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 these 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.

It has been shown that correct seat belt use significantly reduces both maternal and fetal morbidity and mortality following motor vehicle accidents. As care providers, physicians and midwives have not fully educated women in the importance and use of seat belts during pregnancy. In one study, (Wallace, 1997), 25 percent of providers felt that their clients should not wear seat belts in the third trimester and only 30 percent provided regular advice. Less than half indicated that they are aware of the correct advice to give.

A study by Pearlman (1996) revealed that only 68 percent of pregnant women reported using seat belts in the manner currently recommended. Nearly 20 percent stated that they rarely or never used seat belts during their pregnancy.

So what are the recommendations regarding seat belt use in pregnancy?

• All women should wear their seat belt at all times.
• Position the seat belt properly. This is VERY important for pregnant women. The lap portion should always been worn low -- under the belly -- and very snugly across the hips. The loads generated in a collision can be enormous. The bony hip structure is much better suited to take this load than the soft abdomen (and the baby inside). The shoulder portion should be worn correctly over the shoulder (never under) and with a snug tension. Many cars have adjustments that lower or raise the height of the shoulder belt so that it does not cut into your neck. You can also by a pad to slip on the belt in the neck area so that it isn't irritating.
• The seat belt should be adjusted so that it is comfortable. If it fits properly you won't be tempted not to use it each time you get in the car.

Everyone should be properly buckled up in the car. Seat belts really do save lives and correct placement of the belt is very important.