I know, this is shocking, but of the 8.7 million or so Americans that live overseas and the millions more that travel there each year, some of them are… PREGNANT.
You’d think the CDC had never heard of Americans living in other countries. You know, we do! And if you put us all together we’d be the 12th largest state in the US. About the size of New Jersey.
Imagine if the CDC was like, “Listen, to protect your unborn baby’s life don’t travel to New Jersey. At all. Oh and if you’re in New Jersey, well good luck.”
Here’s an example, for Mexico the CDC warns, “Local mosquito transmission of Zika virus infection (Zika) has been reported in Mexico. Local mosquito transmission means that mosquitoes in the area are infected with Zika virus and are spreading it to people.”
Okay but Mexico is as big as the lower 50 states minus CA, OR and WA. It’s big. I think knowing if there are tons of Zika cases in Chiapas state (near the Guatemala border) but not in Jalisco state (1,000 miles north and home of Puerto Vallarta) is going to make a world of difference. That’s a long way to travel for a mosquito that only goes 500 meters in it’s lifetime. It can happen in a season, when it gets warm, but I don’t think that right now, this week, there’s as much to worry about. We’re not there yet. And we should give that kind of information to people who travel so they can make informed decisions instead of just saying, “Go home or risk it blindly.” It’s sort of paternalistic to suggest that if we don’t follow the recommendation to completely avoid an entire country, we don’t deserve to know which areas are the most dangerous. (See my note on the bottom on why it’s not possible for me financially to return to the US to give birth. Spoiler: it’s about health insurance.)
Anyway, after my post the other day I got a lot of emails from women who are pregnant, or trying to get pregnant, who are in the same boat as me. (Quick soapbox: half of all pregnancies are unintended, Zika lives in sperm for 60+ days so if you’re a guy, you should probably follow the same advice as pregnant women, since you have such a large window of an “oops” with really bad consequences – but culturally that’s taboo for some – the CDC has resisted being prescriptive for men, just saying “if you’re planning…” – half of all pregnancies are unplanned!)
Since there’s almost no guides for traveling while pregnant and avoiding Zika out there, I’m putting this together, based on my research. My source has been the CDC website, it’s all in there, they just don’t make it very easy to discern at first glance. I will link to the original pages as much as possible so you can do additional research.
WHERE CAN WE TRAVEL?
It’s safe to travel to most of the world except the certain islands in the South Pacific, some of the Caribbean, and most of Central and South America (plus Cape Verde in Africa is out). The updated list is here. But where can we travel in these hot zones?
CANADA – all of Canada is safe, it doesn’t have the type of mosquito that carries Zika.
UNITED STATES – There are no local cases in the US yet, it’s just been brought in by travelers, so the local population of mosquitos are not infected. However it’s not known if it will cross into the US this summer when it warms up. Here is the map of the range of the Aedes aegypti and Aedes albopictus mosquitos in the US:
Will that be the infected areas? Let’s hope not! Between AC, window screens and bug spray maybe it’ll stop the spread. Time will tell.
MEXICO – Mexico has had local cases of Zika. The CDC recommends not traveling to any area below 6,500 feet. Below is a map of areas by elevation but from a tourism perspective, traveling to Guanajuato (6,600 ft), Mexico City (7,300), Puebla (7,085 ft) are all safe.
However, there have not been an equal number of cases across all states in Mexico. From the Mexican Secretary of Health (in Spanish), here is the latest numbers, as of April 11th:
I live in Oaxaca, which is why I want to move, but if you’re thinking of going to Puerto Vallarta (Jalisco state) or Sayulita (Nayarit) or Cancun/Playa del Carmen/Tulum (Yucatán) we’re talking about 2, 1 and 1 case in each of those states, respectively. I’m not the CDC, but do what you will with that information. To me that doesn’t show that the local mosquito population is infected.
BELIZE – Incredibly, Belize is fine. I don’t know why this is, but they haven’t had any local cases while the rest of Central America is off-limits.
PERU – Zika hasn’t spread locally.
CHILE – Zika hasn’t spread locally.
ARGENTINA – Zika hasn’t spread locally.
URUGUAY – Zika hasn’t spread locally.
PLUS: any cities of high altitude above 6,500 feet, such as:
BOLIVA – La Paz (no mosquitos)
COLOMBIA – Bogotá (no mosquitos)
ECUADOR – Quito, Cuenca (no mosquitos)
CARIBBEAN: I hesitate to include these, because it seems to be an evolving situation: in January the CDC added the US Virgin Islands and the Dominican Republic to the list, so double-check the latest before booking a flight to any of these zika-free places. Here’s what’s restricted: Aruba; Barbados; Bonaire; Cuba; Curaçao; Dominica; Dominican Republic; Guadeloupe; Haiti; Jamaica; Martinique; the Commonwealth of Puerto Rico, a US territory; Saint Martin; Saint Vincent and the Grenadines; Sint Maarten; Trinidad and Tobago; US Virgin Islands
But there are some that are still safe:
ST. BARTS – Zika hasn’t spread locally.
BERMUDA – Zika hasn’t spread locally.
GRENADA – Zika hasn’t spread locally.
TURKS AND CAICOS – Zika hasn’t spread locally.
And that’s it.
SIDE NOTE: Hope this helps other intrepid pregnant women plan better! It’s not just about “where to have a baby moon” (but please, let’s not shame women away from traveling while pregnant, I was in Maui and Belize for my first baby moon and Thailand for my second, all places with excellent private hospitals if anything happened) but what is overlooked is the reality that many women are living overseas and are thinking: wow, I’m pregnant, (perhaps living in Oaxaca, Mexico like me) and I need to go somewhere else for a bit, perhaps for the rest of the pregnancy. What are my options locally? In this region?
The fact is, not everyone can run back to the US. If you’ve been living overseas for years and years, you likely don’t have US health insurance because it’s expensive, you can get care locally for less than the deductibles for out-of-network care and you don’t have a US employer. If you’re pregnant and considering getting US health insurance you’ll have to wait until next January when enrollment opens up. Or you can get private insurance but most of those don’t cover birth until after 12 months of coverage. Right? So if you’re pregnant right now, there is no way to just “hop” back into the US as the CDC suggests.
By the way, travel insurance doesn’t cover pregnancy (it will cover an emergency like an ER visit but not delivery).
Right now, I’m considering: biting the bullet and going to Canada (l would love to visit BC/Alberta for the summer, but I’ve found the same insurance issues as the States – but I could potentially negotiate a package rate at a local hospital there for out of pocket for $5-$10K according to the numbers I was able to find), going to Mexico City (easy, safe, but going to be brutally hot this summer), Peru or Argentina. I researched medical care in Peru and Argentina last time I was pregnant and there are good affordable options.
Or I could just spend a few months somewhere and return from Oaxaca. However, I’d want some confirmation (from the CDC or WHO) that Zika in the third trimester is harmless before doing that. Who knows, maybe by July they’ll have much better information. I am hopeful.
As a diversion from all this “fleeing the coming zikapocalypse” I have the strange luxury of considering whether my child’s second passport should be Canadian, Mexican, Peruvian or Argentine as each of those countries pass citizenship by birth on their soil. Thoughts? Let me know on FB.