Working during pregnancy is quite common. More than 70% of women work during pregnancy and can usually work safely all the way up until delivery. Many studies have shown that an active lifestyle and employment improve the mother’s general health, improve pregnancy outcomes, decrease cesarean section rates, and decrease the length of labor. Most pregnant women can continue to work in the same job during the entire pregnancy. Some jobs are higher risk and may require workplace accommodation. Certain pregnancy complications, such as preterm labor, may limit the number of hours worked.
It is important that you and your doctor work together to determine if a work limitation or accommodation is required due to your medical condition. For your doctor to write a note legally limiting your work, they must be able to document medical necessity and diagnosis, the specific limitation required, what would be a ‘reasonable accommodation’, the ability to work in other areas, and the time of the limitation. You will be required to attend an office visit to make those determinations. Pregnancy is not a disease state, and that diagnosis alone cannot be used to recommend medical leave. Your medical provider can only recommend time off as it necessary for a medical condition. The time off your medical provider can recommend may not necessarily match the time off that you are entitled to through federal and state programs. The standard medical leave after the birth of your child is up to twelve weeks. It’s important to discuss your protected leave benefits with your employer.
Limits During Pregnancy
Some jobs are very high risk, and it may be suggested to stop those jobs during pregnancy, such as horse training, white water rafting guides, wildland fire fighting, combative care with inmates or patients, and the use of toxic chemicals. Other jobs may require some accommodation, as discussed below.
Lifting During Pregnancy
First trimester: Lifting during pregnancy can be essential not only to your job but during your usual daily home activities. Moderate lifting does not increase your risk of miscarriage in early pregnancy. Heavy repetitive lifting every day from 220-1000 lbs., called extensive lifting, can be harmful in early pregnancy. If your job requires repetitive lifting of more than 36 pounds, an early pregnancy accommodation could be requested.
Second trimester: Lifting limits in later pregnancy (after 25 weeks) can help prevent low back muscular-skeletal injury. Some employers will offer worker accommodations to anyone with a lifting limit (not just pregnant women). If your employer offers lifting accommodations for your job, you could ask your doctor for a note to limit lifting without concerns about losing your employment. The ACOG suggested lifting limit in later pregnancy is 26 lbs.
Hours Worked During Pregnancy
Some studies have shown that very long hours, more than 40 hours a week, slightly increased preterm delivery rates. So, your doctor can limit your hours to 40 per week. They cannot limit your shifts or times without a medical diagnosis. So, it is OK to work three, 12 hours shifts as a week or four 10-hour shifts and still be within the 40 hours. The doctor cannot usually specify the night shift or day shift. Some women have severe vomiting that does not respond to prescribed medications. Our office provides daily weekday access to IV hydration and medications if needed. A sick note may be granted on days when you are too ill to work but only if a provider evaluation took place. Your provider is not permitted to provide you with retroactive medical leave. Very rarely would a pregnancy-related illness limit the hours you can work or require a part-time designation in accordance with state and federal leave laws.
Sitting or Standing During Pregnancy
The ideal job would allow you to move freely throughout the day. Use your breaks to stand if you sit and sit if you stand at work. Take walks during your breaks. If you develop signs of preterm labor, your standing hours could be limited to 3 hours a day. If your employer offers standing desks, see if they could get one for you. Standing desks are rarely medically required but are nice if your job offers that. Your doctor should never have to write notes for you to get regular breaks and time for meals as that time is required by law by your employer. If you are not getting regular breaks, then contact your employer’s Human Resources office.
Other Medical Conditions
Acute or chronic problems can arise or worsen during pregnancy. It is important that you seek care for those problems as you would when not pregnant. If another medical condition, such as an infection, back pain, dental condition, or chronic migraine headaches, comes up, it will be up to the treating physician to determine the time off required. If you already have a work accommodation for a medical condition, you will continue to get that from the originating care provider during pregnancy.
Mental health is important during pregnancy. Pregnancy is a time of enormous changes, and it may be necessary to seek or resume care with a mental health care provider. Getting rest, having emotional support, and taking time to care for yourself is mandatory. There are mental health resources in the area and online that can be accessed and local emergency mental health services. If you request a work accommodation or leave due to a mental health condition and stressors, that will need to be determined by a mental health provider working with you. If that provider cannot legally write an accommodation request, your doctor will work with them to facilitate that note. Please ask for a list of community resources, and reach out to your employee assistance program, human resources, and your insurance company for help getting the needed care.
The correct paperwork is mandatory to comply with these laws. Your doctor can document a medical reason for an accommodation, the amount of time, and the specified limit. This will be in the form of a doctor’s note that can be sent to your employer and a medical note in your chart. If your employer requires specific forms for leave or you are applying for FLMA leave, then that paperwork needs to be left at the front desk with the paperwork completion fee of $15. The turnaround time is up to two weeks. Your employer may require 30 days’ notice before beginning maternity leave. So those forms should be dropped off no less than six weeks before you start leave.
WHC’s goal is for you to have a healthy, functional, and active pregnancy. We want to support you and your family and allow you to work and succeed. The pregnancy and workplace protection laws can be confusing, and sometimes different laws overlap. Please talk to your provider your employer’s human resources department and your health benefit plans for assistance.