Inflight-childbirth: An exceptional medical case. A big Cabin Crew challenge - By Ahmed Haouaria

17 Nov 2019

Flight attendant: it’s not only about having a career in the clouds

Flight attendant is a safety al care and inflight medical care demanding job.

The following post will deal with a specific aspect of medical cases on-board; Childbirth on board, an exceptional medical case a big cabin crew challenge.

The aviation industry has known significant changes mainly in dealing with customers on-board with challenges both related to Safety and Customer services care. There is a lot more to being a flight attendant than just handing out headphones, serving meals and soft drinks.

Ultimately, passenger’s safety and medical case treatment on-board are key elements of present day aviation industry priorities and cabin crew are here a major actor. From performing hand-to-hand combat, fighting fires to delivering babies on-board some of cabin Crew responsibilities might surprise you. Whatever the conditions are Cabin Crew are responsible for taking care of 300-plus lives at 35,000 feet.Cabin Crew are trained in how to safely deliver babies until the emergency services can take over on the ground.

IATA instructions related to pregnant women 

According to, nternational Air Transport Association (IATA) Pregnant mothers are not seen as Incapacitated Passengers and are accepted as Airlines passengers without medical clearance unless there is any uncertainty of progress of pregnancy, time of confinement or expected complications in delivery. Medical clearance is recommended where it appears that confinement is expected in less than four weeks prior to the planned date of travel (8 weeks for multiple pregnancies) or if any complications in delivery may be expected. It is recommended that Cabin Crew are alerted via a notation in the Passengers Information Lists PIL where medical clearance has been required. 

Passengers beyond the 28th week of pregnancy should carry a medical certificate confirming the expected delivery date and that they are in good health. 

Passengers with normal pregnancies and no previous history of premature labour can travel up to and including the 36th week. After that time, only short trips will beconsidered and after assurance by the treating physician that there is no sign of imminent delivery.

Air travel is not recommended for: 

  • Women within the last seven days prior to confinement and within the first seven days after delivery;
  • Healthy new-born babies, provided not prematurely born, may travel following the first seven days after birth ;

Premature babies are not accepted within the first 7 days after birth, and then subject to medical clearance depending on individual airlines’ policies.

Airlines requirement aligned with IATA instructions 

While in an advanced stage in pregnancy, women shouldn't be flying. Many, however, try to hide their condition to be able to travel shortly before their pregnancy due dates. Much more frequently, a pregnant woman who is flying goes into early labour, which means that the cabin crew has to deal with probable extra risky early births.

Clearly, Cabin Crew are not doctors or medical staff but part of their mandatory First Aid and inflight medical cases training involves midwifery skills, to enable them to assist women in childbirth.

In most airlines, the related policy states that after 28 weeks, pregnant women must carry confirmation from a doctor, in addition to the pregnancy record, which should be written seven to 10 days prior to a scheduled flight. It should also confirm the estimated due date, and that the concerned pregnant woman is fit to fly with no potential complications with the pregnancy.

Obstetricians state that "In some extreme circumstances, blood thinning medication might be needed as pregnant women are twice as prone to blood clotting compared to non-pregnant women. Therefore, if any other clotting risks are present, blood thinning medication should be discussed with the care-taking doctor’’.

The additional probable risk in flying when pregnant is premature labour and, thus, the vital care of the newborn on the plane with, most probably, no specific resuscitation equipment on-board.

In some airlines, Cabin Crew also have the possibility to get in touch with doctors, specialist ground-to-air medical assistance service, which is operated by doctors with experience in aviation medicine and distant medical assistance.

Cabin Crew are advised to request the help of any medical professionals on board, doctors, nurses, however they should first make sure that they are appropriately qualified to assist.The well controlled pressures in the cabin combined with cabin crew basically highly trained in advanced first aid skills including dealing with childbirth  make such task possible. The bellow selected cases are proofs that even if one would think giving birth on a plane, more than 30 000 feet above sea level, could be dangerous to both the mother and the newborn, it's no more dangerous than delivering at home.

‘’Airlene’’ : First Airplane BabyBorn in 1929

Indeed, It was planned. Dr. Thomas W. Evans and his wife Margaret D. Evans had chartered a Fokker for the very exclusive purpose of having the first air-born baby ever. They could afford it, they did it. As part of the organisation doctors and nurses were also on board. On 26 October 1929, The plane flew over the historic Miami-Dade Country Courthouse located in Miami-Florida at 1,200 feet during the baby birth, which occurred 20 minutes after take-off. Then the plane turned over Biscayne Bay for several minutes before landing. Mother and baby were transported to the hospital for necessary baby post birth check-ups and medical treatment. 

The story of the first airplane baby made headlines of the papers across the USA. The parents received dozens of baby name propositions, including “Airogene, Airlene, Pan Skymiss, Skylove, and others.

What name did they choose for the new baby born? Airlene according to theMiami Daily News issue of December 1946.

'EK' Baby born on Emirates flight

On August 22, 2012 Emirates flight EK332 from Dubai to Manila was diverted to Ho Chi Minh City due to the birth of a premature baby on board. The crew decided to make an emergency landing in Vietnam after a Filipino woman gave birth on-board.

Cabin Crew and two nurses helped deliver and care for the child, who was born premature at 27 weeks. The 35-year-old mother has decided to name the boy EK which is The International Air Transport Association (IATA) code for Emirates Airlines.

The crew and nurses properly applied the process by cleaning the amniotic fluid from the baby’s mouth, nose and ears. The Cabin Crew also managed oxygen masks administration to the new baby born and kept him wrapped in cabin blankets to ensure suitable temperature until landing.

Turkish airlines: Happy Landing with one extra passenger

A Turkish Airlines flight landed with one more passenger than it took off with after a baby was born mid-air with the help of the airline’s crew.

On April 9. 2017Cabin crew on Turkish Airlines Boeing 737 helped a woman give birth to a baby girl mid-flight.

Thanks to the immediate help of the crew the mother who a Guinean 28-weeks pregnant  had earlier complained of birthing pains while the plane cruised from Guinea to Istanbul via Ouagadougou. Diaby welcomed her daughter, Kadiju, at 42,000 feet in the air.

With the flight passengers, the cabin crew celebrated the arrival of the extra passenger thanks to the promptness of reaction to assist the lady childbirth during the flight.

Royal Air Maroc A  baby born over Atlantic ocean

It was a graet moment of joy both for crew members and passengers on July 14th 2018, on a flight between Casablanca and Montréal when a Moroccan-Canadian woman delivered a baby girl during a Boeing 747- 400 Royal Air Maroc (RAM) flight between Casablanca and Montreal just a few minutes after landing.

Seven months pregnant, the young woman felt the first contractions a few hours after taking off at 7 p.m. and gave birth at midnight.

A medical student intervened “successfully” to help the woman deliver the baby. The mother and her newborn were transported to Sainte-Justine Hospital in Montreal. The baby became the second to be born on a Royal Air Maroc (RAM) flight after of a first baby delivery in 2014 when a 33-year-old Moroccan woman gave birth to a baby girl named Ghalia, also on a RAM flight between Casablanca and Montreal.

Air Arabia A Surprise Onboard

On January 12015 A Bangladeshi national has given birth to a baby on board an Air Arabia flight from Lebanon, bound for Hazrat Shahjalal International Airport, Dhaka.

The pregnant passenger, who was returning home after visiting her husband in Lebanon, experienced contractions and with the assistance of the Aairlines professional and the well-trained cabin crew operating on the flight gave birth to her baby delivered safely the new born was immediately given the necessary medical support as per the company Standard Operating procedures.

What about the baby born in the sky ? 

This is not a standard rule but when this occurs, mothers and babies could be rewarded by the airlines. A baby born on a Thai plane in 1995 was even given a special scholarship from the airline. On June 2017 An Indian airline Jet Airways boy born on a plane between Saudi Arabia and India has been promised free flights for life.

Births on planes are such rare and complicated but flight attendant are trained to properly deal with such cases. 



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