Abstract
BackgroundThe Italian Protective Maternity Legislation allows a woman to apply for early maternity leave from work during pregnancy if she is affected by health problems (option A) or if her working conditions are incompatible with pregnancy (option B). A community based health education program, implemented between 1995 to 1998 in North Eastern Italy, provided counseling (by a team of gynecologists, pediatricians, geneticists, psychologists and occupational physicians), and an information leaflet detailing the risks during pregnancy and the governmental benefits available to expectant mothers. This leaflet was distributed to women who were under occupational medical surveillance and to women attending any healthcare office and outpatient department and was also mailed to women working at home as shoemakers.The effectiveness of this intervention has been evaluated in this investigation using an evidence based approach.MethodsA quasi-experimental design was adopted, applying several outcome measurements before (1989 to 1994) and after (1999 to 2005) the intervention. The outcome (ratio B/A) is the number of women receiving approval for B (circumstance where the pregnant woman is employed to undertake activities forbidden under the Article 7 of Law 151/2001, and it is impossible to change her duties) to those receiving approval for A (risky pregnancy due to personal medical conditions, Article 17 of the same Law). A linear regression coefficient (for B/A against years) was obtained separately for time periods "before" (1989-94) and "after" (1999-2005) the intervention program. The two regression coefficients were compared using a t-test.ResultsThe trend over-time for the ratio B/A was steady before the initial intervention (y = 0.008x - 16.087; t = 2.09; p > 0.05) then increased considerably (y = 0.0426x - 84.89; t = 19.55; p < 0.001) in coincidence with the start of the education campaign. There was a significant difference between the two regression coefficients (t = 7.58; p < 0.001).ConclusionFrom a bureaucratic perspective Option B is far more complicated than A. In fact it implies an active approach involving an arrangement between the claimant and the employer, who has to certify to the relevant Authority that the woman's working conditions are incompatible with pregnancy. The increasing number of women availing of option B, as recommended, therefore suggests the suitability of such educational campaign(s).
Highlights
The Italian Protective Maternity Legislation allows a woman to apply for early maternity leave from work during pregnancy if she is affected by health problems or if her working conditions are incompatible with pregnancy
Using the opportunities offered by the project “Woman’s Wellbeing“ launched by the Veneto Region (North Eastern Italy), a comprehensive health education campaign was implemented in the same Region from 1995 to 1998, consisting of:
Face-to-face counseling provided by a team of gynecologists, pediatricians, geneticists, psychologists and occupational physicians throughout the pregnancy - that included information on the adverse effects of environmental, occupational and behavioral exposures on the health of mother and fetus;
Summary
The Italian Protective Maternity Legislation allows a woman to apply for early maternity leave from work during pregnancy if she is affected by health problems (option A) or if her working conditions are incompatible with pregnancy (option B). A community based health education program, implemented between 1995 to 1998 in North Eastern Italy, provided counseling (by a team of gynecologists, pediatricians, geneticists, psychologists and occupational physicians), and an information leaflet detailing the risks during pregnancy and the governmental benefits available to expectant mothers. This leaflet was distributed to women who were under occupational medical surveillance and to women attending any healthcare office and outpatient department and was mailed to women working at home as shoemakers. The effectiveness of this intervention has been evaluated in this investigation using an evidence based approach. Some data collected in those years evidenced in many cases a failure to comply with certain hygiene requirements (for example, the absence of appropriate exhaust systems or incorrect mode of application of glues), and that there was little or no recourse to benefits granted by law 151/2001, in particular there were no or few cases of abstention from work during pregnancy when the problem was the unhealthy workplace (Letter b, Art. 17, Law 151/2001) [1]
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