Pregnant women often get very worried if their job can harm their pregnancy or if they would lose their job or the pregnancy would put an end to their career.
Sometimes the pressure of the job and a sense of lack of control can lead to job strain, work-related stress, and burnout.
It is possible for most pregnant women to safely continue to work and return after the childbirth for a successful career. For example, 82% of the first-time mothers continue to work nearer to their expected delivery dates and the majority (73%) of them return within 6 months post-partum. (1)
However, significant workplace adjustment may be required if you are one of the high-risk jobs or develop certain pregnancy complications.
It is, therefore, important to understand how the work situation can affect your pregnancy and the steps you and your employer may take to ensure a happy and healthy transition to parenthood.
More and more women are choosing to work in recent times and hold important roles in different fields.
The following facts are worth considering about the female workforce:
1. Approximately 40% of the global workforce are women. However, the number varies from one country to the other.
2. 71.8% (over two thirds) of women aged between 16 – 64 years are in employment in the UK.
3. 4 out of 5 women of reproductive age will have children.
4. A significant number of pregnant women have sickness absenteeism. Some reports suggest that about two-thirds of employed pregnant staff could be absent from work. (2)
Therefore, ensuring health and wellbeing at work is vital for women in employment.
We know that, in general, stress during pregnancy can affect the health of the child (through the ‘Fetal Programming’ process) and also result in pregnancy complications.
Pregnant women at work can develop significant work-related stress due to several reasons:
1. Difficult work circumstances:
Such as excessive workload, being given unrealistic targets/ deadlines, and difficult colleagues. Therefore, it is difficult to draw any specific conclusion.
2. Negative organisational culture:
A negative attitude towards pregnant employees, difficulty in getting time off to attend hospital appointments/ scans, bullying, refusal of reasonable job adjustments, Maternity Discrimination.
3. Concerns regarding the effect of work on pregnancy outcomes:
This is especially true if women have had difficulty in conceiving (such as IVF), pregnancy complications (such as vaginal bleeding, preeclampsia, mental health problems, etc) or previous pregnancy problems (such as miscarriage, preterm labour or stillbirth).
This is specifically important if the work involves lifting heavy weight, prolonged standing, shift work (including night shift), extensive travelling, and long hours at work without proper rest.
4. Concerns for the future:
Fear of job loss and unemployment or unable to return to work due to childcare responsibilities.
5. Pregnancy symptoms:
Such as tiredness (may be made worse with insomnia), nausea and vomiting, and backache/ Pelvic Girdle Pain.
Can work-related stress cause pregnancy complications?
Although there is strong evidence of the adverse impact of stress and mental health problems during pregnancy, there is limited scientific data on work-related stress alone.
Some studies have shown that psychological strain at the workplace can result in preterm delivery, intrauterine growth restriction (small birth weight), and spontaneous miscarriage (3, 4). But some other papers did not find any association (5).
Therefore, further research is needed in this area.
How different aspects of work can have an impact on pregnancy?
Sometimes, women worry about the implications of at workplace during pregnancy. However, in general terms, if you are otherwise healthy and have a singleton pregnancy, then the overall risk of work is low.
However, the following activities need considerations during risk assessment during pregnancy:
1. Shift-pattern of work/ night shifts:
There is a slightly increased risk of miscarriage and preterm birth.
Some research suggests that working at night can disturb the circadian rhythm of the mother. This, in turn, can alter the circadian rhythm of the fetus and the growth and development can be affected.
Exposure to light at night during work also reduces melatonin secretion. Reduced melatonin level can reduce the production of the hormone progesterone, which is important for continuing the pregnancy and have a quietening effect on the uterus.
2. Lifting heavy weights:
Very high physical activity and lifting heavy weights have been linked to preterm birth and small for gestational (low birth weight) baby.
There is contradictory scientific evidence if this increases the risk of preeclampsia.
It is again not very clear how this causes pregnancy complications. But, some believe that high physical activity etc. can increase the body’s catecholamine (i.e., the hormones adrenaline and nor-adrenaline) level. These hormones can cause constriction of blood flow of the placenta and therefore, can reduce the nutrition and blood supply to the fetus. (6)
Moreover, lifting heavy objects etc. can worsen backache/ Pelvic Girdle Pain.
3. Prolonged standing:
This can lead to worsening varicose veins
4. Long desk work:
This can lead to sedentary behaviour and increased weight gain during pregnancy and related complications.
5. Noise:
6. Chemical exposure:
You must inform your employer as soon as possible when you find out about pregnancy if you are involved in a high-risk occupation such as exposure to ionising radiation, pesticide or certain toxic chemical products.
Is there any safe upper limit of lifting weights at work during pregnancy?
The National Institute of Occupational Safety and Health (United States) has made recommendations regarding the upper limit of lifting for pregnant women. (7)
Accordingly, pregnant women might need modification of work, if this involves lifting heavy objects.
What you can do to reduce work-related stress and other adverse effects of work?
1. Be aware of the symptoms of stress and burnout and speak to someone you trust. If symptoms are persisting or worsening, speak to your manager and healthcare provider.
2. If you feel you are becoming a victim of bullying or harassment or Maternity Discrimination at work, keep a record and follow the necessary policy.
3. Be aware of the Maternity Benefits of your employer.
4. Plan things ahead and better time management. Allow sufficient time to rest and sleep.
5. Do regular exercise and practice stress management/ relaxation techniques.
6. Ensure good posture at work.
7. Discuss if reasonable adjustments are possible with your manager, such as:
a) Changing the time of work: this might help to avoid rush hour travel.
b) Reduce work-related long-distance travel if you find this uncomfortable.
c) Alter the pattern of work:
Some women prefer desk work/ working from home (if options available) especially if the work involves high physical activity or frequent travelling.
8. Check with your healthcare provider if a certain type of work is suitable for you. This is particularly important if are at risk of pregnancy complications (such as preterm labour or miscarriage) or have developed complications (such as preeclampsia, polyhydramnios, major placenta previa or premature rupture of membrane).
9. Plan your absence (unless sick leave etc):
If you have appointments etc., inform your manager, colleagues/ employer, at the earliest and plan appropriate delegation/ cover.
10. Avoid working overtime/ extra hours if possible.
11. Avoid activities such as climbing a ladder as there could be an increased risk of fall (due to change in the posture and balance).
12. If it involves prolonged standing, then consider wearing compression stockings and supportive shoes.
13. Ensure regular breaks.
14. Have healthy snacks and stay hydrated.
Reference
1. U.S. Census Bureau. Maternity leave and employment patterns of first-time mothers: 1961–2008: current population reports P70-128. Washington, DC: USCB; 2011.
2. Statistics Denmark. Erhvervs- og beskæftigelsesfrekvenser (ultimo november) efter område, herkomst, alder (16-64 år), køn og frekvens (2008-2016) [Profession- and employment frequences (ultimo November) by area, ancestry, age (16-64 years), sex and frequence (2008-2016)]. 2018. Available from http://www.statistikbanken.dk/statbank5a/default. asp?w=1680.
3. Mulder E, De Medina PR, Huizink A, Van den Bergh B, Buitelaar J, Visser G. Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev. 2002;70:3–14. [PubMed]
4. Triche EW, Hossain N. Environmental factors implicated in the causation of adverse pregnancy outcome. Semin Perinatol. 2007;31:240–2. [PubMed]
5.Larsen AD, Hannerz H, Juhl M, et al. Psychosocial job strain and risk of adverse birth outcomes: a study within the Danish national birth cohort. Occup Environ Med. 2013;70:845–851.[PubMed]
6. Juhl, Mette & Larsen, Pernille & Andersen, Per & Wulff Svendsen, Susanne & Bonde, Jens & Andersen, A-M & Strandberg-Larsen, Katrine. (2014). Occupational lifting during pregnancy and child’s birth size in a large cohort study. Scandinavian journal of work, environment & health. 40. 10.5271/sjweh.3422. ResearchGate
7. MacDonald LA, Waters TR, Napolitano PG, Goddard DE, Ryan MA, Nielsen P, et al. Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations. Am J Obstet Gynecol 2013;209:80–8. ⇦