Winnipeg Free Press - PRINT EDITION

Collisions pose risk to fetuses

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A pregnant woman gets lots of advice. Stay away from alcohol. Steer clear of cigarettes and smoke. Watch the caffeine. Think twice before riding a roller-coaster. But does anyone tell her how to properly wear her seatbelt, or that she might want to cut back on how much she drives while with child? According to a growing number of researchers, somebody should.

In North America, more than 600 infants under the age of five are killed in car collisions every year. As a result, there are endless information campaigns devoted to keeping young children safe on the road. Yet, statistics show the car-crash fatality rate for unborn babies is actually four times higher than for toddlers, but the problem of fetal deaths hardly registers with parents and medical professionals.

It is not surprising that unborn children are at greater risk than young ones. As Susan Winlaw, the author of Car Advice for Women (and Smart Men), notes, infants are in the rear, facing backwards, and well away from the sides of the car. The fetus, on the other hand, is inches away from the steering wheel or a couple of feet from the passenger-side dash. The most common cause of fetal death in a collision is abruptio placenta, when the placenta prematurely separates from the uterine wall after a trauma to the mother's abdomen.

It does not require a lot of force to become detached -- in fact, even an abrupt stop or severe slide can damage the placenta (which is why doctors tell pregnant women to avoid jarring roller-coaster rides) -- and when it does, the baby is deprived of oxygen and nutrients, which can be fatal.

North Americans have created a built environment that encourages automobile use, and at the same time, more women of child-bearing age have entered the workforce and are on the road commuting by car. It would obviously be impractical to suggest pregnant women avoid any and all travel, but there are steps they can take to decrease the risk cars pose to their baby.

As expert Hank Weiss at the University of Otago, New Zealand, points out, the most effective measure a woman can take when driving is to always put on a seatbelt, and be sure to wear it correctly. While some riders may be tempted to move the shoulder strap or let the belt ride up to the middle of the abdomen, it should be placed snugly over the bony structure of the hips to avoid harming the unborn passenger. When in the driver's seat, a pregnant woman should also remain as far from the steering wheel as possible. Some vehicles actually have a button to adjust the height of the brake and gas pedal, or women can purchase a pedal extender to add extra inches between the steering wheel and stomach.

If a mother-to-be is involved in a collision, she should seek medical attention as soon as possible. In fact, because of the potential risk of trauma to the unborn child, researchers believe it is worthwhile to consult a doctor after any severe auto incident, including skids, spins, swerves, or even hard braking. Finally, Weiss suggests women may want to consider driving less while pregnant -- opting for roads with slower speeds to avoid traumatic high-speed collisions, letting someone else drive and riding in the passenger seat where there is no steering wheel, or even taking public transportation for some portion of her pregnancy.

These latter recommendations might seem extreme in a culture where car use is so prevalent. Yet, more than 93,000 pregnant women in Canada and the U.S. are hurt in motor-vehicle incidents annually, and these collisions are the leading cause of traumatic fetal mortality and serious maternal injury in North America. In fact, more pregnant woman die in car crashes every year than in birthing complications.

Medical professionals should be providing women with information on the potential harm that can come from collisions and offering advice on how to decrease the risk, so new mothers and fathers can themselves decide what steps they feel are worth taking. Admittedly, it will add to what is already a fairly long list of precautions for keeping unborn babies safe, but considering the obvious value parents place on their children, it is a list they deserve to have.

Benjamin Gillies is a political economy graduate from the University of Manitoba, where he focused on urban development and energy policy. He works as a consultant in Winnipeg.

Republished from the Winnipeg Free Press print edition March 25, 2013 A9

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