When a pregnant woman becomes non-ambulatory due to injury, illness, or an emergency, moving her requires immense caution to protect both her and the fetus. Improper handling can lead to serious complications, including placental abruption, uterine injury, or exacerbating a spinal trauma. The safety of the mother and the developing baby depends on a clear, deliberate, and informed approach to physical transport. Understanding the physiological changes of pregnancy is foundational to executing a safe lift and transfer.
Initial Assessment and Preparation
Before any attempt is made to move a non-ambulatory pregnant woman, a rapid but thorough assessment of the situation and her condition is necessary. The immediate environment must be checked for potential hazards, such as unstable footing, fire, or active traffic, and these must be controlled to ensure the safety of both the helper and the patient. If the woman is conscious, establishing verbal communication is paramount to determine her level of pain, her estimated stage of pregnancy, and any pre-existing conditions.
A secondary helper should be called for immediately, as safely lifting a person, especially one with a shifted center of gravity and increased weight, is difficult and dangerous for a single individual. A crucial step is determining if there is any suspicion of a head, neck, or spinal injury, indicated by severe pain, numbness, or a mechanism of injury like a serious fall or car accident. If a spinal injury is suspected, a layperson must not attempt to move the woman, as movement could cause permanent paralysis or worsen the injury. Stabilization and immediate calling of emergency medical services (EMS) is the only appropriate course of action.
Principles of Safe Lifting
The mechanics of the lift must be adapted to the stage of pregnancy to prevent injury to the mother’s spine and the fetus. For women in early pregnancy, typically before the second trimester, a standardized two-person lifting technique can be used, prioritizing proper spinal alignment. The lifters should bend at their knees, keeping their backs straight, and lift using the powerful leg muscles rather than straining their back.
Once the woman has progressed into late pregnancy, the technique must change to avoid direct pressure on the enlarged abdomen. Lifters must coordinate their movement to support the woman beneath her hips and under her upper back and shoulders. This distributes the weight and prevents the uterus from being compressed, which could harm the fetus or lead to placental complications. Lifters must move in unison, communicating clearly, to execute a single, smooth motion, keeping the woman’s body as a single unit.
The hormone relaxin, present during pregnancy, loosens the woman’s ligaments and joints, making her more susceptible to injury during movement. The goal is to elevate the woman just enough to clear the surface, minimizing the distance and time she is held unsupported. This careful coordination reduces the risk of strain on the woman’s abdomen and back while maintaining stability.
Safe Transfer and Positioning
Once the pregnant woman has been safely lifted, her final resting position is important, particularly after the 20th week of gestation. She must not be placed flat on her back, known as the supine position, for any extended period. Lying flat allows the heavy, gravid uterus to compress the inferior vena cava and the aorta, major blood vessels running along the spine.
This compression can lead to a condition called Supine Hypotensive Syndrome, which rapidly reduces the amount of blood returning to the heart, causing a drop in maternal blood pressure and decreased blood flow to the uterus. To avoid this, the woman must be positioned on her left side, known as the left lateral tilt or left lateral recumbent position. This position shifts the uterus off the major vessels, restoring adequate circulation to both the mother and the fetus.
If a full side-lying position is not possible due to the transfer surface or the woman’s injuries, a modification involving a wedge or rolled blanket placed under her right hip is necessary. This creates a 15 to 30-degree tilt to the left, which is usually sufficient to relieve the compression on the vena cava. Maintaining this slight leftward tilt is a fundamental principle of care when moving or resting a pregnant woman in the second half of her pregnancy.
Situations Requiring Emergency Medical Services
A layperson should never attempt to move a pregnant woman if she exhibits signs of a serious medical or traumatic emergency. Active, heavy vaginal bleeding, which may indicate placental abruption or placenta previa, necessitates an immediate call to EMS. Similarly, the onset of severe, persistent abdominal pain or a sudden, severe headache accompanied by vision changes can signal a life-threatening complication like preeclampsia or eclampsia.
Any sign of a suspected spinal injury, such as numbness, tingling, or weakness in the limbs following a fall or trauma, means movement must be avoided. The safest action is to stabilize the woman in the position she was found. While waiting for professional help, comfort measures, such as covering her with a blanket for warmth, should be provided without attempting to change her position. Monitoring her responsiveness and breathing is the only safe intervention until trained medical personnel arrive.