Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 152 No. 2324 (2022)

Evaluation of a pilot consultation for maternity protection at work in Switzerland

  • Peggy Krief
  • Zakia Mediouni
  • Alessia Abderhalden-Zellweger
  • Dominique Kerr
  • Nesi Seraj
  • Saira-Christine Renteria
  • Julien Vonlanthen
  • Brigitta Danuser
DOI
https://doi.org/10.4414/SMW.2022.w30160
Cite this as:
Swiss Med Wkly. 2022;152:w30160
Published
13.06.2022

Summary

STUDY AIMS: Switzerland’s Labour Law and its Ordonnance on Maternity Protection aim to protect the health of pregnant employees and their unborn children while enabling them to continue to pursue their professional activities. Some companies encounter difficulties implementing the law’s provisions. The Department of Occupational and Environmental Health, part of the Center for Primary Care and Public Health (Unisanté), has provided specialist occupational medicine consultations for pregnant employees since 2015. This study aimed to evaluate how well Swiss’ maternity protection legislation is implemented by examining a list of relevant indicators measured during the occupational health consultation. The study also sought to investigate the consultation support provided to the relevant stakeholders and the adjustments made to pregnant employees’ working conditions.

METHODS: Descriptive variables and indicators relative to the application of the Swiss maternity protection legislation for 83 pregnant employees were collected during the consultation’s pilot phase (between 2015 and 2016). Descriptive statistics and cross-analyses of these indicators were made.

RESULTS: Most pregnant employees faced multiple exposures to occupational risks. Preventive risk analyses were rare. Few adjustments to workstations were proposed. We found a tendency for employees to leave their workstations early on in their pregnancies due to sick leave certificate prescriptions. Specialist consultation and collaboration with occupational health physicians to recommend interventions for pregnant employees can provide significant benefits and help some pregnant women to continue at their workstations with appropriate adjustments.

DISCUSSION: A specialised occupational health consultation is a useful instrument for identifying occupational hazards for both the pregnant woman and her unborn child. It is also an opportunity to explain employers’ legal responsibilities and obligations to safeguard the health of their pregnant employees and to give specific advice for their company’s situation. This consultation also enables employers to maintain their employees’ valuable professional competencies in the workplace for as long as possible. Finally, occupational health consultation helps and supports healthcare providers who must, according to the law, make decisions about whether pregnant employees can continue working safely or not.

References

  1. Federal Statistical Office. Activité professionnelle, tâches domestiques et familiales. 2021.
  2. Giudici F, Schumacher R. Le travail des mères en Suisse : évolution et déterminants individuels. Social Change in Switzerland. 2017;(10): https://doi.org/10.22019/SC-2017-00005
  3. Casas M, Cordier S, Martínez D, Barros H, Bonde JP, Burdorf A, et al. Maternal occupation during pregnancy, birth weight, and length of gestation: combined analysis of 13 European birth cohorts. Scand J Work Environ Health. 2015 Jul;41(4):384–96. https://doi.org/10.5271/sjweh.3500
  4. Fowler JR, Culpepper L. Working during pregnancy. UpToDate [Internet]. 2018. Available from: https://www.uptodate.com/contents/working-during-pregnancy
  5. Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M, et al. The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2020 Mar;222(3):224–38. https://doi.org/10.1016/j.ajog.2019.08.059315504471097-6868 https://doi.org/
  6. Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M, et al. The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019 Dec;221(6):563–76. https://doi.org/10.1016/j.ajog.2019.06.051
  7. Croteau A. Occupational lifting and adverse pregnancy outcome: a systematic review and meta-analysis. Occup Environ Med. 2020 Jul;77(7):496–505. https://doi.org/10.1136/oemed-2019-106334
  8. International Labour Organization. Maternity at work: a review of national legislation: findings from the ILO database of conditions of work and employment laws. Geneva2010.
  9. Council Directive 92/85/EEC of 19 October 1992 on the introduction of measures to encourage improvements in the safety and health at work of pregnant workers and workers who have recently given birth or are breastfeeding (tenth individual Directive within the meaning of Article 16 (1) of Directive 89/391/EEC). The Council Of The European Communities; 1992.
  10. Croteau A, Marcoux S, Brisson C. Work activity in pregnancy, preventive measures, and the risk of delivering a small-for-gestational-age infant. Am J Public Health. 2006;96(5):846-55. Epub 2006/03/31. Doi: https://doi.org/10.2105/ajph.2004.058552. PubMed PMID: 16571706; PubMed Central PMCID: PMCPmc1470590. https://doi.org/10.2105/AJPH.2004.058552
  11. Croteau A, Marcoux S, Brisson C. Work activity in pregnancy, preventive measures, and the risk of preterm delivery. Am J Epidemiol. 2007 Oct;166(8):951–65. https://doi.org/10.1093/aje/kwm171
  12. Villar R, Serra L, Serra C, Benavides FG. Working conditions and absence from work during pregnancy in a cohort of healthcare workers. Occupational and Environmental Medicine. 2019;76(4):236-42. Doi: https://doi.org/10.1136/oemed-2018-105369. PubMed PMID: WOS:000471887500007.
  13. Henrotin JB, Vaissiere M, Etaix M, Dziurla M, Malard S, Lafon D. Exposure to occupational hazards for pregnancy and sick leave in pregnant workers: a cross-sectional study. Ann Occup Environ Me. 2017;29. Doi: https://doi.org/10.1186/s40557-017-0170-3. PubMed PMID: WOS:000401648700001.
  14. Pedersen P, Momsen AMH, Andersen DR, Nielsen CV, Nohr EA, Maimburg RD. Associations between work environment, health status and sick leave among pregnant employees. Scandinavian journal of public health. 2020. Doi: https://doi.org/10.1177/1403494820919564. PubMed PMID: WOS:000536882300001.
  15. Kristensen P, Nordhagen R, Wergeland E, Bjerkedal T. Job adjustment and absence from work in mid-pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Occupational and environmental medicine. 2008;65(8):560-6. PubMed PMID: Medline:18086697.
  16. Adams L, Winterbotham M, Oldfield K, McLeish J, Stuart A, Large A, et al. Pregnancy and maternity-related discrimination and disadvantage: experiences of mothers. London: Department for Business, Innovation and Skills, Equality and Human Rights Commission; 2016.
  17. Lembrechts L, Valgaeren E. Grossesse au travail. Le vécu et les obstacles rencontrés par les travailleuses en Belgique. Etude quantitative et qualitative. Bruxelles: Institut pour l’égalité des femmes et des hommes, hommes Iplédfed; 2010.
  18. COWI. Evaluation of the Practical Implementation of the EU Occupational Safety and Health (OSH) Directives in EU Member States. Report by directive: directive 92/85/EEC on the introduction of measures to encourage improvements in the safety and health of work of pregnant workers and workers who have recently given birth or are breastfeeding (pregnant/breastfeeding workers directive). 2015.
  19. Act E. (EmpA). United Federal Assembly; 1964.
  20. Ordinance MP. The Federal Department of Economic Affairs, Education and Research (EAER); 2001.
  21. Aellen G, Nicollier L, Outdili Z, Ribeiro K, Stritt K. Application de l’Ordonnance sur la protection de la maternité chez les femmes médecins. Rev Med Suisse. 2013 Jul;9(393):1433–4.
  22. Bay R, Simonetti C. Evaluation des connaissances des mesures légales de protection de la maternité au travail (Oproma) chez les femmes enceintes et chez les gynécologues (Travail de Maîtrise universitaire en médecine). Lausanne: Université de Lausanne; 2013.
  23. Rudin M, Stutz H, Bischof S, Jäggi J, Bannwart L. Erwerbsunterbrüche vor der Geburt. Bern Bundesamt für Sozialversicherungen (BSV); 2018.
  24. Abderhalden-Zellweger A, Probst I, Politis Mercier MP, Danuser B, Wild P, Krief P. Implementation of maternity protection legislation: Gynecologists’ perceptions and practices in French-speaking Switzerland. PLoS One. 2020 Apr;15(4):e0231858. https://doi.org/10.1371/journal.pone.0231858
  25. Abderhalden-Zellweger A, Probst I, Politis Mercier MP, Zenoni M, Wild P, Danuser B, et al. Implementation of the Swiss ordinance on maternity protection at work in companies in French-speaking Switzerland. Work. 2021;69(1):157–72. https://doi.org/10.3233/WOR-213465
  26. Krief P, Dorribo V, Probst I. Grolimund Berse tD, Rinaldo M, Eich S, et al. Stratégie en santé au travail : protection de la maternité en Suisse. In: l’environnement Admped, editor. Journées franco-suisses; Strasbourg: Archives des maladies professionnelles et de l’environnement; June 2015.
  27. State Secretariat for Economic Affairs (SECO). Maternité: Protection des travailleuses. In: Département fédéral de l’économie dlfedlrD, editor. Berne2016.
  28. De Pietro C, Camenzind P, Sturny I, Crivelli L, Edwards-Garavoglia S, Spranger A, et al. Switzerland: health system review. Health Syst Transit. 2015;17(4):1–288.
  29. Bonde JP, Jørgensen KT, Bonzini M, Palmer KT. Miscarriage and occupational activity: a systematic review and meta-analysis regarding shift work, working hours, lifting, standing, and physical workload. Scand J Work Environ Health. 2013 Jul;39(4):325–34. https://doi.org/10.5271/sjweh.3337
  30. Palmer KT, Bonzini M, Harris EC, Linaker C, Bonde JP. Work activities and risk of prematurity, low birth weight and pre-eclampsia: an updated review with meta-analysis. Occupational and Environmental Medicine. 2013;70(4):213-22. Doi: https://doi.org/10.1136/oemed-2012-101032. PubMed PMID: WOS:000316119600001.
  31. Henrotin JB, Vaissière M, Etaix M, Dziurla M, Malard S, Lafon D. [Occupational risks during pregnancy: feedback from occupational medical services]. Gynécol Obstét Fertil Sénol. 2018 Jan;46(1):20–7. https://doi.org/10.1016/j.gofs.2017.10.029
  32. Lee LJ, Symanski E, Lupo PJ, Tinker SC, Razzaghi H, Chan W, et al. Role of maternal occupational physical activity and psychosocial stressors on adverse birth outcomes. Occup Environ Med. 2017;74(3):192-9. Epub 2016/12/06. Doi: https://doi.org/10.1136/oemed-2016-103715. PubMed PMID: 27919059; PubMed Central PMCID: PMCPMC5394923.
  33. Malenfant R, De Koninck M. Production and reproduction: the issues involved in reconciling work and pregnancy. New Solut. 2002;12(1):61–77. https://doi.org/10.2190/GN7F-UWBN-6Y3Q-AN16
  34. Malenfant R, De Koninck M, Côté N, Paquet S, Poulin V. Grossesse et travail. La construction sociale du risque Haute-Ville-des-Rivières CLSC-CHSLD, 2004.
  35. Abderhalden-Zellweger A, Mediouni Z, Probst I, Politis Mercier MP, Danuser B, Wild P, et al. Evolution of gynaecologists’ practices regarding the implementation of Swiss legislation on maternity protection at work between 2008 and 2017. Swiss Med Wkly. 2021 Jul;151(2930):w20537. https://doi.org/10.4414/smw.2021.20537
  36. Gravel AR, Malenfant R. Gérer les risques liés au travail durant la grossesse. Vers un nouveau modèle de gestion de la santé et sécurité des travailleuses enceintes. Perspectives interdisciplinaires sur le travail et la santé 2012;14(2). Doi: https://doi.org/10.4000/pistes.2578.
  37. Federal Statistical Office. Live births since 1803 by Year, Demographic characteristic and Sex. STAT-TAB – interactive tables (FSO). Available from: https://www.pxweb.bfs.admin.ch/pxweb/en/px-x-0102020204_110/px-x-0102020204_110/px-x-0102020204_110.px/table/tableViewLayout2/
  38. Lupton D. Precious cargo’: foetal subjects, risk and reproductive citizenship. Crit Public Health. 2012;22(3):329–40. https://doi.org/10.1080/09581596.2012.657612
  39. State Secretariat for Economic Affairs (SECO). Protection de la maternité et mesures de protection (tableau synoptique) Bern 2019. Available from: https://www.seco.admin.ch/seco/fr/home/Publikationen_Dienstleistungen/Publikationen_und_Formulare/Arbeit/Arbeitsbedingungen/Merkblatter_und_Checklisten/mutterschutz-und-schutzmassnahmen.html

Most read articles by the same author(s)