Pregnancy at Work

A pregnant trainee doctor

History

A specialty registrar in surgery was 29 weeks pregnant. The pregnancy had been uncomplicated but she was now experiencing abdominal pain and discomfort. She was having particular problems with driving, walking, and standing. There was also some sleep disturbance and fatigue.

Issues at Work

The rota involved day case surgery when the doctor was usually seated and had no problems. Similarly, clinic work was not a problem.

Main difficulties were with assisting in major cases due to length of time standing; she has had to take time out. Symptoms resolved after 10 minutes of sitting.
On call work is unpredictable involving a wide range of surgical tasks with limited back up at night
Lead aprons - do not provide full protection as do not fit well now. On call duties may require fitting stents under X-ray guidance
Travel: She works across multiple sites requiring regular driving, including to emergencies when on call. Prolonged sitting while driving aggravates abdominal discomfort. In addition involvement in a recent road traffic accident has affected her confidence while driving.

Advice and Adjustments

A new or updated Pregnancy Risk Assessment should be carried out.

Work was restricted to short cases, day cases, clinic and ward work.
It was suggested that working hours should be limited as far as possible to a maximum of 40 hours per week, with no on call / night shifts.
Due to difficulty with fitting of lead aprons as pregnancy progresses and consequent limited protection, image intensifier and x-ray work to be avoided for the remainder of her pregnancy.
In view of difficulties driving it was recommended that she remains on a single site each day if possible.
Because of the restrictions and impending maternity leave, a locum doctor was recruited immediately to provide cover.