Confirmation of your due date and fitness to travel, in the form airlines ask for.
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Most airlines require written confirmation of your due date and fitness to fly from around 28 weeks, and many refuse travel after 36 weeks for a single pregnancy or 32 weeks for twins.
Policies vary considerably between airlines, so check yours before booking the appointment — and before booking the flight.
Your notes or app, showing your estimated due date and any complications. The letter depends on these.
And whether they require the letter to be dated within a set period before departure — many do.
Within about ten minutes of your consultation.
The letter reports your records; it does not create them. We do not perform scans and cannot date a pregnancy ourselves — your estimated due date comes from your booking scan.
So bring your maternity notes or app showing the EDD, your current gestation, whether it is a single or multiple pregnancy, and any complications recorded.
Because these are the things people ask about at the airport rather than beforehand:
Anything other than a straightforward pregnancy belongs with your maternity team. Bleeding, reduced fetal movements, raised blood pressure, placenta praevia, a previous preterm birth, or a complicated multiple pregnancy — contact your maternity unit rather than booking a travel letter.
We can confirm what your maternity records show and that you are well at the time of assessment. We cannot override an airline's policy, and we cannot certify fitness where there are pregnancy complications — that needs your midwife or obstetric team.
If you have had bleeding, reduced fetal movements, or any concern at all, contact your maternity unit rather than booking a travel letter.
Check three things immediately: that the EDD matches your notes exactly, that the gestation stated for both travel dates is right, and that the issue date falls inside your airline's window.
An error in the due date is the commonest reason one of these is questioned at a check-in desk, and it takes seconds to correct today.
Hand luggage, along with your maternity notes. Staff sometimes ask to see the notes as well as the letter, and a document in the hold is a document you do not have.
Take a photograph of both. It will not always satisfy an airline, but it has rescued people.
Bleeding, reduced fetal movements, abdominal pain, headache with visual disturbance, or swelling of the face and hands — contact your maternity unit the same day, and do not travel until you have. These are urgent regardless of what any letter says.
A fit-to-fly letter describes you on the day it was written. If your circumstances change, it no longer describes you.
Send us their exact wording of what was missing. Where it is a matter of format or a phrase we can properly add, we will reissue at no charge. Where you are past their cut-off, no letter from anyone can help — and it is worth asking the airline about a fee-free date change on medical grounds.
Your NHS antenatal care is unaffected by any of this. A fit-to-fly letter is a travel document, not a change to your maternity care — your midwife team remains the people looking after the pregnancy, and we do not take that on.
Keep to your NHS antenatal and newborn screening appointments, and if travel would cause you to miss one, tell your midwife so it can be rearranged rather than skipped.
The letter reports your maternity records; it does not create them. We do not perform scans and cannot date a pregnancy ourselves. Your estimated due date comes from your booking scan, so we need your maternity notes or app to hand. Without them we cannot confirm gestation, and a letter that guesses at it is of no use to an airline.
Anything that is not a straightforward pregnancy belongs with your maternity team. Bleeding, reduced fetal movements, raised blood pressure, a multiple pregnancy with complications, a previous preterm birth, or placenta praevia are all reasons the answer has to come from your midwife or obstetrician rather than from a GP consultation. Contact your maternity unit rather than booking a travel letter.
Most airlines require the letter to be dated within a set window before departure, commonly seven days, and some require it for the return leg too. Check your airline's wording and time the appointment to it — a letter written too early is as useless as none at all.
Worth discussing at the appointment: long-haul flights raise clot risk in pregnancy, and destination matters — Zika transmission areas and malarial regions both carry specific advice for pregnancy. We would rather cover it than have you find out at the airport.
Most airlines ask for one from around 28 weeks, and most refuse travel after 36 weeks for a single pregnancy or 32 weeks for twins or more.
Cut-offs are the airline's, not ours, and they vary. Check your specific airline before booking either the flight or this appointment.
No. No doctor can. If you are past their limit, a letter saying you are well does not change their policy — it is a commercial and operational rule about a plane being hours from a hospital.
Ask the airline about changing your dates instead; many will waive a change fee on medical grounds.
No — we report it, we do not establish it. Your EDD comes from your booking scan, and we do not perform scans.
Bring your maternity notes or app. Without them we cannot confirm gestation, and a letter that guesses is worthless to an airline.
For an uncomplicated pregnancy, flying is generally considered safe, and the RCOG says so. The second trimester is usually the most comfortable.
The considerations are practical rather than dramatic: clot risk is raised in pregnancy and further on flights over about four hours, and the real question is what happens if labour or a complication starts somewhere without the care you would want.
Often worth it on longer flights, and more so with additional risk factors — a previous clot, raised BMI, a multiple pregnancy. Properly fitted ones, not fashion socks.
Alongside that: aisle seat, move hourly, drink water, and avoid sitting completely still for hours.
Usually within seven days of departure, and check whether the return leg needs covering too. Read your airline's wording and time the appointment to it — an early letter is a wasted fee.
Then this is not the right appointment, and we will say so rather than write the letter.
Bleeding, reduced fetal movements, raised blood pressure, placenta praevia, a previous preterm birth, or a complicated multiple pregnancy all need the answer to come from your midwife or obstetrician, who have your full picture.
If you have had bleeding or reduced movements at any point, contact your maternity unit today — that is urgent and quite separate from travel.
Destination matters more in pregnancy than most people expect, and it is worth discussing at the appointment. Zika is a genuine reason to reconsider a destination; antimalarial choice varies by trimester, and some are not suitable at all.
We can advise and refer, though we do not administer travel vaccinations — those need a travel clinic.
Check the policy wording rather than assuming. Many exclude pregnancy beyond a certain gestation, and many exclude neonatal care entirely — which is the expensive part if a baby arrives early abroad.
A fit-to-fly letter is not insurance and does not make you insured. Some insurers ask to see one; none accept it in place of cover.
Often yes, and it is the half people forget. Your gestation on the return date is what matters, and some airlines apply the cut-off to the last flight rather than the first. We state both dates in the letter.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
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