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Protection During Pregnancy

Work and pregnancy.

WebMD Feature

Aug. 28, 2000 -- Joan Bartlet of Clarksville, Tenn., a single mother expecting her second child, may have to work right through her pregnancy. She needs the money and the health benefits that her job as an aide at a nursing home brings. "This is a very stressful job," the 26-year-old says. "I'm studying to become an RN, but for now I've got to do this."

Concerned about Bartlet's health -- and the future health of her baby -- her obstetrician wants her to stop lifting patients from wheelchairs to beds and back during the third trimester of her pregnancy. Although the nursing home says this lifting is essential to her job, Bartlet is petitioning her employers to switch her to lighter duty for these crucial three months. Despite her doctor's advice to take a break if her employers won't budge, she doesn't have disability insurance to cover lost wages if she were to take time off.

Bartlet has reason for concern. A study published in the April 2000 issue of the journal Obstetrics and Gynecology gathered data from 29 recent studies -- published over the last four years -- that monitored the experiences of more than 160,000 pregnant working women. Researchers concluded that physically demanding work during the third trimester significantly increases a woman's risk of pregnancy-related problems. The study found a greater incidence of premature birth, hypertension, and preeclampsia (dangerously high blood pressure accompanied by swelling and toxemia) in the women with strenuous jobs, especially those involving prolonged standing and repetitive lifting.

What Jobs Are Strenuous?

"Our research shows an increased risk for women who work on assembly lines, who do heavy manual labor," says Ellen Mozurkewich, MD, principal author of the study and a professor in the department of obstetrics and gynecology at the University of Michigan Medical School in Ann Arbor. "This is not about people in good shape who exercise sensibly during pregnancy. It's not about women who work in offices."

In fact, all of the studies Mozurkewich and her colleagues analyzed were careful to include a control group of working women who didn't do physically demanding labor. One contrasted veterinarians working with cats and dogs to vets who work with and move large farm animals. Another compared the experiences of ward nurses who are constantly on their feet to nurses who sit in offices doing paperwork. "Women who work tend to be healthier than women who don't work," Mozurkewich says. "So the risk has to do with the kind of work you do, not with working."

Reducing the Risks

Mozurkewich believes that pregnant women in physically demanding jobs should ask to be switched to "light duty" work after the first trimester, but she knows that's not always realistic. "The problem is that these women can't afford not to work, and their employers can't honor their requests for a lighter load without losing money," she says.

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