This photo of a pregnant woman on the sideline of a football game with a child on her back made me smile. The things women do – especially pregnant women – to keep life on track can be pretty incredible.
As I continued to look at it, this picture also reminded me of the ongoing discussion we have in our practice about the letters we write to patients’ employers about work restrictions during pregnancy.
Pregnancy does not mean you have to limit all physical exertion – we just want you to exert yourself safely. The ergonomic baby carrier holding the 3-year-old in the photo, for example, is acting as a counterweight for the woman and giving her back a break.
Pregnancy-related limitations are complicated, and women and their physicians have much to consider before submitting a work restriction note to an employer.
Lifting: What we know
One of the most commonly cited concerns is working in jobs that require lifting – especially heavy lifting – during pregnancy. From a medical standpoint, however, there isn’t a lot of solid data about the risk to mother and baby regarding lifting during pregnancy.
Some studies have suggested an increased risk in preterm delivery in women working jobs that require high exertion, such as heavy manual lifting. Another study suggested frequent lifting of heavy objects by women who didn’t work outside the home (but not by women who lifted at their jobs) led to obstetric complications!
Because the evidence isn’t conclusive, recommendations by obstetricians have been all over the place.
A common recommendation is to not lift objects heavier than 20 pounds during pregnancy. But that fails to take into account the many different factors that may or may not impact the lift. How often is the woman lifting these objects? Is she lifting objects from the floor? How high are the objects lifted? How advanced is her pregnancy?
Each of these factors could make a difference. If they’re not carefully considered, women might be restricted from certain types of lifting that aren’t actually dangerous, at least not at her stage of pregnancy. And the restriction might prevent her from performing crucial parts of her job.
Standing: What we know
Most women report standing as the most frequent physical activity associated with their jobs. But there is even less research about the impact of standing during pregnancy than there is on lifting.
If your job does involve a lot of standing, I think it’s reasonable to ask for a stool or chair, more frequent rest breaks, and a loosening of footwear requirements. Those requests are easy for an employer to accommodate while allowing you to continue doing your job a little more comfortably.
Smarter work restrictions
It’s critical that you give your obstetrician detailed information about your job’s duties before he or she writes a note that would limit your activity.
One article that really made an impression on me last year was “My Obstetrician Got Me Fired.” It opened my eyes to what the consequences of routine activity limitations can be and the importance of what we put in these letters.
If the doctor’s request makes it impossible for you to perform essential parts of your job, or if an employer can’t make a reasonable accommodation, you might be forced to start pregnancy leave early.
The Family and Medical Leave Act allows for some employees to have 12 weeks off during pregnancy with their jobs protected. If an employee isn’t ready or able to return to work after those 12 weeks, however, she can be let go.
Talk to your provider
There is no one-size-fits-all solution to work restrictions during pregnancy.
Certainly there are situations when limited activity or lifting restrictions should be observed. For example, if a patient has an ongoing back condition or has a job that requires repetitive and frequent bending and lifting of objects weighing more than 20 pounds, she may need to curtail some of this activity.
In general, however, most healthy women can continue to safely work through pregnancy, and many employers are willing to provide reasonable workplace accommodations.
As health care providers, we are committed to keeping you and your baby safe throughout pregnancy. But the last thing any of us want is for a patient to potentially lose her job (and employee insurance benefits) because our note requested a change in job activities that wasn’t really necessary.
Have an honest discussion with your provider about what your job really entails and what kind of accommodation your employer might reasonably be able to make. If you work together with your doctor, you should be able to find a solution that works for both your health and your job security.
Getting the job done
And the photo? Turns out the woman is Dr. Megan Meier, a family medicine physician in Oklahoma who practices sports medicine. When a last-minute conflict meant she didn’t have anyone to watch her 3-year-old, she did what many pregnant women do – she went to work and got the job done.
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