Belts on bones, not over the bump: reported seat belt use and positioning among pregnant and nonpregnant drivers and passengers in the U.S.

Reported seat belt use among pregnant people before pregnancy increased during pregnancy, but use during pregnancy did not differ from the nonpregnant sample. Most pregnant respondents reported always using a belt, but only a small proportion positioned it correctly. Discomfort is a key barrier to positioning a seat belt correctly, whether an occupant is pregnant or not. Restraint system design should be improved to accommodate larger abdomens and other physical changes associated with pregnancy. Educational campaigns should target nonpregnant and pregnant people with information about correct belt positioning and address misconceptions that belt use compromises fetal safety.