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Abstract:The largest cause of accidental death and placental abruption in pregnancy is automobile collisions. Lives can be saved by correct use of the three-point seatbelt during pregnancy. Human interaction is essential for correct use of seatbelts. The objective of this study is to investigate pregnant women's use of correct shoulder section together with correct lap section as advised by obstetricians and highway experts and to identify the most common seatbelt misuse during pregnancy. An international web survey was conducted in five languages for this study. 1931 pregnant women reported their use of seatbelts and how they position the shoulder and lap sections of their seatbelts. Special attention was paid to distinguish between 'partly correct' and 'correct' seatbelt positioning. The questionnaire responses are used to determine the magnitude of every combination of the correct and incorrect shoulder and lap section of the seatbelt positioning during pregnancy. Results show that seatbelt usage in pregnancy is generally high in the world. However, the correct use of the entire seatbelt is very low, at only 4.3% of all respondents. 40.8% of the respondents use the shoulder portion of the belt correctly, whilst a 13.2% use the lap section correctly. The most common misuse is 'across abdomen' or 'not using the seatbelt at all', and both pose danger to pregnant women and their fetuses. Correct use of three point seatbelts is a challenge during pregnancy. We recommend that the media, medical community, and automotive industry provide targeted information about correct seatbelt use during pregnancy and accident databases include 'correct seatbelt use' information in crash statistics.