New and Expectant Mothers at Work Policy and Procedure
Documentation Control
Reference
HS/SP/004
Date approved
13 May 2009
Approving body
Directors’ Group
Implementation date
13 may 2009
Version
2
Supersedes
NUH Version 1 (5 February 2007)
Consultation undertaken
Occupational Health, Infection Control,
Matrons and department leads, safety
representatives, Procurement, Trust H&S
Committee, Organisational Risk and Patient
Partnership Committee
Target Audience
Line managers
Supporting procedure (s) Maternity Guidelines (part of Work-life
Balance Policy)
Review date
November 2011
Lead Executive(s):
Medical Director
Author / Lead Manager
Health and Safety Manager/Jenny Hennin
Further
guidance/information
from
Head of Organisational Quality, Risk and
Safety, Health and Safety Manager,
Occupational Health, Trade Union/Staff
Association accredited reps
Carole Jackson, Human Resources
New and Expectant Mothers at Work Policy and Procedures
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CONTENTS
Paragraph
Title
Page
1.
Policy Statement
3
2.
Definitions
3
3.
Diagnosing and managing those at risk
3
4.
Roles and responsibities
3
5.
Consultation
5
6.
Equality and Diversity Statement
5
Appendix 1 Guidance on Physical, Chemical & Biological
Hazards
Appendix 2 Procedures and Guidance
6
Appendix 3 Employee Record of Having Read the Policy
15
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2
1.
Policy Statement
Pregnancy is not an illness. Its health & safety implications can be
adequately addressed by normal health & safety management
procedures. Many women work whilst pregnant and return to work
whilst breast-feeding. Some hazards at work, however, may affect
the health and safety of new and expectant mothers and their
children. This policy covers the actions that managers need to take
to minimise risks.
On 1 December 1994, legislation required to implement the
European Directive on Pregnant Workers was introduced into the
Management of Health and Safety at Work Regulations 1992. The
legislation requires employers to undertake a risk assessment of
working conditions for pregnant women. As a result of the
assessment, employers may need to take action to minimise risks.
2.
Definitions
Under the regulations, new and expectant mothers are defined as
females who have a pregnancy, which has been confirmed in
writing by a health professional (registered doctor or midwife), or
have given birth to a healthy child within the last 6 months, or are
continuing to breastfeed a child. It also includes women who have
delivered a stillborn child of more than 24 weeks’ gestation.
3.
Diagnosing and managing those at risk
Risk assessment is an intrinsic part of the Management of Health
and Safety at Work Regulations 1999, the Control of Substances
Hazardous to Health Regulations 2002 (COSHH), the Manual
Handling Regulations 1992 and the Ionising Radiation Regulations
1999. Managers should assume that there would be female staff of
childbearing potential carrying out the tasks at any time. Some risks
to the unborn child are greatest in the very early stages of
pregnancy, often before the mother realises she is pregnant.
4.
Roles and Responsibilities
It is the employee’s responsibility to notify her manager in writing
that she is pregnant. It is advisable that the manager is notified as
soon as possible, since some risks are greatest in early pregnancy.
Managers may require confirmation in writing from a health
professional.
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When notified of pregnancy, the manager is required to carry out a
risk assessment of the work done by the individual. Appendix 1
contains guidance on working conditions and physical, chemical
and biological hazards can be obtained from the Health and Safety
Executive (HSE) internet. The risk assessment proforma on page
10 will help to recognise risks that have been unidentified or
underestimated. The proforma requires that actions to remove the
risks or reduce them to acceptable levels are documented. The risk
assessment should be filed with the worker’s personal management
file. The employee should have the opportunity to express their
views on risks before reaching a final decision on risk controls. She
should be informed of the outcome of the risk assessment, and any
necessary actions. Nottingham Occupational Health department are
able to give advice on medical aspects of pregnancy or risks
involved with work. Advice can be sought from the Trust Radiation
Protection Advisers where employees are working with x-rays or
radioactive materials or the Health Safety and Ergonomics
department in relation to general workplace risks.
The risk assessment will need to be repeated at appropriate
intervals to take account of pregnancy related changes in the
worker, such as increasing size and ergonomic considerations. A
repeat assessment every 3 months (or sooner if work
circumstances change) may be reasonable, but frequency will
depend upon the hazards in the environment.
If it is not possible to remove the hazard, or reduce the risk to an
acceptable level, the manager must consider:
4.1
4.2
4.3
Temporarily adjusting her conditions of work and/or hours of work;
or
offering her suitable alternative work, if available; or
suspending her on full pay for as long as necessary to protect her
safety or safety and that of her child
The Health and Safety Executive states that they are not aware of
any additional risks to pregnant or breastfeeding women or their
unborn children from working at night. However, other factors
associated with night work should be considered when performing
the risk assessment. Increased risk may arise because fatigue
associated with working nights may compound pregnancy related
fatigue. Night work may also alter working conditions, e.g. lone
working may occur, and opportunities to take regular breaks for rest,
refreshments, expression of breast milk or use of the toilet may be
fewer. Where a new or expectant mother undertakes night work and
has been given advice by a health professional, who states that
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night work could affect her health and safety, or that of her unborn
child, her manager must consider:
4.4
offering suitable alternative daytime work if available; or
4.5
suspending the worker on full pay
Managers are advised to consult Human Resources and
Occupational Health for advice when this situation arises.
Mothers are expected to inform their line manager on return from
maternity leave if they are still breast-feeding.
Managers will need to ensure that workers who are breast-feeding
are not exposed to hazards, which may damage the health and
safety of the mother or child for as long as they continue to breastfeed. The regulations do not put a time limit on breast-feeding;
some mothers may continue for twelve months or longer. It is the
responsibility of local managers to provide mothers with a suitable
private and hygienic place to express and store breast milk.
Where managers are controlling risks in line with regulations, it is
unlikely that mothers who continue breast feeding will be exposed to
risks which require them to be offered alternative work or given paid
leave.
5.
Consultation
Undertaken in accordance with Trust protocols as listed in this
Policy’s “Documentation Control”
6.
Equality and Diversity Statement
The NUH is committed to ensuring that, as far as is reasonably
practicable, the health, safety and welfare of staff, visitors, patients
and students is paramount and does not discriminate against
individuals or groups on the basis of their ethnic origin, physical or
mental abilities, gender, age, religious beliefs or sexual orientation.
Appendix 1
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GUIDANCE ON PHYSICAL, CHEMICAL & BIOLOGICAL HAZARDS
Below is some information on each of the above areas. This is not
exhaustive. Please contact the Occupational Health Department for
additional advice on completing your employee’s risk assessment. Advice
can usually be given by telephone more quickly than by making a written
referral. This is our preferred initial contact when advising on a risk
assessment for new or expectant mothers. Further information may be
obtained from the HSE’s web site or the health and Safety department.
PHYSICAL
Movements and posture
Pregnant and postnatal mothers [up to 3 months postnatal] are at greater
risk of injury due to the effects of hormones of pregnancy on the
musculoskeletal system. Additionally, prolonged sitting or standing may
cause dizziness, faintness or fatigue. There is also an increased risk of
blood clots with prolonged sitting or standing. The opportunity to sit or
stand as comfort dictates may be beneficial. Working in confined spaces
may be uncomfortable with increasing size. Post-Caesarean section,
extra restrictions may apply.
Ionising and Non Ionising Radiation
Consult Ionising Radiation Regulations – specific Policy for Ionising
Radiation and new and expectant mothers.
Optical radiation.
No increased risk.
Electromagnetic fields.
Within current recommendations, not known to cause harm to the unborn
child or the mother.
CHEMICAL
Toxic chemicals
Risk assessment dependant on chemical identified.
Cytotoxic drugs
These can cause genetic damage to sperm and eggs. Some can cause
cancer. A safe level of exposure cannot be determined for these drugs.
Consider preparation of the drug, use and disposal of waste. A pregnant
worker preparing chemotherapy drug solutions should be transferred to
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another job. Consider spillage risk as a source of exposure with use of
prepared solutions.
BIOLOGICAL
Infectious Diseases
For most workers the risk of infection at work is not higher than the risk
from infection outside the work environment. However, if there is a known
high risk of exposure to an infectious disease within the workplace, which
could have an adverse effect on the unborn child or the mother, and the
mother is not protected by immunity, then a risk assessment is
recommended. In healthcare settings, consideration should be given to
risk assessing possible exposures to hepatitis B, HIV, herpes,
tuberculosis, syphilis, varicella, and measles as a basic minimum.
WORKING CONDITIONS
Fatigue
Fatigue has been associated with miscarriage, premature birth and low
birth weight. Tiredness increases during and after pregnancy and may be
exacerbated by work-related factors. Rest is important for new and
expectant mothers. Facilities such as rest rooms may be appropriate. If
this is not possible the risk of fatigue should be controlled as much as
possible. Fatigue is difficult to assess objectively and managers may wish
to ask how day-to-day activities are affected by the pregnancy, then
deciding what adjustments they can consider to the role to try to
accommodate fatigue. Adjustments might include reductions in number of
hours, duration of shifts and/or spacing out of days worked, and allowing
regular rest breaks.
Night work/On call work
Health and Safety Executive experts are not aware of any additional risks
from working at night. It may be worth considering allowing the pregnant
worker to cease cardiac arrest team duties at 28 weeks.
Stress including Post Natal Depression
New and expectant mothers can be particularly vulnerable to both
occupational and domestic/personal stress due to hormonal, physiological
and psychological changes during and after pregnancy,
Working with VDUs
Levels of ionising and non-ionising radiation generated by display screen
equipment are not considered to pose a significant risk.
Working alone
Pregnant women are more likely to need urgent medical attention.
Consider access to communication with others.
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Working at heights
It is hazardous for pregnant women to work at heights. Consider ladders,
platforms and kick stools. Consider hazards related to overbalancing,
particularly when over reaching.
Violence
Violence to a mother may lead to miscarriage or premature delivery. This
risk particularly affects workers in direct contact with customers and
clients.
Working with Personal Protective Equipment
Consider fit and comfort of PPE.
Nutrition
Appetite and digestion are affected by pregnancy and breast-feeding
changes. More frequent meal breaks and more frequent access to
drinking water and other refreshments may be required. In early
pregnancy particularly the mother may only be able to eat little and often.
Morning sickness may cause difficulties working early shifts, or with
strong smells which may worsen symptoms.
Heat and Cold
Pregnant women are less tolerant of heat stress. No additional risks from
cold work.
Hygiene Facilities
Pregnant women often have to go to the toilet more frequently and more
urgently than others. Failure to do this may cause bladder and kidney
infection.
Breast Feeding
Provision of private and hygienic facilities for the expression of breast
milk; together with appropriate storage of same.
Passive Smoking
This poses a risk to infant health.
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Appendix 2
PROCEDURES AND GUIDANCE
Stage 1 – Initial Risk Assessment
The flowchart shows what you must do if you have female workers,
including students, of childbearing age.
NO
Are there
any hazards
present?
Inform
employees
of outcome
YES
Assess risks,
reduce or
remove if
possible
Inform workers of the
risk and the need to
notify you of the
pregnancy or if they
are breastfeeding or
have given birth in the
last six month, as
early as possible.
When you do the initial risk assessment you must take into account any
hazards and risks to females of childbearing age. This includes new and
expectant mothers. Risks include those to an unborn child or the child of a
woman who is still breastfeeding and not just risks to the mother herself.
Look for hazards
The physical, biological and chemical agents, processes and working
conditions, which may affect the health and safety of new or expectant
mothers, are outlined in the attached table. They include the following
possible hazards.
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Physical Risks





Movements and postures
Manual handling
Shocks and vibration
Noise
Radiation
Biological Agents
 Infectious diseases
Chemical agents, including:





Toxic chemicals
Mercury
Cytotoxic drugs
Carbon monoxide
Lead
Working conditions












Facilities (including rest room)
Mental and physical fatigue and working hours
Stress (including postnatal depression)
Passive smoking
Temperature
Working with Visual Display Units (VDU)
Working alone
Work at heights
Travelling
Violence
Working and personal protective equipment
Nutrition
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Decide who might be harmed and how
Your risk assessment may show that there is a substance or work
process in your workplace that could damage the health and safety of
new and expectant mothers or their children. You will need to bear in
mind that there could be different risks depending on whether workers are
pregnant, have recently given birth, or are breastfeeding.
Take into account that there is usually a period of between 4-6 weeks
during which a worker may not be aware she pregnant and is therefore
unable or reluctant to inform her employer. You can overcome this
problem by taking special care in respect of all workers by reducing their
exposure to harmful agents.
Consult your employees and inform them of any risk
You must consult your employees on any health and safety matters,
including decisions you are planning to make which might affect their
health and safety. You should inform your employees or their
representative of what is being proposed, allowing them time to express
their views and should take account of their views before you reach a final
decision.
If your assessment does reveal a risk you should tell all female
employees of childbearing age about the potential risks if they are, or
could in the future be, pregnant or breastfeeding. You should also explain
what you plan to do to make sure that new and expectant mothers are not
exposed to the risks that could cause them harm. It is important that you
reiterate the need for written notification of pregnancy, or that they are
breastfeeding or have given birth in the last six months, as early as
possible.
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Stage 2 – On Notification of pregnancy, birth or breastfeeding
Carry out a specific risk assessment based on initial assessment
Has a risk been
identified?
NO
YES
Can the risk
be removed?
Monitor and
review
Adjust
condition/hours
Remove
risk
YES
NO
ACTION 1
Can the mother’s working
condition/hours of work
be adjusted?
YES
NO
ACTION 3
Suspend her from
work on paid leave
for as long as
necessary to
protect her health
and safety, or that
of her child
NO
ACTION 2
Can she be
given suitable
alternative work?
YES
Give suitable
alternative work
on same terms
and conditions
All of the above actions should be monitored and
reviewed on a regular basis.
If there is a significant risk at work to the health and safety of a new or expectant mother, which
goes beyond the level of risk found outside the workplace, then you must take the following
actions to remove her from the risk:
Action 1 Temporarily adjust her working conditions and/or hours of work; or if it is not
reasonable to do so, or would not avoid risk
Action 2 Offer her suitable alternative work (at the same rate of pay) if available; or if that is not
feasible, you must
Action 3 Suspend her from work on paid leave for as long as necessary to protect her health
and safety, and that of her child.
These actions are only necessary where, as the result of a risk assessment, there is a genuine
concern. If there is any doubt, you may want to seek professional advice on what the risks are,
and whether they arise from work, before offering alternative employment or paid leave. Any
alternative work you offer should also be subject to a risk assessment.
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RISK ASSESSMENT CHECKLIST THAT CAN BE
USED AT STAGE 1 OR STAGE 2, AS CONTAINED
IN THE PROCEDURES AND GUIDANCE
Date of Risk Assessment:
Name of employee:
Department/Ward:
Date of delivery:
Maternity leave commences:
Date returned from maternity
leave:
Proposed date of repeat risk
assessment:
Any significant risks must be
carried forward to Trust’s Risk
Assessment Tool and scored
appropriately. Risks >20 to be
placed on Directorate’s Risk
Register.
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HAZARD
LEVEL OF LEVEL ACTION
RESIDUAL COST OF
RISK TO
OF
REQUIRED? RISK (IF
ACTIONS?
MOTHER? RISK
ANY)?
TO
CHILD?
PHYSICAL
Movements and Posture
(Including Manual
Handling)
Radiation
CHEMICAL
Toxic Chemicals
Cytotoxic drugs
BIOLOGICAL
Infectious Diseases
WORKING CONDITIONS
Fatigue
Night Work / On Call
work
Stress
Working with VDUs
Working alone
Working at heights
Violence
Working with PPE*
Nutrition
Heat and Cold
Hygiene Facilities
Breast Feeding
Passive smoking
Travelling
* Personal Protective
Equipment
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Appendix 3
Employee Record of Having Read the Policy
New and Expectant Mothers at Work Policy and Procedure
I have read and understood the principles contained in the policy
and procedures
Print Full Name
Signature
New and Expectant Mothers at Work Policy and Procedures
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