Comité SST

For a safe maternity experience programme: Towards an optimal standardization of the practices and recommendations

For a safe maternity experience programme: Towards an optimal standardization of the practices and recommendations

It is surprising to note to which point that there can be disparities in the treatment, from one region to another, from one occupational health and safety team to another, when the pregnant or breast-feeding healthcare professionals request a protective reassignment. This lack of standardization in the practices and the recommendations has led to inequities between workers as well as a feeling of injustice.

Installed in 1981 by the Commission de la santé et de la sécurité du travail (CSST), the Maternity Without Danger Programme (PMSD) is a crucial measure for the protection of maternity which first and foremost covers staying at work, in complete safety, for the pregnant or breast-feeding employee. Before issuing the Preventive Withdrawal and Reassignment Certificate for a Pregnant or Breast-Feeding Worker, the attending physician must consult a physician designated by the Direction régionale de la santé publique (DSP) (Public Health Department) to make the recommendations regarding the aggressors or the risk factors identified for the worker’s position. Upon presentation of this certificate, the employer must follow-up immediately and assign the worker to duties exempt from danger, in accordance with the provisions of an Act respecting occupational health and safety and the provincial and local collective agreements of the FIQ.

A request for protective reassignment is not in itself, a request to stop work, but instead a request for assignment to duties without hazards. It is only if the employer is unable to assign the worker to duties without hazards that an employee can stop work and receive the allowances stipulated in the Law. However, she must be both medically fit for the work and available for an assignment that the employer may suggest.

Although unacceptable, the differences seen in the treatment of the requests for protective reassignment throughout Québec can be explained easily enough. According to a study conducted by the Institut national de santé publique du Québec (INSPQ) in 2011 with the 29 teams responsible for implementing the programme, from the 15 administrative regions of Québec, the procedures and the bank of recommendations used vary considerably from one team to another. Software tools in the Système d’information en santé et sécurité au travail (SISAT) make it possible to store the recommendations for every risk factor, the banks are developed by the physicians designated to the PMSD who make up these recommendations.

So, there are four types of banks of recommendations in Québec. First, there is the provincial bank of recommendations, which inspire the Guides for the standardization of medical practices developed across Québec. Then, 28 of 29 teams can also use a bank of regional recommendations in their respective regions. In 5 out of 29 teams, there is a local bank of recommendations, shared by the physicians on the same local team, without it being at the regional level. Lastly, in 16 of 29 teams, the physicians use their personal bank of recommendations, available only for the physician that created it. Several of these personal banks can exist on the same local team. Furthermore, in 6 of these 16 teams, the content of the recommendations for the same risk factor is different, between 2 personal banks at the local level, between the personal or local banks and the regional bank. In 5 teams, the risk factors appear in the personal or local banks, without however being found in the regional bank. Incredible, isn’t it?

Despite all this, the results of this study are enlightening and can greatly help to improve the functioning of the PMSD programme. In its report, the INSPQ recommends improving the consistency between the local and regional recommendations, stepping up the work of standardizing the recommendations on the provincial level and setting up a strict standardization between the teams in the same region, among others.

Since its creation in 1981, the PMSD programme has never been evaluated over all the territories in Québec, because the evaluation done in 2003, under the mandate of the CSST, was only for the Montréal, Quebec City and Laval regions. There is, therefore, hope. We have to remain optimistic and believe in the upcoming “birth” of a standardization of the practices and recommendations across Québec applicable to the treatment of the pregnant or breast-feeding workers’ requests for a protective reassignment.

Do you know ?

For more information on exercising the right to a protective reassignment, you can consult the FIQ brochure: A Safe Maternity Experience – Parental leaves – What are my rights and obligations? for healthcare professionals.

When you exercise the right to a protective reassignment, you conserve all the benefits linked to the job you held prior to your assignment to tasks without hazards or prior to you stopping work. And, clause 22.19 in the FIQ collective agreement stipulates more advantageous provisions for the healthcare professional than those stipulated in the Act for the protective reassignment of the pregnant or breast-feeding worker.

If you want to contest an assignment proposed by the employer and deemed in compliance by the CSST, you can have financial support from the FIQ. Find out from your local union team.

There are no costs for you to pay for issuing a preventive withdrawal and reassignment certificate for the pregnant or breast-feeding worker.

It is important to consult your physician as soon as you are pregnant in order that he can determine, as soon as possible, the different hazards that your working conditions expose you to due to your pregnancy, or expose your unborn or breast-feeding child as well as the date when you should benefit from a protective reassignment.