Seat belt usage in the United States is increasing dramatically, due in part to legislative action. In addition, education programs have improved public awareness of the need for automotive restraints in achieving crash survival and injury reduction. The safety consciousness level of automobile passengers is particularly strong among pregnant women. It is reasonable to expect wider use of seat belts by expectant mothers due to this acute attention to safety. The literature demonstrates that incorrect usage of seat belts is a cause of injury. This can be especially applicable during pregnancy when changes in anatomy dictate a change in belt positioning, Review of the literature shows that the technical issues associated with the use of current production belt restraint systems by pregnant women has not been addressed. Study of restraint systems and pregnancy focus on alternate restraining methods and do not deal with the equipment available today- The results of this literature review are presented with the discussion being closely tied to an annotated bibliography. Accident data is analyzed to evaluate the roll of seat belts in fetal and maternal injury and injury prevention. Current and proposed restraint systems are evaluated for their ability to provide crash protection.