A new study from University of Iowa researchers examining seat belt habits among pregnant and postpartum women finds that while most report wearing seat belts regularly, many also frequently unbuckle during travel, revealing an important but often overlooked safety risk.

Motor-vehicle crashes remain a leading cause of pregnancy complications and maternal death in the United States. In this study, published in the Journal of Safety Research, researchers surveyed pregnant women and parents of young children to better understand both seat belt use and the reasons people remove them while on the road. Although 68% to 86% of participants said they wear seat belts most or all the time, more than one-third also reported unbuckling during trips. Even among consistent users, many said they routinely unbuckle while the vehicle is still moving.

“We were particularly concerned to see how often participants reported unbuckling during trips, especially because that behavior introduces a clear and preventable increase in crash and injury risk,” says Cara Hamann, associate professor of epidemiology at the UI College of Public Health and study co-author.

Participants commonly cited caring for infants or young children, such as responding to crying as a reason for unbuckling, suggesting that caregiving demands can conflict with safe travel practices. Researchers note that safety messaging may need to address these real-life scenarios, encouraging caregivers to wait until a vehicle is stopped before unbuckling whenever possible.

According to Stephanie Radke, clinical associate professor of obstetrics and gynecology at the UI and lead author of the study, this points to a real opportunity for education that recognizes the realities of caregiving. “Parents need support in understanding the risks of even brief unbuckling and in identifying safe ways to respond to their children’s needs while on the road,” she says.

The study also compared two widely used behavioral frameworks to understand what drives these decisions. It found that the Health Belief Model—focused on how people weigh risks, benefits, and barriers—better explained seat belt behavior than the Theory of Planned Behavior, which emphasizes attitudes, social norms, and perceived control. People’s understanding of the benefits of seat belt use and the barriers to keeping it fastened were the strongest predictors of safer behavior.

The findings suggest that public health campaigns and prenatal education should focus not only on encouraging seat belt use, but also on emphasizing the importance of staying buckled for the entire trip and addressing common challenges faced during pregnancy and early parenthood.

“We recognize how quickly parent attention can shift to their children and how easy it is to rationalize unbuckling in those moments, says Hamann. “But with the right information and strategies, parents can protect both their children’s needs and their family’s safety on the road.”

Co-authors of the study include Paige Nelson and Francesca Scheiber from the Department of Psychological and Brain Sciences at the University of Iowa, and Kelli Ryckman from Department of Epidemiology and Biostatistics at Indiana University Bloomington.

Media Mentions:

UI study: Many pregnant women, new moms unbuckle seat belts in moving vehicles – Radio Iowa

UI researchers say many moms unbuckle while driving – The Gazette

UI researchers find that moms often unbuckle to care for infants, young kids in the car – WQAD

UI Study: Some pregnant, postpartum women unbuckle before trips end despite regular seatbelt use – KCRG