Pregnancy changes how the body responds to collapse and to CPR itself, mainly because a woman’s own anatomy starts working against her once she is lying flat in the later stages of pregnancy. Knowing this one adjustment can make a real difference to outcomes for both mother and baby.
Why Position Matters So Much Late in Pregnancy
From around the second half of pregnancy onward, the weight of the uterus can press down on a major vein and artery that run behind it when a woman lies flat on her back. This can reduce blood flow returning to her heart, which in turn lowers her blood pressure and can make any collapse worse, or interfere with the effectiveness of CPR performed in the standard flat position.
Assessing a Pregnant Patient
Follow the same DRABC approach used for anyone else. Check for danger, check for a response, and manage airway and breathing using the same techniques. The adjustment comes in when you need to manage her position, particularly if resuscitation becomes necessary or she needs to be moved.
The Left Lateral Tilt Position
Where a pregnant woman needs ongoing monitoring or transport and is not in cardiac arrest, positioning her with a tilt to her left side, rather than flat on her back, helps take the weight of the uterus off the major vessels. This can be achieved by placing padding under her right hip and side so she rests at an angle rather than completely flat, while still allowing access to her chest and airway.
If CPR Becomes Necessary
If a pregnant woman in the later stages of pregnancy has no response, no normal breathing and no pulse, begin CPR using the standard adult technique and ratio without delay. Current guidance recognises the tension between flat positioning for effective compressions and left tilt for blood flow, and generally supports starting compressions in the standard position while arranging for manual displacement of the uterus to the left, where trained personnel are available to do so, rather than delaying CPR itself to first achieve a tilt.
Airway and Breathing Considerations
Pregnant women can be more difficult to ventilate due to reduced lung expansion room from the growing uterus pressing upward, and their airway can swell and become more easily obstructed. Clear the airway of any vomit promptly, since pregnancy increases the risk of regurgitation, and support breathing efforts closely.
Transporting a Pregnant Patient
Where transport is needed and spontaneous breathing has returned, or resuscitation continues during transport in a remote setting, maintaining a left lateral tilt where practical continues to support blood flow to both mother and baby during the journey to medical care.
Why This Detail Is Easy to Miss
Most first aid training understandably spends limited time on pregnancy specific complications, since they come up rarely compared with general CPR scenarios. That rarity is exactly why it is worth remembering deliberately, since a rescuer who has only ever practised standard adult CPR may not think to consider positioning at all in the moment.
Frequently Asked Questions
Why does lying flat cause problems late in pregnancy?
The weight of the uterus can press on major blood vessels behind it, reducing blood flow back to the heart and lowering blood pressure.
Should you delay starting CPR on a pregnant woman to achieve a tilted position first?
No. Begin CPR immediately in the standard position if she has no response, no normal breathing and no pulse, and arrange manual uterine displacement if trained help is available.
What position helps a pregnant woman who needs monitoring but is not in cardiac arrest?
A left lateral tilt, achieved with padding under her right side, helps relieve pressure on major blood vessels.
References and Last Reviewed
- American Heart Association, Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
- International Liaison Committee on Resuscitation (ILCOR), Consensus on Science and Treatment Recommendations
Jurisdiction: General first aid guidance, internationally applicable.
Last technically reviewed: September 2026
Reviewed by: EHS Guidelines Editorial Team
This article is educational and does not replace accredited first aid training or professional medical care. In a real emergency, call your local emergency number immediately.
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