Second Trimester Pregnancy – from the 14th to 27th week
Photo Credit: Alicia Petresc/Unsplash
Esprit de Corps Magazine January 2021 // Volume 27 Issue 12
Let's Talk About Women in the Military – Column 22
By Military Woman
Question:
Do women need more military workplace considerations to ensure safe pregnancies?
Answer:
To fully answer this question, we need to consider each stage of pregnancy separately. Having already covered pre-conception (July 2020) and first trimester (October 2020), this column will focus on the second trimester of pregnancy (months 3-6).
Generally speaking, if there was a good time to continue one's duties in field, air, or sea operations while pregnant it would be during the second trimester. Why? Largely because this is the time period after the resolution of first trimester risks (e.g., miscarriage, ectopic pregnancy) and yet precedes the start of third trimester risks (e.g., early labour). The second trimester is also the stage of pregnancy where new organs and body systems have finished forming, making them less sensitive to most external hazard exposures. Furthermore, by the second trimester most women no longer suffer from morning sickness, acute sensitivities to smells or motion stimuli (for example, car, air, sea sickness).
Overall, most women feel quite well during their second trimester and may therefore naturally question the need for any operational duty employment restrictions. In fact, often the only potential employment limitation identified by pregnant servicewomen is the sense/need to urinate more frequently (due to the pregnancy's growth placing ever increasing amounts of pressure on her bladder). This may pose operational challenges if there is a lack of easy access to a bathroom and/or if there is a need to remain at one's post (e.g., flying a helicopter). Military women have long self-addressed such situations by tactically reducing their water intake; however, this can potentially lead to dehydration and increased health risks-especially when pregnant.
Since operational environments are neither static nor predictable, another consideration is abdominal blunt trauma. This type of risk increases as the pregnancy starts to grow above and beyond the protection initially provided by the pelvic bones. The risk of being thrown against the wall of a tank/plane/ship upon hitting a pothole/patch of turbulence/sea swell, and suffering a blunt abdominal trauma, although rare, is clearly higher than if working in an office environment.
Medical assessment of any direct abdominal blunt force events for a pregnant woman can require different thresholds of concern, training and equipment than needed for a non-pregnant adult. The specialized care, training and resources required for obstetric-related trauma assessments are not typically available in Canadian operational military settings. Transportation time to the appropriate level of medical care, especially if over one hour away, can increase the risk of adverse outcomes for both the woman and her pregnancy.
Another potential military exposure consideration is noise. Sound waves are known to be able to travel directly through the abdomen and have the potential of negatively impacting a new and still growing auditory system. To minimize this risk, workplace standards for pregnant adults have long been set at a maximum of 115 dBA for high frequency sound exposures. There is, however, a growing body of experts recommending this standard be lowered to 85 dBA. This is especially relevant to serving women as many military workplaces are known to be at 85 dBA exposures or above-including construction sites, machinery spaces, airfields, engine rooms, and anywhere there are weapons and/or explosive discharges.
Avoiding low frequency sound waves, or vibrations, while pregnant is also recommended. Sources of whole-body vibration can include aircraft (especially helicopters), ships and military vehicles. More information about these and other exposures can be found at an online resource called Reproductive Health in the Workplace (US National Institute of Occupational Safety and Health).
In closing, despite the second trimester of pregnancy generally being considered the safest period of time in a pregnancy, there are still many unknowns that require targeted resources and efforts to study properly. Research into identification and risk mitigation strategies for military workplace hazard exposures while pregnant remains woefully lagging. We can and must do better.
Update:
2024. The National Institute of Occupational Safety and Health (NIOSH) has updated materials on workplace reproductive hazards for employers and employees as does the Canadian Centre for Occupational Health and Safety (CCOHS).
