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Just a Few Sentences Can Persuade Pregnant Women to Use Seat Belts


 

KAILUA KONA, HAWAII — Tell pregnant patients to wear seat belts when in a car, and chances are that they'll do it, Dr. William G. Barsan said at a meeting on medical negligence and risk management.

One study found that 92% of mothers who got some prenatal education about seat belt use later reported using seat belts, and 83% could describe proper seat belt placement. Only 71% of mothers who did not get seat-belt advice reported using seat belts, and only 65% could describe proper seat belt placement, said Dr. Barsan, professor and chair of emergency medicine at the University of Michigan, Ann Arbor.

This did not require extensive, 20-minute education sessions but simply telling the patients at an office visit, “The studies are clear—you're better off wearing a seat belt. If you wear it, here's how you want to do it,” he added.

There seems to be some confusion among the lay public and even among some clinicians about the benefits of wearing seat belts during pregnancy. Dr. Barsan argued with his own wife about it during her pregnancy, he said at the meeting, sponsored by Boston University.

Modeling studies suggest that the risk of fetal death from a car crash is similar for an improperly restrained woman in a 10-mph crash and a properly restrained woman in a 22-mph crash. “Without wearing a seat belt, it doesn't take much to potentially cause a very bad injury to the fetus,” he said.

In another study of pregnant Michigan women in 1993, 32% reported sometimes, rarely, or never wearing seat belts, compared with 23% who said they usually wear seat belts and 45% who reported always wearing them. Those kinds of numbers may help explain results of a 2001 study in Pennsylvania that reported 500 fetal deaths after motor vehicle crashes, compared with 300 deaths of children up to age 4 years who were involved in vehicle crashes in the same time period.

Pregnant women should wear lap belts under the protuberant part of the abdomen, low down on the abdomen and pelvis, Dr. Barsan said. Shoulder belts should be worn off to the side of the uterus, between the breasts and over the mid-portion of the clavicle. There is no evidence to suggest that air bags should be disconnected in vehicles for pregnant drivers or passengers, he added.

“Wearing a seat belt properly can give a lot of protection to the baby,” he said.

This did not require extensive, 20-minute sessions but simply telling the patients at an office visit. DR. BARSAN

“Wearing a seat belt properly can give a lot of protection to the baby.” Stanford W. Carpenter

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