Near the end of my pregnancy, my stomach was large enough that strangers at the mall asked if I was having twins. (I was not. Thanks, strangers!)

My feet only fit into the ugliest pair of sandals I’ve ever owned, but mercifully, my stomach was large enough to obstruct my view. And when I managed to flop, whale-like, into the driver’s side of my car, my belly actually touched the wheel.

It might be hard to imagine stretching a seatbelt across that burgeoning bundle of joy, but that’s just what pregnant women should do, according to new research.

In fact, proper seatbelt use by pregnant women would save 200 fetuses a year, according to the recent study from the University of Michigan Transportation Research Institute.

Currently, around 370 fetuses die from car crashes each year in the U.S. That’s more than child deaths due to car accidents in the first year of life, says the study.

The study published in the May, 2008 issue of the American Journal of Obstetrics & Gynecology also found that 6 to 7 percent of pregnant women are involved in car crashes (that’s around 170,000 crashes a year), and that those women who have adverse fetal outcomes (injury or death) are unbelted 62 percent of the time.

Why aren’t all pregnant women buckling up?
The American College of Obstetricians and Gynecologists has long recommended that pregnant women wear seatbelts—but until now, there hasn’t been any strong statistics on fetal loss and seatbelt use in car crashes, explains Kathleen DeSantis Klinich, assistant research scientist in UMTRI’s biosciences division,via e-mail. On the other hand, there has been the occasional journal article describing extremely severe car crashes in which the seatbelt led to the death of the fetus.

“While we think most physicians and their patients realize that these are highly unusual incidents, the lack of solid statistics on factors affecting fetal loss in crashes led some people to question the recommendation for pregnant women to wear seatbelts,” says Klinich.

Klinich says that they were “surprised” by the statistics of unbelted women in the study, “but it definitively demonstrates the effectiveness of seatbelts for pregnant occupants,” she says. “I think that is why this paper is so useful for convincing pregnant women to buckle up.”

“Some women are very concerned because the lap belt overlies their fetus,” says researcher Dr. Mark D. Pearlman, vice-chair in the department of obstetrics and gynecology at the University of Michigan Health System and the S. Jan Behrman Professor of Reproductive Medicine, in an official statement. “This study shows the opposite is true, that seatbelts clearly help to protect the fetus. It’s very clear, based on this study, that pregnant women should buckle up every single time they’re in a vehicle.”

So take heart—even at your most whale-like, that seatbelt is safe. To wear it correctly, make sure that the lap belt is below your belly and the shoulder belt crosses at the center of your chest.