It’s more than just a big belly

You don’t need an expert to tell you that a lot changes in your body when you become pregnant.  You may not be aware of all the changes, though, and many of them have a direct bearing on travel and the problems you might encounter.

Most of the changes that occur are a result of the hormones that are produced by your ovaries and placenta.  Progesterone is a potent relaxer of the muscles that line your blood vessels, your intestinal tract, your urinary system and the bronchioles in your lungs.  Estrogen, meanwhile, increases your respiratory rate, increases the amount of blood in your circulation and promotes clotting.  It also contributes to the nausea of pregnancy.

Relaxation of the smooth muscles means that your esophagus relaxes, your stomach empties more slowly, your intestines get sluggish, and your blood vessels dilate as do your ureters and bladder.  This is largely the cause of the heartburn, vomiting, constipation, abdominal bloating, bladder urgency and urinary infections that are so common in pregnancy.  The relaxed blood vessels may show up as hemorrhoids or varicose veins.  On the good side, your airways relax as well which means that if you have asthma, it may improve.

On the other hand, estrogen increases mucus production and slows its removal from the airways so there is more risk of respiratory infection.  Also, sinus headaches and nasal stuffiness become much more of a problem.

Estrogen also increases your blood volume, the number of platelets in your blood and the clotting factors in your serum.  All of these, combined with the dilated vessels, greatly increase the risk of blood clots forming in your legs and traveling to your lungs (pulmonary embolus).  It also means that if you get injured in an accident there is apt to be a lot more blood loss than usual.  Another effect of all this is the frequent complaint of palpitations and shortness of breath.

Other changes occur in your body chemistry.  The acidity in your stomach decreases.  Blood flow to your kidneys and liver increases, resulting in a more rapid metabolism of certain medications.  Your blood becomes more sensitive to chemical changes and is more apt to become acidic.  Your immune system slows down so that you don’t “reject” the baby you are carrying.  Even though your blood vessels dilate, they become more sensitive to chemicals that cause them to constrict.

All of these changes may become very important if you are traveling.

The decreased stomach acidity, for instance, means that you are more apt to get traveler’s diarrhea, typhoid or cholera.  And if you do get diarrhea, your blood is apt to rapidly become acidic, a condition that can kill the baby.  Meanwhile, the medicines or vaccines that are available to prevent these conditions may themselves cause more side effects during pregnancy.

The increase in blood flow to the kidneys and liver means that many medicines (especially some that are used to prevent malaria) will be broken down more quickly.  You may need to take higher than average doses and even have blood tests to see if you are on an effective dose.

Depression of your immune system can fight you in two ways.  On the one hand, it may make you more prone to infections such as pneumonia, hepatitis, malaria and certain parasites.  On the other hand, it may reduce the effect of the very vaccines that you are given to prevent these diseases.  All of this means you must be much more vigilant than average in preventing these infections by other means such as hand washing and purifying your water.

Accidents may be more of a problem in pregnancy.  The collagen in your joints softens to allow room for the growing baby.  Calcium turnover increases, sometimes robbing calcium from your bones for the sake of the baby.  This makes your joints more lax and your bones more brittle.  Add this to an altered center of gravity, and falls are more likely and injuries more serious.

Finally, don’t forget that the hormone changes of pregnancy can greatly affect your moods.  (If you have forgotten this, just ask your family!)  Insomnia and fatigue are much more of a problem during pregnancy.  You may need to allow for this by reducing the intensity of your itinerary.  One or two things accomplished with vigor may be much more profitable than a dozen done in a state of exhaustion.  An upgrade in your airline and hotel accommodations might also do a lot to make your travel more tolerable.

All of this is not to discourage you from traveling.  As you will see in the other chapters, allowances and adjustments can be made for almost all of these eventualities.  It just means that you, as a pregnant traveler, are going to need to be a little more health conscious than some of your non-pregnant fellow travelers.