What is a fit to fly letter and who can issue one?

A fit to fly letter is a signed medical document confirming there is no medical reason to advise against air travel at the current gestational age. It must include gestational age, expected due date, singleton or multiple confirmation, and a statement that no complications are present. Under GMC standards, the letter must be issued by a registered medical practitioner or registered midwife.

What happens if I fly without a fit to fly letter when one is required?

You will likely be denied boarding. Airlines are within their rights to refuse travel to any passenger without the required medical documentation, and you would not be entitled to a refund or rebooking under the airline's conditions of carriage.

Do I need a fit to fly letter at 27 weeks pregnant?

No, not for most airlines. At 27 weeks you are below the 28-week threshold where most carriers require documentation. However, if your return flight falls at 28 weeks or beyond, you will need a letter for the return leg. Always check your specific airline's policy.

Fit to Fly: UK Airline Pregnancy Policies 2026

Updated June 2026 · Clinically reviewed by Dr Maria Knobel, Medical Director (GMC 7495073)

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Airline policies change frequently and without notice. Always verify your airline's current requirements directly before booking or travelling. The information below reflects policies as last verified in March 2026.

Most UK airlines require a fit to fly letter from 28 weeks of pregnancy, although requirements vary by carrier. The letter must be issued by a GMC-registered doctor or registered midwife, and it must confirm gestational age, expected due date, whether you are carrying a single baby or multiples, and that no complications are present. Singleton pregnancies can typically fly until the end of week 36. Multiple pregnancies face an earlier cut-off, usually week 32. Without a valid letter, airlines including Ryanair, British Airways, and Emirates will deny boarding.

This page compares the pregnancy flying policies of 12 major UK airlines side by side, with clinical context from Dr Maria Knobel explaining the medical reasoning behind these thresholds. The Royal College of Obstetricians and Gynaecologists (RCOG) advises that air travel is generally safe for uncomplicated pregnancies up to 37 weeks for singletons and 32 weeks for multiples, which closely mirrors the cut-offs most airlines apply. You can get a fit to fly certificate online from MedicalCert, same day, issued by a GMC-registered UK doctor.

12 airlines Policies researched and verified March 2026

28 weeks The point at which most airlines require a letter

32 weeks Typical cut-off for twins/multiple pregnancies

Need a pregnancy fit to fly certificate? MedicalCert issues same-day certificates through GMC-registered UK doctors, accepted by all major airlines. No GP appointment required.

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Comparison table showing pregnancy flying policies for 12 major UK airlines including letter requirements, singleton and multiple cut-off weeks, and freshness requirements

12-airline pregnancy policy comparison

Policies verified against each airline's official guidance as of March 2026. Always confirm directly with your airline before travel as policies can change at short notice.

Airline	Letter Required From	Singleton Cut-off	Multiple Cut-off	Doctor or Midwife?	Letter Must Be Dated Within	Notes
British Airways	28 weeks	Before end of week 36	Before end of week 32	Either	As close to travel as possible	Recommended to carry at all times during pregnancy. BA has its own pregnancy form available.
easyJet	Not required*	Before end of week 35	Before end of week 32	Either	N/A	*No letter required unless complications. Recommended to carry one from 28 weeks for peace of mind.
Ryanair	28 weeks	Before end of week 36	Before end of week 32	Either	Within 2 weeks of departure	Mandatory from 28 weeks. Letter must confirm no complications and include due date.
Jet2	28 weeks	Before end of week 35	Before end of week 33	Either	Within 2 weeks of departure	Certificate required from 28 weeks. Present at check-in.
TUI	28 weeks	Before end of week 36	Before end of week 32	Either	Within 14 days of departure	Must notify TUI customer services if flying after 28 weeks (including return leg).
Virgin Atlantic	28 weeks	Before end of week 36	Before end of week 32	Either	As close to travel as possible	Letter must include due date and confirm no complications.
Emirates	29 weeks	Before end of week 36	Before end of week 32	Either	Not specified, recent	Mandatory from 29 weeks. Must include singleton/multiple confirmation, due date, no complications. MEDIF form required for exceptions.
Wizz Air	28 weeks	Before end of week 34	Not permitted after 32 weeks	Either	Not specified	Earliest cut-off on this list. No flying after 34 weeks for singles under any circumstances.
Norwegian	28 weeks	Before end of week 36	Before end of week 32	Either	Not specified	Follows standard industry thresholds. Check route-specific guidance.
Iberia	28 weeks	Before end of week 36	Before end of week 32	Either	Not specified	No authorisation required before 28 weeks. Vueling-operated IB5XXX flights follow same rules. Medical service authorisation required after 36/32 weeks.
KLM	28 weeks (complications/multiples)	Before end of week 36	Consult doctor first	Either	Not specified	No letter required for uncomplicated single pregnancies before 36 weeks. Multiples or complications always require physician consultation.
Lufthansa	28 weeks (recommended) / 36 weeks (required)	Before end of week 36	Before end of week 32	Either	Not specified	Recommended from 28 weeks; mandatory from 36 weeks. Must confirm no complications, include due date.

Sources: Official airline guidance pages verified March 2026. Policies subject to change. Always verify directly with your airline before travel. * easyJet does not mandate a letter but recommends one if complications exist.

Key finding: 10 of the 12 airlines require or strongly recommend a fit to fly letter from 28 weeks. easyJet is the main exception (letter only needed if complications exist). Wizz Air has the earliest cut-off at 34 weeks for singleton pregnancies, four weeks earlier than most other carriers.

What must a fit to fly letter include?

Airlines are specific about what the letter must contain. A letter missing any of these elements can result in denied boarding. The requirements below align with RCOG guidance on the information a medical professional should document before clearing a pregnant patient for air travel.

Required Element	Why Airlines Need It	Included in MedicalCert Letters
Gestational age (weeks pregnant)	To confirm you are within their permitted flying window	Yes
Singleton or multiple pregnancy	Cut-off weeks differ significantly, essential for compliance	Yes
Expected due date (EDD)	Allows airline staff to calculate gestational age at time of travel	Yes
Confirmation of no complications	Required for standard clearance. Complications trigger different procedures	Yes
Doctor's name and GMC/professional registration number	Verifies the letter is issued by a qualified, registered clinician	Yes, GMC number included
Date of issue	Most airlines require the letter to be recent (14 days for Ryanair, TUI, Jet2)	Yes
Statement of fitness to fly	The explicit clinical assessment confirming no medical reason to advise against air travel	Yes

Every element listed above is included as standard. MedicalCert pregnancy fit to fly certificates are reviewed and signed by a GMC-registered doctor, delivered same day as a signed PDF you can print or show digitally at check-in.

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Clinical thresholds explained: why airlines set the rules they do

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Dr Maria Knobel, Medical Director, MedicalCert.co.uk (GMC 7495073)

The thresholds airlines apply are not arbitrary. They reflect a genuine assessment of risk related to cabin environment, access to emergency care, and the probability of labour onset. The Royal College of Obstetricians and Gynaecologists (RCOG) publishes guidance on air travel during pregnancy, and most airline policies align closely with RCOG recommendations.

Why 28 weeks? The third trimester begins at 28 weeks, and this is the point at which the risk profile of the pregnancy changes meaningfully. Reduced cabin pressure (equivalent to approximately 6,000 to 8,000 feet altitude) and lower oxygen saturation become more relevant as the fetus grows and placental demands increase. The NHS advises that flying is not harmful during a straightforward pregnancy, but notes that the risk of going into labour is naturally higher after 37 weeks for a single pregnancy and 32 weeks for twins. From a clinical standpoint, 28 weeks is a reasonable threshold for requiring documented medical clearance.

Singleton cut-off: before 37 weeks. Most airlines align at 36 weeks completed, meaning the flight must be completed before the 37th week begins. This reflects both RCOG guidance and NHS maternity advice that labour is considered "term" from 37 weeks onward. Flying beyond this point risks labour occurring during a flight with no appropriate emergency obstetric care available.

Multiple pregnancies: before 33 weeks. Twin and higher-order pregnancies carry a significantly elevated risk of premature labour. Research cited by RCOG indicates that approximately 50% of twin pregnancies deliver before 37 weeks. Airlines therefore apply a 32-week cut-off for most multiple pregnancies, which aligns with the clinical risk stratification used in obstetric practice across NHS trusts.

What the fit to fly letter actually certifies: When a GMC-registered doctor issues a fit to fly letter, they are confirming that based on the clinical history available, specifically gestational age, absence of complications, and the patient's current health status, there is no clinical reason to advise against air travel for the specified journey. It does not guarantee that no obstetric event will occur. It is a considered professional opinion at a point in time, consistent with the standards set out by the General Medical Council (GMC) for issuing medical documentation.

Airline-by-airline: what to know before you fly

British Airways

BA technically recommends carrying a letter at any stage of pregnancy, but the practical requirement starts at 28 weeks. They have their own downloadable pregnancy form which a doctor or midwife can complete, though a standard headed letter covering the same information is also accepted. Cut-offs are 36 weeks (singleton) and 32 weeks (multiples).

easyJet

The notable exception in this list. easyJet does not mandate a fit to fly letter for uncomplicated pregnancies. If you have experienced any complications, you must consult a medical practitioner before flying. Cut-offs are 35 weeks (singleton) and 32 weeks (multiples). Despite no formal requirement, carrying a letter is advisable from 28 weeks in case of any query at the gate.

Ryanair

One of the strictest in terms of letter requirements. From 28 weeks the letter is mandatory, must be signed by a doctor or midwife, and, critically, must be dated within 2 weeks of departure. A letter issued more than 14 days before travel will not be accepted. The letter must confirm no complications and include the expected due date. Cut-offs match industry standard: 36 weeks (singleton), 32 weeks (multiples).

Jet2

Same 2-week freshness requirement as Ryanair. Letter required from 28 weeks, presented at check-in. Cut-offs: 35 weeks (singleton), 33 weeks (multiples), slightly earlier than BA and Ryanair for multiples.

TUI

Requires advance notification to customer services for any travel at or after 28 weeks, an extra administrative step other airlines do not require. Letter must be dated within 14 days of departure. Cut-offs: 36 weeks (singleton), 32 weeks (multiples).

Virgin Atlantic

Letter required from 28 weeks. Virgin's guidance specifies the letter must include the due date and confirm no complications. Cut-offs match BA: 36 weeks (singleton), 32 weeks (multiples).

Emirates

Slightly stricter than most UK airlines. The letter requirement starts at 29 weeks rather than 28. From 29 weeks, a medical certificate is mandatory. Without it, Emirates will refuse boarding if there is any doubt about your ability to travel safely. In exceptional circumstances, travel beyond 36/32 weeks may be permitted with an Emirates MEDIF (Medical Information Form) cleared by their medical department in advance.

Wizz Air

The most restrictive cut-off on this list: 34 weeks for singleton pregnancies and 32 weeks for multiples, with no exceptions. This is 2 to 3 weeks earlier than most UK carriers. Letter required from 28 weeks. If you are flying Wizz Air on a return journey, factor in that your return flight must be completed before 34 weeks. Book with that in mind.

Norwegian

Follows standard industry thresholds. Letter from 28 weeks, cut-off at 36 weeks (singleton) and 32 weeks (multiples). Check specific route guidance as Norwegian operates both short and long-haul flights where policies may differ slightly.

Iberia

No documentation required before 28 weeks. From 28 weeks, medical authorisation is required. Vueling-operated Iberia Express (IB5XXX) flights follow the same rules. After 36 weeks (singleton) or 32 weeks (multiples), prior authorisation from the Iberia Medical Service is needed. Contact them well in advance.

KLM

The most relaxed policy on letters for singleton uncomplicated pregnancies. No letter formally required before 36 weeks. However, multiple pregnancies always require physician consultation first. Any complications in a single pregnancy also trigger the letter requirement. Cut-off for singles: 36 weeks. Multiples: consult physician before booking.

Lufthansa

A tiered approach: a letter is recommended from 28 weeks and mandatory from 36 weeks. In practice, carrying a letter from 28 weeks is advisable to avoid any gate-level discretion. Cut-offs: 36 weeks (singleton), 32 weeks (multiples).

Do you need a fit to fly letter? Quick guide

You definitely need a letter if…

You are 28 weeks or more (most airlines)
You are 29 weeks or more on Emirates
You have had any complications at any stage (all airlines)
You are carrying twins or multiples from 28 weeks
Your airline requires notification (TUI)
You want to fly close to the cut-off week on any carrier

You are strongly advised to carry one if…

You are flying easyJet at 28+ weeks (not mandatory but recommended)
You are flying KLM with an uncomplicated singleton pregnancy
You are flying Lufthansa between 28 and 35 weeks
Your return flight takes you past the letter threshold week
You are flying long-haul at any stage in the third trimester

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Do not forget the return leg. The letter requirement applies to both outbound and return flights. If your return flight falls at or beyond 28 weeks, you need the letter to cover that date, not just your departure. Ryanair and TUI are explicit about this. Make sure the letter is dated within the required window for your return date as well.

Frequently asked questions

A fit to fly letter is a signed medical document confirming that, based on a clinical assessment, there is no medical reason to advise against air travel at your current gestational age. It must include your gestational age, expected due date, whether the pregnancy is singleton or multiple, and a statement that no complications are present. Under General Medical Council (GMC) standards, the letter must be issued by a registered medical practitioner or registered midwife. MedicalCert letters are issued by GMC-registered UK doctors and include all required elements as standard.

It depends on the airline. Ryanair, Jet2, and TUI require the letter to be dated within 14 days of departure. British Airways and Virgin Atlantic ask for a letter dated as close to travel as possible but do not specify an exact window. Emirates and Norwegian do not state a required window but expect a recent letter. If in doubt, get your letter within 2 weeks of travel to satisfy the strictest requirements across all carriers.

Yes. All 12 airlines on this list accept letters from either a doctor or a registered midwife. However, NHS midwives and GPs are often reluctant to issue fit to fly letters as it falls outside their core clinical duties and they may not be covered by their indemnity insurance for this specific purpose. The NHS does not routinely provide fit to fly letters as a standard service. Private online services like MedicalCert issue letters through GMC-registered doctors, which are accepted by all major UK airlines.

You will likely be denied boarding. Airlines are within their rights to refuse travel to any passenger who does not have the required medical documentation, and you would not be entitled to a refund or rebooking under the airline's conditions of carriage. Ryanair and Emirates in particular are known to enforce their documentation requirements strictly at check-in.

No, not for most airlines. At 27 weeks you are below the 28-week threshold where the majority of carriers start requiring documentation for uncomplicated singleton pregnancies. However, if your return flight falls at 28 weeks or beyond, you will need a letter for the return leg. Emirates triggers their requirement at 29 weeks, so at 27 weeks you would be fine on Emirates without documentation. Always check the specific policy of your airline before travelling.

No. A fit to fly letter satisfies the airline's documentation requirement for boarding, but it does not replace travel insurance. You should have travel insurance that explicitly covers pregnancy-related medical treatment, emergency repatriation, and premature birth in your destination country. Many standard travel insurance policies exclude pregnancy beyond a certain gestational week unless declared. The Association of British Insurers (ABI) recommends checking your policy wording before travel and declaring your pregnancy to your insurer.

Same day. MedicalCert can issue a pregnancy fit to fly certificate the same day via an online consultation with a GMC-registered UK doctor. The certificate is emailed as a signed PDF and can be printed or shown digitally at the airport. Most airlines accept digital copies, though Ryanair and some others may prefer a printed version. It is worth bringing both to avoid any issues at the gate.

Ready to get your pregnancy fit to fly certificate? Complete a short online consultation and receive your signed certificate same day. Accepted by British Airways, Ryanair, easyJet, Jet2, TUI, Virgin Atlantic, Emirates, and all other major UK airlines.

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Sources: Royal College of Obstetricians and Gynaecologists (RCOG), Air Travel and Pregnancy patient information (rcog.org.uk). NHS, Flying in pregnancy (nhs.uk). British Airways medical conditions guidance (ba.com). easyJet pregnancy terms (easyjet.com). Ryanair pregnancy policy (ryanair.com). Jet2 terms and conditions (jet2.com). TUI pregnancy guidance (tui.co.uk). Virgin Atlantic pregnancy page (virginatlantic.com). Emirates pregnancy medical certificate guidance (emirates.com). Wizz Air special assistance (wizzair.com). Norwegian pregnancy guidance (norwegian.com). Iberia pregnancy policy (iberia.com). KLM pregnancy guidance (klm.com). Lufthansa healthy journey guidance (lufthansa.com). Association of British Insurers (ABI) travel insurance guidance. General Medical Council (GMC), standards for issuing medical documentation (gmc-uk.org). All airline policies verified March 2026.

Clinically reviewed by Dr Maria Knobel, Medical Director, MedicalCert.co.uk (GMC 7495073). Last reviewed: June 2026.

Reviewed by Dr Maria Knobel

Medical Director, MedicalCert · GMC 7495073 · Last reviewed: 13 July 2026