Every minute without CPR (cardiopulmonary resuscitation) reduces a cardiac arrest victim’s chance of survival by 7-10%. However, studies show that women are significantly less likely than men to receive bystander CPR or help from an AED (automated external defibrillator) during such emergencies. Gender disparities have real consequences; fewer women survive out-of-hospital cardiac arrests, even though early intervention is one of the strongest predictors of survival. According to the American Heart Association (AHA), a 2018 study published in Circulation: Cardiovascular Quality and Outcomes found that 45% of men received bystander CPR, compared to only 39% of women. Men had 23% higher odds of survival than women.
Bystander CPR, which involves chest compressions performed by a bystander before emergency responders or medical care arrive, helps maintain blood and oxygen flow to the brain and vital organs when the heart stops beating. When someone intervenes promptly, survival rates can double or even triple. But hesitation, fear, or bias can prevent action, leading to worse outcomes, especially for women.
Women’s lower rates of receiving lifesaving help come from a mix of social attitudes, psychological factors, and systemic issues that influence how bystanders perceive emergencies and how confidently they respond. Recognizing these barriers is the first step toward closing the gap and ensuring everyone has an equal chance of survival.
Also, Read: How Can You Achieve a High Chest Compression Fraction (CCF)
Reasons Women Are Less Likely to Receive Help
Despite the proven effectiveness of immediate CPR and AED use, women consistently receive less bystander assistance, largely due to a combination of social, psychological, and systemic factors. These barriers influence how bystanders interpret an emergency and whether they feel comfortable stepping in.
1. Social and Cultural Factors
When someone collapses, bystanders often pause before helping a woman. Social expectations and cultural pressures can make people hesitate, even when every second counts.
1a. Fear of Inappropriate Contact
Many bystanders worry that touching a woman’s chest, required for proper hand placement during CPR, might be misinterpreted as inappropriate. This concern often leads to hesitation or complete inaction during a critical moment. 7 common mistakes to avoid in CPR address issues like improper hand placement.
1b. Concern About Accusations
Some respondents openly report fearing harassment allegations or legal trouble, even though Good Samaritan laws protect those who act in good faith. This fear disproportionately affects responses to female victims.
1c. Gender Norms and Discomfort
Cultural expectations around male-female interactions, especially in public, can make bystanders reluctant to approach or touch an unresponsive woman.
2. Bystander Misperceptions About Symptoms
Sometimes people don’t realize a woman is having a serious heart problem. Mistakes in reading the signs can slow down help when it is needed most.
2a. Misreading the Emergency
Women often show atypical signs before cardiac arrest, and bystanders may misinterpret the situation as fainting, anxiety, or a non-cardiac issue.
2b. Incorrect Assumptions About Women’s Risk
Many people wrongly believe women are less likely to experience cardiac arrest, especially at younger ages. This misconception leads to delays in recognizing the seriousness of the situation. Knowing the reversible causes of cardiac arrest, H’s and T’s can help responders identify emergencies correctly.
3. Psychological Barriers
Even when bystanders know what to do, worry and self-doubt can hold them back. These mental hurdles can stop people from acting fast when every second matters.
3a. Fear of Causing Harm
Some bystanders worry they might injure a woman’s chest or ribs more easily due to perceived frailty, leading to overly gentle compressions or avoidance altogether. Understanding when the rescuer operating the AED should clear the victim can reduce fear during emergencies.
3b. Lack of Confidence
Hesitation is amplified when bystanders feel unsure about performing CPR on female anatomy, especially if they were trained only on male-bodied mannequins.
4. Systemic and Training Issues
Sometimes, the way CPR is taught makes people less ready to help women. Gaps in training and awareness can make bystanders hesitant or unsure when emergencies happen.
4a. Training Mannequins Are Typically Male
Most CPR courses still use flat-chested or male-coded mannequins. This results in a lack of familiarity with performing compressions on a female chest, leading to uncertainty about pad placement, clothing removal, and anatomy. Improving AED use to minimize interruptions in compressions also addresses training gaps.
4b. Limited Awareness Campaigns Addressing Gender Bias
While CPR awareness is growing, few public campaigns explicitly address the gender gap or teach people how to confidently assist women in cardiac arrest.
These combined factors create a perfect storm of hesitation, misjudgment, and lost time, ultimately reducing women’s odds of receiving the lifesaving help they need. Understanding these barriers is essential to creating targeted education and improved CPR training that supports confident, equitable action for all.
Consequences of Unequal CPR and AED Response
The disparity in bystander life-saving intervention has serious, tangible consequences for women experiencing cardiac arrest. When help is delayed or doesn’t come at all, the outcomes can be life-altering.
1. Lower Survival Rates
Women who experience out-of-hospital cardiac arrest are less likely to survive than men, largely due to delays in CPR and AED use. Studies show that early bystander intervention can double or triple survival chances, meaning hesitation or inaction directly contributes to preventable deaths.
2. Long-Term Health Outcomes
Even when women survive cardiac arrest, delayed CPR can lead to more severe neurological damage and prolonged recovery times. Reduced blood flow to the brain during those critical early minutes increases the risk of cognitive deficits, physical disabilities, and long-term dependence on medical care.
3. Broader Public Health Implications
Unequal emergency response isn’t just a personal issue; it affects communities and healthcare systems. Lower survival rates among women:
- Increase the overall burden of cardiac-related illness.
- Strain healthcare resources due to longer hospital stays and rehabilitation needs.
- Highlight systemic inequities in emergency preparedness and public health education.
Closing this gap in CPR and AED response is essential not only to save individual lives but also to strengthen community health and ensure equitable care for everyone.
Solutions and Recommendations
Addressing the gender gap in bystander CPR and AED use requires a combination of public education, improved training, and measures to encourage confident action.
1. Public Awareness
Helping women in cardiac emergencies starts with spreading the word. When more people understand the risks and know what to do, lives can be saved every day.
- Educational Campaigns: Promote awareness that women are equally at risk for cardiac arrest and should receive immediate CPR and AED assistance.
- Challenge Misconceptions: Highlight that cardiac arrest symptoms can differ in women, and emphasize that hesitation can be deadly.
- Community Engagement: Use social media, local workshops, and public events to normalize helping women in emergencies.
2. Training Improvements
Better training helps people act quickly and confidently during emergencies. Practicing realistic scenarios makes it easier to help anyone in need.
- Gender-Diverse Mannequins: Include female and anatomically accurate mannequins in CPR courses to build familiarity and confidence.
- Bias-Focused Training: Address fears and misconceptions directly, teaching participants how to safely and effectively perform CPR and AED use on women.
- Scenario-Based Practice: Simulate emergencies involving women in both public and home settings to reduce hesitation in real-life situations.
3. Encouraging Action
Everyone can make a difference when someone collapses from cardiac arrest. Feeling safe and confident makes it easier to step in and save a life.
- Legal Protections: Publicize Good Samaritan laws to reassure bystanders that helping in an emergency is legally protected. Learn more about whether you will be charged if the person you administer CPR to does not survive.
- Promote Confidence: Share success stories and statistics that show quick intervention saves lives, motivating bystanders to act.
- Normalize Intervention: Encourage everyone, regardless of gender, to feel responsible and capable of providing life-saving assistance.
By combining awareness, education, and empowerment, communities can reduce gender disparities in CPR and AED response and improve survival outcomes for everyone.
Closing Thoughts: Making Emergency Care Equally Accessible for Everyone
In summary, women are less likely to receive bystander CPR or help with an AED, and that gap can make a real difference in survival. Awareness and training can change this. By learning the skills, understanding the fears people may have, and encouraging quick action, everyone can help save a life. Simple steps, like calling for help and starting CPR without hesitation, can make women just as safe as men in emergencies. Also, understanding when to stop performing CPR is a key component in improving outcomes. Everyone can play a part in building a culture where everyone gets the help they need, no matter their gender. One of the best ways to make a difference is to get trained yourself. Same Day CPR offers CPR, AED, First Aid, ACLS, BLS, and PALS training through hands-on sessions focused on practical skills, across Maryland, D.C., Delaware, Virginia, New Jersey, New York, Pennsylvania, Missouri, North Carolina, South Carolina, Texas, and Georgia. By enrolling in a course, you’ll gain the confidence and knowledge to act quickly in an emergency and help save lives.
