Protecting pregnancy at work: Normative safety measures and employees' safety strategies in reconciling work and pregnancy

Background: In Switzerland, occupational risks for pregnant workers are covered by specific maternity protection legislation (MPL); however, studies show significant shortcomings in the implementation of these policies among companies. Aims: Analyse the gaps between the provisions of Switzerland's MPL, the protective measures companies plan to take and actual protection practices. We also aim to understand how employees develop their own strategies in order to make up for the shortcomings or contradictions of companies' measures. Methods: Interviews with 46 different stakeholders from organisations in the healthcare sector and the food industry were transcribed and analysed thematically. Results: Some of the organisations used procedures apparently in line with legislation, while others planned more informal approaches to managing on a case-by-case basis. Normative safety measures within the framework of national legislation served as resources for both managers and their employees. However, implementing these measures ran up against real-world workplace constraints, which sometimes rendered them impracticable. Employees adapted some measures considered insufficient or developed their own strategies to reconcile work and pregnancy. Conclusions: Being pregnant is challenging to represent in occupational settings; it is not a disease, but it involves important physical and biopsychosocial changes, which affect women's occupational life. The multidimensional, evolving, and yet temporary nature of pregnancy represents a significant challenge to the implementation of MPL within companies. Linking the normative safety measures stipulated in the legislation with pregnant employees' needs-and their job-related knowledge and skills-could be an interesting pathway towards improving maternity protection at work

Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature.

Most industrialized countries have introduced maternity protection legislation (MPL) to protect the health of pregnant workers and their unborn children from workplace exposure. This review aimed to assess this legislation's level of implementation, barriers and facilitators to it, and its expected or unexpected effects. A realist narrative review was conducted. Keyword searches of the PubMed, CINAHL, PsycINFO, MIDIRS, Sociological abstracts and Google Scholar electronic databases were performed in March 2018. The 42 publications included show that the implementation of MPL is deficient in most countries. Allowing pregnant women to withdraw from work on preventive leave or sick leave is favored over workplace adaptations or worker reassignments. The publications highlight mechanisms which encourage or obstruct the enforcement of legislation at the levels of the individual, the physical and social environment, and the macrosocial context. The delay between the conception and implementation of maternity protection measures appears to be a major barrier to the efficacy of MPL. The literature also suggests that unexpected adverse effects, such as degradation in working relationships or discrimination can obstruct the implementation of protective measures. This study showed the need for a better implementation of MPL during pregnancy. Further research and recommendations for improvements in MPL should consider the diverse mechanisms and effects of its implementation. Barriers and adverse effects of this implementation do not only ensure a lack of information or awareness about MPL, but are also linked to contradictions between requirements to protect employment and protect pregnancy

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