First aid for pregnant women | ACLS guide to first aid

First aid for pregnant women | ACLS guide to first aid


Two lives are at stake when a pregnant woman goes into cardiac arrest or is choking. By understanding the physical changes brought about by pregnancy, you can respond appropriately to maternal emergencies.

Here is a quick reference guide to first aid modifications for the mother-to-be. This guide will also provide resources under each section if you are interested in the research that defines the problem and outlines what you need to know when a pregnant woman experiences a possibly deadly event.

Maternal cardiopulmonary resuscitation (CPR)

Although most characteristics of maternal resuscitation are similar to the standard adult resuscitation, several aspects are uniquely different.

2015 AHA statement on cardiac arrest in pregnancy — key points to remember about cardiac arrest in pregnancy derived from the 2015 AHA statement on cardiac arrest in pregnancy.

Frequent causes of maternal cardiac arrest in the US — this article discusses the common causes of cardiac arrest in a pregnant woman; these include heart failure, bleeding, amniotic fluid embolism, and infection.

Data on pregnancy complications — these figures show trends from 1993 through 2014 of three serious pregnancy complications.

Pregnancy mortality surveillance system — information about the pregnancy-related mortality ratio.

Cardiac arrest in pregnancy: Out-of-hospital basic life support (BLS) — a one-page algorithm for healthcare providers.

Cardiac arrest in pregnancy: In-hospital basic life support (BLS) — a one-page algorithm for healthcare providers.

How to determine fundal height — this resource explains the significance of fundal height measurement.

Physiological changes in pregnancy — this review highlights the important changes in the cardiovascular system during pregnancy, this includes the normal findings on an ECG.

Cardiac disease and pregnancy — outlines the general guidelines for the management of heart disease in pregnant women.

John Hopkins OB critical care training: Amniotic fluid embolism, massive transfusion protocol, and cesarean delivery — John Hopkins in-hospital training video.

Healthy pregnancy — this article takes you through a healthy pregnancy week by week.

Automated external defibrillator (AED) in maternal resuscitation

The best way to save the baby is to save the mother. Rapid defibrillation, when indicated, can be life-saving. Use the AED as per standard protocol. The guidelines are the same for the pregnant patient as they are for the non-pregnant patient.

Resume compressions immediately after the delivery of the electric shock.

ACLS guide to defibrillation — an online guide to the history and types of defibrillation.

How and when to use an AED — a step-by-step explanation from the National Health Institute of how and when to use an AED.

Overview of AEDs — the Occupational Safety and Health Administration provides a list of resources related to AEDs.

Choking when pregnant

The universal sign of choking is the hands clenched around the throat; however, this signal may not be present. Other immediate indications include not being able to talk or difficulty breathing or wheezing.

If the pregnant woman can cough forcefully, then she should keep coughing. If the woman cannot talk, cry, or laugh, then initiate a modified Heimlich maneuver. In this situation, you protect the developing fetus by using chest thrusts versus abdominal thrusts to dislodge the object.

If the woman becomes unconscious, follow the next steps.

More resources on choking when pregnant

Other potential pregnancy complications and emergencies

Spot the signs of early labor — review the signs of false labor, stages of labor, and management of labor pain.

Emergency childbirth — this article guides you through anatomy and physiology, prehospital care, field delivery, neonatal care, and postpartum care.

Vaginal bleeding in early pregnancy — know the difference between spotting and bleeding, when to worry, and what causes vaginal bleeding.

Premature rupture of membranes (PROM) — a review of what causes the “water to break” prematurely and how a healthcare provider manages the rupture.

Seizure — a summary of preeclampsia and eclampsia.

Gestational Diabetes — a thorough review of the causes, symptoms, risk factors, and complications of gestational diabetes.

Chronic disease in pregnancy — a glance into the risk behaviors and chronic disease of the mother-to-be.

Abdominal pain in early pregnancy — case study and commentary of a 34-year-old-woman who was 14 weeks pregnant that presents to the emergency department with five days of nonspecific abdominal pain, nausea, and vomiting.


1. [Jeejeebhoy FM, Zelop CM, Lipman S, et al. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132:1747-1773. doi: 10.1161/CIR.0000000000000300]

This article is not all-inclusive. Please contact us at to contact the author to add information you think would be helpful in an emergency situation.

Written by on Dec 14, 2017

Sarah has worked in various roles at Coffee Medical Center including nurse, education director, and quality assurance director.

Last reviewed and updated by on Apr 28, 2020

Caitlin Goodwin, DNP, RN, CNM, is a Board Certified Nurse-Midwife, Registered Nurse, and freelance writer. She has over twelve years of experience in nursing practice.

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