Assessing seatbelt use among pregnant drivers in Australia: Correct seatbelt positioning, discomfort, knowledge and information sources

Background: Correct seatbelt use during pregnancy is critical for ensuring maternal and fetal safety during a motor vehicle crash. This study aimed to investigate seatbelt use among pregnant vehicle drivers in Australia, focusing on correct seatbelt positioning and the potential influence of comfort and the receipt of seatbelt information. Method: An online survey was completed by 1,491 participants (M = 33.2 years, SD = 4.1, Range = 18.0 – 50.0 years). Results: While nearly all participants (99.1%) reported ‘always’ wearing their seatbelt while driving a vehicle, only 41.4% met the correct seatbelt positioning criteria, defined as positioning the lap belt under the belly and low over the upper thighs and the shoulder belt between the breasts. Despite increased discomfort with seatbelt use as pregnancy advanced, discomfort was not significantly associated with correct seatbelt positioning. Additionally, while most participants had not received information about seatbelt use during pregnancy (87.7%), those who did had better knowledge (96.2% vs. 90.5%, χ2(1) = 7.16, p < 0.05), and were more likely to meet all three criteria for correct seatbelt positioning during pregnancy (56.8% vs. 39.3%, χ2(1) = 20.26, p < 0.001), than participants who had not received information (90.5%). However, receiving information did not necessarily increase confidence in correct seatbelt use, as participants who had received information were actually less likely to be confident in their ability to use the seatbelt correctly (3.3% vs. 6.6%, χ2(2) = 8.24, p < 0.05). Conclusions: These findings highlight a significant gap in correct seatbelt positioning among pregnant occupants and the scope for substantial improvement in correct positioning by providing specific information on seatbelt use during pregnancy. Practical applications: To improve correct seatbelt use among pregnant individuals, public health messaging should be enhanced, and obstetrician-gynaecologists, nurses and other healthcare professionals should provide clear guidance on correct seatbelt positioning throughout the pregnancy. Future research should focus on developing effective educational strategies, assessing vehicle design improvements for comfort and safety, and exploring other factors influencing correct seatbelt use during pregnancy.