The purpose of this paper is to present the crash exposure patterns of pregnant occupants and to evaluate the effectiveness of restraint systems, including four-point seatbelts, in far side crashes. The NASS CDS database revealed that 53.0 % of pregnant occupants are exposed to frontal crashes while 13.5 % are exposed to far side impacts. Given that far side crashes were the second leading crash mode after frontal impacts, a previously validated MADYMO computer model of a 30 week pregnant occupant was utilized to investigate pregnant occupant biomechanics in far side crashes. Three impact speeds (5, 15, and 25 mph) were simulated with four restraint conditions: unbelted, lap-belt only, three-point belt, and a four-point belt. Direct abdominal contact from the shoulder strap of the three-point or four-point belt caused uterine-placental strain in contrast to the inertial loading induced strain in the lap-belt and unbelted cases. Overall, the three-point and four-point belt systems provide superior restraint effectiveness for the pregnant occupant compared to the lap-belt and no restraint cases. The four-point resulted in slightly better performance than the three-point belt by reducing the fetal injury risk and occupant excursion.