Who Writes a Fit to Fly Letter?

[LeeRoar]

Hi all!

So atm having a wee bit of back and forth between the midwives and the GP. My Mum surprised us by booking a holiday before she knew we were expecting, by the time we fly I will be 31 weeks, and 32 on return. I have mentioned this to my regular midwife and about 3 other midwives that I'd seen who all agreed that it would be my GP who would need to write the letter obviously closer to the time of travel.

My pregnancy has been a very smooth one, I'd been referred to a consultant as my BMI was a wee bit higher - but on seeing the consultant she said she was pretty unconcerned and would only suggest I had a gestational diabetes test, which was clear.

So we are due to travel at the end of May and the receptionist at the doctors told me they point blank do not write Fit to Fly letters, it has to come from my midwife. Called the maternity unit and spoke to a midwife who then called my doctor's office and spoke to the doctor over the phone. The midwife called me back and told me the doctor has agreed to give me an exam nearer the time and if everything is in order he will write a letter saying how far along I am, the pregnancy is going well and he doesn't expect any problems. But will not write the words FIT TO FLY on the letter.

So I call Jet2 and ask them if this would be accepted. The girl goes and checks with her team leader and confirms what I already suspected that if the exact words FIT TO FLY are not on the letter then I could be turned away at the gate. Jet2 don't care if it's the doctor or the midwife who writes the letter.

I call the doctor's office again and spoke to reception, trying to get my point across that what the doctor is offering won't be accepted but she just kept repeating that the doctor would write a letter saying how the pregnancy was going and how far along I was and that should be good enough - but the airline has said it won't be.

I phoned the midwife again and asked her if there was any other options or if there was a member of their medical team at the hospital who could examine me and if I was all good would definitely write the words fit to fly. She was unsure of when a doctor would be in the ward before I travel as the rota's change all the time and my local maternity unit is quite underfunded. But I have an appointment with my consultant exactly a week before take off who might write me a letter.

Sorry for the long post but basically I'm asking has anyone had this much bother with Fit to Fly letters before? And who signed yours?

That sounds like a real pain! I got my GP to sign the letter. I gave him (and filled in some of) the Ryanair expectant mother form. You could print it out and cut off the Ryanair heading. The doctor/midwife would have to tick a box saying 'fit to fly'. But it saves the doctor/midwife from having to write a full letter, and perhaps they'd be more accommodating.

My midwife wrote me a letter stating my due date, how many weeks I was and that it was an uncomplicated pregnancy. Neither her nor my gp would write fit to fly for insurance purposes- ie if something changes mid flight they don't want to be sued...

Not one person asked to see the bloody thing!

Take your notes in your hand luggage as well as any document you do get.

Also be aware no insurance company will cover you for a "normal " delivery abroad only care for you and baby afterwards or in the case if any complications.

I do not think that any GP would write the words "fit to fly" on a letter- the most they would put, I imagine, is to state your due date and whether there have been any complications so far in the pregnancy.

I guess that's all they or the midwife can do.
Airlines seem to be asking for a lot more than is reasonable, in my opinion.

The advice from those who provide the indemnity (insurance) for GPs is not to write fit to fly. It is because pregnancy is uncertain and anyone saying you are fit to fly could have the airline trying to recoup the diversion costs from the GP.

If the letter reference the official air line guidance (which is clear) your gestation and the lack of any complications the airline should accept that. If your airline doesn't the issue is with your airline not your GP.

You won’t find a HCP willing to write the words ‘fit to fly’. They’d be liable in the event that something went wrong. You just have to take your chances, I’m afraid.

My GP wrote mine, but also didn’t write ‘fit to fly’. They wrote exactly what your GP is proposing. It was fine (flew 3 times when I needed the letter and wasn’t questioned any of the times)

I flew around 32 weeks with dc2 and never really got asked, in either direction. Had an are you ok, do you need any help etc.
I would qesr baggy clothes and hope for the best.

It’s alnost impossible to get a ‘fit to fly’ letter as most of the standard templates that airlines provide require the doctor or midwife to tick a box that says ‘fit to fly’ and no one in their right mind would do that!! The most you can reasonably expect is a note giving your due date and saying your pregnancy is uncomplicated. Unfortunately most airlines will no longer accept that so you may be unable to fly.

If you do go then please ensure you are properly insured, to include care of a premature baby and their repatriation - very few companies will insure you beyond 28 weeks so do check.

From a medical perspective, Jet2's position is very annoying.

The GP has had exactly zero training in what 'fit to fly' actually means in aeromedical terms. Neither has the midwife. It is really up to the airline to decide whether you are fit to fly or not.

The GP's position that he can write a letter saying how your pregnancy is going is perfectly reasonable - this is all she/he can do, knowing nothing of aeromedicine and the words 'fit to fly' being a hostage to fortune.

I have dealings with terminally ill adults wanting to fly and all the decisions on them being able to fly are made by airline doctors or the Civil Aviation Authority doctors, or referrals to an actual 'fit to fly' service. Absolutely nothing to do with GP whatsoever.

OK - you made me google.

www.caa.co.uk/Passengers/Before-you-fly/Am-I-fit-to-fly/Health-information-for-passengers/Passenger-health-FAQs--Am-I-fit-to-fly-/

On the pregnancy section it says 'most airlines require a certificate after 28 weeks, confirming pregnancy is progressing normally'

So your GP is quite correct and Jet2 are being arses.

It’s not just jet 2, lots of airlines have standard proformas now. The CAA can say what they like but the airlines are free to make their own rules.

I totally understand wanting to ensure they aren't sued, is there any sort of waiver I could sign or is it as another poster said that perhaps they're afraid the airline themselves would sue? It's a short flight, 2.5hrs.

Also worried about just chancing it with the documents I do eventually get incase the lady at Jet2 has flagged our booking and given a detailed note? Or is that just me being paranoid?

No you can’t sign a waiver. If you don’t get the form I wouldn’t risk going as you could end up stranded abroad if they let you fly out but not back.

I am a bit concerned after reading this thread.... I am due to fly at 35 weeks, and return at 36 weeks (not ideal but it is to fit in during half term). You can fly up to the end of week 36. But what concerns me is that I am having the oral glucose tolerance test on Monday (currently 32 weeks) after having two high glucose dipstick results. If I test positive for gestational diabetes, will my pregnancy still be seen as uncomplicated?

What would the waiver say, though? 'I promise to cross my legs and not give birth on board'? 'I am willing to bear the cost of tens of thousands of pounds worth of diverted flights, compensation for other passengers, and medical treatment for myself'?

No holiday is worth the potential consequences if you can't get on the plan under the airline's ts and cs. If you can't get the paperwork in order then I suggest you explore cancelling or rescheduling, and making a claim on your travel insurance if you are covered.

Don't ask them for a 'fit to fly', ask for a letter stating that you are obstetrically well and the pregnancy is uncomplicated at the time of writing.

Also make sure that your medical insurance will cover a cancellation in case any complications occur and you're unable or unsafe to fly.

What others have said. You can't make this the GP's problem, they can only do what they feel safe to put their signature to, i.e. stating how many weeks and uncomplicated pregnancy so far.

Little cabbage. If you have GD you will not be able to fly at that gestation.

Gunty, most airlines no longer accept that sort of letter. They want a signed proforma that has a fit to fly tick box or declaration, hence it is now v difficult to fly in late pregnancy as most doctors and midwives, quite understandably, won’t sign one.

GP will not sign it as if you did go into labour in the air, the airline can sue your GP regardless of any waiver you sign. I have a family member who is a Doctor who had to assist a person who was ill on the flight, the airline put massive pressure on him to say whether the flight had to be diverted or not, not for the welfare of the patient (who was faint due to lack eating, nothing else) but as the flight attendant said it would make it his responsibility for the divert and potentially sue him. He had to tell them to ask the patient!

Ultimately GPs are not trained in assessing whether someone is fit to fly or not. It is likely they would write a statement of fact i.e. you are x many weeks pregnant and have had ABC complications (or not) in pregnancy. They will not want to pass a judgement i.e. stating whether you are fit to fly. Remember by law it is ultimately the pilots decision whether you are fit to fly or not, not your GP or midwife.

It's actually your GP who has to sign the form but it is not a Fit to Fly - our doctors called it a Fitness to Travel but state clearly that all fault lies with patient and must be signed by patient and will be stamped when picked up no more than 1 day before flying.

You may need to rearrange as consultant may not sign it either.

I totally understand wanting to ensure they aren't sued, is there any sort of waiver I could sign or is it as another poster said that perhaps they're afraid the airline themselves would sue?

This is academic because such a waiver doesn’t exist but please consider for a moment what you are suggesting here. You would be liable for the kind of sum that could bankrupt you several times over.

I agree with PP - your consultant won’t be willing to state that you are ‘fit to fly’ but hopefully s/he will give you a letter which will satisfy the airline. Nevertheless in your position I would be checking the terms of my travel insurance as a plan B.

It really is not worth the risk of flying that close to EDD in my opinion. (Mostly) not because of risk to you or your baby, but the potential financial implications for your family. There is the flight diversion issue, amd being denied boarding on return issue, and associated costs. In the EU, you are covered by the EHIC arrangements for maternity care, both routine and acute. What will not be covered are any on-costs if you give birth abroad: rescheduling fligts, obtaining travel documentation for your infant, accommodation after hospital discharge, accommodation cor your significant other and any other children, etc etc etc.

Antenatal and postnatal care is poor in some countries, but probably not where you are going if with Jet2 - unless Turkey, Bulgaria or parts of Greece. I would not touch them with a bargepole for medical care. I loved next to a hospital in Greece for w years. Relatives usedto turn up at mealtimes wih meals for the patients (none supplied on hospital) and anyone needing a heart op went to germany pronto.

Lived, not loved. Arf.

I travelled NZ to Australia at 29 weeks and my obstetrician write a letter saying I was fit to fly trans Tasman with an uncomplicated singleton pregnancy. I assume the liability situation is different in NZ than that UK.

However I echo what ragusa has said re potential cost/ risk if you did go into labour while away.

I was travelling to Sydney for 1 night for work - I triple checked my work insurance policy to ensure I was covered not only for healthcare while over there but that any child born was also covered. Some policies will cover your healthcare as a pregnant woman but not the resulting baby (which as a premature delivery would obviously be $$$). Also bear in mind if you did give birth while abroad at 32 weeks you wouldn't be able to travel home until the baby was discharged from hospital so potentially 4-6 weeks living expenses in addition. In my case work would have picked up the tab but I probably wouldn't have risked it just for a holiday.