Why Women are Less Likely to Receive CPR

Several large studies from outside South Africa (in the UK and the United States) highlight a consistent trend: women experiencing out-of-hospital cardiac arrest are less likely to receive CPR from bystanders compared with men. For example:

• Researchers analysing more than 300,000 cardiac arrest cases in the U.S. found that women were about 14 % less likely than men to receive bystander CPR or defibrillation.
• Earlier research also showed women in public locations were less likely than men to receive CPR, a difference not fully explained by the setting or other factors.

These differences have real consequences: when CPR isn’t given promptly, survival rates drop sharply. That means some women who could survive with early intervention may not get that chance.

Experts suggest the reasons for this gender gap may be far less about biology and far more about perception and hesitation:

1.  Fear of causing harm or inappropriate contact

Some bystanders hesitate to place their hands on a woman’s chest, worried they might injure her or be accused of inappropriate touching. This fear, rooted in social norms about physical contact, can delay action that should be immediate.

2.  Misconceptions about symptoms and conditions

Women sometimes display different symptoms during cardiac arrest or a heart attack, making it harder for bystanders to recognise the emergency and act quickly. While this has been more studied in heart attacks, similar confusion can delay CPR recognition and response.

3.  Training biases

Traditional CPR training videos and mannequins tend to depict male torsos, which may subconsciously influence people’s confidence or comfort when performing CPR on women. This has led to initiatives like the “Womanikin,” which adapts training models to better represent female anatomy and help learners practise on all body types. 

While specific South African studies on gender disparities in CPR are limited, the global evidence is relevant here too. Sudden cardiac arrest doesn’t discriminate by gender, and South Africans are just as likely to witness a loved one collapse in a public space, in a shopping centre, at school, or at home.

What does differ is people’s confidence and willingness to act. In many communities, hesitation often comes from fear: fear of doing it wrong, fear of touching someone’s body, or fear of legal consequences. These fears can be heightened when the person in need is a woman. This means we may be inadvertently reducing survival chances for women simply because people aren’t confident in responding.

As we celebrate International Women’s Day, it’s worth reflecting on how we can support equal access to life-saving care:

Training more people in CPR for everybody

CPR training should emphasise that the technique is the same regardless of gender. A collapsed person with no pulse needs oxygenated blood circulating. Hands go on the centre of the chest, not on the breasts, and this can be done respectfully and effectively by anyone who has been trained.

Breaking down myths and fears

Part of CPR education must directly address the fears we subconsciously hold: worries about touching someone, doing it wrong, or cultural taboos. Communities that openly discuss and practise CPR are more likely to help when it matters most.

Making training widely available

Whether in schools, workplaces, community centres, or via public education campaigns, everyday people need opportunities to learn how to respond confidently to cardiac arrest. In South Africa, initiatives that bring CPR training into communities, with culturally sensitive messaging and inclusive tools, will help narrow the gap in care.

Cardiac arrest can happen to anyone, anywhere. When it does, the actions of a bystander, even before emergency services arrive, can determine life or death.

Women contribute to every aspect of community life: as mothers, leaders, workers, teachers, caregivers and more. On International Women’s Day, we honour their strength. We can also commit to ensuring that women receive equal access to life-saving care. That starts with acknowledging the gap, educating ourselves, and empowering everyone with the skills and confidence to act.

It is a statement that every life is worth saving, regardless of gender.

• Women are less likely than men to receive bystander CPR and defibrillation (Duke University study).
• Research demonstrating gender disparities in bystander CPR rates for women vs men.
• Northwell Health: Discussion on bystander CPR and women.