Pregnancy and cruising: the 24-week rule and what else to check

Planning a cruise while pregnant? The CDC says safe travel is possible during pregnancy with careful preparation, but cruises add some specific rules and risks (CDC Yellow Book: Pregnant Travelers). Always plan your trip with your obstetric care provider.

The 24-week rule

• Most cruise lines don’t allow boarding after the 24th week of pregnancy (CDC: Cruise Ship Travel).
• The cut-off applies to your stage of pregnancy at any point during the cruise, not just on boarding day. For example, Royal Caribbean can’t accept guests who will be more than 23 weeks pregnant at any time during the cruise. All guests complete a public health questionnaire confirming this (Royal Caribbean FAQ).
• Lines may require a doctor’s note confirming you’re fit to travel, that the pregnancy isn’t high risk, and your estimated due date (CDC: Pregnant Travelers).

Check your cruise line’s exact policy before booking. Royal Caribbean notes that there is no obstetrician on board and that a guest may be at sea for several days without hospital or specialist back-up.

Health risks the CDC highlights for pregnant cruisers

According to the CDC, travel health risks on cruises include GI and respiratory infections, motion sickness, falls on a moving ship, and the possibility of delayed care while at sea (CDC). The CDC also says the risk of obstetric complications is greatest in the first and third trimesters.

Zika and other mosquito-borne infections

Many Caribbean and Latin American ports have mosquito-borne diseases. The CDC advises that pregnant women should reconsider travel to areas with a Zika outbreak, and also to areas with chikungunya or dengue outbreaks, because of possible harm to the baby (CDC: Pregnant Travelers). Check each port’s CDC page (see our Caribbean guide) and talk to your provider.

Vaccines

The CDC says vaccination is the most effective way to keep pregnant women and their infants healthy. Flu and COVID-19 vaccines can be given during pregnancy, while most live vaccines (such as MMR and chickenpox) are not given during pregnancy (CDC). Your provider will check which vaccines are right for you and when.

Medicines

Don’t start any medicine, including seasickness remedies, without checking with your provider. The CDC notes that ginger can help with morning sickness. It also lists antihistamines that are often used in pregnancy, but your provider should decide what suits you (CDC).

Insurance

The CDC notes that many health insurance policies don’t cover pregnancy or newborn complications abroad, and advises pregnant travelers to strongly consider travel health insurance that covers pregnancy-related care and care of the newborn, plus medical evacuation cover (CDC). Read the policy wording carefully. See our insurance guide.

Urgent warning signs

The CDC advises seeking medical care immediately for warning signs including (CDC):

• Vaginal bleeding or fluid leaking
• Severe belly pain or contractions
• The baby’s movements stopping or slowing
• Chest pain, trouble breathing, or fainting
• Severe headache or changes in vision
• Severe swelling of the face or hands, or of one leg
• Fever of 38.0°C (100.4°F) or higher
• Severe nausea and vomiting

On board, go straight to the ship’s medical center.

Pregnancy cruise checklist

• Confirm the cruise line’s week limit for the whole cruise
• Fit-to-travel letter with due date
• Copy of prenatal records and your provider’s contact details
• Check ports for Zika, dengue and chikungunya
• Insurance that covers pregnancy complications, newborn care and evacuation
• Prenatal vitamins and prescribed medicines

Sources