Why Doctors Don’t Talk to Pregnant Women about Driving

Talk to Pregnant Women about Driving

“Motor-vehicle injuries are the leading cause of death and hospitalized trauma during pregnancy.” (Weiss, 2007) You would think doctors and pregnancy books would put more emphasis on driving when they talk to pregnant women.

Based on Pregnancy Risk Assessment Monitoring System, it is estimated that about 92,500 pregnant women are hurt annually in motor-vehicle crashes in the United States. A University of Michigan study cited 116,000 pregnant women incur an injury out of the 170,000 women who experience a car crash during pregnancy every year.

Studies about driving during pregnancy indicate an estimated 3,000 otherwise healthy pregnancies are lost every year from car crashes. Now statistically that may not seem like a lot. It’s less than 1 percent.

pregnancy and seatbeltsBut comparatively speaking there are about 650 fatalities in children from birth to 12 — so roughly through booster seat age — from car crashes. This number is much less than 1 percent of the 48 million children in that age range. Yet there are laws that require using a child restraint for those children. And many pediatricians talk about the importance of car seats at nearly every well-child exam.

“Despite this reported risk and the proven efficacy of restraint use, most pregnant women do not report being counseled about seat belt use during prenatal visits,” Weiss et al. Reducing this number of pregnancy losses with some simple pregnant driving safety tips should be a high priority.

A 2007 study published in the Maternal and Child Health Journal revealed prenatal care providers talk to pregnant women about driving only 48.7 percent of the time. Since every pregnant woman sees some sort of prenatal care provider, they have potential to make a big impact on increasing awareness and lowering the risk.

“Buckle up, keep the seat belt low, drive like you normally would and you should be fine.”

Unfortunately, that may not be the case. It’s easy to disregard the stories of pregnancy loss from car crashes as statistically insignificant or inconsequential. Miscarriage is a common occurrence. Many times loss from a crash comes some time after the crash. Subsequently the loss is never correlated to the crash but written off as a natural miscarriage.

The stories of families suffering the pain of pregnancy loss in any situation are too often ignored, underplayed or quietly accepted as a type of collateral damage in the effort to have a baby.

Yet, the stories of parents living with the permanent disability of a child, or grieving the death of a pregnancy loss, matter. Car crashes during pregnancy can result in either.

George Baladi and his wife weren’t even in an accident but rather a sudden-braking incident to avoid a crash when their daughter at 7 months gestation experienced a brain injury. Their family has dealt with the emotional and economical expense of their daughter’s brain injury for more than 20 years now.

Taylor Baroody was 28 weeks pregnant when she and her fiancé were in a crash from which their unborn baby suffered a fatal brain injury. Taylor was properly buckled in the passenger seat with only a bruise from the seat belt as an indication she was in a crash.

These parents in both examples followed the National Highway Safety Traffic Administration’s recommendation for seat belt use only to discover that their children will never be the same. This profoundly matters.

The majority of pregnant women may walk away from a car crash relatively unscathed and pregnancy intact but it would be prudent to remain open to the suffering of those who experience a different outcome.

What about the high percentage of women who do not routinely wear their seat belt?

A 2004 study of women attending prenatal clinics published in The Journal of Trauma (McGwin et al), reported that only about 45% of women always wear their seat belts (both before and during their current pregnancy) even though 72.5% of subjects were able to demonstrate the proper way to wear a seat belt.

The most commonly reported reasons for lack of restraint use were lack of comfort (52.8%) and forgetfulness (42.5%).

So why don’t providers talk to pregnant women about driving?

When Taylor contacted us after her crash, she said her doctor had not mentioned seat belt use during any of her  prenatal visits.

According to the above 2004 study, 36.9% percent of women reported receiving information regarding restraint use during their current pregnancy.

Respondents in the 2007 study were asked if they received prenatal counseling on 11 different topics. Counseling for seat belt use was ranked second to last at 48.7%. Physical abuse by husband/partner (38.6%) was discussed less often.

One reason prenatal care providers don’t go in depth about driving during pregnancy may be that providers receive very little training in the subject of vehicle safety for pregnant women.

A 2011 study about why doctors don’t talk to pregnant women about toxic chemicals shared part of the reason doctors avoid that concern was the doctors don’t want to make their patients more stressed out about protecting their baby. Perhaps this is also a reason more doctors don’t talk to pregnant women about driving and seat belt use.

While all of the doctor’s offices we’ve spoken with say there is a real issue with pregnancy loss from car crashes, the official recommendation from NHTSA hasn’t changed or been updated in the last 50 years. This is the only information the doctors have to offer.

Although in a 2013 report from the former Director of the Office Of Crashworthiness at NHTSA, James Hofferberth, said it was known at the time {1970s} that the lap and shoulder belts posed a significant risk to unborn babies. In 2009 Ford’s former senior technical leader for safety told USA Today, “the seatbelt is the best safety device in the vehicle today, but it doesn’t mean we can’t make it better.” He advised pregnant women should wear their seat belts until there is a better way.

And then there’s our memory

Pregnant women can’t remember all of the abundance of information shared during initial visits. A follow up survey of pregnant women after their initial prenatal visit showed that 73% of the women did not recall having received advice on seat belt use even though they received brief counseling by a clinician and a pamphlet on seat belt use during pregnancy during their initial visit. (Tyroch et al, 1999)

Possibly only 27% of the 48.7% of pregnant women who discuss driving with their prenatal care giver remember the discussion. That equal only 13% of all pregnant women who recall a discussion with their care provider about driving during pregnancy.

Tummy shield maternity seat belt adjusterThere is room for improvement to increase the number of providers talking to pregnant women about driving. There is also a need to make that information more memorable.

While pregnant women won’t be able to avoid driving during pregnancy, they can take certain measures to reduce their risk. For instance, they can move the seat back or use a Tummy Shield to reposition the seat belt in a safer configuration for the baby.

We developed a downloadable guide for driving during pregnancy with a list of tips to help guide pregnant women. And we offer provider kits for prenatal care providers to have in their offices and share with patients. If you want to give your prenatal care provider the ability to offer more information to other patients, have them go to TummyShield.com/Provider-Order/.

We want to know, … ? Share your comments below.

By Amie Durocher, Creative Director at Safe Ride 4 Kids and certified CPS Tech since 2004

Copyright 2017 Safe Ride 4 Kids. All rights reserved. This material may not be republished, broadcast, rewritten or redistributed without permission. You’re welcome to link to Safe Ride 4 Kids or share on social media.

  1. Weiss, HB; Sirin, Hulya; Sauber-Schatz, Erin K.; Dunning, Kari; “Seat Belt use, Counseling and Motor-Vehicle Injury During Pregnancy: Results from a Multi-State Population-Based Survey.” Maternal and Child Health Journal. Volume 11 (2007): p505-510.
  2. McGwin, G; Russell, SR; Rux, RL; Leath, CA, Valent, F; Rue LW; “Knowledge, beliefs, and practices concerning seat belt use during pregnancy.” The Journal of Trauma. March 2004: p670-675.
  3. Tyroch, A; Kaups, K; Rohan, J; Song, S; Beingesser, K; “Pregnant Women and Car Restraints: Beliefs and Practices.” The Journal of Trauma. February 1999: p241-245.
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1Comment
  • Amanda Ross
    Posted at 14:44h, 19 October Reply

    During my pregnancies none of my doctors or midwife mentioned anything about driving or using the seat belt. When I researched it, at the time, all I could find was wear your seat belt. But the seat belt was so uncomfortable and increased the feeling of having to pee every time I hit a bump. Ultimately I drove one-handed holding my seat belt a bit away from my stomach with the other hand. I wish there were options then like there are now.

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