Working While Pregnant

More women are working outside the home than ever before. In most cases, you can plan to continue working through most of your pregnancy. That's not to say pregnancy won't affect your ability to work. You may feel extremely fatigued, especially in the early weeks, and you'll no doubt have to use the bathroom more frequently than usual. Morning sickness can certainly get in the way of a pleasant day at work. Your need to snack during the day may be against job policy. Increase in body size, back problems, swelling, and fatigue can make some jobs more difficult as pregnancy progresses. Arranging to get away for your regular checkups may conflict with your job schedule. And if complications occur, you may have no choice but to discontinue work altogether.

Although some women actually manage to work safely until the day before delivery, most will take off the last month or so. A nurse patient of mine was actually working on the day she went into labor. She walked downstairs and had her baby -- but no, she didn't finish her shift. A female colleague of mine performed a cesarean section on the morning of her own delivery. Two days later she was back at work. I don't necessarily think this approach is best for everyone, but it can be done.

A job requiring long hours is by itself not a risk factor in pregnancy. A study of physicians-in-training found that professional women who work long hours during pregnancy are just as likely to have healthy babies as other women who work more moderate hours. Researchers emphasize that these findings only apply to healthy women with no pregnancy complications, and that those women in the study who worked as long as 100 or more hours a week were more likely to have a pre-term delivery.

Even before you become pregnant, try to assess yourself and your job realistically; that way, you'll know what to expect and how to plan ahead. As your pregnancy continues, you might have to reduce the number of hours you work each day. In fact, this is often better than reducing the number of days you work, since it's less fatiguing. Lifting, prolonged sitting, or standing may be difficult as you get further along, so that a modification of your job may be in order. If your health insurance is related to your job, be sure it will continue for the duration of your pregnancy. Although most employers are understanding, I have seen a few terminate their pregnant employees and leave them not only without a job but also without insurance when these women need it the most.

Hazards of the Workplace
The possible effect of your work on your pregnancy is probably more important than the effect of your pregnancy on your work. The U.S. Supreme Court has recently ruled that women can't be barred from hazardous jobs just because they are women and capable of bearing children. The responsibility falls on employers to document potential reproductive hazards and obtain individual women's informed consent to continued employment. As a female employee considering pregnancy, you must share this responsibility. In the final analysis, you need to make yourself aware of workplace risks, evaluate them, and avoid them whenever possible. Here are some of the most common hazards you might encounter:

Lead. Lead, which is often used in manufacturing processes, has been linked to miscarriages, deformities, and premature births.
Radiation. Certain radioactive drugs and X rays emit radiation, which is linked to miscarriages and birth defects.
Chemicals. At least 26 substances have been linked to problems for pregnant women, including lead, alcohol, mercury, carbon monoxide, benzene, and toluene. Some of these substances also affect male fertility.
Viruses. Nurses and day-care workers are often exposed to the rubella virus and cytomegalovirus (CMV), both of which are hazardous during pregnancy. Rubella during the first three months of pregnancy may cause severe birth defects in the fetus; CMV can be passed along to a fetus, causing handicaps such as blindness, hearing loss, and cerebral palsy.

Quite a few jobs expose workers to teratogens, or chemical or physical agents that are harmful to a developing fetus. Health-care and laboratory jobs, hairdressing and cosmetology, housecleaning, laundry and dry cleaning, and factory work (including electronics, photography, textiles, and printing) may all expose you to potentially harmful chemicals or infectious agents. These substances can be inhaled, absorbed through the skin, or taken in by mouth. For most substances, there is an exposure level that will produce no detectable effect and a dose above which problems can occur. In some instances this "no effect" level of exposure is known; in others, it is not. In some cases, your exposure can be measured, such as when X-ray technicians wear exposure badges. Often, it can't be. It would be wise to evaluate the potential reproductive effect of any workplace exposures prior to trying to conceive.

If you're a doctor, nurse, laboratory technician, or other health-care worker, you may find yourself exposed to several hazards. These include infectious diseases such as herpes, CMV, and AIDS. Other risky exposures are to anesthetic gases and some cancer drugs, as well as chemicals used for sterilization and radiation. Most of these exposures are minor and usually cause no demonstrable problems, but minimizing exposure before and during pregnancy is certainly recommended.

Lead exposure of the kind that occurs when you work with certain paints, batteries, and ceramics can cause infertility, miscarriages, and mental retardation in your offspring. Other toxic agents to avoid include solvents such as benzene and toluene, since they can cause birth defects. They are used in dry cleaning, paint removers, and electronics manufacturing.