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By Alice Gibbs
Senior Reporter
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What started as a carefree girls' trip was nearly fatal for 34-year-old Emily Jansson, a Canadian woman who suffered a massive pulmonary embolism midair during a long-haul flight.
"On February 5 of this year, during a solo long-haul direct flight from Toronto to Dubai, on the way to meet my friends for a girls' trip, I suffered a 'catastrophic medical event,' according to my cardiologist," Jansson told Newsweek.
"About 10.5 hours into the flight, I was feeling totally fine and I finally got up—for the first time that flight—to use the restroom. I had been sleeping up until this point," Jansson said.
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But what happened next was a medical emergency that most passengers and travelers only imagine in nightmares.
"While waiting for the bathroom, I had a deep, strange pain in my chest, coughed three times, and that was the last thing I remember," Jansson said. "I collapsed, hit my head on something, and went into cardiac arrest due to a massive bilateral saddle pulmonary embolism. I was unconscious for upwards of five minutes or more, according to the flight attendant who I remain in touch with."
"I had a deep, strange pain in my chest, coughed three times and that was the last thing I remember."
Thankfully, there was a doctor onboard the flight who immediately jumped into action. Flight attendants administered oxygen and monitored her during the remaining 2.5 hours of the flight, but when she landed in Dubai, Jansson's ordeal was far from over.
"I was held in Dubai airport for 3.5 hours upon landing while they administered their own medical tests and took my passport away for immigration purposes," Jansson said. "It was nine hours between landing and getting to the hospital before starting the actual treatment."
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Jansson was eventually admitted to Rashid Hospital where she spent six days in intensive care.
Jansson said: "The doctors told me it's a miracle I'm alive because of the amount of time it took before actually receiving treatment at the hospital. However, I must say that the treatment and care I received at Dubai's hospital was incredible and they are amazing."
"I died on a plane three months ago."
Jansson, who had no prior history of blood clots or thrombophilia, was wearing medical-grade compression tights and had been on a combined estrogen oral contraceptive. Her cardiologist identified the contraceptive, along with prolonged immobility during the 13-hour flight, as the cause of the medical crisis.
"At the time, I was on an estrogen hormonal oral contraceptive pill. I had no prior history of blood clots or major risk factors, aside from being on the pill and prolonged immobility. My doctors in Dubai, followed by my care team in Canada, attributed the clots to a combination of long-haul immobility and estrogen-containing birth control," Jansson said.
Are Contraceptives Dangerous During Long-Haul Flights?
Delisa Skeete Henry, MD, a board-certified obstetrician and gynecologist, told Newsweek: "Oral contraceptives, particularly combined estrogen-progestin pills, are associated with an increased risk of venous thromboembolism, which includes pulmonary embolism. [My recommendation is] to use the lowest-effective estrogen dose or consider progestin-only pills."
She also recommends discontinuing oral contraceptive pills before major surgery or prolonged immobilization.
Research shows that long-haul air travel doubles the risk of venous thromboembolism (VTE), and that risk increases three- to fivefold when using combined oral contraceptives.
"I had no idea about the clot risk when combining estrogen birth control with long-haul travel."
When both factors are present, the risk can multiply more than 14 times, according to a case-control study published in 2003. This means women who fly long distances while taking hormonal birth control may face significantly greater danger than previously thought.
Now in recovery, Jansson has shared her story publicly in hopes of helping others recognize the risks associated with long-haul travel and hormonal contraceptives.
In a recent video on her TikTok page, she said: "I died on a plane three months ago, and it's so crazy because now I'm back working out. I'm going about my life but I literally died three months ago."
"I had no idea about the clot risk when combining estrogen birth control with long-haul travel. No doctor had ever explained that to me," Jansson said. "I lived abroad in Singapore and Europe for 10 years, working for Interpol and traveled constantly for work, all while on the pill. I used to joke that my superpower was being able to sleep the whole way. Looking back now, that feels incredibly naive."
Experts advise that women at higher risk of blood clots should take preventive measures during flights, including moving regularly, staying hydrated and using compression stockings. In very high-risk cases, it can be a good idea to stop use of hormonal contraceptives, but this should always be discussed with a health care provider.
"It truly appears to have been a 'perfect storm' situation," Jansson said. "I'm on blood thinners for the foreseeable future and recovering well physically, though it's been a long and emotional road. I'm no longer on hormonal birth control."
Jansson has been sharing her experience on TikTok, where millions of people have learned about the potential risks of flying and birth control combined. The response has been huge, and Jansson is thrilled she has been able to raise more awareness.
"It's been emotional, but also really affirming to know it might help someone else avoid what I went through," she said.
References
Martinelli, I., Taioli, E., Battaglioli, T., Podda, G. M., Passamonti, S. M., Pedotti, P., & Mannucci, P. M. (2003). Risk of Venous Thromboembolism After Air Travel. Archives of Internal Medicine, 163 (22), 2771. https://doi.org/10.1001/archinte.163.22.2771
Trenor, C. C., Chung, R. J., Michelson, A. D., Neufeld, E. J., Gordon, C. M., Laufer, M. R., & Emans, S. J. (2011). Hormonal Contraception and Thrombotic Risk: A Multidisciplinary Approach. Pediatrics, 127(2), 347—357. https://doi.org/10.1542/peds.2010-2221
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