Prenatal care post-collision

Dr. Ashley Waggoner, D.C.

Car accidents are extremely dangerous and damaging to your body, and when pregnant, to the unborn child as well. “Trauma is the leading cause of morbidity and mortality in pregnant women, and motor vehicle accidents account for 60%-80% of all blunt trauma that occurs to pregnant women, said Dr. Hill, director of maternal-fetal medicine at Sarasota (Fla.) Memorial Hospital” (1). Motor vehicle accidents occur in 1 in every 12 pregnancies. If a pregnant patient comes into the hospital after a car accident but has no severe injuries, she should still remain there and be monitored for 4-6 hours in the triage unit, Dr. Hill stressed. Studies have shown that all adverse pregnancy outcomes, including placental abruption and fetal death, are apparent by 6 hours after the traumatic event. Patients who need to stay at the hospital longer than 6 hours are those with increased uterine activity or an abnormal fetal heart rate, vaginal bleeding, uterine tenderness or irritability, ruptured membranes, and, of course, serious injuries.

Call 911 or other emergency services right away if you have been involved in a car accident.

Get immediate medical attention if you experience any of the following:

  • You pass out (lose consciousness).
  • You are experiencing severe vaginal bleeding.
  • You are experiencing severe pain in your belly or pelvis.
  • You are experiencing gushing/leaking fluid from your vagina, and you think, or you know, that the umbilical cord is bulging into your vagina. If this occurs, immediately get down to your knees so that your buttocks are higher than your head. This will decrease the pressure that is on the umbilical cord until medical help can arrive to assist you.

Any pregnancy can become high risk at any time, there are no guarantees. Although the occurrence of any of the following symptoms may not necessarily indicate that the expectant mother is having a problem, you should call your doctor immediately if you experience any of these conditions after an automobile accident:

  • vaginal bleeding or spotting
  • swelling in your face or fingers
  • a leakage of fluid or increased vaginal discharge
  • severe or unrelenting and constant headaches
  • pain in your abdomen or shoulder areas
  • persistent vomiting that is not connected to morning sickness
  • chills or a fever
  • a noticeable change in the frequency or strength of your baby’s movements
  • painful or urgent urination
  • faintness or dizziness

IMPORTANT: it is possible that an expectant mother’s fetus can suffer severe injury in an instance where no physical contact was made. A quick stopping motion can expose a mother and her fetus to a type of injury known as a contra-coup injury. This occurs when a concussion or shock is produced by a blow or other injury, in a part or region of the body opposite to that at which the blow is received, which often causes rupture or disorganization of the parts affected.

The after-effects of an auto accident may place you and you’re unborn at higher risk for problems, such as slowed growth for the baby, any preterm labor complications, elevated stress levels and blood pressure, pre-eclampsia, and problems with the placenta. However, it’s important to remember that being at high risk doesn’t mean that you or your baby will automatically have problems.

1. What should I do if I’m in a car accident while I’m pregnant?

  • Any time you’re in a car accident — whether it’s a fender-bender or a multiple-car pileup — you should be examined as soon as possible, no matter how far along you are in your pregnancy. Time is critical in these types of crashes. (In fact, you should be evaluated if you ever receive any type of blow to the abdomen during pregnancy.) Even if you feel fine get evaluated immediately.
  • While the womb does offer some of the best protection for your baby and placenta during a sudden impact, slamming on the brakes — even if the resulting jerk is not or does not feel severe — can potentially disconnect the placenta from the uterus. This is when a placental abruption is possible, and as discussed, this can lead to serious problems including hemorrhage, miscarriage, or premature delivery.
  • Once in the emergency room, the expectant mother will be examined to determine if everything is ok and the baby and mother are deemed stable. This should include an ultrasound and full OB examination. Depending on the age of the fetus and any symptoms you have, such as bleeding or contractions, the medical professionals may determine that you and your baby need to be monitored for a longer duration of time. Also, if the expectant mother’s blood is Rh-negative, she may receive a shot of Rh immunoglobulin if there’s any chance that your blood has mixed with your baby’s.
  • The medical professionals should explain all of this to the expectant mother during the treatment. If the expectant mother is given a good report, she will still need to watch for subsequent vaginal bleeding, leaking fluid, contractions or other abdominal pain, or a decline in the baby’s movement. If you experience any of these symptoms, contact medical professionals immediately.
  • After being thoroughly checked by emergency medical professionals, contact the family chiropractor or local chiropractor who works with women during pregnancy who will thoroughly examine the spine, round ligaments, extremities, etc for misalignments and injuries that may affect the health of the mother and the unborn child. A chiropractor will provide adjustments specific to the pregnant mother and provide pain relief without the use of drugs or surgery, which both cause damage to the mother and child and should be avoided if at all possible. Pregnancy at the time of a car accident makes you more susceptible to injury because of a hormone called “Relaxin”.  Relaxin stimulates the laxity of ligaments specifically in the low back and pelvis during pregnancy to allow for the baby to transition through the pelvis easier.  This means that your ligamentous system relaxes (compared to normal) and therefore it is easier for a herniated disk or ligament tear to happen due to the crash forces. Chiropractors specifically address the musculoskeletal system, spinal alignment and the ligament, tendons, muscles, etc (soft tissue) involved.

2. I feel fine, is it possible that there are injuries to myself or my unborn baby?

  • Yes, because pregnant women are at risk after car crashes—even if there are not any apparent or visible injuries.
  • Pregnant women who are hospitalized following motor vehicle crashes are at increased risk of adverse pregnancy outcomes, even if they are not seriously injured or not injured at all. These women are at risk for such difficulties as placental abruption and cesarean section and their babies at risk for respiratory distress syndrome and fetal death, according to a new study by investigators at the Harborview Injury Prevention & Research Center (HIPRC).
  • Even though previous studies have uncovered that the severity of the crash is connected to negative pregnancy results, newer, more up to date research reveals that even injuries that are deemed ‘not as severe’, can also have negative and harmful results for the expectant mother and her baby.
  • Expectant mothers who were in an automobile accidents and did not display or have any recorded injuries, were discovered to be at an incredibly higher risk level for any number of premature labor complications compared to those expectant mothers who were not in automobile accidents.

Dr. Ashley Waggoner, D.C.                                                                                                         Chiropractic Physician                                                                                                                                                                  www.ashley-chiropractic.com


1.     Timothy F. Kirn “Motor vehicle accidents: clinical signs can flag some injuries that are missed by ultrasound“. OB/GYN News. FindArticles.com. 09 Jan, 2011. http://findarticles.com/p/articles/mi_m0CYD/is_17_39/ai_n6212352/