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Fitness to Fly Certificate: Another Pregnancy-related Cost


Pregnancy is an expensive time. There’s the baby clothes, maternity wear, nursery furniture, pram, car seats – and the rest. I then discovered about the cost of the fitness to fly certificate when pregnant.

Pregnancy isn’t just demanding on your wallet, it can also be pretty demanding on you physically and emotionally. We went on holiday for the last time as a couple and as a family of three before the arrival of babies two and three. I definitely recommend it by the way, especially the last holiday as a couple!

The Fitness to Fly Certificate

Why NHS doctors charge patients for letters – BBC News –

During my first pregnancy we took said trip to go and visit my family in Italy. We were taking a short EasyJet flight to Nice (we fly to France and then cross the border) when I was 25 weeks pregnant and definitely in the honeymoon period of the second trimester. I mentioned the trip in passing to my midwife when she next visited and discovered that lurking on top of the cost of the holiday was an additional pregnancy-specific expense: the fitness to fly certificate. She advised me that I should get one from my GP. I was charged £20. The minimum charge I’ve heard of is £15 and the most is £30.

My letter consisted of a few short sentences, which I thought was pretty scandalous, especially as the doctor didn’t even see me; it was all on the midwife’s advice. She’d checked my blood pressure, urine etc and she relayed this info to the doctor along with my travel dates. I later learnt that the letter isn’t even normally required until after 27 weeks (and I was still just under 27 weeks on my return flight).

Airline policies

It’s all quite confusing. After looking into it further, I found the rules vary quite a lot – according to carrier – as to when a letter/certificate is required and also at what point in the pregnancy you are not permitted to fly. There are also different rules for multiple pregnancies (which I discovered second time around). It is definitely worth checking out before booking those flights. This guide is very handy.

I do question this charge as the doctor didn’t even ask to see me and it was a very standard letter. £20 for this seems rather excessive. See me talking about it in more detail on the BBC.


About Author

I’m Fran: wife, mother-of-three and freelance publicist. My love for communicating and writing mirrors my passion for trying to be the best mum I can be. I love good food & wine, Italian culture and football and have a keen interest in personal finance. I also blog over on Epsom & Ewell Families and Habyts, and write sporadically for a number of other sites.


  1. The problems is that it’s an incremental cost – it’s not part of their core service. Incremental costs are always expensive: the surgery will be paying for an individual to cover these incremental services, and the cost for that individual will have to be funded from whatever can be recovered from these extra services.

    Consider also that the request has to be read, checked against your records, validated by the doctor, written by an individual, probably checked again before it goes, noted on your records, then the correspondence is addressed, enveloped and posted. For each of these actions, the cost of the individual is not just what they pay, but their overheads as well – an office environment, national insurance, professional indemnity insurance (for the practice) and pension. These costs quickly add up to double what an individual takes home.

  2. Reece Harbour on

    I was just reading about this on the BBC website, I personally think that it is rather over the top for the NHS to justify £20 for an easy five-minute letter which will then be sent onto someone else to deliver. I understand that people are working and they don’t do work for free, but they are being paid to do their job, it’s like teachers/tutors don’t specifically get paid to grade work, but they do it to make life easier (essentially), therefore I believe that payment for such a request should be ridden of.

    I guarantee there are plenty of jobs all around the world where employees have to do that extra bit of work whether big or small and they don’t get paid extra for it, so why should we pay-up for such a service. We may as well just throw £20 in the bin.

    • Could not agree with you more. Teachers are the prime example of a profession that don’t get paid to do all the extras they do.

    • As a GP we get asked for fitness to parachute, fitness to appear on stage for children, fitness to fly, fitness for a patient to have an indian head massage, fitness to do a variety of sports e.g. diving, fitness to have exemption for wearing a seatbelt etc. I have been asked for letters to support having new radiators fitted in a house, fitness to attend school, do exams separately from other children – the list goes on.

      Really most of these do not need medical confirmation but many places and organisations ‘require’ them. I would rather get home to see my family after working for 10-12 hours a day seeing patients and treating ill health rather than filling out these form. The NHS pays me to treat the sick not ensure someone is fit to jump out of aeroplanes etc. The only way we can disuade people and companies from making these requests it to charge them.

      • Thanks for commenting. I can appreciate how tedious and time consuming all of those would be. Do the other ‘fitness to’ letters cost similar amounts? I’m just thinking that many pregnant women do need to fly for various reasons past 27 weeks gestation whereas people don’t need to jump out of a plane. Do you have to see the person for the other letters you mention? I wasn’t seen by my GP and the GP asked me no questions; it was all on the midwife’s assessment.

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