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Useful information

 1. Swine Flu and Pregnancy information

(Reference NHS Choice January 2010)

 2. Maternity Rights

 1. Swine Flu and Pregnancy information 

Why pregnant women are more at risk

In pregnancy, the immune system is naturally suppressed. This means that pregnant women are more likely to catch swine flu, and if they do catch it, they are more likely to develop complications (see below).

Don't panic: your immune system still functions and the risk of complications is very small. Most pregnant women will only have mild symptoms.

Vaccination and pregnancy

Pregnant women are in one of the groups who will be offered the swine flu vaccination first. The vaccine is recommended for all pregnant women, whatever the stage of the pregnancy.

There is no evidence that inactivated vaccines, such as the swine flu vaccine, will cause any harm to pregnant women or their unborn baby. Every year, the seasonal flu vaccine is given to pregnant women who are at risk of seasonal flu.

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has given a clear recommendation that the GlaxoSmithKline vaccine Pandemrix can be given safely to all pregnant women.

Why don't they vaccinate pregnant women against flu normally in the UK?

Seasonal flu is generally mild and a variant on previous strains, so adults tend to have a degree of immunity. Every year, around 18% of pregnant women get seasonal flu and the vast majority have no particular problems. The worry with swine flu is that it is a new strain which is not recognised by the immune system. While also mild at the moment, it might mutate into a more dangerous strain.

But shouldn't you avoid medication when pregnant?

In general, yes. But vaccines can contain live or killed virus particles to boost your immune system and give natural protection against disease. Live vaccines aren't recommended in pregnancy but killed vaccines are considered safe for mother and foetus. So if you cut yourself when pregnant, you'll be offered a tetanus booster. because the vaccine is safe but the disease is potentially fatal.

Can you be certain the vaccine is safe?

No. Studies on the vaccine to be used in the UK have not had long-term follow up and have only included 340 people. There is no guarantee that the vaccine is safe. All one can say is that there is a very high probability that you will be at less risk from the vaccine than the disease, especially if your immune system is compromised.

Are you pregnant and feeling unwell?

If you are pregnant and have flu-like symptoms:

  • Stay at home and call your GP, who will be able to give a diagnosis over the phone.
  • If swine flu is confirmed, your GP will advise you on how to collect antiviral medication.
  • Ask a healthy friend or relative to pick up the antiviral medication for you. 

In the meantime, take paracetamol to reduce fever and other symptoms. Drink plenty of fluids and get lots of rest.

For more advice see the Swine flu pregnancy leaflet.

If you are pregnant, you are in one of the high-risk groups for swine flu, so it is important to read this page carefully and follow the advice to protect yourself and your baby.

This page explains why pregnant women are at greater risk from swine flu, what those risks are, the special precautions you should take and the safety information for swine flu treatments.

Symptoms and risks

If you are pregnant and you catch swine flu, the symptoms should be similar to those of regular flu. You will typically have a fever or high temperature (over 38°C/100.4°F) and two or more of the following:

  • unusual tiredness,
  • headache,
  • runny nose,
  • sore throat,
  • shortness of breath or cough,
  • loss of appetite,
  • aching muscles, 
  • diarrhoea or vomiting.

Most pregnant women will have only mild symptoms and recover within a week. However, there is evidence from previous flu pandemics that pregnant women are more likely to develop complications.

Possible complications are:

  • pneumonia (an infection of the lungs),
  • difficulty breathing, and 
  • dehydration.

In pregnant women, these are more likely to happen in the second and third trimester.

If a pregnant woman develops a complication of swine flu, such as pneumonia, there is a small chance this will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.

It is therefore important to be well prepared and to take precautions against swine flu.

Special precautions

If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible.

Pregnant women should also follow the general advice outlined in the box, top right. Good hygiene is essential.

If a family member or other close contact has swine flu, your doctor may prescribe you antiviral medication (usually Relenza) as a prophylactic (preventative) measure.

If you think that you may have swine flu, call your doctor for an assessment immediately. If your doctor confirms swine flu over the phone, you will be prescribed antiviral medication to take as soon as possible (see box, left).

Unless you have swine flu symptoms, carry on attending your antenatal appointments to monitor the progress of your pregnancy.

Swine flu treatment

Antivirals

If you are pregnant and diagnosed with swine flu, you will usually be given a course of antiviral drugs, which should be taken as soon as possible.

If you have an uncomplicated illness due to influenza and do not have an underlying disease, you can take either Relenza or Tamiflu. Relenza is recommended as first choice.

Relenza is inhaled using a disk-shaped inhaler. It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta. Relenza should not affect your pregnancy or your growing baby.

However, Tamiflu should be offered to you instead of Relenza if you:

  • have a condition such as asthma or chronic obstructive pulmonary disease,
  • have difficulty taking an inhaled antiviral, or
  • develop a severe or complicated disease due to influenza (where you will probably be treated in hospital).

An expert group reviewed the risk of antiviral treatment in pregnancy. It is much smaller than the risk posed by the symptoms of swine flu.

Some people have had wheezing or serious breathing problems when they have used Relenza. Relenza is therefore not recommended for people with asthma or chronic obstructive pulmonary disease (COPD). Other possible side effects include headaches, diarrhoea, nausea and vomiting.

In a small number of cases, nausea is a side effect of Tamiflu.

If you take an antiviral and have side effects, see your healthcare professional to check that you are OK. Then report your suspected drug reaction to the Medicines and Healthcare products Regulatory Agency (MHRA) using their new online system.

Painkillers

You can also take paracetamol to reduce fever and other symptoms; this is safe to take in pregnancy.

However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).

2. Maternity leave - In England

This information applies to England, Wales, Scotland and Northern Ireland


About this information

This information tells you about your rights to maternity leave. It applies to all women whose baby had a due date on or after 1 April 2007.

This information doesn't apply to you if your baby was due before 1 April 2007, even if it was born on or after that date.

However, the information will apply to you if your baby was born before 1 April 2007 although it was due after that date.

If you want to find out about your maternity rights for a baby which had a due date before 1 April 2007, or you're not sure if this information applies to you, you should get advice from an experienced adviser, for example, at a Citizens Advice Bureau.

When can your maternity leave start

You can choose when to start your maternity leave. It can be at any time in, or after, the 11th week before your baby is due. However, your maternity leave will start automatically if you're off work for any reason to do with your pregnancy from the fourth week before your baby is due.

Telling your employer that you want to take maternity leave

You must tell your employer, preferably in writing, by the end of the 15th week before your baby is due:

  • that you're pregnant
  • the date your baby is due
  • the date you want your maternity leave to start.

You must produce a medical certificate (MATB1), if your employer asks for one, showing when your baby is due. You can get your MATB1 from your midwife or GP.

Once your employer has received your notice that you want to take maternity leave, they must write to you within 28 days and tell you the date your maternity leave runs out and therefore the date when you are expected to return to work from maternity leave.

How much maternity leave will you get

Most women employees have the right to take up to one year’s (52 weeks’) maternity leave. This does not depend on how long you have worked for your employer. The only employees who don't have this right are:

  • share fisherwomen
  • women who are normally employed abroad (unless they have a work connection with the UK)
  • self-employed women
  • policewomen and women serving in the armed forces.

If you're not sure whether or not you're an employee, see Contracts of employment.

You can choose how long you take off work for maternity leave, up to a maximum of 52 weeks. However, the law says that you must take at least two weeks immediately after the baby is born. If you work in a factory, you must take at least four weeks.

 

What are your employment rights while on maternity leave

The first 26 weeks of maternity leave are called Ordinary Maternity Leave (OML). During OML, you will still get all the same rights under your contract of employment as if you were still at work. The only exception is that you will not get your normal pay unless your contract allows for it. But you will, for example, still be entitled to build up holiday and to get any pay increase.

Though you are not entitled to your normal pay, most women employees are entitled to Statutory Maternity Pay or Maternity Allowance.

For more information about maternity pay, see Parental rights at work.

For more information on contractual rights, see Contracts of employment.

As well as Ordinary Maternity Leave (OML), you can also take an additional 26 weeks' maternity leave. This is called Additional Maternity Leave (AML). This gives a total of up to 52 weeks’ maternity leave. If you're taking AML, this must follow on directly after OML and there must be no gap between the two.

Your contract of employment will also continue throughout AML unless either you or your employer ends it or it runs out. However, if your expected week of child birth is before 5 October 2008, you won't keep all of your rights under your employment contract during your AML.

Some of the terms and conditions of your employment contract which will still apply during AML include:

  • you're entitled to get whatever period of notice it says in your contract if your employment ends
  • you must give your employer the notice it says in your contract if you want to end the contract
  • you have the right to any redundancy pay if you're made redundant
  • any terms and conditions in your contract of employment about disciplinary or grievance procedures will continue to apply.

birth is before 5 October 2008, it can be

There are other terms and conditions which will not apply unless your employer agrees otherwise. For example, you will not have the right to normal pay or to contractual holiday pay (though you are still entitled to build up statutory holiday) or to a pay increase unless your employment contract gives you these rights.

If your expected date of child complicated to work out which terms and conditions of your employment contract still apply when you're on AML. For more information, you should consult an experienced adviser, for example, at a Citizen’s Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email,

If your expected week of child birth is on or after 5 October 2008, your terms and conditions of employment continue during your AML like they do during your OML. This covers all your rights except you won't get your normal pay unless your contract allows for it.


Returning to work after maternity leave

If you decide you want to return to work earlier than the date your maternity leave is due to end, you must give your employer eight weeks’ notice of your new date of return to work. For more information about returning to work after maternity leave, see under heading Your right to return to work after maternity leave.


Keeping in touch with your employer during your maternity leave

When you are on maternity leave, your employer should keep you informed of issues which may affect you. For example, you should be informed of any relevant promotion opportunities or job vacancies that arise during your maternity leave.

The amount and type of contact between you and your employer must be reasonable. Contact can be made in any way that best suits either or both of you. For example, it could be by telephone, by email, by letter, by you making a visit to the workplace or in other ways.

You are also allowed to work for up to ten days during your maternity leave without it affecting your maternity pay. These are called 'Keeping in Touch Days'.

Both you and your employer must agree about whether you work any Keeping in Touch Days, how many you will work, when you will work them and how much you will be paid for them. You are under no obligation to work them and your employer is under no obligation to offer them to you.

You must also agree between you what sort of work you will do. Keeping in Touch Days could be particularly useful in enabling you to attend a conference, undertake a training activity or attend for a team meeting.

The rate of pay is a matter for agreement with your employer. It may be set out in your employment contract or agreed on a case-by-case basis. However, you must be paid at least the National Minimum Wage.


Maternity leave and continuous employment

Some employment rights, such as the right to claim statutory redundancy pay, depend on how long you have worked for your employer. The length of time you have worked for your employer is the length of your ‘continuous employment’. It is important, therefore, to note that time spent on maternity leave counts when calculating how long you have been with your employer. 


Your right to return to work after maternity leave

Right to return after your Ordinary Maternity Leave

All women have the right to return to their old job after 26 weeks’ OML.

After 26 weeks’ OML, you do not have to give your employer notice that you are returning to work. You can just turn up for work on the day you are due back.

If your employer refuses to let you return after your Ordinary Maternity Leave

If you're not allowed to return to work after your Ordinary Maternity Leave, you can claim your dismissal is automatically unfair for a reason to do with your pregnancy or maternity leave. You could also claim sex discrimination. Both of these claims can be made regardless of how long you have worked for the employer or how many hours a week you work.

If you wish to make claim for automatic unfair dismissal and/or sex discrimination, you should speak to an experienced adviser, for example, a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by e-mail,

If you are sick at the end of your Ordinary Maternity Leave

If you're sick when you are due back to work at the end of your Ordinary Maternity Leave (OML), you must get a medical certificate to send to your employer. Your OML will end at the end of the 26th week and you will then go onto sick leave. You will be protected from unfair dismissal for an additional four weeks after your 26 weeks’ OML if you are sick for this period.

If an employer tries to dismiss a woman who is sick at the end of her maternity leave and so cannot return to work, this is likely to be sex discrimination. If you are in this position, you should consult an experienced adviser, for example, a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by e-mail,

Right to return to work after your Additional Maternity Leave

If you wish to return to work after AML, you should be offered your old job back, unless this is not reasonably practical. If it is not reasonably practical to offer you your old job back, you must be offered a job that is suitable for you and appropriate in the circumstances, on the same terms and conditions as your old job. For example, your pay must be at least the same as your old job.

If you have not been offered your old job back, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by e-mail, 

You don't have to inform your employer of the date you intend to return after your AML, as it will be expected that you'll return at the end of your AML. This is the date your employer told you your maternity leave ended. If you want to return to work earlier than this date, you must inform your employer of this, in writing, at least eight weeks before you want to return.

Right to return part time

You have no automatic right to return to work part time after maternity leave. However, you may have the right to ask for flexible working and this request must be considered seriously by your employer. If they do not consider it seriously, this could be sex discrimination.

For more information about taking a sex discrimination case, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by e-mail,

Maternity pay

While you are on maternity leave, you may be entitled to maternity pay either under your contract of employment or by law through Statutory Maternity Pay or Maternity Allowance, which can be paid for up to 39 weeks. The rules about maternity pay depend on how long you've worked for your employer, how much you earn and what your contract says.

For more information about maternity pay, see Parental rights at work.

Other parental rights

If you’re pregnant or have just had a baby, you may have other rights. These rights include:

  • the right of all pregnant women to take time off work for ante-natal care
  • the right of all pregnant women to work in a safe environment
  • the right of all pregnant women to claim unfair dismissal if dismissed because of pregnancy.








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