Knocked up abroad: second trimester travel

second trimester travel

Not far along enough for second trimester travel? Read more about pregnancy in a foreign country, Turkish prenatal care, travel in the first trimester,Turkish superstitions, and foreign baby names on Knocked up abroad.

A few years ago, before the word staycation foisted itself into the travel lexicon, babymoons were all the rage. A babymoon typically referred to the last getaway for expecting parents, often a deluxe resort vacation replete with couples’ massages, room service, and lots of pampering. I’ve spent my my pre-baby travel slightly differently, exploring post-Soviet museums before needing a stroller, eating at restaurants that have never heard of kids’ menus, and learning what non-alcoholic drinks are on offer in local dive bars. Living abroad in Istanbul has also changed my short-haul destinations considerably. In the first trimester, my husband and I traveled to Kiev and Warsaw, Russia in the dead of winter, and to Frankfurt for the Christmas markets, and I don’t regret having gone without the his-and-hers massages. For second trimester travel, I found Singapore to be nearly ideal: the food and shopping are epic, the street food is safe, and the people polite and helpful. Though the hotel prices and high temperatures can be hard to deal with, the Southeast Asian city-state is a nice balance of relaxation and city exploration.

Ask any new parent or doctor and they will tell you that the second trimester is the best time to travel, after the early days of morning sickness have passed and before you get so uncomfortable that a walk around the block feels like a marathon. Given the relative comfort level, the second trimester is also the best time for longer trips further from home. I flew 10 hours home to New York (my first trip back to the US in 10 months) in late February at 20 weeks, and just returned from a week in Malaysia and Singapore at 27 weeks. Today I hit the 28-week mark of pregnancy, a big milestone as it means the end of unrestricted air travel. For many international airlines, including Turkish Airlines, British Airways, and Qantas, you are required to bring a doctor’s note certifying you are fit to fly overseas. We all want to avoid childbirth on a plane, even if it could mean free flights for life.

Here are a few lessons I’ve learned from travel in the second trimester:

  • Travel when you are showing: Part of what makes first trimester travel tough is that no one knows you are pregnant other than you and your travel companions. Exhausted and need a seat? Tough luck, lady, we’re all tired. Need to make sure that foreign drink is non-alcoholic? Better stick to (bottled) water. While my friends cooed over my five-month baby bump, not a single person gave me a seat on the NYC subway in a week of rides, even when I unzipped my winter coat and looked longingly at strangers. Two months later in Singapore, I barely stepped onto a train before several people offered me a seat and every car has a few reserved seat for passengers in need.
  • Don’t skip the creature comforts: Even if you skip the traditional resort babymoon, you should still give yourself a break when traveling. When booking air travel, if you can find a way to upgrade yourself to business class, you’ll be glad to stretch out even if you can’t sip that free champagne. Coming from rainy and chilly Istanbul, a week in tropical Southeast Asia seemed heavenly, but walking around in humid 90-degree weather felt more like hell. I must agree with my food blogger friend Kate over at Savour Fare who said that “swimming pools are God’s gift to pregnant women.” Staying at a hotel with a pool gave me much-needed relief in between wandering the historic (but seriously hot) streets of Penang, Malaysia.
  • Bring documentation: As noted before, many airlines require a doctor’s note for women to fly between 28 and 35 weeks. But how do you prove how far along you are in the earlier weeks? At my last doctor’s appointment before flying to Asia, I asked for a note allowing me to travel just in case, having heard that Malaysia sometimes restricts entry to pregnant women in later months for fear that they will give birth in the country. Good thing I did as nearly every Turkish Airlines personnel asked me for my medical report: when checking in, at the gate, and on the plane. If you’re traveling internationally after 20 weeks, play it safe and bring a note.
  • Do half as much: For first trimester travel, I noted that you should realize your limits have changed. Though energy levels may increase in the second trimester, jet lag and extreme weather still take a major toll. I had a long to-do list in Singapore but could barely manage half the things. I scoffed at paying for the tram at the zoo, but in hindsight, it would have been much easier and more comfortable to get around Singapore’s massive animal park. Even if you normally avoid overpriced museum cafes, they might provide the break you need to stay a little longer. Taxis are another friend of pregnant women, especially when they are air-conditioned.
  • Buy local snacks: Pregnancy is a double-edged sword when it comes to eating: your hunger is greatly increased but you have to watch what you put into your body, whether you’re in a foreign country or not. Often flights arrive late at night or you mistime your lunch break when all the restaurants are closed, leaving you without many food options. Penang is known as Malaysia’s food capital but I had to make different choices for safety’s sake and avoid some of the famed street food, though Singapore’s hawker centers are quite hygienic even when you are eating for two. A visit to a supermarket can provide an expecting traveler with a range of unusual but safe food. Each night in Asia I tried different bottled drinks, from the tasty calamansi juice to the vile lemon-barley drink. Having a stash of local snacks made me feel better about staying safe with street food while still enjoying products only found in Malaysia. America needs to get with the Kit Kat drumstick ice cream cone, though I’m not so sure about the blueberry-and-hazelnut Pringles.
  • Dress for comfort: Nearly all pregnant women experience swelling in the hands and feet, particularly in the last few months. Air travel, salty foods, and humidity exacerbate this, so halfway through my vacation, I worried I’d burst out of my shoes like the Incredible Hulk. If you’re traveling to a hot place, pack shoes that give you a bit of room and remove your rings before flying (good opportunity to find a nice necklace to wear them on). Also be sure to dress in cool clothing that still provides coverage to avoid (or protect) sunburn.

With three months to go, there’s still more Knocked up abroad to come, stay tuned for more on pregnancy travel.

Knocked up abroad: prenatal care and pregnancy advice in a foreign country

pregnancy foreign country See part 1 of Knocked up abroad: getting pregnant in a foreign country here.

One of the best parts of my experience so far with pregnancy in a foreign country has been the excellent medical care I have in Istanbul. Like many other expats before me, as soon as I took a positive pregnancy test, I called up the American Hospital for an appointment. The hospital treats many foreigners each year, is renowned for infertility treatment as well as other quality medical care, and is popular as part of Turkey’s growing medical tourism (the cow pictured at right is in the hospital lobby; you can tell how serious he is because of the glasses).

My first prenatal appointment was scheduled for Thanksgiving Day, and while many Americans were getting up to stuff the turkey, I confirmed I was six weeks’ pregnant (you’re welcome for sparing the “bun in the oven” puns). My very charming and English-speaking Turkish doctor gave me the usual pregnancy advice/warnings*, all peppered with only-in-Turkey bits:

  • Eat lots of dairy like ayran (yogurt drink Westerners often hate because it’s not sweet), yogurt, and cheese. While pregnant women should avoid unpasteurized milk and soft cheeses, you won’t find many of either in Turkey (or in the U.S.) unless you are looking for them.
  • No undercooked or raw meat like çiğ köfte, a popular raw meat and bulger-wheat snack served all over Istanbul (I first tried it outside a trannie bar here). I’ve discovered that the primary concern with sushi is an elevated risk for food poisoning; there is no additional or specific risk to the fetus. Sushi fish is often flash-frozen when caught, therefore it contains lower levels of bacteria. Use your judgment when ordering raw sushi, or stick to California rolls.
  • It would “be a crime to not eat fish in Turkey,” according to my doctor, but stay away from the big ones like shark which have high mercury levels. 1-2 servings of salmon or tuna per week is fine.
  • Sadly, especially in a country with excellent produce, eating unpeeled vegetables or salads in restaurants is a no-no, due to the hepatitis risk. While most restaurants are very clean in Turkey, when you are in a country with some traditional “natural-position” (aka squat) toilets still in use, you run the risk of some food contamination that’s riskier for expectant women than the general public.
  • Like many Europeans, I was told that 1 or 2 alcoholic drinks a week is okay, such as a glass of wine with dinner. Moderation and common sense are key, and it’s always best to err on the side of caution.
  • Caffeine is also fine in moderation: 1-2 cups of coffee, tea, or sodas are allowed per day, though I’m not convinced that a piping hot, two-sugars-no-milk glass of Turkish çay isn’t higher in caffeine than your average cup of tea.
  • Light exercise like yoga, pilates, and swimming are fine, but no “jumping exercises.”

My other concern was, of course, travel, but that was given the green light as long as I have no complications. Most airlines allow travel up to 28 weeks without a doctor’s note and up to 35 weeks with medical clearance. Whether your flight is short or long-haul, it’s advised to get up and move around every hour or so (good advice even for non-preggos) and choose the aisle seat. As I get bigger, I find puffing out my stomach as much as possible helps to get baggage assistance, and seats on the subway is good too.

The costs of prenatal care in Turkey are low: each of my appointments to a top-end private hospital cost just over $100 USD even with NO insurance (my U.S. insurance treats all international care as out-of-network and thus, out-of-pocket), even with ultrasounds at every visit–most American women get only a few over the course of the pregnancy. I’ll pay less for childbirth with a private room and catered meals for the family than I would for a shared room in a New York hospital. I rarely wait more than a few minutes to see the doctor, and the facilities and equipment are new and clean.

So far, Turkey has proved fairly easy to navigate as a pregnant person. I’ve never had a doctor who I could easily email with problems (such as which cold medicines were okay to take when I was sick in Russia), and everyone I meet is helpful with my concerns and questions. Istanbul is built on hills, so walking to the store can mean a fairly strenuous hike, but modern Turkey accommodates with online food and grocery delivery. Organic food is cheaper than at home, and nearly all of my cravings have been satisfied so far (though I could go for some American mac-and-cheese). I’m not yet halfway through the pregnancy but wouldn’t hesitate to reassure another expat that Turkey is a fine place to have a baby.

*Note: none of this is intended to be taken as medical advice, but rather my personal experience and anecdotal evidence. Talk to your own doctor about warnings and concerns before traveling to a foreign country, pregnant or otherwise.

Stay tuned for more on pregnancy travel, including Turkish superstitions and customs, where to travel in each trimester, what to eat when pregnant abroad, where to do pre-baby shopping, and more on having a baby in a foreign country. Check here for further updates.