In a year, about 436.000 Americans experience cardiac arrest. Out of them, only 86.000 happen in the hospital, while the remaining 350.000 people experience this life-threatening condition at home or in public.
Although CPR is the first line of aid for cardiac arrest, many people hesitate to administer it. In fact, according to the 2023 Heart Disease and Stroke Statistics, only 40,2% of cardiac arrest cases received bystander CPR before medical help arrived.
Sadly, this number differs for men and women. Some stats show that women are less likely to receive CPR than men. This number can get especially low when pregnant women are in question. Whether due to obstetrical emergencies or another medical issue, 1 in every 30.000 pregnant women can experience cardiac arrest.
This article will discuss performing CPR on pregnant women and how it differs from regular CPR. We’ll also cover the steps you need to take if you’re ever a bystander.
CPR on Pregnant Women: What to Keep in Mind
Although regular CPR and CPR for pregnant women differ slightly, they are still pretty similar. However, learning how to perform CPR on a pregnant woman is still necessary, even if you know regular CPR. There are some key differences that make sure both the woman and her baby are safe and you need to be aware of them.
Pregnant women experience an overall 30% to 50% rise in cardiac output, which makes the woman especially vulnerable to oxygen deprivation. This makes a proper emergency response during maternal cardiac arrest beyond necessary.
There are a few key points to keep in mind when administering CPR on a pregnant woman.
- Chest compressions need to be shallower.
- While rescue breathing isn’t recommended in regular CPR anymore, it is when maternal cardiac arrest is in question. The optimal solution would be an oxygen mask, but mouth-to-mouth is the next best thing if that’s not available.
- The position of the woman’s body is very important in order to reduce pressure on crucial blood vessels.
By remembering these, you’ll be able to help in the most effective way.
How to Perform CPR on a Pregnant Woman: Step-by-Step Guide
The first thing you need to do when a pregnant woman needs CPR is to call 911. Then, you need to get ready to perform CPR until medical help arrives.
Here are the steps you will have to take to administer CPR on a pregnant woman.
Check if Chest Compressions are Safe to Perform
In some instances, chest compressions aren’t safe to administer immediately, so you will need to examine the pregnant woman beforehand. There are several issues that may cause chest compressions to be delayed, but usually, the reason is an obstructed airway.
Here are a few examples of obvious symptoms of an obstructed airway and what to do if it occurs.
- If fluid is coming out of the woman’s nose or mouth and she isn’t coughing, her airway may be obstructed. In this case, you’ll need to check her airway for obstructions, clear it, and then administer mouth-to-mouth.
- If you notice she isn’t breathing because of an obstruction in her airway, like vomit or another obstruction, roll her to one side. Then, give her back five thrusts and her abdomen five thrusts.
- Another way to clear an airway is to tilt her chin forward while tilting her head back with your thumbs underneath her jawline. The tilt should be at about a 45-degree angle.
After that, you can start with chest compressions unless rescue breathing is necessary first. If this is not something you have to deal with, you can move on to the next step.
Move the Pregnant Woman to Her Left Side
This position is called the supine position, which doesn’t mean that the woman should be completely on her side. It’s more about the position of her rounded abdomen.
Keep the woman’s back firmly against the ground, but make sure the lower half of her body is leaning to the left. You’re doing this to relieve the pressure the uterus is causing to the abdominal aorta and the inferior vena cava.
These two vessels are responsible for blood circulation between the lower and upper halves of the body. CPR is most effective when they are not under pressure.
Start Chest Compressions
To start CPR, you’ll first need to align the middle of your chest with her spine by getting above her. Try not to cause any pressure to her abdomen or lower body.
Then, place your hands on the middle of her chest. Make sure to use two hands instead of one, as this will give you more control over the depth and speed of the compressions. Start administering about 100 compressions per minute. Check for a pulse every 30 seconds.
Use the rhythm of songs like “Staying Alive,” “Baby Shark,” and “Dancing Queen” to make sure you’re giving the right number. This is a rule for giving anyone CPR, not just pregnant mothers.
However, make sure the compressions are shallower than those of regular CPR. You’re doing this to ensure you’re not causing any fetal distress but still helping blood circulate. Your compressions should go down at least 2 inches.
Administer Assisted Breathing
Give the pregnant woman two mouth-to-mouth breaths between every 30 compressions. This means that you’ll need to give three rounds within one minute, or a total of 6 quick breaths. To do this effectively, do the following:
- Seal their mouth with your mouth and blow steadily for about one second.
- Repeat this twice and make sure their chest is rising.
- Immediately continue with another 30 compressions and then two breaths.
Continue doing this until the pregnant woman recovers or medical assistance arrives.
Use an AED
An AED, or automated external defibrillator, is a device that analyzes heart rhythm and can deliver a shock to the heart. Although there should be an AED at every business in America, only 50% of employees can locate one at their place of work. This number rises to 66% among hospitality workers.
If you can’t locate an AED in your surroundings, proceed with chest compressions and breaths. If you find an AED, follow the instructions on the device to administer a shock. Here is a rundown of these instructions.
- Expose the woman’s bare chest.
- Place one pad below her right collarbone and another near her left armpit.
- Wait for the device to analyze the heartbeat.
- When ready to administer the shock, ensure nobody touches the woman’s body, including yourself.
- Without removing the AED pads, continue CPR for two minutes. After that, the device will reanalyze the heartbeat and administer another shock if necessary.
Continue doing this until medical help arrives or until she is revived.
Common Causes for Cardiac Arrest in Pregnant Women
Cardiac arrest is a serious yet rare occurrence in pregnant women. The usual symptoms of cardiac arrest in a pregnant woman include weakness, dizziness, pain or numbness in the hands or feet, vomiting, confusion, and more.
The most common causes for cardiac arrest can be either directly related to the pregnancy or stem from a prior condition. Here are a few examples.
- Preeclampsia – This condition begins about 20 weeks into the pregnancy and causes high blood pressure and kidney problems.
- Eclampsia – A more severe version of preeclampsia, this condition also causes seizures. Eclampsia accounts for 50.000 maternal deaths worldwide.
- Pulmonary embolism – A rare but deadly condition, PE happens as a result of a blood clot within the lungs. Another form of the condition can affect blood vessels anywhere in the body.
- Sepsis – A condition where an infection essentially poisons the blood, and the body responds strongly. Sepsis is responsible for about half of the maternal death cases.
Other causes may be issues with the heart valves, arrhythmias, infection, recent injuries due to surgery or physical trauma, underlying heart conditions, and more.
CPR on Pregnant Women: Final Thoughts
Learning how to perform CPR on a pregnant woman is something everyone should do. Getting yourself involved can help save both the mother and her baby, even if you’re not officially certified.
However, it’s best to take the time and get a first aid and CPR certification if possible. Only 18% of Americans are up to date with their CPR training, a number far too low for the medical emergencies we experience daily.
By getting certified, you’ll always be ready to help when it’s most important.