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Insta-CoGo: Baby on Board at Sea

Cindy Loose

Pregnant woman and new parents alert: New rules from Royal Caribbean Cruises Ltd. state that women must be less than 24 weeks' pregnant before the first day of a cruise for sailings on the company's three brands -- Royal Caribbean, Celebrity and Azamara.

Additionally, infants must be at least 6 months old before the first day of a cruise, but with a caveat: They must be at least a year old to get aboard transatlantic, transpacific, Hawaii and some South American cruises.

There is a grace period: The new policies will not be enforced until sailings that take place after Oct. 31.

On Royal Caribbean ships until now, there was no baby-age limit. Additionally, women could cruise Rpyal Caribbean ships as long as they were less than 27 weeks pregnant, and they had to submit a physician's "Fit to Travel" note stating how pregnant they were and that their pregnancy was not high risk. That requirement continues, but the doctor's note must confirm that they are less than 24 weeks pregnant.

The new policies were adopted, a cruise line statement says, to "recognize that infants and pregnant women can often require specialized, emergency medical attention that can best be provided by land-based hospitals." To CoGo's surprise, it turns out these rules are pretty standard in the cruise industury, and Royal Caribbean's policy had been, until now, more liberal.

CoGo has always advised pregnant women not to fly and not to even drive too many miles from a decent medical center once they reach their seventh month -- about 28 weeks. At that point, they have a viable fetus than can be saved pretty routinely if something goes wrong. Same would apply to being at sea, come to think of it.

Should CoGo revise down to 24 weeks as well?

As to a baby having to be 6 months old . . . CoGo was strapping a baby into an airline seat starting at 3 months and didn't think twice about it. Would have done the same if a cruise happened to come up. Was that unwise?

Reader thoughts?

By Cindy Loose |  May 20, 2008; 8:28 AM ET  | Category:  Cindy Loose , Insta-CoGo
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if the over 6 months has more to do with other passengers. Granted, a 3 month old sleeps a whole lot more than a 9 month old, but I don't know that a 7 day cruise is good for parents, a newborn and other passengers. (And I'm a mom of a 2 year old)

I think the cruise is trying to prevent babymoon babies. A friend of ours just delivered at 28 weeks on a babymoon vacation, 800 miles from home. They are stuck there, in a hotel, until the baby can leave NICU and fly, closer to the delivery date. She had been given the all clear to fly...

Posted by: I wonder... | May 20, 2008 9:32 AM

Interesting point about the babymoons. In my office, at lot of expected babies arrive prior to their baby showers, which are usually scheduled for pretty late in the process.

As for the difference between flying and cruising with an under-six-month-old: if something goes wrong with the baby while airborn, they can land the plane quickly and have it met by an ambulance to the nearest hospital. If something goes wrong on a cruise ship and it is out of range of a helicopter, the baby will just have to wait under the care of the ship's doctor (some of whom are more competent than other, and none of whom are pediatricians)-possibly dying, causing the parents to sue,and the cruise line to pay big bucks, or the ship will have to change course, inconveniencing the other 3000+ passengers, who will demand compensation from the cruise line. Either way, a no win for the cruise line, which is in the business of making money.

Posted by: Alexandria, VA | May 20, 2008 12:43 PM

You're right about the liability.

As far as pregnant women go--I'm often surprised when I get questions from women planning to travel very late in a pregnancy. I think advances in medical science have lulled us into thinking of pregnancy as a natural and uncomplicated thing, when in fact millions of women and newborns who don't have access to high tech care die every year.

As to babies, though---Are they really more vulnerable at three months than at six months? Or more vulnerable at six months than at a year? Don't have stats, but I'm guessing anyone over 65 is just as vulnerable to sudden health problems as someone over three months, and if we banned those over 65, the cruise industry would be the thing that dies.

Posted by: cindy loose | May 20, 2008 12:53 PM

I think traveling on a cruise with a three month old is unwise. I mean, there are care providers to babysit, but most aren't trained to watch children that small and that utterly helpless. Better to wait.

And I agree with the "babymoon" post. If you are going to babymoon, please go to a major metropolitian area (like Honolulu Hawaii or Miami, Florida) where you can receive high end emergency care b/c let's face it, if you have complications, this is probably where you want to be.

Posted by: tlawrenceva | May 20, 2008 1:10 PM

I cruised on Norwegian when I was pregnant - one week away from their cut off. Luckily, everything went fine. Would I do it again while pregnant? Absolutely Not!

On a later Norwegian cruise, we took our 16 month old son. My husband, son, and I all came down with Norovirus. I've never been so sick in all my life and I had to take care of a sick baby, too.

My son has developmental delays now and I'm convinced that he hasn't been quite the same since getting sick on that cruise.
I would really discourage pregnant women and new parents from cruising.

Posted by: Springfield, VA | May 20, 2008 1:27 PM

What's "CoGo"?

Posted by: Ryan | May 20, 2008 1:48 PM

"I think advances in medical science have lulled us into thinking of pregnancy as a natural and uncomplicated thing..."

Cindy, I would counter that pregnancy is indisputably a very "natural" thing! And while it may be more complicated than some believe, I found to the contrary in both of my pregnancies that the tendency of people in general is to treat a pregnant woman as if she is ill or disabled even when she is very healthy and has no complications.

I sympathize with the cruise line wanting to be safe rather than sorry, especially with our society's penchant for lawsuits, but to me this rule verges on discriminatory. Do they have similar policies in place for people with other medical conditions that *might* require emergency attention? As you concluded your previous comment, "...if we banned those over 65 [and likely with medical problems], the cruise industry would be the thing that dies."

Posted by: Beth | May 20, 2008 1:52 PM

I think you should revise down to 24 weeks, and here's why. I recently had a baby, and I suddenly had troubles at 22 weeks. I went into pre-term labor, and I advised the staff that should my son be born to make him comfortable but take no extraordinary measures to keep him alive. They agreed. Thankfully they stopped the labor, but two weeks later, at 24 1/2 weeks we had another scare and I said the same thing, and they informed me that after 24 weeks they had to do everything possible to save the baby and I couldn't do the equivalent of sign a DNR. Hospitals now seem to be using 24 weeks, not 28 weeks, as the point of true viability. I don't think it's fair to put the burden on the cruise lines or other travel companies to deal with an unexpected birth of a viable baby. And even an totally unremarkable pregnancy can go south very, very quickly with little or not warning.

(Thankfully, my son stayed put until 38 1/2 weeks, when we had to go get him out via a c-section because he was making no further signs of coming out. He's just fine.)

Posted by: Arlington, VA | May 20, 2008 1:58 PM

The difference between a sick baby and a sick 75 year old is that cruise lines, their legal departments, and their onboard doctors have 40 years of dealing with sick (and dead) elderly on board, but families with small children have only been cruising in great numbers for the last decade or so.

I also think that psychologically, if grandpa has a heart attack and dies on a cruise, people are more likely to think that "he died doing something he loved" and regard the death as a normal part of life, since elderly people do often die without much warning, both on land and at sea. However, if a baby dies the reaction is more likely to be an attempt to displace the guilt of putting the baby in what turned out to be harm's way by putting the blame somewhere else, like on the cruise line, its doctor, etc.

Posted by: Alexandria, VA (again) | May 20, 2008 3:28 PM

I would go to 24 weeks. A pregnancy is viable at 24 weeks even though the risk of disability is greatly elevated. It used to be babies had to be 28 weeks to survive, but with really good medical care, 24 weeks is possible. If I ran a ship, I wouldn't want anyone after 24 weeks aboard because if they baby was born disabled, the ship and its doctor might be on the hook for millions of dollars in lifetime medical care.

Posted by: Tom | May 20, 2008 4:08 PM


Regarding: "millions of women and newborns who don't have access to high tech care die every year."

I would argue that more women and babies die because of high tech care than die when nature takes its course. By this I mean that when we interfere with nature and induce labor, manually break the bag of waters, try to control every aspect of birth with high-tech gear, etc. that the outcomes aren't always positive.

Look at the maternal and baby mortality rates... the US is way down the list (22nd, I believe.) The countries that do it better have a low-tech approach.

Off-topic, I realize, but I agree with Beth that the typical preganant woman is not ill or disabled.

Posted by: Herndon | May 20, 2008 4:10 PM

I'm currently 25 weeks pregnant. 1. I guess I'm not cruising anywhere for a while and 2. I travel via air for work at least once a month and asked my dr specifically about this and was told I could travel via air up to 36 weeks! I thought that was WAY late and backed it up to 30 when I informed my boss, maybe I should rethink that!

Posted by: Alexandria | May 20, 2008 4:50 PM

Hey Alexandria,

The only thing I know about pregnancy and delivery I read in the huge stack of books I poured over for nine months, not counting 18 hours or so of labor and delivery. Your doctor presumably has spent years studying and practicing. Still, I think he or she is dead wrong about 36 weeks. Is this doctor by chance a man who doesn't have enough imagination to consider what it would be like to deliver a baby over Houston?
I'm by no means arguing that a pregnant woman is disabled--I worked until the day before I delivered, although I had meant to be off work two weeks before delivery. But things do go wrong, and I wanted to be within a short drive of a major hospital as soon as I reached the point I knew I had a viable fetus that could be saved with the best of care should something go wrong.

Posted by: cindy loose | May 20, 2008 7:03 PM

Herndon, I think you are very, very wrong when you assert that high tech care is responsible for more bad outcomes than low-tech. It is true that the US has poor infant mortality rates compared to other highly industrialized countries, but we are centuries ahead of third world countries. Have you not read of the women in Africa and the poorer parts of Asia who suffer maternal and infant mortality rates much higher than ours, of those who get fistulas due to early child bearing, and then are ostracized for the rest of their lives? These problems are real and tragic, and not at all due to an excess of high tech care.

It is true that we get too many unnecessary c-sections here for first time births, but you have to remember that the rate is inflated by the number of women who get c-sections for all subsequent births. They aren't using high-technology for fun, but out of prudence.

Posted by: annapolis | May 22, 2008 11:23 AM

I have to come to Herndon's defense. Low-tech is NOT the same as No-tech. Herndon wasn't comparing birth here in the US to third world countries in Africa and Asia, but to our industrialized neighbors. The United States has the highest infant mortality rate of any industrialized country. We also have much more technological and medicalized birthing here. Much of the complications of birth in third world countries are not related to a lack of high-tech medicine, but rather to other problems: poverty, malnutrition, spacing between pregnancies, sanitary conditions, lack of public health, lack of trained birth assistants, etc.
The point is not that all medical technology is bad, but that we in the US use medical intervention in far more cases than necessary in a manner that can lead to worse outcomes for mom and baby.

Posted by: houston | May 22, 2008 2:37 PM

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