July 31, 2003
Ask many pregnant women why they don't wear
a safety belt when driving and you're likely to hear a
number of reasons — discomfort,
forgetfulness, the inconvenience. One other reason many expectant
mothers choose to avoid seat belts? Fear they may cause injury
to the fetus or themselves.
But according to experts, this is a common misconception.
And new research suggests pregnant women should be urged
to wear safety belts throughout pregnancy.
The study, published in the latest issue of the journal Obstetrics & Gynecology,
found pregnant drivers who do not wear a seat belt when involved
in a car crash are nearly three times more likely to experience
a fetal death and twice as likely to experience excessive
internal bleeding, compared to pregnant drivers who wore
safety belts.
The study was conducted by researchers at the Intermountain
Injury Control Research Center at the University of Utah
School of Medicine and the Center for Injury Research and
Control at the University of Pittsburgh.
"The take-home message is that pregnant women should
still wear safety belts even if it's uncomfortable, because
it's
safer for the baby and the mother," said Lisa Hyde,
lead author of the study, which looked at statewide motor
vehicle crash, birth and fetal death records in Utah from
1992 to 1999.
A Need to Dispel Misconceptions
One significant difference with previous studies is that
belted pregnant women in crashes were not significantly more
at risk for adverse fetal outcomes than pregnant women not
in crashes. "In other words, wearing a belt doesn't
make you any higher risk than other women," explained
Hyde.
The authors added many pregnant women still do not wear seat
belts despite substantial research on the overall protective
value of seat belts. Since motor vehicle crashes are the
leading cause of traumatic fetal death in the United States,
the researchers suggest strategies be developed to improve
seat belt usage among pregnant women.
Further exacerbating the misconception, the authors add,
is that foreign countries such as Japan, Spain, Poland and
Greece have exceptions in place for pregnant women, who don't
have to use safety belts if they choose not to.
Hyde said the misconception that seat belt use is bad for
the fetus and causes more injury than using nothing at all
is understandable, given that pregnant women involved in
car crashes often suffer from bruising and naturally fear
harming the baby. But she added numerous studies show the
fetus is well protected, and proper safety belt use greatly
reduces harm to pregnant drivers and fetuses during car crashes.
Learning How to Use Safety Belts Correctly
Hyde also said many women are simply unaware of the correct
usage in positioning of seat belts. Current recommendations
by the American Medical Association, the American College
of Obstetricians and Gynecologists and others suggest lap
belts should be placed snugly under the abdomen and shoulder
belts positioned diagonally across the chest. The shoulder
portion of the belt should fit snugly between the breasts
and cross the chest and abdomen diagonally.
Also, pregnant women should sit at least 10 inches back from
the air bag or dashboard of the vehicle, and they should
not disable the air bag, as it can provide further protection
for the mother and her baby in a serious crash.
"I think there should be a lot more education about
where the seat belt should be placed," said Hyde. "Providers
and primary-care physicians should counsel their patients
on proper use, and there should be more general publicity
on this."
Dr. Laura Riley, chairwoman of ACOG's Committee on Obstetric
Practice at Massachusetts General Hospital, said while the
importance of using safety belts during pregnancy is nothing
new, this study serves as a useful reminder that everyone
needs to wear a seat belt, pregnant or not.
"Depending on how pregnant you are, I'm sure it
can get uncomfortable, especially during the third trimester,
but the discomfort
has absolutely no impact on the baby," Riley said. "The
baby is protected inside fluid surrounded by the uterus,
surrounded by your abdomen, and so there's multiple levels
of protection between the seat belt strap and the fetus."
Copyright © 2002 ABC News
