Travel

Many women travel in pregnancy for work or holidays. For most women this is safe but there are some important issues you need to consider when arranging to travel, particularly overseas.

Most airlines will let women fly internationally up to 34 or 36 weeks of pregnancy. You will need to check with your airline their exact cut off date. They may require a letter from us confirming that you are fit to fly. In most cases flying up to this time is possible but may not be advisable for some women, for example if you are expecting twins or are likely to deliver prematurely.

Importantly, travel insurance is very hard to obtain after 28 weeks of pregnancy and this effectively rules out overseas travel for many women after 28 weeks. Having to consult medical help or arrange repatriation without insurance can cost you many tens of thousands of dollars.

All travellers have a small risk of developing blood clots and thrombosis when taking long flights. This risk is greater for women who are pregnant. Do discuss your travel plans with us so we can advise whether any special precautions need to be taken.

Travel within New Zealand is usually fine until close to your due date but do remember that some women will go into labour early and there are parts of New Zealand that are very hard to return from in a hurry.

Wherever you are travelling it is worth checking in advance who you might be able to see locally if there are any medical worries. For some couples this may be their relatives' family doctor. Otherwise your resort or hotel should be able to tell you where a local doctor can be found. Do remember that in many countries medical facilities are a lot less developed than their tourist industry.

If you are overseas and under our care you can call any time for advice. If easier you can also email us though it may take a day or two for us to get back to you.

Work

Many women work full time until as close as two or three weeks before their due date. However, most women start to feel quite uncomfortable working long hours and are sleeping poorly from as early as 32 weeks.

Remember this pregnancy is "all about you" - discuss with work whether working part time is possible in the last trimester. You will often work more efficiently if you can work shorter hours. Do discuss with us when the best time to give up work might be. We can provide you with a letter to confirm your due date so you can arrange maternity leave.

Exercise

Ideally you should aim for 20 to 30 minutes of moderate physical activity every day. This may just mean parking the car further from work or making time with your partner or a friend to go for a walk each evening. Many women have very sedentary jobs and work long hours in pregnancy so it is important to make time to stay fit. Find whatever activity you enjoy most. Build some activity into your working day with stairs, a walk to lunch, or some mid day exercise.

There are many exercises classes aimed specifically at pregnant women which have the added benefit of meeting up with other women expecting a baby soon. See our useful websites and information page for contact details.

Some exercise tips include:

• Keep aerobic exercise low impact and less strenuous in pregnancy. Your joints are softer and stretchier making them more prone to injury.
• Your balance will change in pregnancy and sports such as running may soon become uncomfortable or hazardous.
• Always start exercise with five to ten minutes of warm up and stretches and then again at the end as a cool down.
• If you have not exercised for a while start at a low level and increase steadily.
• Drink plenty of water and avoid dehydration. Be careful to limit your intake of soft drinks which have a very high sugar content.
• Be careful with sports where unpredictable injuries can occur - do discuss with us if you are a keen skier, horsewoman or team sport player.

Diet

Pregnancy can progress very well with only very small increases in your intake of protein, carbohydrate, fat, vitamins and minerals. The digestive system in pregnant women changes and becomes more efficient at absorbing certain nutrients. In fact, with only a few exceptions, most of the additional nutrient needs of pregnancy can be met by eating a well-balanced and varied diet. 'Eating for two' certainly doesn't mean you should eat twice as much food. Aim for a healthy balanced diet during your pregnancy. This includes regular meals and snacks, and a sensible eating regime containing:

• plenty of starchy carbohydrates - bread, rice, pasta, breakfast cereals, chapattis, couscous and potatoes
• plenty of fruit and vegetables - at least five portions a day
• low or reduced fat dairy products such as milk, yoghurt and pasteurised cheeses
• lean sources of protein, such as meat, poultry, fish, eggs (well-cooked), beans and pulses
• not too many fat-rich and sugary foods

Pregnancy is a good time for both you and your partner to do some more "home cooking" and cut back on the consumption of takeaways and junk food that full time work often necessitates.

Food Safety

Most food you prepare at home will be safe to eat in pregnancy so don't worry - you can still eat well in pregnancy. More serious forms of food poisoning associated with miscarriage such as Listeria are actually very rare but women are more prone to food poisoning when pregnant so it is important to obey some simple food hygiene rules. These are often called the four "C's" : clean your hands when preparing food, cook your food well, cover any food to be stored and chill any food that you store after cooking. Some foods such as shellfish should always be avoided in pregnancy but most food that is well cooked and hot will be safe. We will give you a useful information booklet from the Ministry of Health on foods to be careful with or avoid at your booking visit. You can also download the booklet by clicking here.

Smoking

The best time to stop smoking is before you become pregnant because of the well established risks to the developing baby. Smoking has been linked to poor growth in the developing baby and stillbirth. Many smokers find pregnancy the easiest time to give up. There are smoking cessation programmes aimed specifically at supporting pregnant women trying to quit. We can arrange a referral for you. If your partner is a smoker your pregnancy is a great time for him to stop smoking. The risk of cot death and childhood asthma is considerably greater if one or both parents smoke.

Medication

Most prescribed medication is safe to take in pregnancy and women taking medication for a wide range of medical problems are likely to be able to continue their medication. However, it is important that you let us know what medication you are taking so this can be checked. Ideally, check with your doctor before you become pregnant or as soon as you have a positive pregnancy test if you have conceived unexpectedly. It is also important that you don't stop essential medication in pregnancy without checking. If there is any concern about drug safety in pregnancy there are usually safer alternatives available that can be prescribed.

Family Violence

Family violence is a common problem blighting the lives of many women and their families. We often see women with their partners for most of their appointments so this can be a difficult issue for women to bring up themselves. National Women's Health is committed to reaching out to women affected by family violence and you may be asked questions about this if you are seen in clinics or on the wards at the hospital. Do call us if family violence is an issue for you. You can also find out more information from the websites and contact numbers on our useful websites and information page.