Working during pregnancy

Worldwide, women are working during all trimesters of pregnancy for career pursuit and fulfillment, financial necessity, insurance preservation, career advancement, and postpartum leave time. Working pregnant women often request advice and assistance from their clinicians to manage challenges while being pregnant at Work. This topic will review issues including the impact of pregnancy on Work, Work on pregnancy, workplace exposure, leave time and discrimination, and requesting accommodations to enable pregnant women to continue working. Topics related to occupational risks and exposure are presented separately.

?(See “Overview of occupational and environmental risks to reproduction in females”.)

?(See “Occupational and environmental risks to reproduction in females: Specific exposures and impact”.)

?(See “Overview of occupational and environmental health”.)

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Literature review current through Jan 2022. | This topic last updated: October 28, 2021.

This generalized information is a little summary of diagnosis, treatment, and medication information. It is not meant to be comprehensive and should be used to help the user understand and assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding the use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms ©2022 UpToDate, Inc. and its affiliates and licensors. All rights reserved.

REFERENCES

1. Organization for Economic Co-Operation and Development. Employment: Labour force participation rate, by sex and age group, 2014. http://stats.oecd.org/ (Accessed on October 04, 2016).
2. Bureau of Labor Statistics. Employment Characteristics of Families–2019. https://www.bls.gov/news.release/pdf/famee.pdf (Accessed on April 26, 2020).
3. Pew Research Center. Working while pregnant is much more common than it used to be, 2015. http://www.pewresearch.org/fact-tank/2015/03/31/working-while-pregnant-is-much-more-common-than-it-used-to-be/ (Accessed on April 05, 2021).
4. Wood H, McKellar LV, Lightbody M. Nausea and vomiting in pregnancy: blooming or bloomin’ awful? A review of the literature. Women Birth 2013; 26:100.
5. Connolly CP, Mudd LM, Pivarnik JM. Associations Among Work-Related and Leisure-Time Physical Activity With Level of Nausea During Pregnancy. Am J Lifestyle Med 2019; 13:424.
6. Alstveit M, Severinsson E, Karlsen B. Living on the edge of being overstretched–a Norwegian qualitative study of employed pregnant women. Health Care Women Int 2010; 31:533.
7. Mozurkewich EL, Luke B, Avni M, Wolf FM. Working conditions and adverse pregnancy outcome: a metaanalysis. Obstet Gynecol 2000; 95:623.
8. Saurel-Cubizolles MJ, Zeitlin J, Lelong N, et al. Employment, working conditions, and preterm birth: results from the Europop case-control survey. J Epidemiol Community Health 2004; 58:395.
9. Katz VL. Work and work-related stress in pregnancy. Clin Obstet Gynecol 2012; 55:765.
10. MacDonald LA, Waters TR, Napolitano PG, et al. Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations. Am J Obstet Gynecol 2013; 209:80.
11. Bonde JP, Jørgensen KT, Bonzini M, Palmer KT. Miscarriage and occupational activity: a systematic review and meta-analysis regarding shift work, working hours, lifting, standing, and physical workload. Scand J Work Environ Health 2013; 39:325.
12. Palmer KT, Bonzini M, Harris EC, et al. Work activities and risk of prematurity, low birth weight and preeclampsia: an updated review with meta-analysis. Occup Environ Med 2013; 70:213.
13. Juhl M, Strandberg-Larsen K, Larsen PS, et al. Occupational lifting during pregnancy and risk of fetal death in a large national cohort study. Scand J Work Environ Health 2013; 39:335.
14. Davies SJ, Lum JA, Skouteris H, et al. Cognitive impairment during pregnancy: a meta-analysis. Med J Aust 2018; 208:35.
15. Logan DM, Hill KR, Jones R, et al. How do memory and attention change with pregnancy and childbirth? A controlled longitudinal examination of neuropsychological functioning in pregnant and postpartum women. J Clin Exp Neuropsychol 2014; 36:528.
16. Brown E, Schaffer J. “Pregnancy Brain”: A Review of Cognitive Changes in Pregnancy and Postpartum. Obstet Gynecol Surv 2019; 74:178.
17. Salihu HM, Myers J, August EM. Pregnancy in the workplace. Occup Med (Lond) 2012; 62:88.
18. Palmer KT, Bonzini M, Bonde JP, et al. Pregnancy: occupational aspects of management: concise guidance. Clin Med (Lond) 2013; 13:75.
19. Bilhartz TD, Bilhartz P. Occupation as a risk factor for hypertensive disorders of pregnancy. J Womens Health (Larchmt) 2013; 22:188a.
20. Nugteren JJ, Snijder CA, Hofman A, et al. Work-related maternal risk factors and the risk of pregnancy-induced hypertension and preeclampsia during pregnancy. The Generation R Study. PLoS One 2012; 7:e39263.
21. Chang PJ, Chu LC, Hsieh WS, et al. Working hours and risk of gestational hypertension and preeclampsia. Occup Med (Lond) 2010; 60:66.
22. Brooks-Gunn J, Han WJ, Waldfogel J. Maternal employment and child cognitive outcomes in the first three years of life: the NICHD Study of Early Child Care. National Institute of Child Health and Human Development. Child Dev 2002; 73:1052.
23. Hill JL, Waldfogel J, Brooks-Gunn J, Han WJ. Maternal employment and child development: a fresh look using newer methods. Dev Psychol 2005; 41:833.
24. Zorich B, Roberts I, Oakley A. Daycare for pre-school children. Cochrane Database Syst Rev 2000; CD000564.
25. Henrotin JB, Vaissière M, Etaix M, et al. Deprivation, occupational hazards and perinatal outcomes in pregnant workers. Occup Med (Lond) 2017; 67:44.
26. Labbe E, Blanquet M, Gerbaud L, et al. A new reliable index to measure individual deprivation: the EPIC score. Eur J Public Health 2015; 25:604.
27. Gisselmann MD, Hemström O. The contribution of maternal working conditions to socioeconomic inequalities in the birth outcome. Soc Sci Med 2008; 66:1297.
28. Magnus MC, Wilcox AJ, Morken NH, et al. Role of maternal age and pregnancy history in risk of miscarriage: a prospective register-based study. BMJ 2019; 364:l869.
29. Rangel EL, Castillo-Angeles M, Easter S.R., et al. Incidence of Infertility and Pregnancy Complications in U.S. Female Surgeons. JAMA Surg 2021; 156:905.
30. Bat-Erdene U, Metcalfe A, McDonald SW, Tough SC. Validation of Canadian mothers’ recall of events in labor and delivery with electronic health records. BMC Pregnancy Childbirth 2013; 13 Suppl 1:S3.
31. Sou SC, Chen WJ, Hsieh WS, Jeng SF. Severe obstetric complications and birth characteristics in preterm or term delivery were accurately recalled by mothers. J Clin Epidemiol 2006; 59:429.
32. ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol 2015; 126:e135. Reaffirmed 2019.
33. Royal College of Obstetricians and Gynaecologists. Guidelines: Exercise in pregnancy (Statement No 4), 2015. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/exercise-in-pregnancy-statement-no.4/ (Accessed on October 12, 2016).
34. Lee LJ, Symanski E, Lupo PJ, et al. Role of maternal occupational, physical activity and psychosocial stressors on adverse birth outcomes. Occup Environ Med 2017; 74:192.
35. Aune D, Schlesinger S, Henriksen T, et al. Physical activity and the risk of preterm birth: a systematic review and meta-analysis of epidemiological studies. BJOG 2017; 124:1816.
36. Lee LJ, Symanski E, Lupo PJ, et al. Data linkage between the National Birth Defects Prevention Study and the Occupational Information Network (O*NET) to assess workplace physical activity, sedentary behaviors, and emotional stressors during pregnancy. Am J Ind Med 2016; 59:137.
37. Croteau A. Occupational lifting and adverse pregnancy outcome: a systematic review and metaanalysis. Occup Environ Med 2020; 77:496.
38. Sejbaek CS, Bay H, Larsen AD, et al. Combined exposure to lifting and psychosocial strain at work and adverse pregnancy outcomes-A study in the Danish National Birth Cohort. PLoS One 2018; 13:e0201842.
39. Sejbaek CS, Pedersen J, Schlünssen V, et al. The influence of multiple occupational exposures on absence from Work in pregnancy: a prospective cohort study. Scand J Work Environ Health 2020; 46:60.
40. Fernandez RC, Marino JL, Varcoe TJ, et al. Fixed or Rotating Night Shift Work Undertaken by Women: Implications for Fertility and Miscarriage. Semin Reprod Med 2016; 34:74.
41. Begtrup LM, Specht IO, Hammer PEC, et al. Night work and miscarriage: a Danish nationwide register-based cohort study. Occup Environ Med 2019; 76:302.
42. Specht IO, Hammer PEC, Flachs EM, et al. Night work during pregnancy and preterm birth-A large register-based cohort study. PLoS One 2019; 14:e0215748.
43. Hammer P, Flachs E, Specht I, et al. Night work and hypertensive disorders of pregnancy: a national register-based cohort study. Scand J Work Environ Health 2018; 44:403.
44. Cai C, Vandermeer B, Khurana R, et al. The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol 2019; 221:563.
45. Wei CF, Chen MH, Lin CC, et al. Association between maternal shift work and infant neurodevelopmental outcomes: results from the Taiwan Birth Cohort Study with propensity-score-matching analysis. Int J Epidemiol 2019; 48:1545.
46. Cai C, Vandermeer B, Khurana R, et al. The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol 2020; 222:224.
47. Cardwell MS. Stress: pregnancy considerations. Obstet Gynecol Surv 2013; 68:119.
48. Wadhwa PD, Entringer S, Buss C, Lu MC. The contribution of maternal stress to preterm birth: issues and considerations. Clin Perinatol 2011; 38:351.
49. Scheinost D, Sinha R, Cross S.N., et al. Does prenatal stress alter the developing connectome? Pediatr Res 2017; 81:214.
50. Dayan J, Creveuil C, Marks MN, et al. Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med 2006; 68:938.
51. Larsen AD, Hannerz H, Thulstrup AM, et al. Psychosocial job strain and risk of congenital malformations in offspring–a Danish National cohort study. BJOG 2014; 121:830.
52. United States Department of Labor Occupational Safety and Health Administration. The substance data sheet for occupational exposure to lead. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10031 (Accessed on October 12, 2016).
53. United States Department of Labor Occupational Safety and Health Administration. Toxic and hazardous substances, hazard communication. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=10099&p_table=STANDARDS (Accessed on October 12, 2016).
54. Shah-Kulkarni S, Lee S, Jeong KS, et al. Prenatal exposure to mixtures of heavy metals and neurodevelopment in infants at 6 months. Environ Res 2020; 182:109122.
55. http://www.epa.gov/hg/effects.htm (Accessed on May 12, 2014).
56. http://www.atsdr.cdc.gov/toxprofiles/tp.asp?id=115&tid=24 (Accessed on May 12, 2014).
57. Norlén F, Gustavsson P, Wilbert P, et al. Occupational exposure to inorganic particles during pregnancy and birth outcomes: a nationwide cohort study in Sweden. BMJ Open 2019; 9:e023879.
58. Norlén F, Gustavsson P, Wilbert P, et al. Occupational exposure to organic particles and combustion products during pregnancy and birth outcome in a nationwide cohort study in Sweden. Occup Environ Med 2019; 76:537.
59. Frazier LM. Reproductive disorders associated with pesticide exposure. J Agromedicine 2007; 12:27.
60. Birks L, Casas M, Garcia AM, et al. Occupational Exposure to Endocrine-Disrupting Chemicals and Birth Weight and Length of Gestation: A European Meta-Analysis. Environ Health Perspect 2016; 124:1785.
61. Sharing A, Wright J, Blair EM, et al. Occupational chemical exposures in pregnancy and fetal growth: evidence from the Born in Bradford Study. Scand J Work Environ Health 2020; 46:417.
62. Lyall K, Croen LA, Sjödin A, et al. Polychlorinated Biphenyl and Organochlorine Pesticide Concentrations in Maternal mid-pregnancy Serum Samples: Association with Autism Spectrum Disorder and Intellectual Disability. Environ Health Perspect 2017; 125:474.
63. Sabatier R, Hongsibsong S. Effects of prenatal and postnatal exposure to organophosphate pesticides on child neurodevelopment in different age groups: a systematic review. Environ Sci Pollut Res Int 2019; 26:18267.
64. Laslo-Baker D, Barrera M, Knittel-Keren D, et al. Child neurodevelopmental outcome and maternal occupational exposure to solvents. Arch Pediatr Adolesc Med 2004; 158:956.
65. Bouvet JF, Westall C, Koren G, Till C. Maternal occupational exposure to organic solvents during pregnancy and infant visual processing. The University of Toronto, Workplace Safety and Insurance Board of Ontario, 2006.
66. Taskinen H, Kyyrönen P, Hemminki K, et al. Laboratory work and pregnancy outcome. J Occup Med 1994; 36:311.
67. Cordier S, Garlantézec R, Labat L, et al. Exposure during pregnancy to glycol ethers and chlorinated solvents and the risk of congenital malformations. Epidemiology 2012; 23:806.
68. O’Brien JL, Langlois PH, Lawson CC, et al. Maternal occupational exposure to polycyclic aromatic hydrocarbons and craniosynostosis among offspring in the National Birth Defects Prevention Study. Birth Defects Res A Clin Mol Teratol 2016; 106:55.
69. Omidakhsh N, Ganguly A, Bunin GR, et al. Residential Pesticide Exposures in Pregnancy and the Risk of Sporadic Retinoblastoma: A Report From the Children’s Oncology Group. Am J Ophthalmol 2017; 176:166.
70. Omidakhsh N, Bunin GR, Ganguly A, et al. Parental occupational exposures and the risk of childhood sporadic retinoblastoma: a report from the Children’s Oncology Group. Occup Environ Med 2018; 75:205.
71. Costet N, Béranger R, Garlantézec R, et al. Occupational exposure to organic solvents during pregnancy and childhood behavior: findings from the PELAGIA birth cohort (France, 2002-2013). Environ Health 2018; 17:63.
72. National Institute for Occupational Safety and Health (NIOSH). Preventing occupational exposure to antineoplastic and other hazardous drugs in healthcare settings, 2004. https://www.cdc.gov/niosh/docs/2004-165/pdfs/2004-165.pdf (Accessed on October 12, 2016).
73. Dranitsaris G, Johnston M, Poirier S, et al. Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematic review and meta-analysis of the literature. J Oncol Pharm Pract 2005; 11:69.
74. United States Nuclear Regulatory Commission. Regulatory guide 8.13: Instruction concerning prenatal radiation exposure, 1999. http://www.nrc.gov/docs/ML0037/ML003739505.pdf (Accessed on October 12, 2016).
75. United States Nuclear Regulatory Commission. Standards for protection against radiation 20.1208: Dose equivalent to an embryo/fetus, 2015. http://www.nrc.gov/reading-rm/doc-collections/cfr/part020/part020-1208.html (Accessed on October 04, 2016).
76. Shaw GM. Adverse human reproductive outcomes and electromagnetic fields: a summary of the epidemiologic literature. Bioelectromagnetics 2001; Suppl 5:S5.
77. Robert E. Intrauterine effects of electromagnetic fields–(low frequency, mid-frequency R.F., and microwave): a review of epidemiologic studies. Teratology 1999; 59:292.
78. Cawdell-Smith J, Upfold J, Edwards M, Smith M. Neural tube and other developmental anomalies in the guinea pig following maternal hyperthermia during early neural tube development. Teratogen Carcinog Mutagen 1992; 12:1.
79. Graham JM Jr, Edwards MJ, Edwards MJ. Teratogen update: gestational effects of maternal hyperthermia due to febrile illnesses and resultant patterns of defects in humans. Teratology 1998; 58:209.
80. Graham JM, Edwards MJ, Lipson AH, Webster WS. Gestational hyperthermia as a cause for Moebius syndrome. Teratology 1988; 37:461.
81. Edwards MJ. Review: Hyperthermia and fever during pregnancy. Birth Defects Res A Clin Mol Teratol 2006; 76:507.
82. National Institute for Occupational Safety and Health. Criteria for a recommended standard: Occupational exposure to heat and hot environments, 2016. https://www.cdc.gov/niosh/docs/2016-106/pdfs/2016-106.pdf (Accessed on October 04, 2016).
83. National Institute for Occupational Safety and Health. Controls for noise exposure, 2014. http://www.cdc.gov/niosh/topics/noisecontrol/default.html (Accessed on October 04, 2016).
84. Selander J, Rylander L, Albin M, et al. Full-time exposure to occupational noise during pregnancy was associated with reduced birth weight in a nationwide cohort study of Swedish women. Sci Total Environ 2019; 651:1137.
85. www.Reprotox.org (Accessed on September 22, 2009).
86. Lalande NM, Hétu R, Lambert J. Is occupational noise exposure during pregnancy a risk factor of damage to the auditory system of the fetus? Am J Ind Med 1986; 10:427.
87. Daniel T, Laciak J. [Clinical observations and experiments concerning the condition of the cochleovestibular apparatus of subjects exposed to noise in fetal life]. Rev Laryngol Otol Rhinol (Bord) 1982; 103:313.
88. Nurminen T, Kurppa K. Occupational noise exposure and course of pregnancy. Scand J Work Environ Health 1989; 15:117.
89. Selander J, Albin M, Rosenhall U, et al. Maternal Occupational Exposure to Noise during Pregnancy and Hearing Dysfunction in Children: A Nationwide Prospective Cohort Study in Sweden. Environ Health Perspect 2016; 124:855.
90. Gerhardt KJ, Pierson LL, Huang X, et al. Effects of intense noise exposure on fetal sheep auditory brain stem response and inner ear histology. Ear Hear 1999; 20:21.
91. Gerhardt KJ, Abrams RM. Fetal exposures to sound and vibroacoustic stimulation. J Perinatol 2000; 20:S21.
92. ACOG Committee Opinion No. 746: Air Travel During Pregnancy. Obstet Gynecol 2018; 132:e64.
93. Blackmore-Prince C, Harlow SD, Gargiullo P, et al. Chemical hair treatments and adverse pregnancy outcome among Black women in central North Carolina. Am J Epidemiol 1999; 149:712.
94. Burnett C, Goldenthal EI, Harris SB, et al. Teratology and percutaneous toxicity studies on hair dyes. J Toxicol Environ Health 1976; 1:1027.
95. Holly EA, Bracci PM, Hong MK, et al. West Coast study of childhood brain tumors and maternal use of hair-coloring products. Paediatr Perinat Epidemiol 2002; 16:226.
96. Gallicchio L, Miller S, Greene T, et al. Cosmetologists and reproductive outcomes. Obstet Gynecol 2009; 113:1018.
97. Kersemaekers WM, Roeleveld N, Zielhuis GA. Reproductive disorders due to chemical exposure among hairdressers. Scand J Work Environ Health 1995; 21:325.
98. Efird JT, Holly EA, Cordier S, et al. Beauty product-related exposures and childhood brain tumors in seven countries: results from the SEARCH International Brain Tumor Study. J Neurooncol 2005; 72:133.
99. McCall EE, Olshan AF, Daniels JL. Maternal hair dye use and risk of neuroblastoma in offspring. Cancer Causes Control 2005; 16:743.
100. ACOG Committee Opinion No. 733: Employment Considerations During Pregnancy and the Postpartum Period. Obstet Gynecol 2018; 131:e115.
101. U.S. Equal Employment Opportunity Commission. Pregnancy discrimination. https://www.eeoc.gov/eeoc/publications/fs-preg.cfm (Accessed on October 10, 2016).
102. United States Department of Justice, Civil Rights Division. Americans with Disabilities Act: Information and technical assistance. https://www.ada.gov/ada_intro.htm (Accessed on October 10, 2016).
103. https://www.eeoc.gov/eeoc/history/35th/thelaw/pregnancy_discrimination-1978.html (Accessed on October 12, 2016).
104. Center for American Progress. Efforts to Combat Pregnancy Discrimination. https://www.americanprogress.org/issues/women/news/2018/11/02/460353/efforts-combat-pregnancy-discrimination/ (Accessed on April 27, 2020).
105. United States Department of Labor, Wage and Hour Division. Family Medical Leave Act. https://www.dol.gov/whd/fmla/ (Accessed on October 09, 2016).
106. Mayer G. The Family and Medical Leave Act (FMLA): Policy Issues, Library of Congress, Washington, DC 2013.
107. https://www.dol.gov/whd/regs/compliance/whdfs28l.pdf (Accessed on December 02, 2016).
108. Jou J, Kozhimannil KB, Blewett LA, et al. Workplace Accommodations for Pregnant Employees: Associations With Women’s Access to Health Insurance Coverage After Childbirth. J Occup Environ Med 2016; 58:561.
109. https://www.eeoc.gov/laws/types/pregnancy.cfm (Accessed on December 02, 2016).
110. U.S. Equal Employment Opportunity Commission. Pregnancy Discrimination Charges F.Y. 2010 – F.Y. 2019. https://www.eeoc.gov/eeoc/statistics/enforcement/pregnancy_new.cfm (Accessed on April 25, 2020).
111. https://www.eeoc.gov/eeoc/statistics/enforcement/pregnancy_new.cfm (Accessed on December 02, 2016).
112. https://www.eeoc.gov/eeoc/statistics/enforcement/pregnancy.cfm. (Accessed on December 02, 2016).
113. Equal Employment Opportunity Commission Office of Legal Counsel. EEOC enforcement guidance on pregnancy discrimination and related issues, 2015. https://www.eeoc.gov/laws/guidance/upload/pregnancy_guidance.pdf (Accessed on December 06, 2016).
114. National Conference of State Legislatures. Paid Family Leave Resources. https://www.ncsl.org/research/labor-and-employment/paid-family-leave-resources.aspx (Accessed on April 24, 2020).
115. Montoya-Williams D, Passarella M, Lorch SA. The impact of paid family leave in the United States on birth outcomes and mortality in the first year of life. Health Serv Res 2020; 55 Suppl 2:807.
116. Lee BC, Modrek S, White JS, et al. The effect of California’s paid family leaves policy on parent health: A quasi-experimental study. Soc Sci Med 2020; 251:112915.
117. Stearns J. The effects of paid maternity leave: Evidence from Temporary Disability Insurance. J Health Econ 2015; 43:85.
118. Paid Family and Medical Leave in the United States. Congressional Research Service. February 2020. https://crsreports.congress.gov/product/pdf/R/R44835 (Accessed on March 26, 2021).
119. Steenland MW, Short S.E., Galarraga O. Association Between Rhode Island’s Paid Family Leave Policy and Postpartum Care Use. Obstet Gynecol 2021; 137:728.
120. Van Niel MS, Bhatia R, Riano NS, et al. The Impact of Paid Maternity Leave on Mothers and Children’s Mental and Physical Health: A Review of the Literature and Policy Implications. Harv Rev Psychiatry 2020; 28:113.
121. Nandi A, Jahagirdar D, Dimitris MC, et al. The Impact of Parental and Medical Leave Policies on Socioeconomic and Health Outcomes in OECD Countries: A Systematic Review of the Empirical Literature. Milbank Q 2018; 96:434.
122. Donovan SA. Paid Family Leave in the United States [CRS Rep.R44835]. Washington, DC: Congressional Research Service, 2019. https://crsreports.congress.gov/product/pdf/R/R44835 (Accessed on April 26, 2020).
123. A hammer A, Halla M, Schneeweis N. The effect of prenatal maternity leave on short and long-term child outcomes. J Health Econ 2020; 70:102250.
124. Vargas-Prada S, García AM, Ronda E, et al. Influence of paid maternity leave on return to Work after childbirth. Med Lav 2018; 109:243.
125. Jackson RA, Gardner S, Torres LN, et al. My Obstetrician Got Me Fired: How Work Notes Can Harm Pregnant Patients and What to Do About It. Obstet Gynecol 2015; 126:250.
126. American College of Obstetricians and Gynecologists. Patient brochure: Pregnant and working: What you need to know, 2016. https://www.acog.org/-/media/Districts/District-IX/MembersOnly/PatientBrochure.pdf?dmc=1&ts=20161005T1353143834 (Accessed on October 05, 2016).
127. Balrampur H, Heaman M, Duncan KA, Tough S. Predictors of perception of pregnancy risk among nulliparous women. J Obstet Gynecol Neonatal Nurs 2013; 42:416.
128. Little LM, Hinojosa AS, Paustian-Underdahl S, Zipay KP. Managing the harmful effects of unsupportive organizations during pregnancy. J Appl Psychol 2018; 103:631.
129. Department of Labor. Family Medical Leave Act regulations. The medical certification and verification process, 2007. https://www.dol.gov/whd/FMLA2007Report/Chapter6.pdf (Accessed on December 06, 2016).