Until when is a pregnant woman allowed to fly? It turns out this seemingly simple question has a lot more than one answer. Take, for example, Tamar, a woman in the 32nd week of her pregnancy who had planned a two-day business trip to Eilat. When she arrived at the check-in counter at Sde Dov Airport, the clerk noticed her large stomach and asked how many months pregnant she was. After hearing the answer, she unequivocally informed her: "If you don't have a medical consent form, you will not be able to fly; that is company policy."
Tamar was convinced that she had already missed out on the trip, the meetings, and the pool and pampering at the hotel that had been booked in advance for her by her company - but soon discovered there was some hope left: A brief survey found that Arkia, which also flies to Eilat, does not require a written medical consent form in and would gladly allow her to fly.
The case of Tamar is an example of airlines' lack of uniformity when it comes to carrying pregnant women: Every airline has its own policy, with the considerations ranging from the desire not to lose customers (the woman, and her family, who also may not fly if the woman is not allowed to) and fear of having a woman give birth in flight.
Yossi Fattal, the director general of the travel agents association, explains that a situation in which a woman gives birth on board a plane very much frightens the airlines because a birth may force the plane to land before reaching its destination, thus entailing a serious financial loss for the company. However, Fattal, reassures, if a company allows a pregnant woman to fly and she gives birth early, the company, and not the woman, will cover the losses.
What is the origin of the lack of uniformity in airline policy when it comes to criteria for allowing pregnant women to fly?
It turns out that the International Air Travel Association (IATA) does not set specific guidelines for flying pregnant women and therefore every company chooses its own criteria based on its own risk analysis.
Avner Gordon, the manager of Swiss Airlines' Israel office, explains that, "IATA's guidelines do not refer to pregnant women as passengers with restrictions of any kind, and the responsibility of notifying the airline of the pregnancy lies therefore with the woman traveling."
This is another detail worth remembering when you book a ticket: They will not ask if you are pregnant; you have to inform them and find out exactly what restrictions apply.
We contacted the large airlines operating in Israel and asked what restrictions they have on pregnant women wishing to fly with them. The results reveal large variations - from Continental Airlines, which allows pregnant women to fly throughout the entire pregnancy, to Israir, which demands a medical consent form from the 28th week and onward and does not fly pregnant women at all after the 32nd week.
In general, it may be said that most companies set the limit in the 36th week of pregnancy (the beginning of the ninth month), and some airlines require a medical consent form for flying earlier - and sometimes even require a very detailed consent form drawn up by the airline itself. For pregnant women who are at a high risk or are carrying more than one child, it is even harder to obtain permission to fly late in the pregnancy.
The possibility of flying is, however, only one side of the coin. The other side relates to insurance coverage in the event of additional expenses related to the pregnancy, or birth by the women during the flight or while abroad.
Dr. Udi Frishman, a medical and homecare insurance consultant to the insurance agents association, clarifies that "the fact that the airline allowed the woman to fly really does not mean that she has insurance coverage."
The reason: Most standard travel insurance policies do not include a clause on expenses related to pregnancy and birth.
Yaakov Kiehl, the head of the business development unit at The Phoenix insurance company' elementary department, explains that in the market there are three ways of relating to pregnant women in travel insurance policies - policies that do not cover pregnant women at all, not even in cases that are totally unrelated to the pregnancy, such as a broken leg or other ailment; policies that cover pregnant women up until the 26th week, but only with standard coverage that does not cover expenses resulting from the pregnancy; and policies that cover miscarriages only.
In other words, in the event of giving birth early while abroad, which usually means the birth of a premature baby that occasionally requires lengthy hospitalization, if you do not make sure to supplement your insurance beforehand, you will have to cover the cost of the birth, hospitalization of the mother and infant, extending your stay abroad and more.
According to Frishman, "The risk is huge and the costs may amount to as much as half a million dollars. This is a genuine risk."
So what can be done?
"In order to be covered, one has to buy a travel insurance policy with an addendum to cover pregnancy, and to verify that the addendum corresponds to how far along in the pregnancy the woman is.
"In addition, one should consider the length of the trip: Let's say you're in the 30th week and need to return in the 34th week; make sure that coverage is valid up to the 34th week."
Finally, Frishman recommends reading the policy carefully and knowing exactly what it covers, and making sure to consult a gynecologist.
Incidentally, the insurance clause does not apply to flights within Israel because within Israel all residents are covered by the National Insurance Law, so the woman who arrives in Eilat and goes into early labor will be hospitalized at Yoseftal Hospital and will not have to pay for the hospitalization, just as she would not pay had she gone into early labor while she was at home.
We checked with several insurance companies, health maintenance organizations and credit card companies that together insure most of those traveling abroad to find out how much it costs to expand an insurance policy and what the terms are. Here, too, we found large variations that consumers should be aware of.
For example, the Meuhedet HMO sells supplementary insurance for $1.50 per day, plus a one-time payment of $15 to cover the full cost of airlifting the woman back to Israel. This insurance covers women under the age of 39 and up to their 32nd week of pregnancy - for $50,000.
The Clalit HMO, on the other hand, offers a supplement that goes only until the 30th week, and for a premium of $3.50 day. This policy provides the same coverage - $50,000 for hospitalization costs and medical expenses related to pregnancy problems.
The Leumit HMO sells a policy that provides cover up until the 26th week of pregnancy, and also for $3.50 per day. The policy provides for $100,000 in hospitalization costs and medical expenses abroad.
Maccabi also offers an insurance policy supplement that offers cover until the 26th week for women until the age of 24 at NIS 13.60 a day), while women aged 25-49 pay NIS 15.50. The policy covers pregnancy-related medical expenses, baggage and a medical airlift.
Visa CAL has supplementary insurance policies that cover until the 32nd week of pregnancy for women under 39, at a cost of $4.74 per day, excluding baggage, and $5.55 with baggage. This policy covers medical expenses, hospitalization costs for the infant and early delivery - up to $10,000.
Leumi Card's policy goes until the 26th week and costs $3.00 a day. The ceiling varies depending on the credit card held by the policyholder.
And what about the insurance companies? Migdal does not sell policy extensions, only a broader policy that costs $4.50 a day (three dollars more than the standard policy) and covers, among other things, pregnancy until the 26th week. The maximum is $5,000 for pregnancy-related expenses.
The Phoenix also sells an extension that provides coverage only until the 26th week for an additional three dollars per day. The ceiling is the same as the general ceiling of the policy - up to $500 per day.
And another detail worth remembering: Not all of the policies cover the cost of hospitalizing a premature baby. Many, in effect, only insure the mother, and the heavy cost of hospitalizing a premature baby will fall on you. It is certainly an important item to consider before deciding to fly during the course of a pregnancy.
So before traveling abroad when pregnant, remember that it is a considerable insurance risk; and even if they are willing to fly you back, it is does not mean you have insurance protection.
And we cannot conclude without looking at the famous popular legend: Does an infant born during a flight really get free air travel for life?
It turns out that even though this is a myth, there is a reasonable chance that it will happen: "There is no law or rule obligating an airline to give such an infant free tickets for life," notes Fattal, "but many of them do take advantage of the opportunity for endearing and favorable press coverage."