Healthy work in pregnancy

This thesis concerns working pregnant women: the impact of working conditions on their pregnancy and unborn child, the implementation of Maternity Protective Legislation and the guidelines and opportunities for prevention of adverse pregnancy outcomes.
In low-risk pregnancies, various forms of physically demanding work and long working hours have a moderately increased risk of preterm birth. Physical and job strain and long and irregular working hours increase the risk of preterm birth in multiple pregnancies. 50% of working pregnant women with low-risk pregnancies and nearly 60% of women with multiple pregnancies continue to work not in accordance with legislation and guidelines, even though these have been drawn jointly with all stakeholders. This puts mother and child at risk of adverse outcomes and seems the result of little knowledge of working pregnant women and their obstetric caregivers about risks in the workplace, lack of access to occupational health care and absence of financial incentives for employers.
To improve working conditions for pregnant women, this thesis recommends further research on the redefinition of roles in the (occupational) care of pregnant women and on employers' incentives and barriers to implementation. In particular, it is also recommended to involve health insurers and the government, as they benefit from implementation.
We conclude that the blended care intervention ‘Pregnancy and Work’ can be further developed into an effective tool in advising on work adjustment to obstetric caregivers and their clients. This includes new designs of the 'Pregnancy and Work' app, aimed at working pregnant women on the one hand, their midwives and obstetricians on the other, and finally at their employers. Ultimately, this can lead to a safe work environment for pregnant women.