1,000 on airfare and travel. 

“It is a very big, traumatic grieving process for the patient, as well as the physician delivering the news,” Lyons said, and Idaho’s laws have introduced unnecessary extra steps, in terms of “advocacy to ensure that our patient gets the health care they need and deserve.” Idaho’s laws, she suggested, make women who face these painful situations feel stigmatized: “It takes away the ability to grieve publicly.”

Working from their sheet of paper, St. Michel and her husband found several non-working phone numbers for clinics that had shut down. Among those still open, most had lengthy waiting lists. 

After two days of increasingly frantic calls, they connected with a clinic in Seattle that had an unexpected opening. They scrambled to buy three last-minute plane tickets and three nights in a hotel. Like Vincen-Brown, they had no choice but to bring their older daughter along.

At the Seattle clinic, St. Michel went to her appointment for dilation and evacuation, or D&E, alone. “I had to say goodbye to this extremely wanted child by myself,” she said. “That was taken away from my husband, which should have never happened.”

Within a few weeks, the sadness had given way to anger. “I started to get really, really angry about how things went down,” she said. “The more I thought about it, and after my grief settled a bit, I realized that was not OK.” 

*  *  * 

It’s reasonable to wonder about the alternative case: What is likely to happen when a pregnant woman carries a nonviable pregnancy to term? In terms of physical risk to the mother, there is no single straightforward answer: It depends on the circumstances, medical experts told Salon, especially the nature of the fetal anomalies, the mother’s previous health history and her previous pregnancies, if any. That makes it difficult for providers in states like Idaho to terminate a pregnancy under the “life of the mother” exception often written into abortion laws. 

“I had to say goodbye to this extremely wanted child by myself. That was taken away from my husband, which should have never happened.”

Providing obstetrical care to a pregnant patient carrying a fetus with severe fetal anomalies is “very nuanced,” Lyons said. “Each patient does have their own individual risk. We can't always assess when or how, and that's what's so frustrating about these laws: They don't allow doctors the autonomy that we need to provide nuanced care.”

Dr. Maria Phillis, a maternal fetal medicine specialist, told Salon that continuing with a pregnancy under such circumstances is nearly always riskier than termination. 

To some extent, she said, it’s a simple equation: “If you think about benefit versus risk, pregnancy is always more dangerous than not being pregnant.” Indeed, in a 2012 researchers study published in the journal Obstetrics & Gynecology, researchers concluded that the risk of dying in childbirth was “approximately 14 times higher than that with abortion.”

Many people confronted with likely fatal fetal anomalies would conclude, Phillis said, that “the risks that I would be willing to undergo to my own health and life to obtain a healthy pregnancy are not worthwhile in this situation.” But there’s no right or wrong answer, she said, in either moral or medical terms: “Every patient is a different person, and they have different thoughts about what they want to do. The key is to provide options.”

Caitlin Silverstein is very familiar with women who face the trauma of “no good choice.” She’s a licensed social worker and therapist in New York who specializes in perinatal loss, including stillbirths, miscarriages and terminations performed for medical reasons. Much of her work, when supporting pregnant women going through the decision to terminate a nonviable pregnancy, is to validate that trauma, she says. 

For the patient, that process involves “multilayered grief,” Silverstein said, which begins with hearing a dire diagnosis. Follow-up tests may offer some hope, but when the outcomes are unfavorable that can lead to deeper feelings of loss and grief. When a woman chooses to terminate the pregnancy, Silverstein tries to help her manage the depression, anxiety and shame that can come along with that decision. The current landscape of ever tighter legal restrictions on abortion care, she believes, only makes the emotional and psychological effects worse. 

A pregnant person may be thinking that “the government doesn't think that this is good for me to do, I shouldn't be doing this — but I don't want this future for my child,” she said. No parent wants a child to lead a life of pain and suffering, and through that lens many may conclude that termination is the most compassionate option. Women who feel that choice being taken away, Silverstein said, are at risk of “hopelessness,” a principal component of depression. “You're going to feel trapped, you’re going to feel hopeless, isolated, stigmatized, already more than you already would be,” she said. “Regardless of what choices they had to make for whatever reason,” women facing this situation “have lost a child. They are grieving mothers."

For Jillaine St. Michel, being open about what happened led to the realization that she was not alone, and that many other women have faced similar situations. 

“Regardless of what choices they had to make for whatever reason,” women facing this situation “have lost a child. They are grieving mothers."

“I had people from work that I'm not even that close with, that I would have never expected would even approach me, tell me how proud they are of me,” she said. Several told her they had daughters of their own and were glad “that somebody is speaking up.” 

That made her wonder where restrictive abortion laws like Idaho’s were coming from, and why legislators in her state and many others were passing them. 

“Who is part of this? It's a very small minority of people,” St. Michel said. “So why is this happening? It's very, very confusing.” 

A report published in January 2024 by Boise State University’s Idaho Policy Institute found that only 33 percent of those surveyed in Idaho — by any standard, one of the most conservative states in the country — supported keeping the current abortion laws intact, while 58 percent supported changing them. Within that second cohort, 24 percent wanted to expand the law’s exceptions to allow termination in the case of a nonviable pregnancy, while the other 34 percent favored either no restrictions at all or unrestricted access until 22 or 24 weeks of pregnancy. Nationwide, according to Pew Research Center , 63 percent of Americans say abortion should be legal in all or most cases. 

In January 2023, the Idaho Supreme Court took up a case arguing that the state’s abortion laws violated the state constitution, which contains language about fundamental privacy rights and the right to make family decisions. But the justices upheld Idaho’s abortion ban by a 3-2 vote, writing in the majority opinion that they “cannot read a fundamental right to abortion into the text of the Idaho Constitution.” 

The current case, Adkins v. Idaho, rests on a similar argument that the laws violate the state constitution, but Hearron says his legal team is demanding the “bare minimum” in asking the state to expand and clarify exceptions to current law. “The risk of death does not have to be imminent or extremely high in order for that right to access abortion care to exist,” he said. “We're not asking here for all of the abortion bans to be stricken down in their entirety.”

More recently, the Texas Supreme Court rejected a challenge to that state’s restrictive abortion laws. Plaintiffs in that case were women who’d had serious pregnancy complications. One of them, Amanda Zurawski, spent  days in intensive care with sepsis after being denied an abortion when her water broke at 18 weeks. Similar lawsuits have been filed in Tennessee and North Dakota.

Personal stories, like those of Vincen-Brown and St. Michel, will serve to illustrate the “harm” done to Idaho citizens, Hearron said. “We’re going to ask the court to alleviate that harm and vindicate constitutional rights.” A trial is scheduled for November.

Meanwhile, pregnant women in Idaho, as in many other states, continue to struggle with the consequences of these laws. 

Vincen-Brown and St. Michel both got pregnant for a third time after their traumatic terminations. There’s good news: Both women delivered healthy babies in the end. But their journeys to that destination were clouded with fear and anxiety, they say. 

“We couldn't go through this feeling blissful,” St. Michel said. “It was always like: What if?”

Vincen-Brown said that this time around she never stepped into the nursery until after she had a full anatomy scan. She kept the door to that room closed.

“We didn’t tell people about it. We didn't get excited and jovial, like you would when you’re pregnant, because of the fear of it happening again.” Her entire third pregnancy, she said, had been “tainted.”

about abortion in the Dobbs era

• Medical school graduates are avoiding states with abortion bans. Experts warn it could cause chaos
• Florida clarified abortion rules after enacting ban. Doctors say it's "gaslighting" and unhelpful
• Abortion travel is predicted to rise after Florida's ban. Providers say they can't handle the surge

Nicole Karlis is a senior writer at Salon, specializing in health and science. Tweet her @nicolekarlis .

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Why a rise in 'tourism-phobia' should give Australians flocking to European summer a cause for pause

It's that time of year again when social media feeds become flooded with "Euro summer" holiday content.

Every winter, there's a cohort of Australians who escape to the Mediterranean Sea, seeking an idyllic scene to sip Aperol spritz in the sun.

But, they may not all be getting a warm welcome. 

Since pandemic travel restrictions eased, tourism has come surging back and Europe is copping an influx of visitors in record numbers.

And some locals aren't happy about it. 

Graffiti and stickers exclaiming, "Tourists go home!" and threats such as "We'll spit in your beer" are becoming a common sight across major cities. 

Anti-tourism protests are also spreading, with locals angered by "bad tourists", short-term rentals and "the touristification of daily life".

Experts say at this rate there's no way tourism can be sustainable, and we need to re-think the way we travel so we're not part of the problem. 

A return to overseas travel

Australians are back on the move.

In 2023, nearly 10 million residents returned from a short-term trip overseas , an increase of over 4.7 million on the previous year, according to the Australian Bureau of Statistics (ABS).

June was a particularly high time to travel, with more Australians leaving the country in mid-last year than in December 2022. 

Skyscanner Australia travel expert, Jarrod Kris, says there has been an increase in Australians searching for flights to European destinations.

Search volumes for European countries in 2023 were up by 28 per cent on the previous year, with Greece, France, Italy and Spain among the most popular.

Searches were also 16 per cent higher than pre-pandemic 2019, Mr Kris said. 

Based on Skyscanner flight booking data, the most popular 2024 Euro summers destinations for Australians so far are: 

• 2. Manchester
• 4. Istanbul

Landing in an overtourism crisis

Many of these popular destinations are facing an "overtourism crisis", Claudio Milano from the University of Barcelona's department of social anthropology, said. 

And it's leading to a resurgence of "tourism-phobia".

The term emerged around the 2008 financial crisis with locals blaming tourists for their deteriorating quality of life.

Now as crowds have come flooding back in record numbers after the pandemic reprieve, so too has social unrest and tourism rejection.

Especially as cities confront housing emergencies, masses of Airbnb lockboxes strewn down residential streets are a scathing sign of the times. 

Already Europe's foreign tourist arrivals for 2024 have exceeded 2019 levels.

And summer is bringing two major sporting events to the continent — the Paris Olympics and the UEFA European Football Championship in Germany.

Tourism officials expect 15.3 million visitors to the French capital over the Olympics period. 

Parisians have been staging protests and strikes, calling out the social impact the Games will have on their city, which is already the most-visited destination in the world.

Locals lash out   

In recent weeks, tens of thousands of residents have also been taking to the streets in Athens, Venice, Barcelona and Spain's Balearic Islands.

Last weekend, protesters occupied beaches frequented by tourists in Mallorca, after about 10,000 demonstrated the previous week under the banner #Mallorca no es ven — Mallorca is not for sale. 

Smaller protests have been held in neighbouring Menorca and the notorious party island Ibiza.

And throughout April, more than 50,000 people from the small Spanish Canary Islands took part in demonstrations.

Freya Higgins-Desbiolles, a lecturer in tourism management at the University of South Australia, says it's clear impacts of overtourism have reached new heights.   

"The recent activism in the Canary Islands, where tens of thousands of people came out in a relatively small community, indicates just how angry people are," she told the ABC.

Fake signs have been spotted at Spanish beaches warning tourists that there's dangerous jellyfish and falling rocks.

Then small-print in Catalan reads "the problem isn’t a rockfall, it's mass tourism", according to local media reports. 

There's also been more confronting backlash with reports of rentals cars, bikes and tourist buses being vandalised or their tires slashed.

Tourists making life unlivable

Professor Milano says similar messages are being echoed by anti-tourism activists and movements across the board.

Locals are frustrated by cities being oversold and overcrowded with "capitalistic tourism".

Short-term rentals are raising housing costs, taking over residential buildings, and pricing locals out of living in their own towns.

Javier Carbonell, a real estate agent in Mallorca, told Reuters over half of rental properties were used for holiday rentals and were not affordable for locals.

"We want less mass tourism and more sustainable tourism," Mr Carbonell said.

Professor Higgins-Desbiolles said cities and towns have become completely over-run by tourists, making them unlivable and unrecognisable to those who call them home.

"There's no problem having tourists in the city, the problem is to have only tourists in the city," Professor Milano said. 

He called it the "touristification of daily life".

In places such as Venice, Italy, locals have been displaced due to poorly managed tourism, Professor Higgins-Desbiolles said.

Some shops that sustained local life have been replaced with tacky souvenir shops.

"Because of tourism developments and the way tourism has run, it's made it difficult to lead normal lives," she said.

"Whether you can travel to Venice, and have that accepted, requires thought on the part of the traveller."

Should you still travel?

Professor Milano says for the most part activists are not angered by the tourist encounter, rather the tourism model and the issues it provokes. 

They don't want no tourism at all, but he admitted they do want better tourists. 

And there are ways to minimise negative effects so your travels benefit local businesses. 

Avoid Airbnb 

In Athens, graffiti is sprayed across walls showing buildings up in flames alongside the words "burn Airbnb", according to local media.

And protesters in the city have been waving signs reading "Barcelona: Tourists welcome, locals NOT welcome", and chanting "tourists are taking our houses".

Professor Milano said travellers should avoid booking Airbnb and instead find a hotel.

And tourists should try to spend money on local businesses as much as they can. 

A lot of frustration stems from outside entities profiting while locals suffer, Professor Higgins-Desbiolles said. 

"The most simple advice that I could give to make sure you're welcome — no matter where you go — is to knowledgeably and intentionally spend money in that local economy." 

Beware of 'live like a local' myths 

Travellers are being warned about falling for commercial narratives that promote getting a local's experience. 

"With Airbnb, we have brought tourism into our buildings," Professor Milano said. 

"Airbnb used to be promoted as 'live like a local' ... But it’s not 'live like a local' because the property manager is a big company that probably owns 200 apartments in Barcelona."

In some cities, residential areas are becoming so congested locals can't easily access their own streets or get on a bus. 

The advice is to stay away from the crowded areas and avoid travelling at peak seasons.

Scrap the multi-stop trips

What has been called the "Ryanair revolution" has enabled travellers to jet between European destinations for next to nothing.

This hyper mobility is a big part of the problem, Professor Milano said.

Regularly flying to Europe for two weeks and visiting several destinations isn't uncommon for some Australians. 

But Professor Higgins-Desbiolles says we need to consider slowing down — not just for the wellbeing of the local communities, but for the environment.

"Access to these places is not our right, it’s a privilege," she said.

"We need to get more considered in our consumption."

She said we don't need to stop holidaying, but it would be better to scale it back to one big holiday every few years, and staying in the one country.

'Don't be a jerk'

Protesters in the Canary Islands have been calling out "bad tourists" who disrespect the land and culture.

While campaigns in Amsterdam have been targeting badly-behaved tourists with the slogan "stay away" if your plan is to come for a messy night "getting trashed".

Professor Higgins-Desbiolles says if you want to be accepted in cities, simply "don’t be a jerk".

"You're a visitor in somebody's home, and that's the thing about these destinations that we forget — these are local people's homes," she said.

"Visitors think they have a right to go to places, that their money buys them access, and that they don't need to be thoughtful and sensitive."

This also applies to "commodifying travels", and the lengths people will take to get the perfect social media shot. 

Listen to communities 

Policies and measures are being rolled out in many places to address overcrowding, such as introducing tourist taxes, entry fees, and capping visitor numbers at peak times. 

Professor Higgins-Desbiolles says it's also important to listen to what communities want, because locals are saying this isn't enough.

"We should stop emphasising continual economic growth to instead look at wellbeing," she said. 

Countries outside Europe have been developing responsible tourist pledges for visitors to sign when they arrive.

The Pacific Island nation of Palau has taken this a step further, opening up local opportunities for tourists who abide by the pledge and show respect.

"That's what gets you a warm welcome into these places," Dr Higgins-Desbiolles said.

"We really should centre tourism on local community rights. That would make the difference."

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