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When you are pregnant, you take extra care to eat well and avoid things that might harm your baby. After birth, you still need to protect your baby. The best way to keep you and your baby safe in a car or truck is to use safety belts and child safety seats. Buckle up every time you drive or ride. It takes only a few seconds.

This pamphlet will explain:

  • Why you need to use safety belts and child safety seats
  • How to wear a safety belt during your pregnancy
  • How to choose the best safety seat for your baby

Safety Belts and Safety Seats Save Lives

Car crashes cripple and kill more people from birth to age 34 than anything else. Many of these deaths and injuries could have been prevented with safety seats and safety belts.

All states and the District of Columbia have child restraint laws. All states (except New Hampshire) and the District of Columbia have laws that require riders and drivers to buckle up. Most of the laws cover only people in the front seat. Some states also require that everyone in the car wear a seat belt.

In most cars the safety belt is one unit made up of the lap and shoulder belt. In some cars the lap and shoulder belts are separate. Always wear both. If a car only has a lap belt, wear it.

What Happens in a Crash

In a car crash, there are two collisions. The first is when the car hits something, or is hit, and comes to a sudden stop. The second crash happens a split second later when anyone not buckled in can fly forward, slamming into the steering wheel, windshield, dashboard, or front seat (from the back seat). The force of a 30-mph crash is like jumping headfirst off a three-story building.

In a crash or sudden stop, safety seats and belts hold everyone in their place. This helps keep them from smashing into the inside of the car or into each other. It also keeps them from being thrown through the windshield.

It takes only a second or two for an adult to buckle up. It takes only a couple of minutes to get a baby into the safety seat. Take the time to be safe—even when you are only going a short distance.

Buckling Up During Pregnancy

Your baby's first ride is in your belly. Although the baby is well protected inside of your body, for the best protection in a vehicle, wear a lap-shoulder belt while you're pregnant every time you travel. The safety belt will not hurt your baby. You and your baby are far more likely to survive a car crash if you are buckled in.

When wearing your safety belt:

  • Always wear both the lap and shoulder belt.
  • Buckle the lap belt low on your hipbones, below your belly.
  • Never put the lap belt across your belly.
  • Place the shoulder belt across the center of the chest (between your breasts)—never under your arm.
  • Make sure the belts fit snugly.

The upper part of the belt should cross your shoulder without chafing your neck. Never slip the upper part of the belt off your shoulder. Safety belts worn too loosely or too high on the belly can cause broken ribs or injuries to your belly. But more damage is caused when they aren't used at all.

Safety Seats for Babies

Infant-only seat
You will need a safety seat for your baby's first ride home from the hospital. Plan to get a safety seat well before your due date. This will give you time to practice using the seat in your car before your baby's first car ride.

Rear-facing convertible seat
The safest place in the car for an infant is facing the rear of the car in the middle of the back seat. This helps support the baby's head and back. If the seat doesn't fit in the middle, place it in the back seat where it fits best. The back of the safety seat supports the baby's back, neck, and head in a crash.

If your baby's head flops forward, place a rolled towel under the front edge of the child safety seat. Also, place rolled towels or blankets on both sides of the baby's head and shoulders for support.

Two kinds of safety seats are made for babies—infant-only seats and convertible seats. Infant-only seats fit babies only under 17-22 pounds and always face the rear of the car. A convertible seat fits children from birth to about 40 pounds. It is used facing the back of the car for the first year, then can be turned to face the front when the baby is at least 1 year old and weighs at least 20 pounds.

Choosing the Best Seat

By September 2002, all new cars and trucks must have the same system to install child safety seats. This means every child safety seat will fit in a car or truck the same way. Special anchors—instead of seat belts—will hold the seat in place. All child safety seats will be redesigned to use the anchors. If you have an older model child safety seat, you can buy a special belt designed to fit the new anchors.

Until all new cars and seats have these anchors, some safety seats will fit in your car better than others. A seat that is easy to use will be the best for you and your child. When buying a seat, keep these tips in mind:

  • Try locking and unlocking the buckle while you are in the store. Try changing the lengths of the straps.
  • Try the seat in your car. If it doesn't fit, you'll need another model.
  • Read the labels to check weight limits.

Using the Seat in Your Car

Your child's safety seat is best placed in the middle of the back seat.
To protect your child, the safety seat must be secure in the car. First, place the seat in the middle of the back seat, facing the rear. Lock the seat into its base, if it has one. The base should not move more than 1 inch when pushed. The lap part of the seat belt should be tightly fastened to the seat frame. To make sure it's tight, push the safety seat down into the seat cushion while you tighten the belt around it. Check the car's owner's manual for instructions about using belts for safety seats.

Safety Seat Checklist

  • Have I read the label on the safety belt and seat for any special instructions?
  • Is my baby in the back seat?
  • Is my baby facing the rear of the car?
  • Does the safety belt hold the child safety seat tightly in place?
  • Does the harness fit snugly around my baby?
  • Does my baby's head have support?
The safety seat's harness should fit snugly around the baby. You should be able to slide one finger under the straps at your child's chest. The straps should be over your baby's shoulder. The chest clips should be placed at your baby's armpit.

If you want to cover your baby, first buckle the baby in without any covering. Then, place a blanket over the baby.

Air Bags

Many new cars have air bags to protect the driver and the passenger riding in the front seat. Air bags are inside the steering wheel and dashboard in front of the passenger seat.

In a crash, air bags inflate very fast. The force of an air bag can hurt people who are too close to it. To avoid injury to you and your child from an air bag, follow these steps:

  • Never put a child age 12 and under in the front seat—children should always ride in back.
  • Never put an infant seat that faces the rear of the car in the front seat.
  • Buckle up with both the lap and shoulder belts on every trip.
  • Keep driver and passenger seats as far back from the dashboard as you can.

Finally…

It is very important to protect yourself and your baby—both before and after birth—by using safety belts and seats. Make sure to wear your safety belt and to use a safety seat for your baby every time you get into a car.

For more information on car safety for you and your baby, contact:

National Highway Traffic Safety Administration
400 Seventh Street, SW
Washington, DC 20590
Web site: www.nhtsa.dot.gov

This Patient Education Pamphlet was developed under the direction of the Committee on Patient Education of the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.
Copyright © May 1999

ISSN 1074-8601

Requests for authorization to make photocopies should be directed to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923.

The American College of Obstetricians and Gynecologists
409 12th Street, SW

PO Box 96920

Washington, DC 20090-6920

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