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

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Abstract

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.

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Notes

  1. This also implies that, in several countries, the present legislative framework is different from the regulations in force when the studies included in this review were made.

  2. The ILO defines informal sectors as those where “the salaried and unsalaried activities of intentionally unregistered or partially registered companies do not respect labor and social protection regulations: illegal work, clandestine sweatshops.” (Adair 2009 p. 1121). Translated by the authors.

  3. Translated by the authors.

  4. Translated by the authors.

  5. All quotations of Legrand (2015) translated by the authors.

  6. Translated by the authors.

  7. Restrictions lifted by the implementation of European Council Directive 92/85/EC.

  8. Translated by the authors.

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Acknowledgements

This study was funded by the Swiss National Science Foundation, Grant No. 162713.

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Authors and Affiliations

  1. School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011, Lausanne, Switzerland

    Isabelle Probst, Alessia Zellweger & Maria-Pia Politis Mercier

  2. Institute for Work and Health (IST), Universities of Lausanne and Geneva, Route de la Corniche 2, 1066, Epalinges, Switzerland

    Alessia Zellweger, Brigitta Danuser & Peggy Krief

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  1. Isabelle Probst
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Correspondence to Isabelle Probst.

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Appendix

Appendix

Exhaustive search strategy in all databases

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Table 6 Exhaustive search strategy in all databases
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Probst, I., Zellweger, A., Politis Mercier, MP. et al. Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature. Int Arch Occup Environ Health 91, 901–922 (2018). https://doi.org/10.1007/s00420-018-1339-y

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