When to Scale Back Your Professional Obligations

July 26, 2017 · Todd Coopee

Common day-to-day exposures in medicine can present increased risks to pregnant mothers and fetuses. The actual risks of many exposures are largely based on animal studies and they are not likely to be studied in a randomized fashion in humans. Therefore, as a pregnant resident you are recommended to gauge your own comfort with substances and situations encountered as part of your job.

In many circumstances, you may avoid the exposure by adjusting your rotation schedule or having a colleague see a patient. The National Center on Birth Defects and Developmental Disabilities (NCBDDD) website provides a list of exposures to should consider, with links to information that can help you make an informed decision.

Heavy lifting and prolonged standing are associated with increased risk of preterm labour, preterm birth, low birth weight, or a small-for-gestational (SGA) infant.

  • Heavy lifting is defined as repetitive lifting or carrying or lifting greater than 23 kg.
  • Excessive standing or walking is defined as standing for greater than three to four hours a day.
  • The Alberta Perinatal Health Program’s consensus is that eliminating heavy lifting by the 20th week of pregnancy, and eliminating excessive standing by the 24th week of pregnancy, reduces the risk of adverse perinatal outcomes to those of unexposed women.
  • If you are expecting multiples, speak with your physician. You may be advised to abstain from call duty earlier than during a singleton pregnancy.

Provincial Policies for Pregnant Physicians

Each province and program has unique policies regarding on-call and extended shifts during pregnancy. The table below shows the number of gestational weeks at which a pregnant physician is no longer required to fulfill extended shifts and on-call duty in each province. Links to each province’s complete policy are also given.

Table 1: Summary of Provincial Policies on Reduced Workload for Pregnant Physicians

Province: BC Alberta Saskatchewan Manitoba Ontario Quebec Maritimes Newfoundland and Labrador
# of gestational weeks: 24 27 28 31 27 20 28 32
Link to policy: Policy Policy Policy Policy (PDF) Policy Policy Policy (note 17.01 (d)) Policy