Introduction

Pregnancy is a very exciting time for expectant mothers and families, but it can also be a very challenging and difficult time for women,⁽¹⁾ particularly those who have an unplanned or unwanted pregnancy, or who face unexpected complications during pregnancy and childbirth. No two pregnancies are the same. Some women may have an uneventful pregnancy with minimal concerns, while others may face many challenges, including loss of the baby. Some may lose a function that makes them unable to return to the same working conditions. This article takes a look at the intricacies of working while pregnant.

Work and pregnancy challenges

The first reality that women have to deal with is when and how to inform their employer and colleagues of their pregnancy. Employers may be concerned about loss of productivity due to the timing of the pregnancy, leading to difficult negotiations, especially if the expectant mother requires flexible working hours or additional sick leave.

The first trimester may be characterised by uncomfortable symptoms of pregnancy. The woman may not enjoy compassion from peers and colleagues during this time, as the pregnancy is often not yet visible. Women in the final weeks of their pregnancy may still try to work as hard as ever, to avoid being singled out for not carrying an equal load of the work. The interactive effects of work and pregnancy are seldom discussed, yet employment remains an important consideration in family planning.

Pregnancy is associated with hormonal changes that may also cause physiological symptoms such as memory problems, absentmindedness, and poor concentration. Post-birth, many women also experience postnatal depression. The changing emotions can be overwhelming, especially in work environments where employees’ work requires high levels of concentration and attention.

Certain conditions may require the woman to be on bed rest for several weeks, or, if the baby is born prematurely, she may need additional time in hospital or at home with the baby, beyond the prescribed duration of maternity leave. In addition, returning to work after a miscarriage or stillbirth can be a daunting experience for both the mother and her co-workers.

Women are generally able to work during most of their pregnancy, but symptoms of pregnancy could make it difficult to cope with certain tasks and pressures. Common symptoms include pain, cramps, nausea, vomiting, and frequent urination.

While it is a woman’s prerogative to decide when to tell colleagues and her manager that she is pregnant, women need to consider the risk of absenteeism due to these symptoms. Informing the employer early creates open communication and understanding, which may lead to better support, as it allows the employer more time to prepare for the woman’s absences.

It is important that employers perform a risk assessment to determine whether the working conditions or environment could adversely affect the baby or the viability of the pregnancy, e.g., toxins in the atmosphere or otherwise hazardous conditions. Women may have other medical conditions that could be exacerbated by pregnancy, and some may have to discontinue medication that is unsafe for the baby, which could further affect their health and productivity.

Attending antenatal clinics and consultations is very important in monitoring the health of the mother and assessing the baby’s growth and well-being. Women are often hesitant to request time off from work for antenatal visits, especially if this would require a full day, and they may then decide to start their antenatal care late in their pregnancy. This leads to missed opportunities to detect and treat complications and risks to mother and baby.

International Labour Organization recommendations

The International Labour Organization considers maternity leave a human right.⁽²⁾

The World Health Organization⁽³⁾ notes that the ILO Maternity Protection Convention No. 183 of 2000 and ILO Maternity Protection Recommendation No. 191 of 2000 recommend the following, respectively:

• Maternity leave duration of 14 to 18 weeks, to allow rest and proper nutrition of both mother and child;
• Cash benefits sufficient to allow proper living conditions and an acceptable standard of living, which should be no less than two-thirds of the mother’s earnings, or her full remuneration. As it may not be feasible that employers bear the full financial burden of this benefit, countries should put in place compulsory social insurance or public funds.
• Women should have the right to continue breastfeeding after returning to work, necessitating shorter work hours or breaks that count as work hours. Breastfeeding mothers also require hygienic facilities for this purpose.

Maternity and other parental leave benefits in South Africa^(4)(5)(6)

No employee may be discriminated against based on pregnancy. An employer not allowing the mother to return to work after expiry of the agreed-upon term is considered dismissal, but it is not characterised as automatic unfair dismissal. The dismissal would only qualify as automatically unfair if the decision was based on the pregnancy or an intended pregnancy.

Women are entitled to four consecutive months’ maternity leave, and may take this leave from four weeks before the baby is due. However, a medical practitioner or midwife may certify that taking the leave earlier is necessary for the health of the mother or the baby. The mother is not allowed to resume work within six weeks of the birth of the baby without a doctor’s certification that she is fit to do so. If the mother suffers a miscarriage during the third trimester, she is entitled to six weeks’ maternity leave.

Employees on maternity leave can claim from the Unemployment Insurance Fund (UIF). The application has to be brought within 12 months of the birth. The benefits range from 38% to 58% (subject to credits) of the employee’s monthly income, and are payable for a maximum period of 21 days. In the case of a miscarriage or stillborn baby, the benefits are paid for a maximum of six weeks.

Safety is of paramount importance. No employer may allow a pregnant or nursing mother to perform work that endangers either her or the baby, including night shifts. In such instances, the employer has to seek a suitable alternative position for the woman, one that is not less favourable than her current position. Pregnant employees should also be granted rest breaks and two 30-minute periods for breastfeeding.

The other parent is entitled to 10 consecutive calendar days’ leave. Individuals who take parental leave, which may commence from the date of the birth of the child, may also apply for UIF benefits. However, UIF coverage applies only to formally employed workers.

In a groundbreaking judgement handed down on 25 October 2023, the Gauteng High Court found that the existing parental leave provisions are unconstitutional, as they unfairly discriminate between different categories of parents (mothers, fathers, adoptive parents, commissioning parents). In the case of Van Wyk v Minister of Employment and Labour and Others (25 October 2023), the Gauteng High Court declared the current parental law provisions of the Basic Conditions of Employment Act No. 75 of 1997 (BCEA), as well as the corresponding provisions of the UIF Act No. 63 of 2001, invalid. The new parental rights for South Africa are yet to be legislated,⁽⁷⁾ and the current laws will remain in effect until they are amended or repealed.

Recommendations

Women need to be aware of their rights and the conditions of pregnancy benefits; for example, some medical aids do not cover pregnancy within the first six months of joining the programme. Confirm whether the medical aid will cover your baby from the moment of birth (in the event that the baby requires medical care or surgery after birth), and also whether you are covered for elective procedures such as a caesarean section.

Determine what assistance programmes your employer offers, and communicate your needs in terms of breastfeeding or expressing facilities. A risk assessment should be done to determine whether there are any risks to your pregnancy related to your work. These may be physical or mental. Discuss these with your doctor and your employer, giving your employer sufficient time to make accommodating arrangements.

These discussions should also include arrangements to allow you to freely attend antenatal consultations. Once you are ready to reveal your pregnancy to co-workers, discuss issues around productivity in your absence. Collaboration and preparation could prevent future conflict and blaming.

A woman with a high-risk pregnancy may require psychological or emotional support during the pregnancy. The work environment should be supportive of women going through difficult pregnancies.

The decision on when to return to work is dependent on a number of considerations: the duration of maternity leave, your health and well-being, and the baby’s health. If you experience post-partum blues or require mental health support, it is best to consult your doctor as soon as possible for referral to a practitioner. Remember that your energy levels will be low, and you will have to adjust to leaving a baby who is still breastfeeding in the care of another. Preparing yourself mentally and physically for the adjustment is important.

Follow a healthy diet and stay active. Obesity in pregnancy is related to a host of short- and long-term risks for both mother and baby. The mother risks gestational diabetes and hypertension, postpartum weight retention, pre-eclampsia, and cardiovascular disease. There is also a higher risk of the baby being premature or stillborn.⁽⁸⁾ Consult a dietary expert to design an eating plan that complements your work routine.

Conclusion

Pregnancy is a very exciting time for most women and families, but because women’s reproductive years coincide with their most productive work years, pregnancy can have an effect on work, and work can have an effect on pregnancy. For most couples, planning a family starts long before the pregnancy. Employers need to be careful not to place unnecessary stress or pressure on women regarding their fertility. Women should not have to choose between having children and a successful career.

For more information, also refer to the 2016 edition of the Women’s Report titled Pregnancy in the Workplace (www.womensreport.africa under Downloads (2012 – 2019).