Definition Employee reports that she is pregnant and requests prenatal information. Prenatal health care benefits include increased pregnancy health and reduced infant mortality, maternal mortal- ity, and low birth-weight infant. Characteristics Most women feel healthy during pregnancy. As the pregnancy progresses, employee can ex- perience morning sickness, fatigue, swelling of feet and ankles, more frequent urination, varicose veins, mood changes, and backache. Policy All pregnant women should be under care of or referred to a health care provider. Prenatal education is integral to a healthy pregnancy outcome and can be provided at the worksite. Hazardous exposures should be eliminated or avoided. If in doubt about a potential haz- ardous exposure, consult employee’s health care provider, company physician, or Material Safety Data Sheets. Objectives Clinical Assessments and Interventions Referral for Medical Action 31 Pregnancy and Prenatal Health 11 ● Preterm labor. ● Hypertension. ● Vaginal bleeding. ● Extreme edema. ● Urinary tract infection. ● Decreased fetal movement. ● Diabetes (pre-existing or gesta- tional). ● Severe headaches/visual changes. ● Decreased fetal movement. Follow-up Actions ● Collaborate with health care provider regarding follow-up and monitoring of employee. ● Counsel employee about child- birth classes. ● Assist employee with maternity leave explain medical insurance benefits as needed. ● Counsel employee about return to work or limited duty after delivery. ● Assess need for supportive ser- vices (e.g., breastfeeding, parent- ing skills, daycare). ● Refer to employee assistance pro- gram if needed. Obtain pertinent history. Discuss prenatal health promotion. Monitor employee throughout preg- nancy. ● Review employee nutrition habits, tobacco and alcohol use, environmental hazards, family history, medical history, reproductive history, and drug use. ● Evaluate employee for risk factors of preg- nancy. ● Conduct workplace assessment to deter- mine if modification of work area is neces- sary. ● Emphasize importance of early prenatal care. ● Explain actions employee can take to maxi- mize the likelihood of a healthy pregnancy and infant: maintaining prenatal health care, eating a balanced diet, avoiding ciga- rettes and alcohol, limiting caffeine intake, getting moderate exercise, drinking six to eight glasses of water daily, and avoiding use of non-prescribed medications. ● Check employee weight, blood pressure, and urine and record them. ● Discuss signs of preterm labor. Guideline continues on next page