Is Wearing the Seat Belt Really Safe for Pregnant Women?

seat belt really safe for pregnant womenThis pregnant Child Passenger Safety technician is showing a “properly” worn seat belt.

The question every mom-to-be asks herself when pulling that strap across her body in the car… “Is the seat belt really safe for pregnant women?”

She may even ask someone else, like her OB or other health care provider. Even though she hears them say, “yes,” there remains a lingering concern for her little, yet to be born, baby.

It just doesn’t seem like this belt, that is already putting pressure on her pregnant belly, is safe should the car come to sudden stop or, heaven forbid, get in a crash. She can feel that the baby is just a few layers of skin and muscle away. There is not that much between the baby and the seat belt. “How can this be safe?” she wonders.

Crashes happen so fast! The reality is that yes indeed according to one study, mom is 3x safer when wearing the seat belt according the published guidelines (whether it is comfortable or not) but another study shows that the in-utero baby is up to 5x more likely to die than an infant or child restrained in a car seat in the same car.

The current “best practice” for mom is:

  • Lap belt under the belly bump — low on the hips or on the thigh
  • Shoulder belt above the belly bump between the breasts and on the shoulder
  • If driving moving the seat back to maximize the distance between belly and steering wheel

But, is that the whole story? No.

Unfortunately it is not and to understand things better we need to go back to the very early days of seat belt use in cars.

pregnancy and seat belt useThe very first law regarding seat belts was a Federal Motor Vehicle Safety Standard requiring cars sold in the USA to have seat belts and that was not on the books until 1968. The question of how safe they are for pregnant women has been under discussion since that time as documented by studies being published and crash tests being performed at the time.

According to the former Director of the Office of Crash Worthiness NHTSA who was actively serving at the time the standards were being developed, NHTSA knew about the risks and decided that publishing the data they had on the risks to pregnant women would be counter productive to the goal of increasing seat belt use for the general population, thereby saving more lives. (via Jim Hofferberth)

Remember in the 70s people in general were driving a fraction of the miles driven today by the average American and women were driving even less. So at the time the logic used by NHTSA was sound. The information provided to the pregnant American motor vehicle passenger has been virtually unchanged since that era.

It has been known for more than 40 years that there needs to be a safer way for pregnant women and their babies to ride in cars but virtually no progress has been made in providing a solution.

Here’s the reality of the situation

And I apologize in advance, this is not a pleasant topic to learn about. From at least 16 weeks, if not earlier, the uterus placenta and/or the baby are in the direct path of the lap portion of the seat belt during a crash. The goal of the seat belt is to engage the mother’s bony structures and to keep her restrained, but as the pregnancy advances, the iliac crest or hip bones, which are the intended bony structure to make contact with the lap portion of the seat belt, are behind the most anterior points of the abdomen. This requires that the seat belt compress the pregnancy in order to even contact the iliac crest. The further out the pregnancy, the deeper the lap portion must intrude prior to contacting the iliac crest.

A crash unfolds in 1/10 of second or less. These are extreme acceleration and deceleration loads in extremely short periods of time with forces into the 2,000 lb plus range. And, to make matters worse, for those in late stage pregnancy, there is on average only 2.5” of space between the most anterior points of the iliac crest and the spinal column into which the baby is being compressed.

Not a pleasant thought, again, I’m sorry. So what to do about it? In order to be 100% safe a woman would have stay at home or walk everywhere she needs to go or take public transportation which is statistically much safer than driving in a passenger car.

But what about those aftermarket seat belt positioners I see around? Are they safe?

You will hear from many safety advocates that one should never trust your safety to “aftermarket” or “unregulated” products and, while generalized, often that is good advice but not always.

The term “unregulated” simply means that there are no government issued testing standards to certify or test a product to. It does NOT always mean that the product is poorly designed or not adequately tested. As a consumer it is important to understand what the outcome is your trying to achieve then to evaluate if a certain product accomplishes that outcome. The next step would be to research what testing has been done on the product itself.

In the world of seat belt comfort items for pregnant women there are several options available but when we look at what we’re trying to accomplish which is reducing or eliminating the possibility of the lap portion of the seat belt from intruding into the abdomen, we find that most products do not even address or much less accomplish this. They are simply a comfort item during normal driving conditions and would provide very little to no protection during a crash. Some introduce padding in between mom and seat belt which, when in a crash, will allow mom to travel forward before engaging the seat belt. Mom’s pregnant belly is already closer to the steering wheel; we don’t want her that much closer in the earliest stages of the crash.

There is one…

tummy shield pregnancy seat belt positionerThere is one pregnancy seat belt positioner product currently on the market in the USA, that completely removes the lap portion of the seat belt from the abdomen and upper pelvis area, positioning it on the legs and lower pelvis, thereby virtually eliminating the possibility of the lap portion intruding into the pregnant abdomen.

It was crash tested to verify the seat belt still functions correctly. The tests showed crash forces experienced by the user are within the limits allowed under the crash testing criteria in Federal Motor Vehicle Safety Standards as well as the Australian equivalent, called Australian Design Rule. This product can be described as a heavy duty stainless steel plate and hook assembly embedded into a comfortable cushion. It creates a substantial anchor point between mom’s legs, very much like a child’s five-point car seat.

After the initial easy installation of the product in the car, mom-to-be puts on her seat belt on as usual. Then she reaches down to slip the lap belt  into the stainless steel anchor between her legs. She then snugs and tightens the seat belt to a comfortable level.

This product is called the Tummy Shield. It has been for sale internationally since 2008 and in the USA since 2014. It is currently for sale in 20 countries. The Tummy Shield makes wearing the seat comfortable, which will likely increase seat belt use during pregnancy and it protects baby from an intruding seat belt during a crash. WIN, WIN!

When you were pregnant, did you wonder, “is this seat belt really safe for pregnant women”? Share your comments below.

By Greg Durocher, CEO at Safe Ride 4 Kids and certified CPS Technician Instructor since 2002

Copyright 2014 Safe Ride 4 Kids. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission. This post was originally published September 2014 and has been updated for accuracy and comprehensiveness.

@ amie durocher
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1 Comment
  • Airport Playaobgyn
    Posted at 23:41h, 14 September Reply

    I have read your post it is really very informative thanks for sharing.

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