Pregnant women who undertake strenuous physical activity at work can be reassured by the latest guidance for doctors, issued today by the Health and Work Development Unit (a partnership between the RCP and Faculty of Occupational Medicine). However, the guideline says employers should consider making ‘reasonable adjustments’ to limit excessive work demands where women experience discomfort and fatigue, particularly later in pregnancy.
The new concise guideline follows an extensive and systematic review of the evidence of certain common work activities (heavy physical effort and lifting, prolonged standing, working long hours and shift working) to see whether these might adversely affect pregnancy outcomes (eg miscarriage, pre-term delivery, delivering a small-for-dates baby).
Pregnant women can be reassured that these activities do not pose a big risk to their pregnancy; if there is any risk at all it is likely to be very small. There are also health advantages in remaining normally active during pregnancy.
The guideline, funded by the NHS Health at Work Network, was developed by a multidisciplinary Guideline Development Group. The group comprised representatives from occupational medicine, epidemiology, general practice, midwifery, obstetrics, trades unions and the National Childbirth Trust. Recommendations were based on available evidence using a rigorous guideline development process.
These latest guidelines build on previous guidance on physical and shift work in pregnancy. They are aimed at doctors advising healthy women about the risks that the reviewed work activities may pose to their pregnancy.
They focus on uncomplicated, singleton (ie not twins or triplets) pregnancies. Women pregnant with more than one baby, a history of adverse outcomes such as miscarriage or pre-term delivery, or medical conditions that may affect their pregnancy, should be advised to seek the advice of an obstetrician or midwife.
Prof Keith Palmer, lead author of guidelines and deputy president Faculty of Occupational Medicine said:
The evidence in this area is extensive, and reassuring to the many women working during pregnancy. If there are risks at all, they are likely to be small. The Royal College of Obstetricians and Gynaecologists advises women to remain active during pregnancy, and work within limits can safely contribute to this goal.
Dr Ursula Ferriday, Chair of the NHS Health at Work Network said:
70% of the NHS workforce is female and many of them undertake shift work and have jobs that involve prolonged standing. NHS Health at Work funded this extensive review of the evidence because it’s vital that as occupational health practitioners we know how to advise women in the NHS who become pregnant. However, the guidance will also be useful for occupational health practitioners in other sectors; other health care workers who come in to contact with pregnant women as well as being reassuring for pregnant women themselves.
For further information, please contact Hannah Bristow, Clinical Standards communications officer, on +44 (0)20 3075 1447 / 07584 303 784 or email Hannah.Bristow@rcplondon.ac.uk, or Vanessa Hebditch +44 (0)7899 895 674, or email firstname.lastname@example.org
- Access a copy of the 'Pregnancy: occupational aspects of management' guidelines
- The Health and Work Development Unit (HWDU) is a partnership between the RCP and the Faculty of Occupational Medicine (FOM). The HWDU’s remit is to contribute to improving the health of the workforce by supporting the implementation of evidence-based guidance. The unit carries out national clinical and organisational audit, facilitates change management work with participants and develops evidence-based guidelines.
- The FOM aims for healthy working lives through:
- maximising people’s opportunities to benefit from healthy and rewarding work while not putting themselves or others at unreasonable risk
- elimination of preventable injury and illness caused or aggravated by work
- access for everyone to advice from a competent occupational physician as part of comprehensive OH and safety services
- providing support to the Faculty’s membership to raise the standard of OH practice.
- NHS Health at Work is the network of occupational health teams dedicated to improving the health and wellbeing of the NHS workforce. Their mission is to increase the quality and delivery of health and work services and support the broader Health, Work and Wellbeing Strategy through:
- helping develop the NHS as a model employer
- delivering services to other public sector bodies and smaller businesses
- supporting the development of quality occupational health practices.