As a occupational therapist who is seven months pregnant, I am writing about this topic to bring awareness to employers and to other pregnant employees, the essential accommodations that should be considered and provided to working pregnant women. The literal pain in my butt that is shooting down my leg as I sit here typing away at my computer, is my reminder that accommodation is not just about an employer's responsibility to have a job waiting for the pregnant employee upon their return from maternity leave, but about providing administrative, environmental, and ergonomic supports to reduce her pregnancy symptoms while accommodating the physical and physiological changes that occur over those 9 months. The employer's goal should be to promote comfort and productivity as well as prevent musculoskeletal injuries from developing in their valued pregnant employee.
Pregnancy definitely morphs a women's body inside and out, so it is not surprising that there are changes to the musculoskeletal system that places us at risk of acquiring an musculoskeletal injury like carpal tunnel syndrome, low back pain, sciatica, pelvic girdle pain and many other pregnancy-related conditions (curses).
Healthy pregnant women gain on average 25 to 35 pounds, if they started off with a healthy BMI. However if the woman is overweight before pregnancy or gains more than the average weight during pregnancy, the stressors to the musculoskeletal system are increased. To complicate the risks there are also waves of hormonal and chemical changes that make us forget what "Normal" ever felt like. Here are some examples of how these changes impact our bodies:
Forces across weight bearing joints is increased.
Exaggerated lordosis (lumbar curve) of the lower back, forward flexion of the neck, and downward movement of the shoulders typically occur to compensate for the enlarged uterus and change in center of gravity. Stretching, weakness, and separation of abdominal muscles further impede neutral posture and place even more strain on muscles that support the spine.
Joint laxity in the anterior and posterior longitudinal ligaments of the lumbar spine creates more instability in the lumbar spine and can predispose to muscle strain.
There is widening and increased mobility of the sacroiliac joints and pubic symphysis of the pelvis in preparation for the fetus' passage through the birth canal.
A significant increase in the anterior tilt of the pelvis occurs, with increased use of hip extensor, abductor, and ankle plantar flexor muscles Stance is widened to maintain trunk movement.
Fluid retention can cause compression of certain vulnerable structures such as the median nerve in the wrists or the sciatic nerve in the lower back and legs.
Let's not forget about the well known symptoms that affect most us as at some point in the pregnancy (or all the way through for other) like morning sickness, fatigue, difficulty concentrating and forgetfulness(Baby Brain).
With this cyclone of symptoms following us to work, extra supports are required to allow us to function and make it through the day as a productive employee. While application of sound ergonomic principles benefits all workers, the following actions can be considered when modifying a pregnant worker's job:
- Assign less physical tasks
- Restrict lifting to 25 pounds or less
- Adjust work (flexible scheduling, day shift rather than night shifts, etc.)
- Vary tasks to avoid static posture
- Adjust height of work surfaces and chairs
- Install foot rests
- Limit standing to less than three hours per day
- Offer shorter, more frequent breaks
- Reduce the amount of work performed at heights
- Provide more space for moving around
- Remove obstacles in the work area, particularly those placed at lower levels
- Promote safe lifting techniques.
- Provide a quiet space for taking breaks when headaches or nausea ensue
Accommodations that have worked for me at my workplace include, taking stretching breaks many times throughout the day as muscle fatigue sets in, starting a walking routine at lunch to alleviate sore joints moving my keyboard lower to change the angle of my wrists and reduce the beginning signs of nerve compression, sitting on a supportive cushion to relieve coccyx pain.
Most workplaces have pregnancy accommodation guidelines built into their employee's manual or at least in the Policies and Procedures Binder tucked away in someone's office. Many workplaces, however still do not have clear guidelines that focus on individual pregnancy accommodations, which is important to considers since each woman experiences pregnancy differently.
The Canadian Human Rights Commission protects pregnant workers from discrimination and outlines the employer's obligations to accommodate us. If you believe you are being discriminated against at work visit the links below to read about your rights and the best practices for accommodating pregnant women. Canadian law puts a heavy fine on companies if they are found to have committed acts of pregnancy discrimination.
Share your pregnancy workplace accommodation nightmare or success story here to help other readers going through the "invasion of the body snatcher's" pregnancy experience.
Marnie Courage, OT Reg.(MB)