From the moment you find out you’re pregnant, you may find elements of your working life a little harder than before.  Not only will you be keeping your new condition quiet until your first scan, but you may well be trying to cope with morning sickness and tiredness, not to mention hormone fluctuations and the odd mood swing.  Yes, working whilst pregnant is something that most of us do, but that many of us struggle with.  It’s not just being at work either; commuting isn’t much fun even when you’re not pregnant, but add a bump, swollen ankles and the need to pee into the bargain and you’ll be counting down to your maternity leave with all your might!

We’ve been speaking to a number of experts at London Bridge Hospital about the changes a woman’s body goes through during pregnancy and how best to accommodate these while travelling to work.

Commuting:  If you can sit down, do!

When you are pregnant, even in your first trimester, it is really important that you sit down when possible to reduce the risk posed to you and the baby. “Pregnancy hormones such as those aimed at relaxing you not only cause relaxation of the joints around the pelvis, aimed at preparing the body for childbirth, but also generally around the body”, explains Mr Simon Moyes, Consultant Orthopaedic Surgeon. “This, combined with even a normal amount of weight gain will put additional strain on the joints during pregnancy. On top of this, the change in the body’s centre of gravity alters the posturing and gait, which can also contribute to joint pains”.

While sitting down obviously offloads the affected joints reducing the chance of flare-ups, Emma Brockwell, Senior Physiotherapist with an interest in Women’s Health, highlights which other pregnancy-related issues can be alleviated by sitting down on the tube, train or bus:

  • During pregnancy the body’s centre of gravity if altered which can affect your balance and increase your risk of falling. Falls will always put the baby and you at risk, thus sitting will reduce this risk compared with standing
  • Standing in the same position whilst pregnant can also cause dizziness and fainting because blood pools in the lower extremities, again increasing the risk of falls
  • People barging and elbows digging in, whilst unlikely to injure the baby can be very uncomfortable to you and make you feel vulnerable. Taking a seat helps avoid this
  • Water retention and swollen ankles is yet another symptom you are likely to experience so taking some load and sitting can help even the most swollen extremities
  • Morning sickness is a very common symptom of pregnancy and can affect women throughout their pregnancy if they are suffering from hyperemesis gravidarum. Motion can trigger the sickness but it is easier to cope with it sitting down

Commuting: Posture is key

Sitting down, while helping to alleviate the above issues, is not where it stops. It is still important to be aware of your posture throughout the journey to avoid placing strain on different parts of the body.

Emma Brockwell suggests

  • On the rare occasion that you may be spoilt for seat choice, choose the seat nearest to the door. This avoids the risk of falling if the train or tube moves suddenly before you have sat down. It also means that when you get up you do not have to clamber over feet and bags and risk falling again.
  • When sitting, sit with your shoulders back and neck long. As your bump gets bigger, most women will adopt postural adaptations, commonly leading to an increase in the curve at the small of your back which can cause lower back pain. Popping a spare jumper behind the small of your back can help support this change and decrease pain.
  • Keep your knees in line with your hips when you are sitting and keep weight spread evenly through both hips. Crossing or widening your legs may feel more comfortable but can place unnecessary strain on pelvic and low back joints.
  • If your journey is longer than 30 minutes, wriggle your toes and pump your ankles up and down frequently to prevent blood pooling at the bottom of your legs.”
  • Hold your head up straight; do not tilt your head forward, backward, down or sideways. Stretch the top of your head towards the ceiling
  • Make sure your earlobes are in line with the middle of your shoulders
  • Keep your shoulder blades back and your chest forward
  • Keep your knees straight but not locked
  • Pull your stomach in and up (as much as possible) and keep your buttocks tucked in
  • Point your feet in the same direction, with your weight balanced evenly on both feet. The arches of your feet should be supported with low-heeled (but not flat) shoes to prevent stress on your back. Avoid standing in the same position for more than 10 minutes

Keep hydrated and well nourished

While commuting, especially during warmer periods, it is important to keep hydrated at all times, especially if you are suffering from morning sickness or, more severely, hyperemesis gravidarum. Commuting with morning sickness can be miserable; Robyn Coetzee, Specialist Dietitian, has offered some tips on how to reduce symptoms as much as possible so as to make that journey just a little more bearable:

  • Take a cold bottle of water or diluted fruit juice to sip on during the journey. This will help to keep you cool and hydrated
  • Take something to snack on if you have a long journey. Long periods without eating can make nausea worse. Plain biscuits, cereal bars and nuts all travel well and can be helpful to nibble on
  • Make sure to wash your hands after travelling and before eating. A woman’s immunity drops slightly during pregnancy making it easier to pick up bugs and become sick from food contamination

Further tips to reduce nausea throughout the day include:

  • Try to have small, frequent meals and snacks. Having an empty stomach tends to make feelings of nausea worse
  • Keep hydrated. Sip on small amounts of fluids across the day
  • Cold, plain foods are often better tolerated than hot food as these tend to have less of an aroma which can aggravate nausea
  • Avoid spicy or fatty foods
  • Sip or suck on ginger flavoured drinks and sweets
  • Stay out of the kitchen during meal preparation. If possible, ask someone else to prepare meals or make use of ready prepared meals to reduce exposure to aroma during cooking
  • Sometimes drinking and eating at the same time can make nausea worse. Consume foods and fluids separately

At work

Once you arrive at work, there are still several important things to remember throughout the day. When pregnant you are more susceptible to low back pain and pelvic girdle pain due to the changes in your body. Therefore, it is vital that the equipment around you like your desk and chair offers you more support.

If you have an ergonomics assessor at work, request a review of your desk space or speak to your occupational health department. When at your desk, stay mindful or your posture.

Emma Brockwell advises:

  • Make sure that your back is well supported when you are sitting down. A cushioned support that fits over the back of your chair can help with this.
  • Ideally, your back should be slightly arched, with your breasts pointing straight ahead, rather than down towards your bump.
  • Shoulders should be back and neck long, wrists in neutral rather than flexed or extended.
  • Weight should be distributed evenly through buttocks, hips and knees.
  • It is worth tilting your pelvis every 20 minutes by sitting on the edge of the chair and rocking the pelvis back and forth to reduce stiffness in that area.

As well as ensuring you have a good posture, there are a number of other things that you can do to prepare for childbirth while at work. Pregnancy related incontinence problems are common during and after pregnancy; use time spent sitting at your desk to complete pelvic floor exercises to strengthen your muscles and reduce the risks!

  • Sit comfortably with your knees slightly apart
  • Pull up the muscles surrounding your back passage, as if you are stopping yourself from passing wind
  • Now add a squeeze towards the front around your vagina and bladder, as if stopping the flow of urine
  • Hold the squeeze while you count to four seconds, remembering to breath normally. Rest for a few seconds, then repeat your long squeeze
  • See how many good quality squeezes you can do before the muscles get tired

“You may find that holding for four seconds is too easy, or for some women it is too hard”, says Emma, “if this is the case, try holding for more or less time, concentrating on getting a good quality squeeze. Once you know how long you can hold a good squeeze, you can work to build this up over time. When you find this exercise becomes too easy, try holding for a longer count, up to or beyond 10 seconds. You should also gradually increase the number of repetitions you do in each session – practise these exercises several times a day.”

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