Pregnant women who undertake strenuous physical activity at work can be reassured by the latest guidance for doctors, issued 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 the guidelines and vice president of the 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.’
Notes to editors
To obtain a copy of the guidelines visit the publications section of the Faculty website: