This document discusses motor vehicle safety for pregnant women. It recommends that pregnant women always wear seat belts correctly, with the lap belt below the belly and shoulder belt between the breasts. Wearing seat belts reduces both maternal and fetal injury and death in car crashes. It also discusses proper seating positions and seeing a doctor immediately after any car crash during pregnancy.

1. Motor Vehicle Occupant
Safety During Pregnancy
James M. DeCarli, MPA, MPH, CHES
Research Analyst III/Behavioral Sciences
Injury & Violence Prevention Program
Department of Public, Los Angeles County

2. Should You Wear Your Seat Belt
While Pregnant?
Yes, always wear a seat belt. Wearing your seat belt
protects you and your baby. The most common reason
a fetus dies after a car crash is because the mother dies.
Be sure to wear your seat belt correctly:
The lap and shoulder belts keep you from being thrown from
the car.
The shoulder strap also keeps the pressure of your body off
of the baby after a crash.
You should wear a seat belt no matter where you sit in
the car.

3. Motor Vehicle Occupant Injuries
The leading cause of death for US residents between
the ages of 15 and 44 is motor vehicle accidents.
Pregnant women and their babies are particularly
vulnerable to complications associated with motor
vehicle accidents.
Depending upon the severity of the trauma, women may be
at risk for miscarriage, preterm labor, premature rupture of
the membranes, and placental separation (abruption), as well
as complications sustained from blood clots, fractures, and
internal injuries to vital organs.
The stress and anxiety encountered after such trauma is
frightening for both the woman and her family.

4. Motor Vehicle Occupant Injuries
Studies show that only 68 percent of pregnant women
reported using seat belts correctly (Pearlman, 1996).
Additionally, nearly 20% stated that they rarely or never
used seat belts during their pregnancy.
Many women have concerns about how to wear a seat
belt when they're pregnant — and with good reason!
When lap belts are improperly worn (over the dome of
the uterus), they can significantly increase pressure on
the baby and may possibly lead to fetal injury.

5. Anatomic Changes During
Pregnancy
1st Trimester: Uterus is thick walled
Provide considerable fetal protection
2nd Trimester: Uterus is more exposed
But fetus is mobile and cushioned by amniotic fluid
3RD Trimester: Uterus is large and thin walled
Less fetal protection
Head in pelvis (exposed to pelvic injury)

6. Crash Impact Sequence:
Relationship between body motion,
uterine pressure & seat belt tension

7. Seat Belt Use During Pregnancy
It has been shown that correct seat belt use significantly
reduces both maternal and fetal morbidity and mortality
following motor vehicle accidents.
The American Medical Association and the American
College of Obstetricians and Gynecologists recommend
pregnant women always wear seat belts while traveling.
Pregnant women wearing safety restraints while in motor
vehicle crashes have lower rates of personal injury, and of
fetal injury and fetal death, than women who aren't
buckled up when in a crash.*
*Hyde LK, et al. (2003). Effect of motor vehicle crashes on adverse fetal outcomes. Obstetrics and Gynecology, 102(2): 279–286.

8. Correct & Incorrect Use
Remember that the Lap Belt should never be positioned on the
abdomen, rather on the lap below the abdomen.
The Shoulder Belt must never be placed behind or under the arm,
but rather diagonally between the breasts.

9. Correct Seat Belt Use
The lap strap should go under your belly, across your hips, and
flat as possible on your thighs.
The shoulder strap should go between your breasts, and off to
the side of your belly.
The seat belt should fit snugly.

10. Air Bags
Air bags are safe and can protect the mother from head injury
and the unborn child from injury.
The air bags in your car should never be turned off because you
are pregnant.
Airbags are not a substitute for a seat belt, so always wear your
seat belt even if your car has air bags.
Remember, both air bags and seat belts work together to protect
both the mother and the unborn child in a crash.
During a crash without a seat belt, a pregnant women can be thrown into
a opening air bag (approximately 200mph).
Such a force can injury or kill the mother and her unborn child)

11. Safest Seat Location as Passenger
If you are not Driving, the safety location to be
seated when pregnant is in the back seat.
Injuries from car crashes tend to be less serious
to people who are sitting in the back seat, again
when buckled up properly.
However where a mother sits has not been
shown to affect the safety of an unborn baby in
a crash. But rear seat location is safest overall.

12. Seating Adjustment
If you are driving, move the front seat as far
back as possible
Your breastbone should be at least 10 inches form
the steering wheel or dashboard.
As your abdomen grows during pregnancy, more the
seat back to keep as much distance as possible (but
safe enough, so your feet can operate the vehicle
pedals effectively)

13. If you are in a car crash
If you are in a car crash, you should see your doctor
right away, even if you think you are not hurt.
Most injuries to the baby happen within a few hours
after a crash.
Your doctor needs to check you and your baby as soon
as possible after a crash, especially if you are more than
six months pregnant.
If right after the crash, you have any of the following,
call 911:
Pain in your belly
Blood or fluid leaking from your vagina
Contractions

14. Preventive Resources
Injury & Violence Prevention Program (IVPP)
Website www.ph.lacounty.gov/ivpp
National Highway Traffic Safety Administration
[www.nhtsa.dot.gov]
Questions/Comments:
jdecarli@ph.lacounty.gov
(213) 351-7888