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J Trauma. 2004 May;56(5):1016-21.

A focused educational intervention can promote the proper application of seat belts during pregnancy.

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Section of Trauma, Burns, and Surgical Critical Care, Division of General Surgery, Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.



The failure to properly use automobile restraints during pregnancy is a significant contributor to both maternal and fetal injury and death. Misconceptions as to the effects of restraint use on the fetus and a lack of instruction as to proper restraint positioning contribute to this problem.


Focus groups were used to develop an intervention consisting of educational material for prenatal care clinic patients and staff pertaining to seat belt use during pregnancy. The intervention was administered over a 2-month period. Two groups of women, one preintervention and one postintervention, were surveyed to determine demographics, pregnancy status, and current restraint use characteristics.


Preintervention and postintervention surveys were administered to 450 and 285 women, respectively. The proportion of women reporting correct placement of seat belts increased from 70.8% to 83.0% (p < 0.001) after the intervention. Knowledge of seat belt effectiveness also increased significantly (p < 0.001) after the intervention. Only 25.2% of women in the preintervention group reported receiving information from clinic staff on restraint use compared with 76.8% of the postintervention group (p < 0.001).


Lack of knowledge regarding restraint use during pregnancy contributes to a lack of consistent and proper use of restraints. Educational tools that improve both knowledge and behavior have the potential to increase automotive safety during pregnancy.

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