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Pregnancy and the Workplace

Pregnancy and the Workplace
Pawan Preet Kaur, OTR/L, ATP
October 29, 2018

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Preet: Good afternoon everyone. I hope everyone can hear me well. I am very excited to present this topic because I am also a new mom. I was fortunate enough to have a pregnancy without any complications, therefore I worked throughout my full term pregnancy. I am going to share a few tips for expectant moms that have helped me work up until the end of my pregnancy and that have helped the majority of the women work up until their pregnancy. If there are any men in the audience, please share these with your significant other, or your friends who are expecting moms and are working currently. The strategies and tips mentioned in this presentation are for women who have no medical complications like dietary or bed rest restrictions. Keep that in mind. However, if you have a normal pregnancy, you still want to discuss with your OB/GYN if there are strategies mentioned in the presentation that are a proper fit for you.

Research

While pregnancy in the workplace is a fairly common occurrence today, there are still numerous biases that women must navigate when pregnant at work. Historically pregnant women and women with pregnancy-related medical conditions faced significant discrimination in the workplace (Chester & Kleiner, 2001). Pregnancy discrimination is most prevalent in the hiring practices of a corporation. So it is important to know your rights in the workplace.

Pregnancy Discrimination Act (PDA)

First, let's talk about the Pregnancy Discrimination Act, that was passed in 1978 and was enforced by the US Department of Labor. Pregnancy discrimination involves treating a woman or an applicant employee unfavorably because of pregnancy, childbirth, or a medical condition related to pregnancy or childbirth. It also states that pregnant women are to be treated the same as other employees for related purposes such as hiring, firing, promotions, and fringe benefits as other employees similar in their ability or inability to work (https://www.eeoc.gov/laws/types/pregnancy.cfm).

  • Title VII of the Civil Rights Act of 1964 
  • Unlawful sex discrimination
  • Also, applies to employment agencies and to labor organizations, as well as, to the federal government
  • Employers with 15 or more employees, including state and local governments 

The Title VII of the Civil Rights Act of 1964 states that it is unlawful sex discrimination. It also applies to employment agencies and to labor organizations, as well as to the federal government. It also applies to employers with 15 or more employees including state and local governments.

Is Pregnancy a Disability?

Now, I want to propose a question, "Is pregnancy a disability?" Yes or no? The majority of the participants are saying, "No." Yes, that is correct. Pregnancy is not a disability. The Americans with Disabilities Act defines a person with a disability as a person who has a "physical or mental condition that limits one or more major life activities." (https://www.eeoc.gov/laws/types/pregnancy.cfm) 

Pregnancy Discrimination and Temporarily Disabled

Pregnant women should have equivalent opportunities compared to other temporarily disabled employees. If a woman is temporarily unable to perform her job due to a medical condition related to pregnancy or childbirth, the employer or other covered entity must treat her the same way as it treats any other temporarily disabled employee. For example, the employer may have to provide light duty, alternative assignments, disability leave, or unpaid leave for pregnant employees, if it does not so for other temporarily disabled employees.

Pregnancy and Harassment

It is unlawful to harass a woman because of pregnancy, childbirth, or a medical condition related to pregnancy or childbirth. Harassment is illegal when it is so frequent or severe that it creates a hostile or offensive work environment, or when it results in an adverse employment decision such as the victim being fired or demoted. The harasser can be a victim's supervisor, a supervisor in another area, coworker, or someone who is not an employee of the employer, such as a client or a customer.

Fair Labor Standards Act (FLSA)

The Fair Labor Standards Act, or FLSA, as amended by the Affordable Healthcare Act in 2012 (https://www.dol.gov/whd/regs/compliance/whdfs73.htm).

  • 50 or more employees
  • Breast milk expression
  • Breast milk location
  • Coverage and compensation

It requires that an employer with 50 or more employees provide its hourly worker's reasonable break time to express breast milk for her nursing child for one year after the child's birth. Employers are also required to provide a place other than a bathroom that is shielded from view and free from intrusion from coworkers and the public that can be used by an employee to express breast milk. Employers with fewer than 50 employees are not subject to the FLSA break time requirement if compliance with the provision would impose an undue hardship. Undue hardship is determined by looking at the difficulty or expense of a compliance for a specific employer in comparison to the size, financial resources, nature, and structure of the employer's business. All employees who work for the current employer, regardless of work site, are counted when determining whether this exemption may apply. Employers are not required under FLSA to compensate nursing mothers for break times taken for the purpose of expressing milk. However, where employers already provide compensated breaks, an employee who uses that break time to express milk must be compensated in the same way that other employees are compensated for the break time. In addition, the FLSA's general requirement that the employee must be completely relieved from duty or else that time must be compensated as work time applies.

Occupational Safety and Health Act (OSHA)

  • Provide a workplace free from hazards
  • Provide facts to employers regarding harmful agents
  • National Institute for Occupational Safety and Health (NIOSH)

The Occupational Safety and Health Act, or OSHA, provides a workplace free from hazards likely to cause death or serious physical harm. It provides facts to employers regarding harmful agents. NIOSH is an agency that researches workplace hazards and makes recommendations for preventing injury or illness. You or your union can request that NIOSH conduct a health hazard evaluation. Certain state or city laws also give workers the right to ask for names of chemicals and other substances as well.

Family & Medical Leave Act (FMLA)

  • 12 work weeks of unpaid leave (cannot exceed)
  • Return to the same job or equivalent job
  • Dads can also use FMLA during pregnancy to care for their spouses
  • To qualify:
    • 50 or more employees
    • Worked for at least 12 months
    • Have worked at least 1,250 hours during

The Family & Medical Leave Act states that employer with 50 or more employees must provide eligible employees a total of 12 work weeks of unpaid leave during any 12 month period because of the birth of a child. It cannot exceed 12 weeks. It also guarantees a return to the same or equivalent job if it is within the 12 week time period. If it is more than 12 weeks, then they do not guarantee that same job placement. Dads can also use FMLA during pregnancy to care for their spouses. To qualify, the company has to have 50 or more employees, and the applicant has to have worked for at least 12 months and worked at least 1,250 hours.

Body Changes Affecting Work Performance

Now, we are going to shift gears here and talk about body changes that come along with pregnancy and how that may affect work performance.

  • Loosening of the Joints
  • Weight gain/Balance
  • Heart rate
  • Hormonal
  • Frequent urination
  • Self-image

Some pregnancy hormone causes the ligaments that support joints to stretch, and this makes them more prone to injury. Weight gain affects balance as it shifts your center of gravity forward. This puts stress on your joints and muscles, especially the lower back and pelvis. It can make you less stable and more likely to fall. Heart rate is also affected as extra weight makes your body work harder. Often, women can get short of breath and may need to slow down. There are a lot of hormonal changes that are happening and can lead to emotional changes. Frequent urination can be another problem at work. Self-image is another big one. Some women feel great about the way they look during the pregnancy, while others may experience low self-image and confidence which may affect their performance at work.

Biofeedback

Now, we are going to talk about biofeedback. Biofeedback involves the monitoring and use of physiologic information to teach patients to modify specific physiologic functions. 

  • Abnormal vital signs
  • Sudden loss of balance
  • Diaphoresis
  • Shortness of breath

There can be abnormal vital signs, such as increased heart rate. They may need to be proactive and monitor their vital signs at the workplace. For example, they can keep a digital pulse ox and a blood pressure monitor handy at work. Diaphragmatic breathing, pursed-lip breathing, music, imagery, and breathing can also help reduce an increased heart rate. I had an increased heart rate during my pregnancy and pursed-lipped breathing helped me tremendously.

Early in your second trimester, it is also normal to feel dizzy or lightheaded at times. The body is going through a lot of changes in circulation such as less blood flow to your head and upper body. To prevent dizziness, they want to move slowly when standing up or changing positions. Drinking lots of fluid may also help with that. Also, they may need to avoid standing for long periods of time or getting too hot. They may need to sit down, or ideally lay down on their side.

Diaphoresis is excessive perspiration. It is a good idea for them to wear loose clothing to work, drink plenty of fluids, and find a cool environment at work if possible.

Shortness of breath is caused by the growing uterus pushing the stomach and diaphragm up against the lungs. To help with breathing easier, so they want to move slowly, and sit or stand up straight to give the lungs more room to expand.

Managing Signs & Symptoms at Workplace

There are many pregnancy symptoms.

  • Fatigue
  • Morning sickness
  • Frequent hunger/thirst
  • Emotional changes including pregnancy-related stress
  • Hot flashes
  • Forgetfulness …(aka “mommy brain”)
  • Pain (lower back pain, cramps in calves)
  • Swelling in legs and feet
  • Carpal tunnel syndrome

In the first trimester, the woman will probably feel totally exhausted. Hormone levels are increased and the metabolism is running high due to burning energy, even during sleep. To alleviate fatigue, they need to listen to signals their body is sending. They need to slow down at work and get the rest they need. They may need to take a cat nap during lunch time. Resting is more important than completing a to-do list at this time. They need to use their coworkers to share the load if possible. A healthy diet and yoga exercise may also help boost energy levels. Exercise may be the last thing on an expectant mom's mind, but it can definitely boost energy. Fatigue will usually go away the second trimester and appear back the third trimester.

The next one is morning sickness. The feeling of nausea and vomiting can happen at any time of the day. Keeping citrus-based candies or even citrus-based fruits may help with nausea. Many women report feeling better with citrus fruits, and some report that citrus fruits make them more nauseous, so you have to find which one works for you. For me, citrus fruits did help. I always had an orange on me, and that helped me with nausea and vomiting. What might also help is avoiding smells that are bothersome. They can keep a fragrance that will help with nausea like water beads might be a good idea to keep in your backpack. Also, ginger-flavored candies and ginger ale can help.

Hunger and thirst are other symptoms. They need to make sure that their stomach is never empty. It is better to eat five or six meals throughout the day or quick snacks. Keeping many snacks on hand is a great idea. It is important to pack lunch and snacks the night before, instead of that morning. This way they do not walk out the house without lunch or snacks. Bland foods such as bananas, rice, applesauce, toast, and tea can be good to include. Healthy snacks throughout the day may help with nausea and supply with a source of energy. These include crackers, fresh raw vegetables, fruits, and cheese are also good. It is important to keep hydrated and keep a water bottle handy. If there is a lot of vomiting, they may want to try rinsing their mouth with a teaspoon of baking soda to neutralize the acid.

There are also a lot of emotional changes that come along with pregnancy which can affect the workplace. Again, yoga will help boost mood and help sleep. They may want to take advantage of any flex time their employer provides. They want to think about the best time of the day to maximize energy. They may want to consider coming in later to work if the early morning is bad or vice versa. Their body is going through big changes and many emotions, therefore it may affect their relationships with co-workers or personal relationships. Relaxation techniques may help. Listening to music during lunchtime, going for a quick massage nearby if possible, or burning a scented candle are options. Lavender, for example, has a calming aroma which can relieve stress.

If they experience hot flashes, loose clothing and drinking plenty of water are good ideas and finding a cool place to work if possible.

There can be a lot of forgetfulness, I am sure that you have heard of mommy's brain. It is a good thing to write things down or use a smartphone with alarm features.

They may experience low back pain and cramps in calf muscles. That was a big one for me, cramps in the calves. Stretching their legs before starting or massaging calves in long downward strokes work might. They can also flex their toes upward and then back down to relieve the cramp.

Most pregnant women have swelling in their legs. To relieve the swelling, they can try to avoid prolonged standing. When sitting, they can prop their legs up for a few minutes. Comfortable shoes may help as well.

Finally, some women develop carpal tunnel syndrome due to the swelling. Wrist and resting hand splints are recommended.

Ergonomic Strategies at the Workplace

Now, we are going to talk about ergonomic strategies in the workplace.

Back Pain

The expanding uterus shifts the center of gravity and stretches out and weakens abdominal muscles. This changes a woman's posture and puts a strain on her back. The extra weight being carried means more work for muscles and increased stress on joints. This is why many women experience back pain. In an article by Sabino and Grauer (2008) it showed during pregnancy alone, the incidence of back pain was reported by 50 to 80% of women. In a study, 61.8% of women who reported low back pain during pregnancy claimed the pain was at least moderately severe and 9% claimed that they were completely disabled by pain. It is a big deal to experience this during pregnancy and working at the same time.

Safe Environment

  • Heavy lifting, climbing, carrying, long period of standing
  • Be aware of any harmful chemicals at the worksite.
  • Factories Dry cleaners, electronics, or printing, hobbies such as painting, pottery
  • Comfortable attire
  • Handwashing

A pregnant woman should avoid any heavy lifting, climbing, or carrying anything heavy. They want to avoid long periods of standing as well. I already touched on harmful chemicals. It is important to know what chemicals may be at work site. If a woman is working in a factory, dry cleaners, or in electronics or printing, these workplaces usually have chemicals so they should be aware of that. Additionally, hobbies such as painting and pottery may have chemicals or noxious smells. They should wear comfortable attire at work if able. Finally, they want to remember proper hand washing. These tips may seem basic, but sometimes we do not always remember them.

To earn CEUs for this article, become a member.

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pawan preet kaur

Pawan Preet Kaur, OTR/L, ATP

Preet is currently practicing as an occupational therapist within the Department of Education. Preet is also an Assistive Technology Practitioner (ATP).  Preet also has experience working in an in-patient, outpatient and sub-acute rehab with neurological and orthopedic conditions.



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