It may be difficult to carry out abdominal thrusts in a choking victim who is pregnant or very obese. If you are unable to encircle the victim’s abdomen, the BLS/AED Subcommittee of the Resuscitation Council (UK) recommends that you stand behind the victim, as for abdominal thrusts, but position your hands somewhat higher, over the lower end of the sternum (breastbone). Pull hard into the chest with quick thrusts.

If the choking victim is in the late stages of pregnancy, chest thrusts should be used instead of abdominal thrusts.