Fitness to Fly Reports

Midwives may wish to refer to resources from the Government of Canada or the Royal College of Obstetricians and Gynecologists regarding the risks of air travel specifically and international travel generally. These documents reference recommended vaccinations and the increased (yet still low) risk of thromboembolism in pregnancy associated with flights longer than four hours. Midwives may also advise clients to research any travel advisories for their destination (e.g., Zika, Middle East Respiratory Syndrome).

Some airlines require written confirmation that a pregnant passenger can fly. As airlines may have specific elements that they want included in the letter or may insist that it come from a doctor, clients should contact the airline that is operating their flight to confirm the requirements. For example,

• Westjet and Air Canada do not require documentation and state that passengers may fly until 36 weeks of pregnancy
• British Airways requires written confirmation from a physician or midwife and medical records after 28 weeks gestation
• Air Transat requires written confirmation after 36 weeks gestation

In writing such letters, midwives should keep them as simple and brief as possible. For example, the letter may read:

Client is under my care for her pregnancy. Her estimated due date is MONTH DAY, YEAR. She is experiencing an uncomplicated pregnancy thus far and is in good health. At this point in her pregnancy, I have no concerns about her travelling by air.

Midwives may also wish to recommend that clients travel with their Ontario Antenatal Record, insurance documentation and record of immunizations.

Note that some travel health insurance policies will not provide coverage for pregnancy complications past a certain gestation and most will not provide coverage for an infant born after the policy was purchased.