Maternal car driving capacity after birth: a pilot prospective study randomizing postnatal women to early verses late driving in a driving simulator

Abstract

Background: Women are commonly advised to avoid driving following cesarean section (CS), however, this advice is based upon little evidence.

Aims: We aimed to assess a woman’s capacity to drive a car postbirth using a driving simulator to objectively examine driving behavior and competencies.

Materials and methods: We conducted a pilot, prospective, randomized study from a tertiary referral hospital in Sydney, Australia. Postnatal women who were regular drivers and had given birth by vaginal delivery (VD), elective cesarean section (ElCS) or emergency cesarean section (EmCS) were randomized to early (2–3 weeks post birth) or late (5–6 weeks post birth) driver simulator testing. Driving performance was measured by reaction time to simulated impediments, awareness, attention, braking ability, traffic infringements, and accidents. Analysis was by intention to treat. Outcomes were assessed using contingency analysis via two-sample t-tests and Wilcoxen rank-sum tests.

Results: 66 women were randomized and 38 attended simulator testing (57.6%; 19 early, 19 late; 8 VD, 14 ElCS, 16 EmCS). There was no difference in reaction times, driver awareness, braking times, or traffic infringements by early versus late testing (all p > .05), nor by mode of birth (p > .05) amongst the women who completed driver testing. At 7–8 weeks, all women were driving, without an accident.

Conclusions: Although the study is limited by small sample size, there was no difference in driving capability by early versus late driving time since birth, nor by mode of birth. Further research is needed, but we cannot provide evidence to discourage well women from driving from 2–3 weeks post birth.

Keywords:

• Cesarean section
• driving
• driving capacity
• postoperative recovery

Acknowledgments

We thank the women who participated and their families for their support; and Rachel Deacon for conducting a large number of the driving assessments.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the RANZCOG Research Foundation Taylor–Hammond Research Scholarship and a RANZCOG Research Foundation Trainee Research Grant. NN is supported by a National Health and Medical Research Council (NHMRC) Career Development Fellowship (APP1067066). The funding sources had no role in study design, data collection or analysis, report writing or the decision to submit the paper for publication.