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

You can be denied boarding. Airlines are within their rights to refuse travel to a passenger without the required documentation, and you would not be entitled to a refund or rebooking.

Fit to Fly Certificate: UK Airline Pregnancy Policies 2026

Updated March 2026 · Reviewed by Dr Maria Knobel, Medical Director (GMC 7495073)

Flying while pregnant is safe for most women — but every airline sets its own rules on when a fit to fly letter is required, how recent it must be, and when you can no longer fly at all. This page compares the pregnancy policies of 12 major UK airlines in one place, with clinical context from Dr Maria Knobel on what a valid letter must contain. 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

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.

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	Earlier cut-off than most — 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 any 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 being denied boarding.

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 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 — the core of the letter	Yes

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.

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 6,000–8,000 feet altitude) and lower oxygen saturation become more relevant as the fetus grows and placental demands increase. 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 the NHS guidance that labour is considered "term" from 37 weeks. Flying beyond this point risks labour occurring during a flight with no appropriate emergency obstetric care.

Multiple pregnancies: before 33 weeks. Twin and higher-order pregnancies carry a significantly elevated risk of premature labour — approximately 50% of twins deliver before 37 weeks. Airlines therefore apply a 32-week cut-off for most multiple pregnancies, which aligns with clinical risk stratification used in obstetric practice.

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 — 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.

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 kicks in 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 the 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 — this is an extra administrative step others don't 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 — standard across the industry. Cut-offs match BA: 36 weeks (singleton), 32 weeks (multiples).

Emirates

Slightly stricter than most UK airlines — the letter requirement kicks in 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 2–3 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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Don't 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. TUI and Ryanair 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 medical document issued by a GMC-registered doctor or registered midwife confirming that, based on a clinical assessment, there is no medical reason to advise against air travel at the current gestational age. It must include your gestational age, expected due date, singleton or multiple confirmation, and a statement that the pregnancy is progressing without complications. MedicalCert letters are issued by GMC-registered UK doctors and include all required elements as standard.

It varies by 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. Emirates and Norwegian do not specify a window but expect a recent letter. If in doubt, get your letter within 2 weeks of travel to satisfy the strictest requirements.

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 duties and they may not be covered by their indemnity insurance for this specific purpose. Private online services like MedicalCert issue letters through GMC-registered doctors, which are accepted by all major UK airlines.

You can be denied boarding. Airlines are within their rights to refuse travel to a passenger who does not have the required documentation, and you would not be entitled to a refund or rebooking. Ryanair and Emirates in particular are known to enforce their documentation requirements at check-in.

For most airlines, 27 weeks is just below the threshold and no letter is formally required for an uncomplicated singleton pregnancy. 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 a letter. Always check the specific policy of your airline before travelling.

A fit to fly letter satisfies the airline's documentation requirement but 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. Check your policy before travel — many standard policies exclude pregnancy beyond a certain week unless declared.

MedicalCert can issue a fit to fly certificate the same day via an online consultation with a GMC-registered UK doctor. The certificate is emailed to you 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.

Sources: British Airways medical conditions guidance (ba.com); easyJet pregnancy terms (easyjet.com); Ryanair pregnancy policy (ryanair.com); Jet2 terms and conditions; 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). All policies verified March 2026.

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