Companies market pregnancy-specific seatbelt adjusters as safer alternatives to a traditional seatbelt, with compelling claims that they reduce risks to both the mother and the baby. In this episode, we examine the evidence on car crashes during pregnancy, the proven benefits of seatbelt use, and the real-world challenges of proper seatbelt positioning during pregnancy. You will learn what major safety organizations recommend, how these aftermarket products work, and whether their safety claims hold up under scrutiny.
Listen Now
I appreciate your support for the brands that help power this podcast. Check out all of the discounts available to Pregnancy Podcast listeners here.
Become a Pregnancy Podcast Premium member or log in to access all articles and episodes ad-free.
Article and Resources
Hey Vanessa!
I am newly pregnant and have been loving the advice your podcast gives. Thank you for giving me comfort and arming me with knowledge at every stage.
I am being influenced on social media to purchase a pregnancy-specific seatbelt. The ads boast increased safety for mom and baby, but I’m not sure if it’s been properly safety tested or if the risks of traditional seatbelts are as high as they claim.
Can you do an episode talking about seatbelts in pregnancy and whether a pregnancy-specific seatbelt is worth the purchase?
Thanks,
Harley
Harley, thank you so much for your email. There is no end to products marketed specifically for pregnancy, and it is easy to feel like you need them. This is especially true when advertising appeals to safety or to the desire to do the very best for your baby. With the way companies collect data and target users online, companies can easily reach expecting parents. When companies bombard you with ads, it makes it even more tempting to believe you need every product promoted to you.
Car Crashes During Pregnancy
In the United States, it is estimated that 92,500 pregnant women are involved in car accidents each year. This number is likely an underestimate. Many crashes are not reported, and pregnancy status is not always known early on. Motor vehicle collisions account for 82% of injury-related fetal deaths and 55–78% of trauma-related hospital admissions among pregnant women. The most common risk of trauma to your abdomen is placental abruption. This occurs when the placenta detaches from the uterus and can no longer supply oxygen to the baby. Trauma can also result in a ruptured uterus, changes in fetal heart rate, or preterm delivery.
There is some speculation that pregnancy itself may contribute to an increased risk of serious crashes. For example, one study found that serious motor vehicle accidents were more common during the second trimester. Pregnancy brain is a thing, but I am not sure that makes you a worse driver. Regardless of the cause, accidents are unpredictable, and you should take precautions to drive safely.
Seatbelt Safety
It is well established that the most critical thing you can do to reduce risks in a car accident, whether you are pregnant or not, is to wear a seatbelt. Research shows that seatbelts are associated with lower injury severity, reduced need for emergency surgery, and shorter hospital stays. Interestingly, researchers also found that intra-abdominal injuries during pregnancy did not vary according to seatbelt use.
Automotive manufacturers have performed crash tests with dummies modeled after pregnant women. In tests where dummies did not use seatbelts, the abdomen made direct contact with the steering wheel. This was in both front and rear crashes. These tests show that wearing a seatbelt reduces abdominal pressure and can prevent the abdomen from striking the steering wheel during a collision.
Seatbelt Usage in the Real World
Although we widely accept that seatbelts offer safety, seatbelt use is not 100% everywhere. In the United States, about 88% of pregnant women report always wearing a seatbelt. In other countries, the rate can differ. For example, a study in Indonesia found that only 34.7% used seatbelts. Common reasons for not wearing a seatbelt include forgetting, abdominal discomfort, or uncertainty about its safety for mom and baby.
Even among pregnant women who do wear seatbelts, many do not use them correctly. A study in Japan found that 13.1% wore seatbelts incorrectly. The most frequent mistakes were the lap belt crossing over the abdomen (7.4%). Next was the lap belt across the thighs (2.9%). Followed by the shoulder belt across the abdomen (1.1%). In the United States, one study found that only 21% of pregnant women positioned both the lap and shoulder belt correctly. Part of the issue is a lack of education. On average, only about 48.7% of care providers counsel pregnant patients on how to wear a seatbelt properly.
Recommendations for Seat Belts
The American College of Obstetricians and Gynecologists recommends that you should wear a lap and shoulder belt every time you travel while you are pregnant for the best protection. The National Highway Traffic Safety Administration (NHTSA), which is part of the U.S. Department of Transportation, provides detailed instructions on how to position a seatbelt and yourself in a car:
- The shoulder belt should be away from your neck, but not off your shoulder, and across your chest, between your breasts. You should never place it under your arm or behind your back.
- You should secure the lap belt below your belly so that it fits snugly across your hips and pelvic bone. Never place it over or on top of your belly.
- Remove any slack from your seat belt.
- Sit in a comfortable, upright position. Maintain as much distance as possible between your belly and the steering wheel while still being able to reach the pedals and wheel. Avoid letting your belly touch the steering wheel. If you are a passenger, move your seat back as far as possible.
- Avoid reclining your seat more than necessary to minimize the gap between your shoulder and the seat belt.
- Always leave airbags on. They are designed to work with seatbelts, not replace them.
Wearing a seatbelt correctly is the single most effective action you can take to protect yourself and your baby in a crash. The question that follows is whether pregnancy-specific seatbelts actually improve comfort and safety.
Pregnancy Specific Seatbelts
There are several pregnancy-specific seatbelt products on the market. While they differ in design, they all function similarly by anchoring in the middle of the seat and redirecting the lap belt so it runs over each leg instead of across the lower abdomen.
The Tummy Shield includes a cushion that goes on your seat and straps around the back of your car seat. You buckle your seatbelt as usual, then the center of the lap belt anchors on a hook in between your legs. This redirects the lap belt so that it wraps around each leg rather than resting across your pelvis below your belly. The Tummy Shield is the most expensive product in this category, with a retail price of around $900.
The Mimi Belt is another pregnancy seatbelt adjuster. It uses a strap that threads through the gap between your seat and backrest, with a hook that redirects the lap belt so it straps around each leg. The Mimi Belt retails for about $36.
There is also a range of similar products on Amazon that range from around $20 to $30.
Seat Belt Extenders
Some companies that manufacture seat belt adjusters also sell a buckle extender. Seatbelts fit a wide range of body sizes. Plus, when you consider that the lap belt should go below your belly, and not over it, the seatbelt should be long enough without the need for an extender. (As a side note, I found it interesting that one of the promotional images for an extender shows the seatbelt positioned over the belly. Without the extender, the seatbelt was compressing the belly, and with it, it appeared much more comfortable. All safety guidelines explicitly advise against wearing the lap belt across your belly.)
Safety Claims
Manufacturers of pregnancy-specific seatbelt adjusters make bold claims about the safety of their products. The Tummy Shield states that it is crash and strength-tested for safety purposes and compliant with all ADR, EU, and U.S. seatbelt safety regulations. The company claims that by redirecting the force to your upper legs during collisions and jolts, it significantly lowers the risk of harm to your unborn baby. The Mimi Belt also claims to be crash-tested and certified. According to the manufacturer, it was developed with the help of professional automotive engineers over a 4-year period of research and testing. Marketing materials further state that the device significantly reduces the chances of lost pregnancies in car accidents by over 82.7% compared to regular seatbelts.
Validity of Safety Claims
While companies may conduct their own crash testing, I was unable to locate specific data on that testing, and manufacturers offer no links to additional data on their websites. I did find some information that the Tummy Shield crash tested their product on a male dummy at 30 mph with no breakage of the product or damage to the seat belts. It is difficult to assess the specifics of these tests and the performance of the devices, and to speculate whether they are truly safer during pregnancy. In addition, I could not locate any data to verify claims about reducing risks, particularly in terms of a specific percentage. Also, remember terms like “certified” or “tested” are not regulated and companies can use these terms in marketing without clear standards.
Regulation
In the United States, the NHTSA develops and enforces safety standards for motor vehicle equipment, including seatbelts. However, NHTSA does not directly test or approve each product. Instead, manufacturers must to self-certify compliance. While we will focus on specifics in the United States, the process is similar in other countries. Globally, there is limited independent oversight of these devices.
In a formal letter to the manufacturer of a pregnancy seatbelt adjuster called Belly Safe (a product nearly identical to the Mimi Belt), NHTSA clarified that no existing federal safety standard applies to these types of aftermarket belt-positioning devices. Standards apply only to new vehicles or new seatbelt assemblies, not to add-on devices. NHTSA expressed several concerns about products like Belly Safe:
Seatbelts are designed to distribute crash forces across the skeletal structure, away from the abdomen. The “Belly Safe” places an object between the legs of the occupant. This change in the distribution of crash forces could have serious safety implications for the wearer of the belt.
There are other concerns about the “Belly Safe.” The realigning of the lap belt through the “Belly Safe” could increase the amount of webbing in the belt system. If the straps which attach around the back of the seat or the Velcro holding the lap belt are unable to withstand the forces of a crash, there would be excessive slack in the lap belt. Slack in the lap belt would increase the risk of the occupant sliding under the lap belt (submarining) and slack in the belt system generally introduces higher crash forces, both of which would increase the risk of injury.
Should You Buy a Pregnancy-Specific Seat Belt?
The marketing for pregnancy seatbelt adjusters can be compelling. Official guidance from safety organizations continues to emphasize that the most effective protection in a crash is wearing a standard seatbelt correctly. If comfort is a challenge for you, that may factor into your decision. For most expecting moms, the number one priority is safety. I could not locate clear independent evidence showing that these products improve safety. Ultimately, every car ride carries some degree of risk. What you can do is focus on the things within your control, like wearing your seatbelt properly, driving attentively, and minimizing distractions.
