Washington, DC — Obstetrician-gynecologists can play a valuable role in helping women during pregnancy and the postpartum period to maintain employment, understand the role of medical leave, and find information and resources to better understand their rights as employees. In a new Committee Opinion, the American College of Obstetricians and Gynecologists (ACOG) outlines the key considerations for ob-gyns assisting patients with questions regarding continued employment and employment protection.
Patients who become pregnant may approach their ob-gyn with questions about the safety of continuing to work, and patients should be reassured that working during pregnancy is generally safe. As many as 56 percent of pregnant women continue to work full-time during pregnancy.
However, the specific requirements of a woman’s job or complications during pregnancy may necessitate work accommodations to protect her health and/or the health of her fetus. Job-protected leave, wage replacement while on leave, pregnancy-related discrimination and lactation accommodations are among other key employment issues for pregnant and postpartum women. Women who work in occupations where they are exposed to teratogenic toxins (e.g., pesticides or heavy metals), in physically demanding professions and in jobs with increased risk of falls or injuries may need accommodations.
“It’s important that ob-gyns discuss workplace expectations with their working pregnant patient,” said Yasser El-Sayed, M.D., vice chair of the Committee on Obstetric Practice. “Some women may be unaware of attendant risks to pregnancy at their job, while others may be unaware that their ob-gyn can offer both support and potential solutions or resources, whether in the form of slight modifications or a formal medical note detailing the need for an accommodation to protect the patient’s health.”
Being able to continue work through pregnancy may be especially important to women who will not be paid during their maternity leave. Just 42 percent of women in the private sector have access to paid medical leave, and only 14 percent have access to paid family leave. For many women and families, losing their job or wages could have significant negative impact. Accommodations that allow a woman to keep working provide the most reliable way to guarantee pay, benefits and job protection. An ob-gyn can be instrumental in obtaining accommodations for patients who are able to continue working.
However, the way in which medical certification notes are written can affect whether employers comply with their suggestions or what coverage a patient might receive. The Committee Opinion provides a detailed overview of the necessary structure and contents of a medical note to optimize its impact.
Health care providers should be aware of relevant state or federal protections for pregnant or new moms in the work force or on medical leave. In some circumstances, it may also be necessary or appropriate for a woman to consult with an employment lawyer or free legal aid service.
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommend that all adults receive an annual influenza vaccine. Influenza vaccination is an essential element of preconception, prenatal and postpartum care because pregnant women are at an increased risk of serious illness due to seasonal and pandemic influenza. Since 2010, influenza vaccination rates among pregnant women have increased but still need significant improvement. It is particularly important that women who are or will be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available. It is critically important that all obstetrician-gynecologists and all providers of obstetric care advocate for influenza vaccination, provide the influenza vaccine to their pregnant patients and receive the influenza vaccine themselves every season. It is imperative that obstetrician–gynecologists, other health care providers, health care organizations and public health officials continue efforts to improve the rate of influenza vaccination among pregnant women.
The American College of Obstetricians and Gynecologists (ACOG), is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. www.acog.org