An article in the December issue of Obstetrics and Gynecology brings attention to a common concern of many pregnant women: What effects could my job have on my pregnancy and how will being pregnant affect my ability to do my job?

I’ve become more interested in this subject of late, because our practice in Hawaii includes many hotel workers who face significant challenges among their jobs, their supervisors, and their pregnancies. I am frequently frustrated by the lack of flexibility these pregnant workers face. My experience is that most women want to work during pregnancy, but they do not want to experience undue risk and strain, and they don’t want the burden of bureaucratic hassle every time something comes up that limits or prevents their abilities to work.

The study by Lisa A. Pompeii, PhD, COHN-S, et al., from the University of North Carolina at Chapel Hill, studied 1908 women during pregnancy. The results suggest that working long hours, heavy lifting, and prolonged standing do not contribute increased risk of preterm or small-for-gestational-age (SGA) birth. There was a statistically significant increase in the risk (50% increase) of preterm delivery in women who work the night shift, however.

The correlation between night work and preterm birth was a surprise, and this information made the news in a big way. The authors caution, however, that further study is necessary to confirm these findings before any definite conclusions about this are made.

The information that work activity during pregnancy (lifting and standing) does not increase the risk of premature or SGA birth is good news. It will be useful information for women who are doing fine and want reassurance that their work activities are not likely to negatively affect their pregnancies.

But this great study did not address some of the more complex issues around pregnancy and work. What about common discomforts of pregnancy and the effect that work may have on them? Many women complain of fatigue, weakness, back pain, leg pain, abdominal pain, etc., and most believe that work worsens these complaints. While it may be true that these serious complications of pregnancy are not increased by working, it is my belief that many of these complaints are exacerbated by prolonged standing, lifting, exertion, and staying too long in one position.

And what about women who experience preterm contractions at work? This study does not suggest that pregnant patients and obstetricians should disregard these complaints and tell women to keep doing what they’re doing that seems to increase uterine activity. Standard practice is to evaluate these patients for preterm labor and put them to rest. Most women with preterm contractions won’t deliver prematurely, but right now, there’s no effective way to tell who will deliver early and who won’t. What we need is a study that compares our standard “go to bed and observe” policy with continued activity, but such a study will probably not be done because we always think we have to do something…

I’m not suggesting that this study should or could have answered all the questions about pregnancy, work, activity, and preterm birth. I’m grateful for the insight that this paper does provide. And I am also inspired by this opportunity to address the very real challenges that working women face when they’re also pregnant. I believe that women need to face reality when it comes to their jobs and their pregnancies, and they need to put themselves in positions that allow flexibility and understanding of their potential needs. And, if more than two-thirds of pregnant women work these days, there is a huge opportunity for change in our workplace expectations, laws, disability policies, and compassion for pregnant women. Pregnancy is not an illness, it is a normal part of life, and it’s challenges should be supported and celebrated – not stressed over.

RW, MD

Related Topics: Pregnancy Fitness, Preparing for Pregnancy Emotionally