(390) Employment experiences of high-risk obstetric patients: a post-Pregnant Worker’s Fairness and PUMP Act cohort study

The 2022 Providing Urgent Maternal Protections (PUMP) Act and the 2023 Pregnant Workers Fairness Act have recently changed employment laws in pregnancy. We evaluated employment benefits, knowledge of employment laws, and racial differences among hourly wage and salaried workers receiving high-risk obstetric care.


Study Design: Self-identified non-Hispanic Black (NHB) and White (NHW) patients at a single high-risk OB clinic within a Southeastern tertiary academic medical center were surveyed. We excluded major fetal anomalies, stillbirth or fetal demise. Participants completed surveys on work hours and duties, employment benefits at a single timepoint between 28 weeks’ gestation to 12 weeks postpartum.  Participants also reported if they received any information about employments laws or employment discrimination resources and the source of that information. Results were analyzed using descriptive statistics with SAS 9.4 (SAS Institute Inc., Cary, NC).

Results:

50/86 participated including 26 NHB and 24 NHW. Of these, 28 (56%) had hourly wage jobs, and 22 (44%) held salaried positions (Table 1). Thirty-seven (74%) had health insurance, and 31 (62%) had paid maternity leave. NHB patients were more often hourly wage earners compared to NHW patients (19/26, 73% vs. 9/24, 37.5%). Although mandated by the PUMP Act, only 13 (26%) patients in the total cohort and 2 (7.1%) hourly workers reported having private lactation facilities in their workplaces. 33 (66%) received information about Family Medical Leave Act (FMLA), while fewer knew about the Pregnant Worker’s Fairness Act (8, 16%) and the PUMP Act (8, 16%). Some participants who did not receive information expressed a desire for more information on these laws (Table 2).


Conclusion:

While most participants had health insurance and paid maternity leave, a significant gap existed in workplace lactation support and knowledge of employment laws. These results highlight need for patient education about employment laws in pregnancy.