During your first trimester (up to about week 12 or so), your uterus is well protected behind the pubic bone. The fetus is also cushioned inside the thick-walled muscular uterus and surrounded by amniotic fluid. But as the uterus grows, it extends into the abdomen, out of the protection of the pubic bones and pelvis, so it becomes more susceptible to trauma. In fact, the American College of Obstetrics and Gynecology reports that about one in 12 women will experience some trauma during pregnancy.

Because the growing uterus is suspended, hammock-fashion, from the uterine ligaments, even abrupt movements – such as sudden deceleration in a car accident without direct trauma – can jolt the uterus. Even non-contact trauma can be dangerous because it can precipitate damage to the delicately attached placenta, but it is rare except for in car accidents. Even with a direct blow to the belly, injury to the placenta, the nutritional source for the fetus, is far more common than direct injury to the fetus.

According to the Journal of Trauma, injury is the No. 1 non-obstetric cause of maternal death, and injury is the top cause of death in all adults under age 45. So, pregnant or not, accidents are always risky. The fact is that regular exercise will help you become more flexible, stronger and better aware of how to prevent injuries in the first place.

Here are some tips to help prevent injury to your belly:

• Get medical attention immediately if you are injured, fall or are in an accident.
• Avoid situations where your belly is more likely to be injured, such as contact sports, rough trails, ice or roller sports, high-speed activities and steep slopes – especially later in pregnancy.
• Always wear a seatbelt with a shoulder and lap belt.
• Wear your seatbelt lap belt low across your hip bones, not across your belly.
• Keep airbags activated; they prevent more serious trauma, such as hitting the steering column.
• Modify your favorite activities to reduce risk. If you love basketball, try competitive shooting rather than a contact game; try playing tennis doubles rather than singles to reduce the strain on your joints; and try cross-country skiing rather than downhill to avoid bad falls.
• Stick with a buddy who will be cautious, respect your limits and look out for you.

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