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Cardiac arrest in pregnancy
The bystander sequence does not change: compressions, defibrillator, shock. What does change is one pair of hands pushing the bump to the left, and why the fastest treatment for the baby is treating the mother.
CPR in sixty seconds
- Unresponsive and not breathing normally? Gasping is not breathing. Treat it as a cardiac arrest.
- Call 112 (113 in Norway). Speaker on, phone on the floor. Stay on the line — the dispatcher will coach you.
- Push hard and fast in the centre of the chest: 5–6 cm in an adult, 100–120 per minute, letting the chest come all the way back up.
- Send somebody else for a defibrillator. Do not go yourself unless it is seconds away. Keep compressing.
- Turn the device on and do what it says. It decides whether to shock. After a shock, go straight back to compressions.
This is a reference written for bystanders, not a diagnosis, a training course or medical advice. It cannot tell you what is wrong with a particular person, and it does not replace the dispatcher on the other end of an emergency call — they can see what is near you and they will talk you through it. If you are worried about your own heart, or about a symptom, that is a conversation with a clinician rather than a page on a website.
Everything you already know still applies
A pregnant woman in cardiac arrest gets the same resuscitation as anyone else: hard, fast compressions in the centre of the chest at 100 to 120 a minute and 5 to 6 centimetres deep, a defibrillator as soon as one arrives, pads in the normal position, standard shock energy. There is no reduced-force version and no reason to wait for a specialist. Hesitation is the main risk a bystander adds, and the guidelines are explicit that the standard sequence is used.
The one addition: move the uterus off the vein
From roughly twenty weeks — in practice, once the bump reaches the navel — the pregnant uterus lying on the inferior vena cava can block the blood returning to the heart, so compressions circulate very little. The fix is mechanical and anyone can do it: a second helper kneels on the woman's right side and pulls the bump up and to the left with both hands, holding it there continuously while compressions go on. If nobody can be spared, the woman stays flat on her back and compressions continue regardless; manual displacement is an addition, never a substitute.
Keep her flat
Older teaching tilted the whole body onto a wedge. Current guidance keeps the woman supine and displaces the uterus by hand instead, because a tilted body makes effective compressions much harder — you cannot push straight down on a sloping chest, and depth collapses. Flat back, hands in the normal place, someone else holding the bump aside.
The best treatment for the baby is treating the mother
This is worth saying plainly to bystanders who freeze out of fear of harming the pregnancy. The fetus depends entirely on the mother's circulation, so effective compressions and early defibrillation are also the fetal resuscitation. Hospital teams may perform a caesarean delivery within minutes of an unsuccessful resuscitation, both to save the baby and because emptying the uterus improves the mother's chance — but that is an in-hospital decision that depends on the CPR you are doing until they arrive.
Tell the dispatcher she is pregnant
Say it in the first sentence, with the approximate stage of pregnancy if you know it. It changes the response: emergency medical services in this region will typically alert an obstetric team and route to a hospital with maternity and neonatal cover. It also prompts the dispatcher to talk you through the uterine displacement if you have a second pair of hands.
Sources: European Resuscitation Council Guidelines · checked 2026-09-08
Frequently asked questions
Is a defibrillator safe in pregnancy?
Yes. Standard pad placement and standard shock energy are used, and defibrillation is not withheld because a woman is pregnant. The current does not meaningfully reach the fetus.
Do I compress in a different place or less hard?
No. Centre of the chest, 5 to 6 centimetres, 100 to 120 a minute, exactly as in any adult. Reduced-force CPR is not a thing.
What is the left-lateral displacement for?
From about twenty weeks the uterus can compress the main vein returning blood to the heart. A helper pulls the bump up and to the woman's left so that compressions can actually move blood.
What to do, right now
Is this a cardiac arrest?
Two checks decide it: not responding, and not breathing normally. The noisy gasping that fools nearly everyone, why a brief seizure at the start is a cardiac sign, and why a heart attack is a different emergency.
Hands-only CPR, in sixty seconds
Centre of the chest, 100 to 120 pushes a minute, 5 to 6 cm deep, let the chest come all the way back up, and do not stop. The rate, the depth, the fatigue problem, and a pacer that keeps you on the beat.
The emergency call, and the address problem
What the dispatcher asks, why the phone goes on speaker on the floor, how dispatcher-guided CPR works, and the single hardest question in a rural arrest: where exactly are you?
Using a defibrillator, step by step
Open it, turn it on, bare the chest, follow the voice. What the machine decides for you, what it will never do, and the one instruction people get wrong — go straight back to compressions after the shock.
Where the pads go, and what gets in the way
Right collarbone and left ribs, or front and back. Chest hair, sweat, snow, a medicine patch, a pacemaker lump, an underwired bra, a tattoo: which of these actually matter and what to do about each.
Everything on this subject
Before the emergency, there is a long quiet stretch
Blood pressure, resting heart rate, movement and sleep are the part of this you can act on for years beforehand. TempoLife keeps them in one place, free to start.