women
Q: My manager said I can't have time off for my prenatal doctor visit, is this true?
A: There are many arrangements that employers can use to solve the problem of time off for health-care visits. Not many states have laws addressing this issue but there are some pending that would allow parents-to-be to get to prenatal visits.

Check with your union representative, human resources manager, or meet with your boss to discuss arranging time for these 10–15 visits. Ask your doctor's receptionist if he or she will save you the spots at the beginning or end of the day and ask them if evening hours are available. Some employers have “paid time off” or PTO plans, by which employees accrue days off in a single account and spend them more or less as they wish.

Q: When is the best time to tell my employer that I'm pregnant?
A: As soon as your employer knows that you are pregnant, the employment laws that protect you will apply, so it's a good idea to tell them right away. It is recommended that you inform your employer in writing with details of your expected due date. Any risks identified should be removed or, if this is not possible, alternative arrangements should be made for you. Prolonged standing (more than four hours at a time) and a high-stress work environment have been associated with preterm labor. Ask your midwife or doctor to write you a note if your employer declines to offer appropriate arrangements. You can also discuss when your maternity leave will start, and when you can take any outstanding vacation days. If your baby is born early or your maternity leave starts earlier than planned due to illness, the arrangements can be altered. Your employer should respect your right to confidentiality, so by telling them, this should not mean that everyone else at work will know. If you wish the issue to remain confidential until a certain date, you could add this to your letter.
Q: What programs are available to me if I can't afford to pay for care and delivery of my baby?
A: There are government-sponsored “safety-net” facilities that provide medical care for those in need, even if they have no insurance or money. Safety-net facilities include community health centers, public hospitals, school-based centers, public housing primary care centers, migrant health centers, and special needs facilities. To find a facility near you, contact your local or state health department or visit the website womenshealth.gov.

WIC (Women, Infants, Children) provides grants to states for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breast-feeding, and nonbreast-feeding postpartum women, and to infants and children up to age five. WIC referrals are available through your clinic or hospital. Faith-based organizations such as B'nai B'rith, Catholic Charities, Lutheran Social Service, or American Friends Service Committee have services or can refer women to assistance organizations.

Q: My back hurts all the time. Is there anything I can do?
A: Most women do suffer from some degree of back discomfort during their pregnancy. Placental hormones work on your joints to soften ligaments in preparation for birth. Also, your center of gravity changes with the advancing months, centering it more in front which puts stress on muscles and ligaments. Some women notice that the lower back curves inward to a greater extent than prior to pregnancy; this puts stress on the lumbar vertebrae.

As your baby gains weight, more pressure is applied downward and back and baby's firmer head can apply pressure to nerves in the back, down the buttocks and into the legs. This “sciatica” can cause great pain and may impair your mobility.

Back pain seems to be accentuated when you rise from a sitting position or from bed, after a long car ride, or when lying on your back. This is why midwives and doctors recommend stretching exercises when in a plane or car, lying on your side with a pillow between the legs, and keeping feet elevated when relaxing.

Q: What helps?
A: Avoid bending over at the waist and lifting. If you have a little one at home, have her climb into your lap before you stand. Maintain a straight back when lifting. Squat to pick things up rather than bending over at the waist.

It also helps to maintain an active lifestyle. Plan a 30–45 minute walk into each day. Warm up by stretching or slow walking. Hold each stretch for 20 seconds, and repeat 2–3 times; always avoid “bouncing” with stretching. Initially, you may experience pain but it will work itself out after a few minutes.

When sitting, move around, put your feet up and rock your pelvis back and forth. Ask your partner to give you a massage or if available, visit a massage therapist on a regular basis. Friends and family might offer a gift certificate for massage as a shower gift. Warm baths, ice, and/or acetaminophen may be helpful.

Some women may benefit from arch supports in shoes and avoiding shoes with a greater than one inch heel. Support for the abdomen can help too. A belt or light weight abdominal support garment may be beneficial.

A daily regimen of back strengthening exercises serve to make the muscles less prone to injury. A browser search for “back exercises in pregnancy” will yield many excellent pages of suggestions. If back pain is sudden in onset or associated with burning on urination or if the pain seems to be located on the right or left side, near your kidneys, consult your midwife or doctor right away. Kidney infections can cause back pain.

Q: My boss is interviewing my replacement. Can't I have my old job back after I return to work?
A: If you are eligible for benefits under the Family and Medical Leave Act (FMLA), you do have the right to return to your old or an equivalent job. Eligible FMLA employees are entitled to 12 weeks of unpaid FMLA leave in a 12 month period; continuation of group health benefits during FMLA leave; restoration to the same or an equivalent job upon return to work; retention of accrued benefits; and protection from discrimination as a result of taking FMLA leave. Unfortunately, many workers are not covered under FMLA. In this circumstance, it is wise to inform your employer early in your pregnancy and ask him to keep in mind that you are a valuable employee and see what can be arranged for your return.
Q: The worker at the next desk is sick. Should I stay home or stay away from her?
A: It would be best to avoid direct contact with anyone you know is ill. You would not want to share a soda or shake hands but it is probably safe to work in the same room. Always wash your hands after using the facilities and before and after eating. Unless you have proven immunity, pregnant women should stay away from fellow employees who have cytomegalo virus (CMV), fifths disease, rubella, chicken pox, and those who are just plain sick.

CMV is the most common congenital viral infection in the US and the most common infectious cause of mental retardation in the country. Almost 40,000 babies are infected before birth in the US, transmitted from mother to baby. Most women have protection against transmission from immunity in childhood. Young children, day care centers, and schools are sources of CMV virus. Most children and adults who catch the flulike illness suffer little from its effects and build up antibodies. Immune mothers pass on the antibodies through breast-feeding. The danger comes when a mother with no antibodies contracts the illness during pregnancy. Her baby may suffer brain damage from the effects of the virus.

Exposure to small children before pregnancy is the best source of prevention as it is estimated that up to 80 percent of toddlers are shedding CMV at any given time. Once pregnant, if a woman works with small children, she should be aware that the virus lives in urine, saliva, mucus and feces of those infected and good hand washing is imperative. If you feel you are at risk for exposure, a CMV blood titer can be run to check your immunity or exposure.

Q: Since I told my boss I'm pregnant he has been really dismissive—what should I do?
A: The law protects you from being unfairly treated as a result of you being pregnant. This includes dismissal on the grounds of being pregnant or a reason that is connected to pregnancy. If you feel that your boss is treating you unfairly, try to resolve this with him first.

To protect yourself, it is advisable that you keep your manager informed of your maternity leave, return date, and prenatal appointments. Always confirm appointments in writing or provide official documents that show appointment times. You should also ask your employer about any additional benefits the company may have and when you will have your risk assessment. If your employer does not respond satisfactorily to these requests, seek advice from your human resources department, a senior member of staff, or trade union representative.

Q: I want to work part time after my baby is born—is that okay?
A: After a vaginal birth, you will need about 6 weeks (12 weeks for a cesarean) to recover from the birth and be ready to take on responsibilities outside the home. Much depends upon your baby's feeding pattern, growth and well-being, support at home, your childbirth experience, and your general state of physical and psychological health. Some mothers return to work part time finding this essential to pay bills, pay for insurance, get back into touch with their profession, or have some diversion outside the home.

If you are breast-feeding, try to arrange ahead for a clean safe place to pump milk. Working or attending school for 4 hours a day after 4–6 weeks following a normal birth might be appropriate for some new mothers.

Q: Am I entitled to a certain amount of time off after a baby?
A: There are no universal laws that pertain to all postpartum mothers. There is, however, The Family and Medical Leave Act (FMLA) which entitles you to take up to 12 weeks of leave after your baby is born. Employees are eligible to take FMLA leave if they have worked for their employer for at least 12 months, and have worked for at least 1,250 hours over the previous 12 months, and work at a location where at least 50 employees are employed by the employer within 75 miles. Smaller private sector jobs are not covered by the act but your employer may have its own guidelines.
Q: Will I get paid leave after my baby is born? Will they hold my job?
A: Check with your employer about your particular status and salary during your leave. In general, laws do not specify a particular payment due you after your baby is born. The FMLA only provides for unpaid leave. Often, women take advantage of accrued sick leave and vacation time and may be eligible for short-term disability for the 6–12 week postpartum period. The FMLA requires that your employer restore you to the same or an equivalent position and that the leave not be counted against you for seniority or for bonuses.
Q: I want to work right up to the birth—is that allowed?
A: Yes, you can do this, but you may need a doctor's medical certificate to confirm that you are healthy enough to do so. You should tell your employer when you want to start your maternity leave at least 15 weeks before your baby is due. It's important to think carefully before making this decision. Late pregnancy can be extremely tiring and, if your job is mentally and/or physically taxing, it may be better to begin your leave a few weeks before your due date. You will also need time to prepare for the arrival of your baby.
Q: I want to go back to work very quickly—how soon can I start?
A: Legally, you can return to work anytime from two weeks after the birth, or four weeks if you work in a factory. However, on a practical and emotional level, returning so soon may not be a good solution. Most women find that it takes around six weeks to recover after the birth. Breast-feeding takes around six weeks to become established too. Even if you bottle-feed, it is probable that your hormones, together with the natural exhaustion that follows having a baby, prevent you from concentrating fully. You may find that it is hard to be apart from your baby for long periods.

Paternity leave Rights for fathers

Paternity leave is a relatively new concept in the US with other European countries far ahead in how much time a father can take off work after the birth of a baby.

The US Family & Medical Leave Act (FMLA) allows for leave in certain instances. If you have worked for your employer for 12 previous months, if you work for a public agency, if you are an elementary or secondary school (public or private) employee, or if your company employs 50 or more employees, the FMLA may apply to you. Under its guidelines, you are entitled to 480 hours of unpaid time off to use to care for your wife (check with your employer as domestic partners are sometimes included), your family if the mother is on bed rest or to use after the baby arrives. Your job will be protected if you give appropriate notice and follow the guidelines set out by your employer.

NOTE

Have the confidence to find out about your rights and talk to your employer about what you think will work best for you

NOTE

Some mothers have a change of heart about work when their baby arrives. Don't be afraid to change your mind

NOTE

Deciding exactly when you should return to work is hard. Try not to feel pressured and just do whatever feels right for you and your family. Every choice is different

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