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Abderhalden-Zellweger A, Probst I, Mercier MPP, Danuser B, Krief P. Maternity Protection at Work and Safety Climate: The Perceptions of Managers and Employees in Three Healthcare Institutions in Switzerland. Scandinavian Journal of Work and Organizational Psychology 2021. [DOI: 10.16993/sjwop.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abderhalden-Zellweger A, Politis Mercier MP, Probst I, Wild P, Danuser B, Krief P. Midwives and protection of pregnant workers in Western Switzerland: Practices, difficulties and contributions. Midwifery 2021; 102:103125. [PMID: 34428629 DOI: 10.1016/j.midw.2021.103125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Switzerland's maternity protection legislation aims to protect the health of pregnant employees and their unborn children by regulating their potential occupational exposure to hazards and strenuous activities. This legislation provides a role for obstetricians, but not for midwives. AIMS Identify the practices of Switzerland's French-speaking midwives that favour the implementation of maternity protection legislation and reflect on the profession's role in supporting pregnant employees. METHODS 356 midwives answered an online questionnaire. The analysis focuses on the 205 midwives who perform pregnancy consultations in their practice. Data were analysed in two stages using STATA software: 1) simple descriptive and correlational statistics and 2) hierarchical cluster analysis to identify typologies of practices by grouping similar responses. FINDINGS Despite having no officially defined role in Switzerland's maternity protection legislation, its midwives actively participate in protecting pregnant employees , especially those with more knowledge of the legislation, those with more years of experience and those practicing independently. The barriers that midwives face when trying to provide greater support for pregnant employees are linked significantly to their lack of knowledge about the legislation, a lack of recognition for their role in the current legislation and a lack of continuing education about the occupational health risks associated with pregnancy at work. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Their profession and specific practices give midwives privileged access to pregnant employees. Midwives' knowledge of the legislation, their awareness of the occupational risks and hazards facing pregnant employees and the conviction that their profession has the potential to make a difference could all be improved. The role of midwives should be-and deserves to be-formally and legally recognised and integrated into Switzerland's maternity protection legislation.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011 Lausanne, Switzerland; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland.
| | - Maria-Pia Politis Mercier
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Isabelle Probst
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Pascal Wild
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; INRS Scientific Management Unit, Nancy, France
| | - Brigitta Danuser
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland
| | - Peggy Krief
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland
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Abderhalden-Zellweger A, Mediouni Z, Probst I, Politis Mercier MP, Danuser B, Wild P, Chiarini B, Hale ML, Krief P. Evolution of gynaecologists' practices regarding the implementation of Swiss legislation on maternity protection at work between 2008 and 2017. Swiss Med Wkly 2021; 151:w20537. [PMID: 34318910 DOI: 10.4414/smw.2021.20537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In accordance with the International Labour Organization’s Maternity Protection Convention (No. 183) and European Union Directive 92/857CEE (1992), Switzerland’s Labour Law and its Maternity Protection Ordinance (OProMa) aim to protect the health of pregnant employees and their future children while enabling them to pursue their working activities. Gynaecologists-obstetricians have a key role in this legislation, particularly through the prescription of preventive leave for patients who would otherwise face dangerous or arduous tasks in the absence of an adequate risk analysis or suitable protective measures. However, international and national literature suggests that gynaecologists-obstetricians may encounter difficulties in fulfilling their role. AIMS This study aimed to: (1) describe the practices and difficulties encountered by gynaecologists-obstetricians in the practical implementation of the OProMa; and (2) compare the evolution of these practices and difficulties between 2008 and 2017. METHODS A survey by questionnaire was conducted in 2008 and repeated in 2017. Both surveys focused on gynaecologists-obstetricians working in the French-speaking part of Switzerland (in private practices, hospitals or both). Descriptive and comparative analyses were carried out. RESULTS 83 gynaecologists-obstetricians responded in 2008 and 93 in 2017: response rates of 47% and 32%, respectively. In 2017, gynaecologists-obstetricians were more likely to ask questions about occupational risks faced by their patients when consulted by working mothers about their pregnancies. The estimated percentage of patients exposed to an occupational risk remained constant (20% in 2008 and 22% in 2017). Communication and collaboration with employers were reported to be difficult in both surveys, even though these are key elements in the implementation of the OProMa. Collaboration with occupational physicians, however, was more frequent in 2017. CONCLUSION In 2017, gynaecologists-obstetricians showed a greater awareness of occupational risks and collaborated more frequently with occupational health specialists. However, the application of the OProMa remained limited over the studied time period. Improving training of gynaecologists-obstetricians in this field could be a significant factor in encouraging better implementation of the current legislation. Moreover, gynaecologists-obstetricians need to be given the necessary support to enable their clinical practice to evolve towards a more preventive type of medicine. Collaboration with relevant stakeholders, including occupational physicians, midwives and workers, should be encouraged.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland / Center for Primary Care and Public Health (Unisanté), Occupational Health and Environment Department (DSTE), University of Lausanne (UNIL), Switzerland
| | - Zakia Mediouni
- Center for Primary Care and Public Health (Unisanté), Occupational Health and Environment Department (DSTE), University of Lausanne (UNIL), Switzerland
| | - Isabelle Probst
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland
| | - Maria-Pia Politis Mercier
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Switzerland
| | - Brigitta Danuser
- Center for Primary Care and Public Health (Unisanté), Occupational Health and Environment Department (DSTE), University of Lausanne (UNIL), Switzerland
| | - Pascal Wild
- Center for Primary Care and Public Health (Unisanté), Occupational Health and Environment Department (DSTE), University of Lausanne (UNIL), Switzerland / INRS Research and Studies Management, Vandoeuvre les Nancy, France Center for Primary Care and Public Health (Unisanté), Occupational Health and Environment Department (DSTE), University of Lausanne (UNIL), Switzerland
| | - Bastien Chiarini
- Center for Primary Care and Public Health (Unisanté), Occupational Health and Environment Department (DSTE), University of Lausanne (UNIL), Switzerland
| | - Marie-Louise Hale
- Occupational health physician and general practitioner in private practice, 1162 St-Prex, Switzerland
| | - Peggy Krief
- Center for Primary Care and Public Health (Unisanté), Occupational Health and Environment Department (DSTE), University of Lausanne (UNIL), Switzerland
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Abderhalden-Zellweger A, Probst I, Politis Mercier MP, Zenoni M, Wild P, Danuser B, Krief P. Implementation of the Swiss ordinance on maternity protection at work in companies in French-speaking Switzerland. Work 2021; 69:157-172. [PMID: 33998579 DOI: 10.3233/wor-213465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Switzerland's Ordinance on Maternity Protection at Work (OProMa) requires that companies take the necessary measures to ensure that pregnant employees can continue working without danger. OBJECTIVE To investigate the extent of compliance with OProMa within companies in French-speaking Switzerland as well as factors which facilitate and obstruct the ordinance's implementation. METHODS A stratified random telephone survey of 202 companies from the healthcare and food industry was conducted. Descriptive and correlational statistics were calculated. Responses to open questions were analysed thematically. RESULTS Only a minority of companies performed risk analyses or adapted employees' workstations, as per the legislation. OProMa was implemented more effectively in larger companies than smaller ones, in public rather than private ones, in the healthcare sector rather than the food industry, and when the person responsible for the wellbeing of pregnant employees within the company had undergone specific training on the subject. Data extrapolation suggested that only 2% of pregnant employees in French-speaking Switzerland's food industry and 12% in its healthcare sector are properly protected according to OProMa's provisions. CONCLUSIONS Maternity protection in French-speaking Switzerland's companies urgently requires improvement. In addition to the apparent need for stronger incentives and for monitoring of companies, our findings indicate a need to provide them with resources to meet OProMa's provisions.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.,Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Isabelle Probst
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Maria-Pia Politis Mercier
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Michela Zenoni
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Pascal Wild
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.,Research and Study Management Unit, INRS, Vandoeuvre les Nancy, France
| | - Brigitta Danuser
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Peggy Krief
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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Abderhalden-Zellweger A, Probst I, Politis Mercier MP, Danuser B, Wild P, Krief P. Implementation of maternity protection legislation: Gynecologists' perceptions and practices in French-speaking Switzerland. PLoS One 2020; 15:e0231858. [PMID: 32353865 PMCID: PMC7192633 DOI: 10.1371/journal.pone.0231858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/02/2020] [Indexed: 01/01/2023] Open
Abstract
Background In several countries, maternity protection legislations (MPL) confer an essential role to gynecologist-obstetricians (OBGYNs) for the protection of pregnant workers and their future children from occupational exposures. This study explores OBGYNs’ practices and difficulties in implementing MPL in the French-speaking part of Switzerland. Methods An online survey was sent to 333 OBGYNs. Data analysis included: 1) descriptive and correlational statistics and 2) hierarchical cluster analysis to identify patterns of practices. Results OBGYNs evoked several problems in MPL implementation: absence of risk analysis in the companies, difficult collaboration with employers, lack of competencies in the field of occupational health. Preventive leave was underused, with sick leave being prescribed instead. Training had a positive effect on OBGYNs’ knowledge and implementation of MPL. Hierarchical cluster analysis highlighted three main types of practices: 1) practice in line with legislation; 2) practice on a case-by-case basis; 3) limited practice. OBGYNs with good knowledge of MPL more consistently applied its provisions. Conclusion The implementation of MPL appears challenging for OBGYNs. Collaboration with occupational physicians and training might help OBGYNs to better take on their role in maternity protection. MPL in itself could be improved.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
- * E-mail:
| | - Isabelle Probst
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Maria-Pia Politis Mercier
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Brigitta Danuser
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
| | - Pascal Wild
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
- INRS Research and Studies Management, Vandoeuvre les Nancy, France
| | - Peggy Krief
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
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Probst I, Zellweger A, Politis Mercier MP, Danuser B, Krief P. Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature. Int Arch Occup Environ Health 2018; 91:901-922. [DOI: 10.1007/s00420-018-1339-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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Krief P, Zellweger A, Politis Mercier MP, Danuser B, Wild P, Zenoni M, Probst I. Protection of pregnant women at work in Switzerland: practices, obstacles and resources. A mixed-methods study protocol. BMJ Open 2018; 8:e023532. [PMID: 29903801 PMCID: PMC6009567 DOI: 10.1136/bmjopen-2018-023532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Like most industrialised countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace exposure. This legislation provides for a risk assessment, adaptations to workplaces and, if the danger is not eliminated, preventive leave (prescribed by a gynaecologist). This study's first objective is to analyse the degree to which companies, gynaecologists and midwives implement the law. Its second objective is to understand the obstacles and resources of this implementation, with a focus on how relevant stakeholders perceive protective measures and their involvement with them. METHODS AND ANALYSIS Data will be collected using mixed methods: (1) online questionnaires for gynaecologists and midwives; telephone questionnaires with company human resources (HR) managers in the healthcare and food production sectors; (2a) case studies of 6-8 companies in each sector, including interviews with stakeholders such as women workers, HR managers and occupational health physicians; (2b) two focus groups, one involving occupational physicians and hygienists, one involving labour inspectors.Quantitative data will be analysed statistically using STATA software V.15. Qualitative data will be transcribed and thematically analysed using MaxQDA software. ETHICS AND DISSEMINATION The Human Research Ethics Committee of the Canton Vaud (CER-VD) has certified that this research study protocol falls outside of the field of application of the Swiss Federal Act on Research Involving Humans.The publications and recommendations resulting from this study will form the starting point for future improvements to the protection of pregnant women at work and their unborn children.This study started in February 2017 and will continue until January 2020.
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Affiliation(s)
- Peggy Krief
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
| | - Alessia Zellweger
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Maria-Pia Politis Mercier
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Brigitta Danuser
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
| | - Pascal Wild
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
- Scientific Management, INRS, Vandœuvre-lès-Nancy, France
| | - Michela Zenoni
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
| | - Isabelle Probst
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
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Zellweger A, Probst I, Danuser B, Politis Mercier MP, Wild P, Zenoni M, Krief P. Application des dispositions juridiques de protection de la maternité au travail en Suisse romande : les pratiques des gynécologues et des sages-femmes. ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2018.03.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Floris L, Irion O, Bonnet J, Politis Mercier MP, de Labrusse C. Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction. Women Birth 2017; 31:124-133. [PMID: 28711398 DOI: 10.1016/j.wombi.2017.06.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 06/06/2017] [Accepted: 06/22/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period. AIM The goal of this study was to evaluate the satisfaction and outcomes of the obstetric and neonatal care of women who received comprehensive support during pregnancy, childbirth and the postpartum period, and compare them to women who received shared care. METHODS This was a prospective comparative study between two models of care in low risk pregnant women. The satisfaction and outcomes of care were evaluated using the French version of the Women's Experiences Maternity Care Scale, two months after giving birth. FINDINGS In total, 186 women in the comprehensive support group and 164 in the control group returned the questionnaire. After adjustment, the responses of those in the comprehensive support programme were strongly associated with optimal satisfaction, and they had a significantly lower epidural rate. No differences were observed between the two groups in the mode of delivery. The satisfaction relative to this support programme was associated with a birth plan for intrapartum and postnatal care. CONCLUSIONS Team midwifery had a positive impact on satisfaction, with no adverse effects on the obstetric and neonatal outcomes, when compared to shared care.
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Affiliation(s)
- Lucia Floris
- Nursing Directorate, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland; University of Applied Sciences in Western Switzerland (HES-SO, HESAV), 1011 Lausanne, Switzerland.
| | - Olivier Irion
- Department of Gynaecology and Obstetrics, Geneva University Hospitals (HUG), 1205, Geneva, Switzerland
| | - Jocelyne Bonnet
- Nursing Directorate, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
| | | | - Claire de Labrusse
- University of Applied Sciences in Western Switzerland (HES-SO, HESAV), 1011 Lausanne, Switzerland
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