AED pads go in the same position on a pregnant woman as on anyone else. The American Heart Association recommends standard anterolateral placement: one pad on the upper right chest below the collarbone, and one on the lower left side of the chest beneath the breast tissue. Pregnancy does not change where the pads go, but it does change what else needs to happen during resuscitation.
Standard Anterolateral Pad Placement
The anterolateral position is the recommended default for defibrillation during pregnancy. Place the first pad on the right side of the chest, just below the collarbone and to the right of the breastbone. Place the second pad on the left side of the ribcage, under the breast tissue and along the side of the body. The AHA specifically notes that positioning the lateral pad beneath the breast is an important consideration in pregnant patients, since breast tissue increases in size during pregnancy and can interfere with proper contact.
For the pads to work, they need direct skin contact. AED kits include scissors for cutting away clothing, and you should remove or cut through any bra or undergarment covering the chest. This applies to all women, not just pregnant patients. The electrical energy travels between the two pads through the heart, so good adhesion to dry skin is what matters. If the skin is sweaty, wipe it quickly with a towel or gauze before applying the pads.
Why You Should Not Hesitate
Cardiac arrest during pregnancy is survivable, but the window is narrow. The maternal survival rate after out-of-hospital cardiac arrest is roughly 12% to 16% overall. In studies focused specifically on pregnant women, maternal survival reached about 29% and neonatal survival about 25% when resuscitation was attempted. The difference between these numbers comes down to how fast effective care begins. Early return of a heartbeat after cardiac arrest is the strongest predictor of a good outcome for both the mother and the baby.
Pregnant women are more vulnerable to oxygen deprivation than non-pregnant women and can sustain brain damage in as little as four minutes. That compressed timeline makes immediate AED use critical. The device will analyze the heart rhythm and only deliver a shock if one is needed, so there is no risk of shocking someone who doesn’t require it. Do not skip or delay defibrillation because of pregnancy.
What Else Changes During Pregnant Resuscitation
While AED pad placement stays the same, CPR technique requires one key modification. After about 20 weeks of pregnancy, the uterus is large enough to compress major blood vessels when a woman lies flat on her back. This compression reduces blood flow and makes chest compressions less effective. To counteract this, someone should manually push the uterus to the left side while CPR is in progress. This is called left uterine displacement.
A second rescuer places their hands on the abdomen and gently lifts or pushes the uterus up and toward the patient’s left side. The goal is to shift the weight of the uterus off the large blood vessels that run along the spine. It’s important not to push downward, which would actually worsen the compression. If only one rescuer is present, chest compressions and AED use take priority over uterine displacement.
The AHA’s 2025 cardiac arrest in pregnancy algorithm also specifies that if CPR does not restore a heartbeat within four minutes and the pregnancy is advanced enough (roughly 20 weeks or more), medical teams should prepare for emergency surgical delivery within five minutes. This procedure improves outcomes for both the mother and the baby by relieving the cardiovascular burden of the pregnant uterus. That decision belongs to the arriving medical team, not to bystanders, but it underscores why calling 911 immediately and starting CPR with an AED matters so much.
Step-by-Step Summary for Bystanders
- Call 911 and tell the dispatcher the patient is pregnant, including how far along if you know.
- Start chest compressions on a firm, flat surface. Push hard and fast in the center of the chest.
- Send someone for an AED while compressions continue.
- Expose the chest by cutting or removing clothing and any bra.
- Place one pad on the upper right chest below the collarbone.
- Place the second pad on the left side beneath the breast tissue, along the ribcage.
- Follow the AED’s voice prompts to analyze the rhythm and deliver a shock if advised.
- Resume compressions immediately after the shock and continue until paramedics arrive.
- If a second rescuer is available and the pregnancy is visibly advanced, have them kneel beside the patient and push the uterus gently to the left.
After the AED Is Used
Once paramedics arrive and the mother is stabilized, fetal monitoring begins as soon as possible. For pregnancies beyond 20 weeks, continuous heart rate monitoring of the baby is standard. At a minimum, monitoring lasts four hours after the event. If complications like frequent contractions are detected during that window, monitoring extends to 24 hours. Before the baby reaches viability (around 23 to 24 weeks), intermittent checks with a handheld Doppler device are used instead of continuous monitoring.
The critical takeaway is simple: AED pads go in the exact same place on a pregnant woman as on anyone else. The device is safe to use during pregnancy, and delaying it is far more dangerous than using it.