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PEOPLE@HES-SO – Directory and Skills inventory

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Abderhalden Alessia

Abderhalden Alessia

Adjointe scientifique HES

Main skills

Health Psychology

Perinatal Health

Maternity protection at work

Quality of care

Health systems analysis

Qualitative Research

Mixed-methods research

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  • Research

  • Publications

  • Conferences

Main contract

Adjointe scientifique HES

Desktop: BM21-T/02/204

HESAV - Haute Ecole de Santé Vaud
Avenue de Beaumont 21, 1011 Lausanne, CH
HESAV
Faculty
Santé
Main Degree Programme
Sage-femme

Adjointe scientifique HES

Desktop: BM21-T/02/204

HESAV - Haute Ecole de Santé Vaud
Avenue de Beaumont 21, 1011 Lausanne, CH
HESAV
Faculty
Santé
Main Degree Programme
Sage-femme
No data to display for this section

Ongoing

Les compétences professionnelles à l’épreuve du réel : Deskilling et Upskilling des sages-femmes en Suisse.

Role: Co-applicant

Financement: Commission scientifique de la Ra&D du domaine santé

Description du projet :

Afin de garantir une qualité optimale des soins pour les femmes et leurs familles, les sages-femmes[1] doivent posséder des compétences spécifiques à leur profession à la fin de leur formation et dans leur pratique. Cependant, l'étendue de leur champ de compétences dans l’exercice de leur métier et les facteurs pouvant l’influencer sont peu connus en Suisse. Ce projet, mené en partenariat avec la Fédération Suisse des Sages-Femmes et ses sections, vise à identifier les compétences déployées par les sages-femmes dans leur pratique, et à explorer d'éventuels écarts entre celles-ci et celles attendues. En combinant de manière inédite des données mixtes (questionnaire et focus groupes) le projet encourage des échanges fructueux avec les institutions responsables de la formation et de la pratique professionnelle pour déterminer les mesures essentielles au maintien du niveau de compétences requis, renforçant ainsi la profession de sage-femme en Suisse

 


[1] Nous parlerons des sages-femmes en utilisant la formulation féminine car les femmes représentent la grande majorité de cette profession en Suisse.

Research team within HES-SO: De Labrusse Claire , Abderhalden Alessia , Pfund Anouck

Durée du projet: 01.05.2024 - 30.04.2025

Montant global du projet: 80'062 CHF

Statut: Ongoing

IMAgiNE EURO (Improving MAternal Newborn carE In the EURO Region)

Role: Collaborator

Description du projet :

IMAgiNE EURO (Improving MAternal Newborn carE In the EURO Region), coordinated by the WHO Collaborating center of the Child Referral Hospital and Research Institute (IRCCS) Burlo Garofolo Trieste is a project based on a network of currently 24 countries. It includes two online surveys (one for mothers, the other for health workers) to explore maternal and newborn health service preparedness, quality and resilience, among countries of the WHO European Region, at different phases of the COVID-19 pandemic. The study should help to understand the views and experiences of women giving birth, as well as health workers involved in maternal and newborn care.

As of 1 July 2021, HESAV will assume responsibility for the collection of national data for IMAgiNE EURO on behalf of Switzerland. The project is managed by three researchers: Claire de Labrusse, Alessia Abderhalden, and Anouck Pfund. They are responsible for overseeing data collection in the French- and Italian-speaking regions of Switzerland. From autumn 2021, a research team from the Zurich University of Applied Sciences (ZHAW), comprising Dr Michael Gemperle, Dr Suzanne Grylka and Antonia Müller, will also be providing support for the project and assisting with data collection in the German-speaking region of Switzerland.

Research team within HES-SO: De Labrusse Claire , Abderhalden Alessia , Pfund Anouck

Statut: Ongoing

Completed

Protection de la maternité au travail : pratiques, obstacles, ressources
AGP

Role: Collaborator

Requérant(e)s: VD-HESAV

Financement: FNS

Description du projet : Malgré les incertitudes sur les effets de certaines expositions professionnelles, la littérature médicale montre que les conditions de travail peuvent avoir un impact sérieux sur la santé de la mère et de l'enfant. Des mesures ciblées permettent de prévenir une partie de ces effets négatifs. C'est pourquoi la Suisse a mis en place des dispositions juridiques sur la protection de la maternité (DJPM), au travers de la Loi sur le travail (LTr) et depuis 2001, de l'Ordonnance sur la protection de la maternité (OProMa). Celles-ci visent à protéger la santé des travailleuses enceintes et de leur enfant à naître dès le début de la grossesse et jusqu'à la fin de la période d'allaitement. Des observations de terrain et des études exploratoires indiquent que les DJPM sont appliquées de manière inégale (selon les occupations professionnelles, les entreprises, les professionnels qui suivent la grossesse, etc.) et que les pratiques réelles présentent des écarts importants avec les procédures prévues par la loi, par exemple, utilisation de certificats d'arrêt de travail pour raison de maladie en lieu et place des certificats d'inaptitude, absence d'analyse de risque, non annonce de la grossesse, etc. Certains procédés mettent à mal l'esprit de la loi, et son effet incitatif à développer des stratégies de prévention au poste de travail. En nous basant sur des études menées dans d'autres pays, nous faisons l'hypothèse que les difficultés d'application ne découlent pas uniquement d'un manque d'information des travailleuses, employeurs et professionnels de la santé sur les DJPM. Nous faisons au contraire l'hypothèse que les difficultés sont liées aux exigences complexes et partiellement contradictoires de la conciliation entre travail et maternité, qui mènent les différents acteurs à développer des pratiques non prévues par le cadre juridique. L'étude des pratiques réelles apparaît donc cruciale pour trouver les moyens d'une protection plus efficace. Nous les étudierons dans une perspective alliant modèle écologique et analyse de l'activité, afin de saisir à différents niveaux ce qui fait obstacle ou ressource pour la mise en oeuvre des mesures de protection. Le projet a pour objectifs d'effectuer un état des lieux sur l'application des DJPM dans les entreprises de deux divisions économiques (santé et industrie alimentaire) et par les gynécologues et les sages-femmes en Suisse romande ; d'en déterminer les obstacles et les appuis au travers de l'étude des pratiques réelles ; et d'évaluer la perception qu'en ont les travailleuses concernées. Le projet prévoit deux volets complémentaires : d'une part, un recueil de données par questionnaires auprès de gynécologues et sages-femmes, ainsi que des employeurs de deux divisions économiques (volet quantitatif) et d'autre part, des études de cas dans 6 à 8 entreprises des mêmes divisions économiques (volet qualitatif), comprenant des entretiens qualitatifs avec les responsables des ressources humaines, les spécialistes de la santé sécurité au travail et des travailleuses (environ 50 entretiens au total). Cette étude permettra de rédiger des recommandations afin de favoriser une action plus efficace de la part des professionnels et de proposer des améliorations concrètes applicables et acceptables sur le terrain pour les différentes parties prenantes. Elle servira ainsi de base pour offrir aux travailleuses une meilleure prévention des risques au cours de la maternité.

Research team within HES-SO: Probst Isabelle , Politis Mercier Maria-Pia , Abderhalden Alessia , Zenoni Michela

Partenaires académiques: VD-HESAV

Durée du projet: 01.02.2017 - 30.09.2020

Montant global du projet: 321'381 CHF

Url of the project site: http://p3.snf.ch/project-162713

Statut: Completed

2025

The association between women's perception of birth during the pandemic, companion of choice and support from health professionals :
Scientific paper ArODES
a cross-sectional study in 20 countries in the WHO European region

Stephanie Batram-Zantvoort, Céline Miani, Ilaria Mariani, Emanuelle Pessa Valente, Mehreen Zaigham, Alessia Abderhalden-Zellweger, Claire De Labrusse

Birth,  To be published

Link to the publication

Summary:

Background: Mitigation measures implemented in response to the COVID-19 pandemic led to significant changes in maternity care across Europe, including restrictions on companions during labor and birth. This cross-sectional study explores the association between the presence of a companion of choice and a positive perception of the birth experience. Additionally, it explores the association between health professionals' attention, assistance, and availability during labor and birth and a positive perception of birth. Methods: We utilized a structured, validated online questionnaire, available in 25 languages, to assess the quality of maternal care during the COVID-19 pandemic from women's perspectives. We conducted logistic regression to explore associations between variables related to the presence of a companion of choice, health professionals' attention, assistance, and availability, and positive perceptions of birth, when controlled for confounders, including birth mode and medical interventions. Results: Responses from 48,039 women across 20 countries in the WHO European Region were included. Always having a companion of choice during birth (aOR: 2.11) and always receiving adequate care from health professionals (assistance aOR: 2.12, attention aOR: 36.64, availability aOR: 2.12) were associated with positive birth perception. Instrumental births (aOR: 0.76), episiotomies (aOR: 0.74), fundal pressure (aOR: 0.52), and cesarean births (planned aOR: 0.80, unplanned prelabor aOR: 0.60, unplanned in-labor aOR: 0.52) were associated with less positive birth perceptions. Discussion: This study highlights the critical role of having a chosen companion and receiving adequate attention, assistance, and availability from health professionals in promoting positive birth perceptions, even in times of crisis such as the COVID-19 pandemic. Ensuring the presence of a companion of choice and comprehensive professional support is crucial for delivering high-quality, respectful maternity care.

Assessment of a specialized medicine consultation for pregnant workers :
Scientific paper ArODES
the users’ perspective

Julien Vonlanthen, Alessia Abderhalden-Zellweger, Saira-Christine Renteria, Karine Moschetti, Loïc Brunner, Pascal Wild, Isabelle Probst, Peggy Krief

WORK: A Journal of Prevention, Assessment & Rehabilitation,  2025, 80, 2, 774-789

Link to the publication

Summary:

Background: Occupational exposures can endanger the health of pregnant workers and their unborn children. The Department of Occupational and Environmental Health of Unisanté has established a specialized occupational health consultation to assist pregnant workers, employers and gynecologists in implementing maternity protection provisions in the workplace. Objective: The study aims to assess the satisfaction of the users of the consultation, describe their overall experience and identify the benefits and limitations of the consultation. Methods: A mixed-methods approach was used. A telephone questionnaire with both closed and open-ended questions was administered to pregnant workers who had attended the consultation in 2021, as well as to their employers and gynecologists. Quantitative data on users’ satisfaction were statistically analyzed using STATA 17, while responses to open-ended questions were thematically analyzed using MAXQDA20. Results: All users expressed high levels of satisfaction: 95% of pregnant workers, 88% of employers and 97% of gynecologists were satisfied with the consultation. Users highlighted the value of the consultation in providing insight into the legal framework and occupational risks, as well as the neutrality and support of occupational health physicians. However, they reported challenges in implementing recommended measures and ineffective monitoring of their application. Conclusions: The study indicates that users are highly satisfied with the services provided by the consultation. It is recommended that these services be maintained and extended to other regions of Switzerland, with particular attention to pregnant women who do not have access to such services in their company.

2024

Women ‘s perception on the quality of maternal and newborn care during the COVID-19 pandemic in German-speaking countries :
Scientific paper ArODES
Findings from the IMAgiNE EURO project comparing data from Germany, Switzerland and Austria

Susanne Grylka-Baeschlin, Michael Gemperle, Ilaria Mariani, Alessia Abderhalden-Zellweger, Céline Miani, Christoph Zenzmaier, Antonia Nathalie Mueller, Stephanie Batram-Zantvoort, Martina Koenig-Bachmann, Claire De Labrusse, Maryse Arendt, Stefano Delle Vedove, Anouck Pfund, Imola Simon, Emanuelle Pessa Valente, Marzia Lazzerini, IMAgiNE Euro Study Group

Midwifery,  2025, 140, Article 104209

Link to the publication

Summary:

Problem : Restrictions during the COVID-19 pandemic compromised maternal and newborn care. Background : Countries in the German speaking area share several clinical care guidelines but differed significantly in the strictness of COVID-19 protective measures. Aim : To investigate the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic in the German-speaking area and explore associations between the reorganisational changes due to COVID-19 and QMNC, as described with WHO Standards-based Quality Measures. Methods : As part of the IMAgiNE EURO study (ClinicalTrials.gov: NCT04847336), we conducted an online survey on the QMNC in the German-speaking area, including women who gave birth in Germany, Switzerland, and Austria. Descriptive statistics, Spearman rank correlation coefficient and multivariable quantile regression were used. Findings : Out of a total of 70,721 women accessing the online questionnaire, 1,875 were included (Germany: n = 1,053, Switzerland: n = 494, Austria: n = 328). Significant differences across countries were found in Quality Measures. In Switzerland, women scored Quality Measures more favourable than in Germany and Austria in all four sub-indexes of QMNC. In Austria, Quality Measures gaps in the sub-index ‘Experience of care’ were higher. The sub-index ‘Reorganisational changes due to COVID-19′ correlated weakly to strongly with the other sub-indexes (between r = 0.33 and r = 0.62, p < 0.001 for all correlations). Discussion : Midwives and other health professional should pay particular attention to the provision of respectful, high-quality care. Conclusion : To effectively improve QMNC, further research is essential to monitor the quality of care and develop targeted interventions beyond the COVID-19 pandemic addressing inherent challenges in the organisation and delivery of care.

Health workers’ perspectives on the quality of maternal and newborn health care around the time of childbirth :
Scientific paper ArODES
results of the Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) project in 12 countries of the World Health Organization European Region

Emanuelle Pessa Valente, Ilaria Mariani, Arianna Bomben, Sandra Morano, Michael Gemperle, Alessia Abderhalden-Zellweger

Journal of Global Health,  2024, 14, article no 04164

Link to the publication

Summary:

Background : Health workers’ (HWs’) perspectives on the quality of maternal and newborn care (QMNC) are not routinely collected. In this cross-sectional study, we aimed to document HWs’ perspectives on QMNC around childbirth in 12 World Health Organization (WHO) European countries. Methods : HWs involved in maternal/neonatal care for at least one year between March 2020 and March 2023 answered an online validated WHO standards-based questionnaire collecting 40 quality measures for improving QMNC. A QMNC index (score 0–400) was calculated as a synthetic measure. Results : Data from 4143 respondents were analysed. For 39 out of 40 quality measures, at least 20% of HWs reported a ‘need for improvement’, with large variations across countries. Effective training on healthy women/newborns management (n = 2748, 66.3%), availability of informed consent job aids (n = 2770, 66.9%), and effective training on women/newborns rights (n = 2714, 65.5%) presented the highest proportion of HWs stating ‘need for improvement’. Overall, 64.8% (n = 2684) of respondents declared that HWs’ numbers were insufficient for appropriate care (66.3% in Portugal and 86.6% in Poland), and 22.4% described staff censorship (16.3% in Germany and 56.7% in Poland). The reported QMNC index was low in all countries (Poland median (MD) = 210.60, interquartile range (IQR) = 155.71, 273.57; Norway MD = 277.86; IQR = 244.32, 308.30). The ‘experience of care’ domain presented in eight countries had significantly lower scores than the other domains (P < 0.001). Over time, there was a significant monthly linear decrease in the QMNC index (P < 0.001), lacking correlation with the coronavirus disease 2019 (COVID-19) pandemic trends (P > 0.05). Multivariate analyses confirmed large QMNC variation by country. HWs with <10 years of experience, HWs from public facilities, and midwives rated QMNC with significantly lower scores (P < 0.001). Conclusions : HWs from 12 European countries reported significant gaps in QMNC, lacking association with COVID-19 pandemic trends. Routine monitoring of QMNC and tailored actions are needed to improve health services for the benefit of both users and providers.

Grossesse et médecine du travail
Professional paper ArODES

Alessia Abderhalden-Zellweger, Isabelle Probst, Julien Vonlanthen, Karine Moschetti, Loïc Brunner, Saira-Christine Renteria, Peggy Krief

Reiso : revue d'information sociale,  2024

Link to the publication

Investir dans la protection des travailleuses enceintes s'avère rentable
Professional paper ArODES

Loïc Brunner, Peggy Krief, Isabelle Probst, Alessia Abderhalden-Zellweger, Saira-Christine Renteria, Julien Vonlanthen, Karine Moschetti

HR Today (édition française),  2024, 3, 40-43

Link to the publication

Summary:

Alors que 81% des femmes enceintes ont connu une interruption d’activité professionnelle pendant leur grossesse en 2017, notre analyse montre que respecter la loi s’avère rentable économiquement pour les différences parties prenantes.

Women’s experiences of disrespect and abuse in Swiss facilities during the COVID-19 pandemic :
Scientific paper ArODES
a qualitative analysis of an open-ended question in the IMAgiNE EURO study. BMC Pregnancy and Childbirth

Alessia Abderhalden-Zellweger, Claire De Labrusse, Michael Gemperle, Susanne Grylka-Baeschlin, Anouck Pfund, Antonia N. Mueller, Ilaria Mariani, Emanuelle Pessa Valente, Marzia Lazzerini

BMC pregnancy and childbirth,  2024, 24, 1, art. 402

Link to the publication

Summary:

Background: The COVID-19 pandemic has challenged the provision of maternal care. The IMAgiNE EURO study investigates the Quality of Maternal and Newborn Care during the pandemic in over 20 countries, including Switzerland. Aim: This study aims to understand women’s experiences of disrespect and abuse in Swiss health facilities during the COVID-19 pandemic. Methods: Data were collected via an anonymous online survey on REDCap®. Women who gave birth between March 2020 and March 2022 and answered an open-ended question in the IMAgiNE EURO questionnaire were included in the study. A qualitative thematic analysis of the women’s comments was conducted using the International Confederation of Midwives’ RESPECT toolkit as a framework for analysis. Findings: The data source for this study consisted of 199 comments provided by women in response to the openended question in the IMAgiNE EURO questionnaire. Analysis of these comments revealed clear patterns of disrespect and abuse in health facilities during the COVID-19 pandemic. These patterns include non-consensual care, with disregard for women’s choices and birth preferences; undignified care, characterised by disrespectful attitudes and a lack of empathy from healthcare professionals; and feelings of abandonment and neglect, including denial of companionship during childbirth and separation from newborns. Insufficient organisational and human resources in health facilities were identified as contributing factors to disrespectful care. Empathic relationships with healthcare professionals were reported to be the cornerstone of positive experiences. Discussion: Swiss healthcare facilities showed shortcomings related to disrespect and abuse in maternal care. The pandemic context may have brought new challenges that compromised certain aspects of respectful care. The COVID-19 crisis also acted as a magnifying glass, potentially revealing and exacerbating pre-existing gaps and structural weaknesses within the healthcare system, including understaffing. Conclusions: These findings should guide advocacy efforts, urging policy makers and health facilities to allocate adequate resources to ensure respectful and high-quality maternal care during pandemics and beyond.

Manuel Oxford en sciences sage-femme
Book ArODES

Janet Medforth, Linda Ball, Angela Walker, Sue Battersby, Sarah Stables, Claire De Labrusse, Alessia Abderhalden-Zellweger, Murielle Caldelari, Patricia Perrenoud, Mélanie Picavet, Pauline Thomas, Julie Flohic, Marielle Schmied, Diane Waller, Christelle Kaech, Léo Pomar, Magali Bonzon, Maëva Pretalli, Clémence Haydar, Franziska Schläppy Muntwyler, Maria-Pia Politis Mercier, Lucia Floris, Fabienne Salamin, Bénédicte Michoud, Yvonne Meyer, Harriet Thorn-Cole

2024,  Chêne-Bourg : RMS éditions / Médecine & Hygiène,  1168 p.

Link to the publication

Summary:

Le Manuel Oxford en sciences sage-femme est une ressource unique, qui fournit aux sages-femmes tout ce dont ils et elles ont besoin dans leur pratique. Il réunit des informations concises, pratiques et spécialisées sur tous les aspects du rôle de sage-femme, allant des conseils pré-conceptuels à l’examen postnatal final de la mère et du bébé. Cette version traduite a été adaptée à la francophonie au niveau des actes, de la médication et des rôles des soignants, coordonnée par Claire de Labrusse et Alessia Abderhalden-Zellweger, et validée par la Filière Sage-femme de la Haute École de Santé Vaud, en Suisse.

Les compétences des sages-femmes :
Professional paper ArODES
de la théorie à la pratique ?

Claire De Labrusse, Alessia Abderhalden-Zellweger, Anouck Pfund

Obstetrica,  2024, 3, 40-43

Link to the publication

Summary:

En Suisse, la formation des sages-femmes et leurs compétences sont réglementées et détaillées dans divers textes de loi et référentiels. Une recherche lancée en 2024 va étudier l’adéquation entre les compétences prévues par la formation et leur mise en pratique réelle: observe-t-on une sous-utilisation de ces compétences (déqualification) ou, à l’inverse, à un élargissement du champ d’action professionnel (requalification)? Explications.

Predictors of the return to work for pregnant employees on preventive leave :
Scientific paper ArODES
patients from an occupational medicine consultation in Switzerland

Karine Moschetti, Loïc Brunner, Alessia Abderhalden-Zellweger, Isabelle Probst, Saira-Christine Renteria, Julien Vonlanthen, Peggy Krief

Plos one,  2024, 19, 3, art. e0300686

Link to the publication

Summary:

According to the Swiss legislation on maternity protection in the workplace (OProMa), if pregnant workers are exposed to occupational hazards and no protective measures are taken, a gynecologist will prescribe a certificate of preventive leave and the women must stop working. Returning to work is only possible if job adjustments are made. This study aims to evaluate the burden of absences on companies and to examine the predictors of the return to work for pregnant workers on preventive leave, by examining both the probability of return to work and the time required to return to work. The study sample includes data on 258 workplaces of pregnant workers on preventive leave, collected during an occupational medicine consultation aimed at supporting the implementation of the OProMa. Information is available on the worker (age, date of consultation), the hazards to which she is exposed, the company’s knowledge of the OProMa and whether a risk analysis exists. Descriptive statistics and multivariate regression analysis are carried out. In 58% of the workplaces, it was not possible to return to work before the end of the pregnancy. This corresponds to an average absence of 4.5 months. In 42% of the workplaces, a return to work was possible thanks to workplace adaptations. A conforming risk analysis and a full knowledge of the OProMa for companies, and an early visit to the occupational medicine consultation for workers are good predictors of the likelihood of returning to work. Younger age and exposure to certain types of risks are factors that influence the duration of preventive leave. The implementation of OProMa in Switzerland poses serious challenges, but early identification of occupational hazards and practices that anticipate compliance with the law in the company increase the return to work in safety for pregnant workers.

Enhancing maternity protection at work :
Scientific paper ArODES
assessing the contribution of a specialized occupational medicine consultation for pregnant employees in Switzerland

Alessia Abderhalden-Zellweger, Julien Vonlanthen, Saira-Christine Renteria, Pascal Wild, Karine Moschetti, Loïc Brunner, Zakia Mediouni, Isabelle Probst, Peggy Krief

Journal of public health,  to be published

Link to the publication

Summary:

Aim: Occupational exposures may harm the health of pregnant workers and their future children. While Switzerland has established specific regulations to safeguard pregnant employees while enabling them to pursue their job, there are limitations in implementing these provisions. This study aims to evaluate the contribution of an occupational medicine consultation (PregOH-consultation) in protecting pregnant workers and facilitating their safe return to work. Pregnant employees were referred to the consultation by their attending physicians in need of support in applying pregnancy protective legislation. Subject and methods: Between 2015 and 2021, indicators were collected from pregnant workers who sought the consultation, as well as from their employers. Descriptive and correlational statistical analyses were performed. Results: Out of the 328 work situations analysed, 98% presented at least one occupational hazard. Among the 272 companies contacted, only 14% had conducted a risk analysis, and 39% had implemented job adaptations. Among the pregnant workers whose employers were involved in the PregOH-consultation, 44% were able to return to work safely. Early referral to the consultation and pre-existing preventive measures within the company were identified as potential predictors of successul of the consultation in terms of safe return to work. The impact of the consultation was found to be less pronounced for women of foreign nationality. Conclusion: The observed companies have insufficient measures in place to adequately protect pregnant employees, potentially jeopardizing their health or leading to premature job withdrawal. The PregOH-consultation serves as an effective intervention by facilitating hazard identification and enabling pregnant workers to safely continue their employment.

2023

A narrative review on factors associated with job interruption during pregnancy
Scientific paper ArODES

Loïc Brunner, Peggy Chagnon Krief, Isabelle Probst, Alessia Abderhalden-Zellweger, Saira-Christine Renteria, Julien Vonlanthen, Karine Moschetti

International journal of occupational medicine and environmental health,  36, 3, 303–323

Link to the publication

Summary:

Most women continue to work during pregnancy. However, some of them have to stop working before giving birth. Absence from work poses several challenges for employers and employees, as well as for society. The literature on absence from work during pregnancy and its determinants remains inconsistent and rather scarce. To conduct a narrative literature review on the factors associated with work interruption and on existing interventions aimed at reducing the absence prevalence during pregnancy. The review refers to published peer-reviewed articles dealing with all types of work interruption among pregnant women. Keyword searches were performed in the electronic databases PubMed, EMBASE, and Google Scholar, covering the period 2000–2022. The review, which includes 42 papers, presents a broad and comprehensive picture of factors and interventions associated with absence from work among pregnant workers. The factors appear at different levels and include factors related to the pregnant women, such as individual health and socio-demographic factors; employer and workplace-related factors, such as risk exposures and working conditions; factors related to the role of the healthcare provider; and factors related to the national context (social benefits/insurance). The determinants of absence from work during pregnancy are complex and multifactorial and involve multiple stakeholders. The discussion addresses gaps and needs in the literature on pregnancy at work and in the field of occupational health.

Consultation en médicine du travail pour les travailleuses enceintes :
Professional paper ArODES
satisfaction et expériences

Alessia Abderhalden-Zellweger, Julien Vonlanthen, Saira-Christine Renteria, Karine Moschetti, Loïc Brunner, Pascal Wild, Isabelle Probst, Peggy Krief

Obstetrica,  2023, no 4, pp. 58-63

Link to the publication

Summary:

Une étude financée par la Direction générale de la santé du canton de Vaud a visé à explorer les apports d’une consultation en médecine du travail pour les travailleuses enceintes. Dans une précédente édition d’Obstetrica, les effets de la consultation sur le retour au travail des employées enceintes ont été présentés. Les auteur.e.s exposent ici les résultats concernant la satisfaction et les expériences des usager.ère.s de ce dispositif, unique en Suisse.

2022

Quality of maternal and newborn care in Switzerland during the COVID -19 pandemic :
Scientific paper ArODES
a cross-sectional study based on WHO quality standards

Claire De Labrusse, Alessia Abderhalden-Zellweger, Ilaria Mariani, Anouck Pfund, Michael Gemperle

International journal of gynecology obstetrics,  December 2022, vol. 159, no. S1, pp. 70-84

Link to the publication

Summary:

Objective: To explore quality of maternal and newborn care (QMNC) in healthcare facilities during the COVID-19 pandemic in Switzerland. Methods: Women giving birth in Switzerland answered a validated online questionnaire including 40 WHO standards- based quality measures. QMNC score was calculated according to linguistic region and mode of birth. Differences were assessed using logistic regression analysis adjusting for relevant variables. Results: A total of 1175 women were included in the analysis. Limitations in QMNC during the pandemic were reported by 328 (27.9%) women. Several quality measures, such as deficient communication (18.0%, n= 212), insufficient number of healthcare professionals (19.7%, n= 231), no information on the newborn after cesarean (26.5%, n= 91) or maternal and newborn danger signs (34.1%, n= 401 and 41.4% n= 4 87, respectively) suggested preventable gaps in QMNC. Quality measures significantly differed by linguistic region and mode of birth. Multivariate analysis established a significantly lower QMNC for women in French- and Italian-speaking regions compared with the German-speaking region. Moreover, in several quality indicators reflecting communication with healthcare providers, women who did not answer the questionnaire in one of the Swiss national languages had significantly worse scores than others. A significant lower QMNC was also found for young and primiparous women and for those who experienced cesarean or instrumental vaginal birth. Conclusion: Women giving birth in Switzerland during the pandemic reported notable gaps in QMNC. Providers should be attuned to women who are younger, primiparous, and those who had an emergency cesarean or instrumental vaginal birth given the lower QMNC reported by these groups. Women who did not respond in a Swiss national language may need improved communication strategies.

Individual and country-level variables associated with the medicalization of birth :
Scientific paper ArODES
multilevel analyses of IMAgiNE EURO data from 15 countries in the WHO European region

Céline Miani, Lisa Wandschneider, Stephanie Batram-Zantvoort, Alessia Abderhalden-Zellweger, Claire De Labrusse, Anouk Pfund

International Journal of Gynecology Obstetrics,  December 2022, vol, 159, no. S1, pp. 9-21

Link to the publication

Summary:

Objective: To investigate potential associations between individual and country- level fac-tors and medicalization of birth in 15 European countries during the COVID- 19 pandemic. Methods: Online anonymous survey of women who gave birth in 2020– 2021. Multivariable multilevel logistic regression models estimating associations between in-dictators of medicalization (cesarean, instrumental vaginal birth [IVB], episiotomy, fundal pressure) and proxy variables related to care culture and contextual factors at the individual and country level. Results: Among 27 173 women, 24.4% (n= 6650) had a cesarean and 8.8% (n= 2380) an IVB. Among women with IVB, 41.9% (n = 998) reported receiving fundal pressure. Among women with spontaneous vaginal births, 22.3% (n= 4048) had an episiotomy. Less respectful care, as perceived by the women, was associated with higher levels of medicalization. For example, women who reported having a cesarean, IVB, or episiotomy reported not feeling treated with dignity more frequently than women who did not have those interventions (odds ratio [OR] 1.37; OR 1.61; OR 1.51, respectively; all: P< 0.001). Country- level variables contributed to explaining some of the variance between countries. Conclusion: We recommend a greater emphasis in health policies on promotion of respectful and patient- centered care approaches to birth to enhance women's experiences of care, and the development of a European- level indicator to monitor medicalization of reproductive care.

Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities :
Scientific paper ArODES
results of the IMAgiNE EURO study in 16 countries

Marzia Lazzerini, Emanuelle Pessa Valente, Benedetta Covi, Alessia Abderhalden-Zellweger, Claire De Labrusse

International journal of gynecology obstetrics,  December 2022, vol. 159, no. S1, pp. 22-38

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Summary:

Objective To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean. Methods Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities. Results Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52–1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65–2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14–1.70) (P < 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone. Conclusion The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution.

Travail et grossesse :
Professional paper ArODES
apports et limites d’une consultation spécialisée en médecine du travail

Alessia Abderhalden-Zellweger, Julien Vonlanthen, Saira-Christine Renteria, Pascal Wild, Karine Moschetti, Loïc Brunner, Isabelle Probst, Peggy Krief

Obstetrica,  2022, no. 10, pp. 48-50

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Summary:

En Suisse, une règlementation spé­cifique vise à protéger la santé des travailleuses enceintes et de leurs futurs enfants face à des dangers présents dans l’environnement de travail. En pratique, ces dispositions protectrices ne sont pas toujours appliquées. À Lausanne, Unisanté a développé une consultation de médecine du travail pour soutenir les parties impliquées dans la mise en œuvre de ces législations. Une étude en cours examine les apports et limites de ce dispositif unique.

Impact of the COVID-19 pandemic on maternity services in Europe :
Scientific paper ArODES
a mixed methods systematic review protocol

Harriet Thorn-Cole, Claire De Labrusse, Alessia Abderhalden-Zellweger, Christelle Kaech, Raphaël Hammer

JBI Evidence Synthesis,  September 2022, vol. 20, no. 9, pp. 2303-2311

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Summary:

Objective: This review will synthesize and integrate the best available evidence on the changes caused by the COVID-19 pandemic in access to and the provision of maternity services in Europe. The review will also consider health care professionals’ experiences in providing maternity care during the COVID-19 pandemic in Europe. Introduction: Governments and maternity services have introduced various protective sanitary and organizational measures to reduce the spread of COVID-19 and protect the global population, including health care professionals. Since March 2020, the number of publications on this topic has soared, yet little is known about the effect of the pandemic and the accompanying measures on access to and the provision of maternity care in Europe. Inclusion criteria: The review will consider quantitative, qualitative, and mixed methods studies on the impact of COVID-19 on European maternity services. For the quantitative component, the review will consider studies evaluating maternity services outcomes across all types of maternity care settings. For the qualitative component, the review will consider studies exploring maternity health care providers’ experiences and perceptions of the impact of the pandemic on care provided to women and their babies. Methods: Six bibliographic databases will be searched for published and unpublished studies since March 2020. Study selection, critical appraisal, data extraction, and data synthesis will follow JBI's segregated mixed methods approach. The quantitative component will be adapted to follow the JBI requirements for systematic reviews of etiology and risk. Systematic review registration number: PROSPERO CRD42021283878

Evaluation of a pilot consultation for maternity protection at work in Switzerland
Scientific paper ArODES

Peggy Krief, Zakia Mediouni, Alessia Abderhalden-Zellweger, Dominique Kerr, Nesi Seraj, Saira-Christine Renteria, Julien Vonlanthen, Brigitta Danuser

Swiss medical weekly,  2022, vol. 152, art. w30160

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Summary:

STUDY AIMS: Switzerland’s Labour Law and its Ordonnance on Maternity Protection aim to protect the health of pregnant employees and their unborn children while enabling them to continue to pursue their professional activities. Some companies encounter difficulties implementing the law’s provisions. The Department of Occupational and Environmental Health, part of the Center for Primary Care and Public Health (Unisanté), has provided specialist occupational medicine consultations for pregnant employees since 2015. This study aimed to evaluate how well Swiss’ maternity protection legislation is implemented by examining a list of relevant indicators measured during the occupational health consultation. The study also sought to investigate the consultation support provided to the relevant stakeholders and the adjustments made to pregnant employees’ working conditions. METHODS: Descriptive variables and indicators relative to the application of the Swiss maternity protection legislation for 83 pregnant employees were collected during the consultation’s pilot phase (between 2015 and 2016). Descriptive statistics and cross-analyses of these indicators were made. RESULTS: Most pregnant employees faced multiple exposures to occupational risks. Preventive risk analyses were rare. Few adjustments to workstations were proposed. We found a tendency for employees to leave their workstations early on in their pregnancies due to sick leave certificate prescriptions. Specialist consultation and collaboration with occupational health physicians to recommend interventions for pregnant employees can provide significant benefits and help some pregnant women to continue at their workstations with appropriate adjustments. DISCUSSION: A specialised occupational health consultation is a useful instrument for identifying occupational hazards for both the pregnant woman and her unborn child. It is also an opportunity to explain employers’ legal responsibilities and obligations to safeguard the health of their pregnant employees and to give specific advice for their company’s situation. This consultation also enables employers to maintain their employees’ valuable professional competencies in the workplace for as long as possible. Finally, occupational health consultation helps and supports healthcare providers who must, according to the law, make decisions about whether pregnant employees can continue working safely or not.

Protection des travailleuses enceintes et allaitantes en Suisse :
Scientific paper ArODES
guide pratique

Peggy Krief, Isabelle Probst, Alessia Abderhalden-Zellweger, Saira-Christine Renteria, Marianne Kamara, Carole Clair

Revue médicale Suisse,  2022, vol. 18, no. 788, pp. 1306-1312

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Summary:

Specific working conditions may endanger pregnant women’s and their children’s health. Switzerland has specific legislation for the protection of pregnant and breastfeeding employees. However, the implementation of these provisions presents important shortcomings. Attending physicians or gynaecologists-obstetricians who care for pregnant women have a central role in controlling the efficacy of protective measures put in place for their patients at work. What are the occupational exposures at risk and their health impact ? What are the collaboration with the different actors involved in the protection of maternity at work ? What steps should be taken if occupational dangers are identified? What tools can be used ? This article answers and explore these questions.

Soins périnatals gérés par les sage-femmes :
Professional paper ArODES
définitions et principes

Claire De Labrusse, Alessia Abderhalden-Zellweger, Anouck Pfund

Obstetrica,  2022, no. 4, pp. 44-47

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Summary:

Les auteures de cet article offrent ici un aperçu du modèle de soin périnatals gérés par les sage-femmes, et exposent ses particularités, ses principes et ses apports tels que décrits dans la littérature scientifique.

2021

Maternity protection at work and safety climate :
Scientific paper ArODES
the perceptions of managers and employees in three healthcare institutions in Switzerland

Alessia Abderhalden-Zellweger, Isabelle Probst, Maria-Pia Politis Mercier, Brigitta Danuser, Peggy Krief

Scandinavian Journal of Work and Organizational Psychology,  2021, vol. 6. art. 8

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Summary:

The literature on the application of legal maternity protection measures in the workplace reveals that many organizations are failing to develop and maintain an in-house safety climate that manages to accommodate work and pregnancy. This study sought to understand managers’ and employees’ perceptions vis-à-vis different ways of managing pregnancy in healthcare settings. Further, the study aimed to identify pathways towards establishing a safety climate that makes pregnant employees feel protected and able to continue their work without discrimination or danger to their health or that of their unborn child. We investigated three healthcare institutions in Switzerland, carrying out 30 interviews with different stakeholders involved in maternity protection at work and analyzing their transcripts thematically. Managers and employees in the same healthcare institution can have divergent perceptions of maternity protection measures and their effects. Elements associated with pregnant employees perceiving a positive safety climate included their direct superiors’ perceived commitment to safety, shared perceptions of risks, the perception of adequate levels of information, the presence of an occupational health unit, and formal institutional procedures for managing and supporting pregnant employees. Incorporating and considering different stakeholders’ experiences is essential to understanding and improving the institution’s safety climate and women’s overall experience of pregnancy at work.

Zwanzig Jahre Mutterschutz in der Schweiz :
Scientific paper ArODES
Quid ?

Brigitta Danuser, Alessia Abderhalden-Zellweger, Isabelle Probst, Maria-Pia Politis Mercier, Pascal Wild, Peggy Krief

ASU : Arbeitsmedizin, Sozialmedizin, Umweltmedizin : Zeitschrift für medizinische Prävention,  2021, vol. 56, no. 8, pp. 484-489

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Summary:

Aim: In 2001, the Maternity Protection Ordinance (MSV) came into force in Switzerland. The aim of our study was to better understand how the MSV is applied in two economic sectors, i.e. health care and food industry, in French-speaking Switzerland and how those affected deal with it. Method: A mixed method design was applied: quantitative surveys among 200 companies and 93 gynaecologists (GG) and case studies in six organisations with a total of 46 semi-structured interviews. Results: The GG estimate that they receive a risk analysis (RA) for only 5 % of pregnant women with an occupational hazard and 35 % of GG never/rarely request an RA. Sick leave is preferred to protective leave. Almost half (48 %) of the companies involved stated that they have in-house procedures that correspond to the Swiss MSV. Nevertheless, only 25 % (n = 51) stated that an RA was carried out in their company, and only 15 of these were prepared by a qualified specialist. We extrapolated from stratified random sampling that 6 % of companies in the health care sector and 1 % in the food industry are legally compliant with the MSV. Affected women develop various strategies to reconcile pregnancy and work and they rely heavily on their colleagues and on the GG. Conclusions: Maternity protection at work is only marginally implemented in Switzerland. The question arises as to how the implementation can be improved and whether certain insurance law content of the MSV should be revised.

Protecting pregnancy at work :
Scientific paper ArODES
normative safety measures and employees’ safety strategies in reconciling work and pregnancy

Alessia Abderhalden-Zellweger, Isabelle Probst, Maria-Pia Politis Mercier, Brigitta Danuser, Peggy Krief

Safety science,  October 2021, vol. 142, article 105387

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Summary:

Background In Switzerland, occupational risks for pregnant workers are covered by specific maternity protection legislation (MPL); however, studies show significant shortcomings in the implementation of these policies among companies. Aims Analyse the gaps between the provisions of Switzerland’s MPL, the protective measures companies plan to take and actual protection practices. We also aim to understand how employees develop their own strategies in order to make up for the shortcomings or contradictions of companies’ measures. Methods Interviews with 46 different stakeholders from organisations in the healthcare sector and the food industry were transcribed and analysed thematically. Results Some of the organisations used procedures apparently in line with legislation, while others planned more informal approaches to managing on a case-by-case basis. Normative safety measures within the framework of national legislation served as resources for both managers and their employees. However, implementing these measures ran up against real-world workplace constraints, which sometimes rendered them impracticable. Employees adapted some measures considered insufficient or developed their own strategies to reconcile work and pregnancy. Conclusions Being pregnant is challenging to represent in occupational settings; it is not a disease, but it involves important physical and biopsychosocial changes, which affect women’s occupational life. The multidimensional, evolving, and yet temporary nature of pregnancy represents a significant challenge to the implementation of MPL within companies. Linking the normative safety measures stipulated in the legislation with pregnant employees’ needs—and their job-related knowledge and skills—could be an interesting pathway towards improving maternity protection at work.

COVID-19 et femmes ­enceintes :
Professional paper ArODES
une action de plaidoyer en temps réel

Maria-Pia Politis Mercier, Alessia Abderhalden-Zellweger, Isabelle Probst, Brigitta Danuser, Peggy Krief

Obstetrica,  Mai 2021, no. 5, pp. 58-61

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Summary:

Maria-Pia Politis Mercier, maître d’enseignement et sage-femme (HESAV), Alessia Abderhalden-Zellweger, chargée de recherche et psychologue (HESAV et ­Unisanté), Isabelle Probst, professeure associée et ­psychologue (HESAV), Brigitta Danuser, Professeure honoraire et médecin du travail (Unisanté) et Peggy Krief, médecin adjointe et médecin du travail ­(Unisanté), témoignent dans cet article de leur action pour alerter des impacts du COVID-19 sur les femmes enceintes et protéger les travailleuses. Un défi de ­santé publique, relevé en temps réel.

Implementation of the Swiss ordinance on maternity protection at work in companies in French-speaking Switzerland
Scientific paper ArODES

Alessia Abderhalden-Zellweger, Isabelle Probst, Maria-Pia Politis Mercier, Michela Zenoni, Pascal Wild, Brigitta Danuser, Peggy Krief

Work,  2021, vol. 69, no. 1, pp. 157-172

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Summary:

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.

Les futures mères sont mal protégées au travail
Professional paper ArODES

Isabelle Probst, Alessia Abderhalden-Zellweger, Maria-Pia Politis Mercier, Brigitta Danuser, Peggy Krief

Reiso : revue d'information sociale,  2021, mis en ligne le 1er avril

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Summary:

Une enquête menée auprès de 202 entreprises romandes montre que les prescriptions légales en matière de protection des travailleuses enceintes ne sont que peu appliquées.

Evolution of gynaecologists’ practices regarding the implementation of Swiss legislation on maternity protection at work between 2008 and 2017
Scientific paper ArODES

Alessia Abderhalden-Zellweger, Zakia Mediouni, Isabelle Probst, Maria-Pia Politis Mercier, Brigitta Danuser, Pascal Wild, Bastien Chiarini, Marie-Louise Hale, Peggy Krief

Swiss medical weekly,  2021, vol. 151, no. 29, art. w20537

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Summary:

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.

Midwives’ practices, difficulties and contributions to protecting French-speaking Switzerland’s pregnant employees
Scientific paper

Abderhalden Alessia, Politis Mercier Maria-Pia, Probst Isabelle, Pascal Wild, Brigitta Danuser, Peggy Krief

Midwifery, 2021 , vol.  102

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2020

Les sages-femmes et la protection des ­travailleuses enceintes
Professional paper ArODES

Maria-Pia Politis Mercier, Alessia Abderhalden-Zellweger, Briggita Danuser, Peggy Krief, Isabelle Probst

Obstetrica,  2020, no. 10, pp. 68-72

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Summary:

Les femmes enceintes qui travaillent ne sont pas ­toujours bien informées quant à leur protection, et les sages-femmes elles-mêmes manquent parfois de compétences en la matière. Une recherche a été menée en Suisse romande sur le sujet et propose quelques pistes de réflexions et des ­recommandations.

Les travailleuses enceintes sont sous-protégées
Professional paper ArODES

Maria-Pia Politis Mercier, Peggy Krief, Isabelle Probst, Alessia Abderhalden-Zellweger, Brigitta Danuser

Reiso : revue d'information sociale,  2020, mis en ligne le 8 mai

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Summary:

L’ordonnance fédérale sur le COVID-19 n’a pas intégré les travailleuses enceintes parmi «les personnes vulnérables». Des arguments cliniques, juridiques et sociaux plaident pourtant pour que le principe de précaution leur soit appliqué.

Implementation of maternity protection legislation :
Scientific paper ArODES
gynecologists’ perceptions and practices in French-speaking Switzerland

Alessia Abderhalden-Zellweger, Isabelle Probst, Maria-Pia Politis Mercier, Brigitta Danuser, Pascal Wild, Peggy Krief

PLoS One,  2020, vol. 15, no. 4, article e0231858

Link to the publication

Summary:

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.

2019

Protection of pregnant women at work in Switzerland :
Book chapter ArODES
implementation and experiences of maternity protection legislation

Alessia Abderhalden-Zellweger, Peggy Krief, Maria-Pia Politis Mercier, Brigitta Danuser, Pascal Wild, Michela Zenoni, Isabelle Probst

Dans Albolino, Sara, Alexander, Thomas, Bagnara, Sebastiano, Fujita, Yushi, Tartaglia, Riccardo, Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018): Vol. II. Safety and health, slips, trips and falls  (12 p.). 2019,  Cham : Springer

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Summary:

Objectives. Like most industrialized countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace hazards. This study aims to assess legislation’s degree of implementation in the French-speaking part of Switzerland and understand the barriers to and resources supporting its implementation. Methods. Data were collected using mixed methods: (1) an online questionnaire send to 333 gynecologist-obstetricians (GOs) and 637 midwives; (2) exploratory semi-structured interviews with 5 workers who had had a pregnancy in the last 5 years. Results. Questionnaire response rates were 32% for GOs and 54% for midwives. Data showed that several aspects of the implementation of maternity protection policies could be improved. Where patients encounter workplace hazards, GOs and midwives estimated that they only received a risk assessment from the employer in about 5% and 2% of cases, respectively. Preventive leave is underprescribed: 32% of GOs reported that they “often” or “always” prescribed preventive leave in cases involving occupational hazards; 58% of GOs reported that they “often” or “always” prescribed sick leave instead. Interviews with workers identified several barriers to the implementation of protective policies in workplaces: a lack of information about protective measures and pregnancy rights; organizational problems triggered by job and schedule adjustments; and discrepancies between some safety measures and their personal needs. Conclusions. Results demonstrate the need to improve the implementation and appropriateness of maternity protection legislation in Switzerland. More research is required to identify the factors affecting its implementation.

2018

Implementation, mechanisms and effects of maternity protection legislation :
Scientific paper ArODES
a realist narrative review of the literature

Isabelle Probst, Alessia Abderhalden-Zellweger, Maria-Pia Politis Mercier, Brigitta Danuser, Peggy Krief

International Archives of Occupational and Environmental Health,  2018, vol. 91, no. 8, pp. 901-922

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Summary:

Purpose : Most industrialized countries have introduced maternity protection legislation (MPL) to protect the health of pregnant workers and their unborn children from workplace exposure. This review aimed to assess this legislation’s level of implementation, barriers and facilitators to it, and its expected or unexpected effects. Methods : A realist narrative review was conducted. Keyword searches of the PubMed, CINAHL, PsycINFO, MIDIRS, Sociological abstracts and Google Scholar electronic databases were performed in March 2018. Results : The 42 publications included show that the implementation of MPL is deficient in most countries. Allowing pregnant women to withdraw from work on preventive leave or sick leave is favored over workplace adaptations or worker reassignments. The publications highlight mechanisms which encourage or obstruct the enforcement of legislation at the levels of the individual, the physical and social environment, and the macrosocial context. The delay between the conception and implementation of maternity protection measures appears to be a major barrier to the efficacy of MPL. The literature also suggests that unexpected adverse effects, such as degradation in working relationships or discrimination can obstruct the implementation of protective measures. Conclusions : This study showed the need for a better implementation of MPL during pregnancy. Further research and recommendations for improvements in MPL should consider the diverse mechanisms and effects of its implementation. Barriers and adverse effects of this implementation do not only ensure a lack of information or awareness about MPL, but are also linked to contradictions between requirements to protect employment and protect pregnancy.

Protection of pregnant women at work in Switzerland :
Scientific paper ArODES
practices, obstacles and resources : a mixed-methods study protocol

Peggy Krief, Alessia Abderhalden-Zellweger, Maria-Pia Politis Mercier, Brigitta Danuser, Pascal Wild, Michela Zenoni, Isabelle Probst

BMJ Open,  2018, vol. 8, no. 6, e023532

Link to the publication

Summary:

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.

2023

Evaluation of an Occupational Health Intervention for Maternity Protection at Work :
Conference ArODES
a users' perspective about the specialized medicine consultation of Unisanté

Saira-Christine Renteria, Alessia Abderhalden-Zellweger, Julien Vonlanthen, Karine Moschetti, Loïc Brunner, Isabelle Probst, Peggy Krief

Gynecologic and obstetric investigation

Link to the conference

2021

Protection de la grossesse au travail :
Conference ArODES
entre cadre législatif, perceptions et pratiques en entreprise

Alessia Abderhalden-Zellweger, Isabelle Probst, Maria-Pia Politis Mercier, Brigitta Danuser, Peggy Krief

Actes du 55ème Congrès de la SELF 2021, "L’activité et ses frontières". Penser et agir sur les transformations de nos sociétés

Link to the conference

Summary:

The protection of pregnant workers is subject to specific laws and regulations. This interdisciplinary study sought to understand how workers who had experienced pregnancy in the workplace and their managers, perceive protective measures which flow out of these policies. Forty-six interviews, with different stakeholders, were conducted in six companies in French-speaking Switzerland. Transcripts were analysed using a phenomenological approach. The existence of an internal procedure, a risk analysis and a resource person for supporting pregnant employees promoted similar representations of occupational risks among the stakeholders and the implementation of protective measures within companies. However, specific working conditions and management patterns can impede the implementation of prescribed protection measures. In conclusion, taking into account the lived experience of the various stakeholders and their knowledge of real work is necessary in order to improve protection policies.

2018

Application des dispositions juridiques de protection de la maternité au travail en Suisse romande :
Conference ArODES
les pratiques des gynécologues et des sages-femmes

Alessia Abderhalden-Zellweger, Isabelle Probst, Brigitta Danuser, Maria-Pia Politis Mercier, Pascal Wild, Michela Zenoni, Peggy Krief

Archives des maladies professionnelles et de l'environnement

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