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.

IntroductionLike most industrialised countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace exposure. This legislation provides for a risk assessment, adaptations to workplaces and, if the danger is not eliminated, preventive leave (prescribed by a gynaecologist). This study’s first objective is to analyse the degree to which companies, gynaecologists and midwives implement the law. Its second objective is to understand the obstacles and resources of this implementation, with a focus on how relevant stakeholders perceive protective measures and their involvement with them.Methods and analysisData will be collected using mixed methods: (1) online questionnaires for gynaecologists and midwives; telephone questionnaires with company human resources (HR) managers in the healthcare and food production sectors; (2a) case studies of 6–8 companies in each sector, including interviews with stakeholders such as women workers, HR managers and occupational health physicians; (2b) two focus groups, one involving occupational physicians and hygienists, one involving labour inspectors.Quantitative data will be analysed statistically using STATA software V.15. Qualitative data will be transcribed and thematically analysed using MaxQDA software.Ethics and disseminationThe Human Research Ethics Committee of the Canton Vaud (CER-VD) has certified that this research study protocol falls outside of the field of application of the Swiss Federal Act on Research Involving Humans.The publications and recommendations resulting from this study will form the starting point for future improvements to the protection of pregnant women at work and their unborn children.This study started in February 2017 and will continue until January 2020.

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Objectives Like most industrialized countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace hazards. This study aims to assess legislation's degree of implementation in the French-speaking part of Switzerland and understand the barriers to and resources supporting its implementation. Methods Data were collected using mixed methods: 1) an online questionnaire send to 333 gynecologist-obstetricians (GOs) and 637 midwives; 2) exploratory semi-structured interviews with 5 workers who had had a pregnancy in the last 5 years. Results Questionnaire response rates were 32% for GOs and 54% for midwives. Data showed that several aspects of the implementation of maternity protection policies could be improved. Where patients encounter workplace hazards, GOs and midwives estimated that they only received a risk assessment from the employer in about 5% and 2% of cases, respectively. Preventive leave is underprescribed: 32% of GOs reported that they "often" or "always" prescribed preventive leave in cases involving occupational hazards; 58% of GOs reported that they "often" or "always" prescribed sick leave instead. Interviews with workers identified several barriers to the implementation of protective policies in workplaces: a lack of information about protective measures and pregnancy rights; organizational problems triggered by job and schedule adjustments; and discrepancies between some safety measures and their personal needs. Conclusions Results demonstrate the need to improve the implementation and appropriateness of maternity protection legislation in Switzerland. More research is required to identify the factors affecting its implementation.

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