Pregnant at work: time for prenatal care providers to act

The Health Care Provider's Role in Securing Work Accommodations for Pregnant and Postpartum Patients

“…An effectively written work note from a health care provider can be a critical tool when a pregnant or postpartum patient needs access to workplace protections, increasing the likelihood that the patient will receive the accommodation they need to stay safe and healthy on the job while continuing to earn critical income for their family. [1][2][3][4] These notes can assist patients who need adjustments to how, when, or where their job is done to continue working during pregnancy or while breastfeeding. But for all their promise, work notes can put an employee's job at risk.…”

“…Unhealthy working conditions and employment discrimination against pregnant, postpartum, and breastfeeding workers lead to long-lasting harm for entire families. Midwives and other health care providers can play a central role in supporting their patients with work-related problems, [1][2][3][4] reducing the risk that a patient will need to decide between their health and keeping their job. A patient-centered care approach that focuses on communication, counseling, and guidance is not only a hallmark of midwifery care but is also precisely what is needed to assist patients who require accommodations or who face workplace pregnancy or breastfeeding discrimination.…”

“…Over 40% of mothers are their family's sole or primary breadwinner, bringing in at least half of their families' earnings, and another 22.4% of mothers are cobreadwinners. 3,8 Further exacerbating the vulnerability of pregnant workers is the fact that women make up the majority of minimum or low-wage workers in the United States, 9,10 and 50% more women than men earn wages at or below the federal minimum wage. 11 When pregnancy, childbirth, or breastfeeding discrimination causes these workers to lose their jobs, their families' economic security suffers.…”

“…workers' health, 3 providing accommodations often benefits businesses by increasing employee productivity, retention, commitment, and safety while reducing absenteeism and insurance costs. 20,21 Despite these benefits, more than 250,000 pregnant women are denied their accommodation requests each year.…”

“…17 When clinically indicated accommodations are not provided, a worker's health may suffer, with consequences ranging from inability to attend prenatal care appointments, to mismanagement of conditions such as gestational diabetes, up to and including loss of pregnancy in the worst cases. [1][2][3][4] Pregnancy discrimination also has long-lasting economic consequences, such as loss of health insurance, income, and employment, which may lead to food and housing insecurity for the entire family. 22 Moreover, job loss due to pregnancy exacerbates income inequality and the gender wage gap.…”