A healthy pregnancy in the workplace

Close to half of all American workers are women in their reproductive years -- 18 to 44 years.

Once pregnant, most of them will work throughout their pregnancies and will return to work within six weeks to 12 months. While an employer has a moral and legal obligation to provide all employees with a safe and healthy working environment, the needs of pregnant women are different from those of other workers and deserve special attention.

The National Institute for Occupational Safety and Health states that the normal woman with an uncomplicated pregnancy and a normal fetus may continue to work without interruption until the onset of labor, as long as the job presents no greater potential hazards than those encountered in normal daily life. Generally, employers pay sickness benefits to pregnant women only if they are unable to continue work because of a strenuous or hazardous job or a pregnancy complication.

Once a woman knows she is pregnant, she should discuss working during pregnancy with her physician and with her employer. Together, they should consider the demands of the job and the individual's physical condition. When a woman reports to her employer that she is pregnant, several things should be considered. Depending on individual circumstances, does she require:

* A change in the nature of her job duties such as reduction in heavy lifting or standing for long periods, removal from radiation or chemical risks.

* A change in working hours, either reduced hours or an adjustment in starting time.

* Arrangements for rest breaks and provision of facilities such as a couch in a restroom.

The following special restrictions will require accommodation. If they are not met, a doctor may recommend the patient quit working:

* As early as 24 weeks into the pregnancy if she has a job that requires standing for long periods of time. The doctor will consider the patient's medical history, how long she is required to be on her feet and if she can take rest breaks and put her feet up.

* As early as 20 weeks into the pregnancy if stooping and bending below knee level is part of her job, or if she lifts heavy objects.

* At 20 weeks to 28 weeks if she must climb ladders or stairs on the job.

At different stages of pregnancy, women will experience symptoms of the pregnancy that can temporarily affect their work. But, with the support of a sympathetic employer, they can get their jobs done effectively. In the first 12 weeks following conception, nausea, vomiting and fatigue can be a problem.

In the second trimester (13 to 28 weeks after conception), many pregnant women experience musculoskeletal problems because of the outward bodily expansion. Some physical difficulties may include reduction in effective arm reach, a chair that cannot be pulled in as close to a desk as usual, and a decrease in balance. Many of these problems are merely uncomfortable and awkward for the worker, but won't seriously affect her ability to do her job well. More serious affects could include dizziness and fainting, particularly in a hot environment or with prolonged standing.

In the third trimester (after 29 weeks from conception), the problems of the second trimester continue. Fatigue is more pronounced, and can be worsened by insomnia. There may also be a variety of aches and pains due to stretching of abdominal and pelvic muscles and ligaments. More frequent rest periods will become necessary as the pregnancy progresses.

The control of reproductive hazards in the workplace -- the effects of the physical and chemical occupational environment on reproduction -- should be an integral part of the occupational health and safety practices of an employer. Information on the effects of exposure should be gathered through material safety data sheets and made readily available to women and their doctors.

Women have proven themselves to be a vital part of the American work force. Because pregnancy is an integral aspect of our society, employers should be, and generally are, supportive of allowing these women to work as long as they are able. Allowances and adjustments should be made when necessary and when possible to make the pregnant worker as comfortable and safe as possible. Working with pregnant workers and their doctors, employers can help their employees meet personal needs and, at the same time, retain valuable personnel.

Randel D. Estep is with Saints Occupational Health Network/Reno Clinic.

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