Births like these occur in approximately one in every 26 million passengers, per aviation medical support firm MedAire. “In-flight childbirth is very, very rare, and when you review the cases they were unexpected—these were premature babies,” says Dr. Paulo Alves, the company’s global medical director. “It’s not the best place for you to have your child, for many reasons. For one thing, the air is thinner, so it’s harder for the baby to breathe. It’s like giving birth to a premature child in Mexico City, altitude-wise.” Even more sobering: There are no prenatal experts with high-tech equipment to assist if there is distress during birth, or an emergency C-section is required; and the Eustachian tubes in newborn babies’ ears struggle with changes in air pressure.
The risks aren’t just around premature birth, as Laura Einstetler, a pilot for a major U.S. airline who blogs as Captain Laura learned first-hand. “On a particular flight half way from Los Angeles to Hawaii, a passenger who was nearing seven months pregnant began to hyperventilate,” says Einstetler. “She had a previous medical condition that she could not take medication for once she was pregnant, and we were two-and-a-half hours from the closest airport. We were able to get her stabilized, but not without some anxious moments.”
Procedures for in-flight births are not formalized: Commonly, as in Debbie Owen’s case, the passenger might be moved to a more spacious and comfortable seat in business or first class, or have an area cleared in the galley. Einstetler also says that emergency landings are unlikely. “It would take a minimum 45 minutes to get the passenger from, say, 39,000 feet to a hospital,” she says. “This option is inconvenient for the other passengers, costly for the airline, and disruptive to the aircraft schedule.” Instead, cabin crew will act as ad hoc midwives as the plane speeds to its original destination.
Aviation regulations around pregnant fliers are woolly. There is no industry-wide rule: Some airlines refuse to carry women after 36 weeks of pregnancy, while others will accept them up to 40 weeks, with appropriate medical notes—Delta is one such airline. (“The recommendation is that pregnant women not fly within four weeks of their due date, and to check with their physician before flying,” says a Delta spokesperson. “But it is a recommendation.”)
As for the citizenship of a child born at 36,000 feet, MedAire’s Alves says that can vary, too. “There is no universal rule, but keep in mind an aircraft is considered that country’s soil,” Alves says, meaning a plane is tied to the country it is legally registered in, under the 1961 Convention on the Reduction of Statelessness. It’s a technicality, he points out, since in most cases children receive their parents’ citizenship via the convention of jus sanguinis, or right of blood. This is the policy most often followed, though some countries adhere to the alternative concept of jus soli, or right of soil, which confers citizenship on a child according to the location in which they are born. The only time the 1961 Convention rules comes into play is on the rare occasion when the child would otherwise be stateless; in that case, the airline’s country of origin will determine the passport. Per the U.S. State Department, a child born in international waters should list place of birth as “at sea;” if a child is born in flight in a region which no country claims, he or she would officially be classified as born “in the air.” The US, unusually, grants citizenship to any child born on a plane over US territory, or within its airspace.
