Based on semi-structured interviews with seventeen participants—eight pregnant employees and nine managers—we explored how pregnant employees and their managers experience and manage pregnancy at the workplace. Based on the pregnant employees’ descriptions of being pregnant at work, we identified the themes, “Preconditions for successful workplace adjustments” and “Pregnant women’s experiences of sick leave.” Based on the managers’ descriptions of having a pregnant employee, we identified the themes, “Preconditions for successful workplace adjustments” and “Difficulties of managing the problems experienced by pregnant employees.” For each theme, we organized the descriptions into sub-themes. Each sub-theme illustrates nuances and differences in the experiences of the pregnant employees and their managers. In the following sections, we present each of the main themes and the sub-themes in detail.
Pregnant employees’ perspective: preconditions for successful workplace adjustments
Although most of the pregnant women in this study continued to work while pregnant, work was not always easy. Pregnant women may experience various pregnancy-related symptoms that may present a challenge in the workplace, and that need to be resolved, if she is to continue to work during her pregnancy. The pregnant women in this study experienced pregnancy-related symptoms such as pelvic pain, fatigue, and Braxton-Hicks contractions. Several of the pregnant women explained that they and their managers collaborated in an effort to meet these challenges by implementing workplace adjustments, such as flexible schedules, avoiding certain tasks, and reducing work hours. However, the success of these workplace adjustments varied. Based on the pregnant employees’ descriptions, we identified three preconditions for positive experiences of workplace adjustments. These include: “concern, understanding, and acknowledgment from the manager,” “support and acceptance from colleagues,” and “the pregnant women’s acceptance of their need for adjustments.” In the following sections, we present each of these sub-themes in detail.
The managers’ concern, understanding, and acknowledgment
The pregnant employees’ descriptions of successful adjustments to their work during their pregnancy included instances where their managers showed concern, understanding, and acknowledgment of their needs. Some of the pregnant employees explained that their manager was very understanding, and helped them with information about handling pregnancy at work. Several women also mentioned that they had extensive contact with their managers while pregnant, and that their managers helped them implement workplace adjustments (Pregnant employee 4). This acknowledgement from the managers, together with their paying attention and listening to their pregnant employees, seemed to be an important precondition for successful workplace adjustments.
In contrast, pregnant employees’ descriptions of unsuccessful efforts to implement workplace adjustments included descriptions of managers who did not pay attention, did not take the initiative when talking to their pregnant employees, or did not support or respect the agreements on workplace adjustments. One woman explained that she felt like a burden to her former employer, who did not respect her needs. Her manager had promised to reduce her work hours, but she still felt she had to work more than he had promised. She explained: “They [The managers] did not argue for sick leave, and when I had to go on part-time sick leave, I was still working 37 hours a week” (Pregnant employee 6). Another example of a negative experience with a manager was a manager who had previously ignored a pregnant employee’s request for adjustments at work, and therefore she continued to conceal her pain. She did not communicate much with her manager during her pregnancy, and she did not expect the manager to listen her. She did not even bother to ask her what to do about her pregnancy-related challenges. “I wouldn’t even waste my time on that,” she reported (Pregnant employee 1), and explained how her unpleasant work conditions and her need for adjustments had been ignored by her manager several times. The manager’s lack of concern, understanding, and acknowledgment prevented this pregnant employee from having a positive experience of workplace adjustments.
Support and acceptance from colleagues
The pregnant employees’ descriptions of positive experiences of workplace adjustments also mentioned colleagues’ support and acceptance. One pregnant employee explained that her colleagues helped reorganize the work to relieve her as much as possible, and she emphasized that her colleagues paid significant attention to her condition, which she appreciated: “Actually, it was very nice that somebody said, ‘now, we are a bit worried about you’” (Pregnant employee 5). These expressions of colleagues’ support and acceptance indicate that the pregnant employees did not necessarily feel entitled to recognition of pregnancy-related needs. Colleagues’ supportive attitude seemed to be an important precondition for successful workplace adjustments.
In contrast, pregnant employees' negative experiences of workplace adjustments included colleagues’ failure to recognize their needs. The pregnant employees described this as very painful. According to one woman, the worst aspect of workplace adjustments during her pregnancy was the lack of acknowledgment from a group of colleagues. She felt that they did not understand, and that they disapproved of the adjustments because such adjustments had not been made when they were pregnant. One woman felt that they did not understand her needs and thought the adjustments unfair. She explained:
They thought, “Why does she get half an hour? We didn't get that when we were pregnant!” That, I would say, was the hardest thing for me. When they were pregnant, those things weren’t considered. (Pregnant employee 8)
As the foregoing statement illustrates, colleagues’ lack of support and understanding seems to form a great barrier to positive experiences of workplace adjustments for pregnant employees.
Pregnant employees’ acceptance of their need for adjustments
The pregnant employees’ descriptions of positive experiences of workplace adjustments also included descriptions of their own acceptance of their need for adjustments. One woman explained that she thought it was easier to take care of herself now that she was pregnant. She explained: “I became a little calmer, and took a bit more care of myself when I got pregnant” (Pregnant employee 3). She accepted her pregnancy-related needs, and thought that her pregnancy was a legitimate reason to take better care of herself. In contrast, other pregnant employees described their difficulty in accepting their need for workplace adjustments, and their problems with accepting the strain they felt while pregnant. Some disliked being dependent on help from their colleagues. One woman mentioned that adjustments had been made for her, but it was difficult for her to take advantage of these adjustments, because she perceived herself as hardworking and tenacious. She refused to be “a burden to her colleagues”, and although they accepted the adjustments, she could not accept them (Pregnant employee 6). The pregnant employees’ acceptance of their need for adjustments seemed to be an important precondition for successful workplace adjustments. Failure to accept their needs seemed to be a barrier to successful workplace adjustments.
In this study, the pregnant employees’ descriptions of their positive and negative experiences of workplace adjustments for pregnancy revealed that acknowledgment, acceptance, and approval of these adjustments by the manager, colleagues, and the woman herself are important to employees having a positive experience of being pregnant at the workplace. All these aspects seem to be preconditions for successful workplace adjustments for pregnant women.
Pregnant employees’ perspective: experiences of sick leave
Some of the employees in this study were more challenged by their pregnancies than others, and some had to take sick leave, whereas others continued to work until their scheduled maternity leave. Based on the pregnant employees’ descriptions, we identified three different experiences of sick leave: “sick leave as the last option,” “sick leave as a relief,” and “sick leave that led to feelings of insecurity and ambivalence.”
Sick leave as the last option
Most of the pregnant women in our study expressed a wish to remain active at their workplace for as long as possible while pregnant. They described the importance of maintaining their relationships with their colleagues, and they wanted to continue working, as work was important to them. One woman reported that she had pressured herself, and continued to work for too long, because she wanted to work throughout her pregnancy. Another woman reported that she wanted to remain on the job, even though her manager suggested sick leave. She explained:
I have been my own worst enemy, because I have had difficulty saying “no” at my workplace. I like my job, and I don’t want to be at home, so it’s been a difficult balance. […] In fact, my manager would have preferred that I called in sick right away, to take care of myself. But I did not [...] Looking back, I should have done it [taken sick leave] long before. But it is hard when you're happy with your work, you're happy with your workplace. (Pregnant employee 7)
This woman was not the only one who talked about sick leave as "the last option." Other women expressed this in terms of "making it just until maternity leave," which also indicates the employees’ strong desire to remain on the job throughout their pregnancy, despite the pregnancy-related challenges they faced.
Sick leave as a relief
Some women found sick leave a relief, because it allowed them to take care of themselves. One woman explained that taking sick leave was a positive thing. She explained, “It was a relief that now I could do things at my speed” (Pregnant employee 1). Similarly, another woman reported that her manager’s suggestion of a period of sick leave left her with a feeling of “relief,” but also with a feeling of ambivalence. She described it in these terms:
Well, it [the suggestion to take sick leave] was both positive and negative. On the one hand, it was somehow a relief. Well, then he [the manager] said it was okay that I am sick and that I must take care of myself. On the other hand, it was also kind of, “well but I'm not doing my job well enough” and “what's the reason?” (Pregnant employee 2)
Pregnant employees’ descriptions of taking sick leave reveal that this may give rise to various feelings. The suggestion of sick leave may conflict with some women’s strong desire to continue working throughout their pregnancy, but other women may find it a relief to be able to fully take care of themselves not worrying about their job. Lastly, the descriptions indicate that suggesting sick leave may lead to feelings of insecurity and ambivalence when the pregnant woman is unsure why the manager is suggesting this.
Managers’ perspectives: “preconditions for successful workplace adjustments”
The managers’ experiences with pregnant employees varied. They found that some of their pregnant employees made several adjustments and took sick leave while pregnant, whereas others remained on the job. Based on the managers’ descriptions of having a pregnant employee, we identified the following preconditions for successful workplace adjustments: “an open and honest dialogue” and “a systematic approach.” We also identified the following barriers to successful workplace adjustments, from the perspective of the managers: “pregnant employees push themselves” and “difficulty planning and/or organizing work-related tasks.” In the following sections, we present each of the main categories and the subcategories in detail.
An open and honest dialogue
The managers emphasized that an open and honest dialogue with the employees was a prerequisite for addressing pregnant employees’ needs in the workplace. Some managers reported that they depended on pregnant employees being open and honest about their need for adjustments (between workplace-adjustment meetings), as the managers did not always have time for individual follow-up. One manager emphasized the need for open dialogue as follows:
[…] I cannot see it or feel it (the need of the pregnant woman) […] Be open and honest about it, and come to us, because then maybe we can adjust the work. (Manager at a hotel)
The managers explained that if pregnant employees did not talk to them, it was difficult for them to act in time. For instance, one manager talked about her experiences with two pregnant employees, where one was open and honest, which made it possible to adjust her work, whereas another woman suddenly said she was unable to work. The manager was surprised, because she did not know that the latter pregnant employee had suffered as a consequence of working during her pregnancy. She explained:
We had one pregnant employee who managed to remain on the job until six weeks before she gave birth. She was working and doing her best. And she was really good at letting me know, “I can feel in my body that it is hard to wash the floor.” We communicated well, and it worked really well. But on the other hand, there was another pregnant employee who, after three months of pregnancy, said that she could not continue working, and that her doctor agreed with her on that. (Manager at a cleaning company)
These statements from managers indicate that honest dialogue is a prerequisite for addressing pregnant employees needs in the workplace, and a precondition for successful workplace adjustments that may help pregnant women to continue work.
A systematic approach
The managers’ descriptions of positive experiences of workplace adjustments included experiences of working systematically when implementing workplace adjustments for pregnant employees. They explained that they followed their workplace’s pregnancy policy, and used workplace assessments when they had a pregnant employee. They called the pregnant woman in for a meeting, and followed up on her situation throughout her pregnancy. In this way, they were able to adjust work-related tasks if needed. Most of the managers worked very systematically. The one manager who did not work as systematically as the others considered changing her informal practices, because of the advantages of doing so. When she considered the matter, she thought it would be easier for her to remember to talk to the pregnant woman if it was a part of a formal procedure. Furthermore, she thought it would be easier for the pregnant woman to come to her.
Managers’ perspectives: difficulties of managing the problems experienced by pregnant employees
Pregnant employees push themselves
The managers sometimes had difficulty managing the problems experienced by pregnant employees. Several managers mentioned that some pregnant employees pushed themselves too hard. In the interviews, they commented on the question of pregnant employees who they thought were too proud to ask for and accept workplace adjustments. One of the managers described an employee who was usually capable of lifting as much as the male employees in the shop, but during her pregnancy she was not able to work and do the heavy lifting as she was used to. It was difficult for her to adjust to her new situation, and therefore the manager had to be aware of this, and keep telling her to take care of herself, instead of pushing herself too hard. When pregnant employees had difficulty accepting their need for workplace adjustments, the managers felt that they had to be more attentive to their difficulties.
Difficulties planning and/or organizing work-related tasks
Managers mentioned challenges related to planning and organizing work-related tasks, because the pregnant employees’ condition sometimes changed from one day to the next, and they would lack the time to make useful, alternative arrangements. Moreover, they did not always know what to expect, or how much to demand of pregnant employees. Therefore, some of them asked pregnant employees about their healthcare providers’ recommendations. These recommendations were often used to justify and legitimize workplace adjustments or absences from the workplace, and they sometimes made it easier for pregnant employees and their managers to balance the workplace adjustments, and informed them about how to respond to various symptoms. Healthcare providers seemed to play a key role in offering advice about a given situation, and when consulted, they sometimes had a strong influence on future adjustments and developments in pregnant employees’ work. According to the managers, pregnant employees sometimes managed to remain on the job because of guidance from these professionals; in other situations, they immediately recommended sick leave, because of the job’s demands.
Finally, managers mentioned possible challenges and dilemmas related to the fact that adjustments for pregnant employees should not adversely affect other employees. One manager emphasized that “It must not be that pregnant employees are penalized […] It is a balance” (Manager, hotel).
These statements by managers reveal a possible challenge, as they are responsible for managing the workplace and ensuring workplace adjustments for pregnant employees, and at the same time, they must balance the probability of an increased workload for the other employees, which is often uncompensated.