Table 1
Institutional characteristics and number of interviews carried out by institution and type of actor.
| Rehabilitation hospital | General care hospital | Homecare services | Total | |
|---|---|---|---|---|
| Legal structure | Semi-public | Private | Public | |
| Size in Full-Time Equivalent employees | >50 to <250 | >250 | >250 | |
| Interviews with institutional representatives and employees | ||||
| Director of the Clinic | 1 | – | – | 1 |
| Human resources manager | – | 1 | 1 | 2 |
| Occupational health physician or occupational health nurse | – | 2 | 1 | 3 |
| Ward manager | 2 | 4 | 4 | 10 |
| Member of staff committee | 1 | – | – | 1 |
| Employee who had been employed and pregnant in the past 5 years | 13 | |||
| Nurses | 4 | 2 | 3 | |
| Physiotherapists | – | 2 | – | |
| Community healthcare assistants | – | – | 2 | |
| Total | 8 | 11 | 11 | 30 |
Table 2
Institutional procedures and perceptions of the management of maternity protection and the institutional safety climate.
| Type of institution | Procedures for protecting pregnant employees | Managers’ and employees’ perceptions about the management of pregnancy protection in the workplace | Employees’ perceptions about the safety climate during pregnancy | ||
|---|---|---|---|---|---|
| Perceptions about occupational risk assessment | Perceptions about the level of information given/received | Perceptions about the pregnancy protection measures implemented | |||
| Rehabilitation hospital | No RA. No specific procedures. Informal meetings between the pregnant employees and their ward manager. Adjustments to work schedules (max. 9 hours/day; a move to 8-hour shifts from 12-hour shifts; an end to night shifts; extra breaks). Adjustments to employees’ tasks (relief from strenuous tasks; reorganization of pregnant employees’ work by pairing them up with another colleague). Reassignment to more administrative tasks. | Divergent perceptions between managers and employees about occupational risks. Most employees thought that their managers failed to consider activities which they viewed as strenuous. | Managers considered that providing informal information was adequate. Most employees were disappointed about the level of information received. | Managers perceived the protection of pregnant employees to be well managed through a case-by-case and on-demand approach. Managers perceived colleagues to be an essential resource. Most workers highlighted a lack of anticipation and proactivity from their organization. Employees found it difficult to ask their colleagues for help. | Employees perceived a lack of foresight in their protection and that pursuing on-demand protection measures was exhausting. Guilty feelings with regards to colleagues led some employees to potentially put their health at risk. Most employees experienced tensions between the protection of their health, their work and safeguarding their jobs. |
| General care hospital | RA for pregnant employees. On hiring, staff attend an OH briefing which includes a part dedicated to the OProMa. Interview with the HR department as soon as employees announced their pregnancy. Consultation with the institution’s OH nurse after the announcement of the pregnancy. Regular meetings with the direct superior. Adjustments to work schedules (max. 9 hours/day; a move to 8-hour shifts from 12-hour shifts; an end to night shifts; extra breaks). Adjustments to employees’ tasks (relief from strenuous tasks, a ban on working in operating theatres or with teratogenic agents). Reassignment to more administrative tasks. Access to a rest area. | Managers’ and workers’ perceptions of what constituted a dangerous or strenuous activity were very similar. Some of the managers did not know whether their organization had done an RA. | Managers were satisfied with information procedures. The OH nurse was considered a valuable resource. Employees designated the OH nurse as their point of access to information. However, they sometimes met her at an advanced stage of their pregnancy. | Most managers perceived that their organization had put in place the legal safety measures. However, some of the protective measures were perceived to be difficult to implement because of a lack of personnel and resources. The extra workload had to be taken on by the pregnant employee’s colleagues. Most employees perceived that the measures proposed only kicked in after a certain amount of time or that they failed to consider their actual working environment. Some employees perceived that certain work adjustments ended up adding to their colleagues’ burdens. Some employees perceived that occupational risks were well managed, mostly thanks to their colleagues’ help. | Guilty feelings with regards to colleagues led some employees to not take their allotted extra breaks. Employees perceived a lack of enforceability in the planned measures. This failing contributed to creating a safety climate which made it difficult to accommodate work and pregnancy. |
| Homecare services | RA for pregnant employees. Consultation with the institution’s OH nurse after the announcement of the pregnancy. Adjustments to work schedules (max. 9 hours/day; a move to 8-hour shifts from 12-hour shifts; an end to night shifts; extra breaks). Adjustments to employees’ tasks (relief from strenuous tasks; removing employees from contact with patients who pose a risk of infection or for whom cytostatic must be handled). Other procedures require the employees’ active participation, such as in the identification of the risks faced. | Managers and workers’ perceptions of what constituted a dangerous or strenuous activity were very similar. Some managers perceived that working in homecare services was more dangerous than in hospital settings. The majority of employees perceived that occupational risks were well taken into account by their managers. | Managers mainly evoked the HR department as the source of information for pregnant employees. They perceived that their organization properly informed pregnant employees about occupational risks. Employees mainly evoked their immediate supervisors as their source of information. Most of them perceived an appropriate level of information. | Most managers thought that their organization did what was necessary to protect pregnant workers. Some managers felt that it was difficult to protect their staff because of the very nature of homecare services. The fact that homecare services do not take place in a fixed location obliges pregnant employees to be strongly committed to identifying potential dangers and, at the same time, requires the management to be flexible to ensure protection. Employees were satisfied with maternity protection measures. They felt well listened by the hierarchy. | Employees perceived support from their direct supervisors; they valued being involved in the identification of dangerous situations and benefitting from protection measures that were equal for everyone. Workers felt considered and valued, which fostered a corporate climate in which it felt legitimate to speak with their managers and to benefit from their rights. |
[i] RA, Risk analysis; OH, occupational health.