How should you position a pregnant patient (>6 months) who requires spinal motion restrictions?

• A. Tilt 30° right lateral decubitus
• B. Flat supine
• C. Tilt 30° left lateral decubitus
• D. Semi-prone with hips elevated

Answer: (C)

In late pregnancy, the enlarged uterus can compress the inferior vena cava when a patient lies flat, reducing venous return and harming both mother and baby. Placing the patient on her left side with a 30-degree tilt relieves this compression by shifting the uterus off the vessels, improving blood flow to the heart and placenta while still maintaining spinal immobilization. A flat supine position would worsen the compression, and other positions don’t reliably relieve the vascular pressure as effectively. Therefore, the best choice is the left lateral decubitus tilt with about a 30-degree angle.