*This post may contain affiliate links. You can find our disclosure page here. *Post updated on 11/20/19
Nursing is a challenging career, and working 12 hour shifts as a pregnant nurse is no exception. In fact, most pregnant nurses are concerned about occupational precautions as well as the health of their unborn babies at some point during their pregnancies.
Some of the questions I asked when I was working as a pregnant nurse were:
Was I going to be able to tolerate being on my feet all day?
What is the best way to prevent dehydration as a pregnant nurse working 12 hour shifts?
And most importantly, how am I going to keep my energy up for my entire shift?!
But by taking proper precautions and always putting safety first, working as a nurse while pregnant is possible. In fact, many nurses work all the way through their pregnancies until a few weeks or days before they give birth. This information is intended to help you thrive while working as a nurse while pregnant.
Talk to you OBGYN about your concerns about working as a pregnant nurse
First off, it is always important that you talk to your doctor to discuss any occupational concerns you have during your pregnancy. Continue the dialog at your prenatal appointments as you move along your pregnancy. If you have questions in between your appointments then contact your doctor.
It is also crucial that you communicate with hospital management and your charge nurse about your pregnancy. They cannot help you avoid potential pregnancy hazards if they don’t know that you are expecting.
Physical challenges of working as a nurse while pregnant
The physicality of working as a pregnant nurse can be very difficult for some women, especially for those working on high acuity floors such as the Emergency Department and Intensive Care Unit. However, many hospital units are able to offer modified duty for pregnant nurses who have instructions from their doctors to stay off their feet.
However, there are still a few physical challenges that pregnant nurses should consider during nursing shifts:
Stress
Working night shift or rotating schedules
Heavy lifting
Exhaustion
Standing and walking for long periods of time
Managing nausea during shifts
Additional pregnant nurse precautions and occupational hazards to consider
Nursing is unique to many other professions because there are a lot of additional occupational hazards to consider, especially for the pregnant nurse. Working as a nurse while pregnant can be dangerous for both mom and fetus, therefore it is always important to wear the correct protective equipment or even possible refrain from working with some patients with highly infectious diseases.
Here are a few pregnant nurse precautions to consider:
Radiation from diagnostic imaging
Standing and walking for long periods of time
Working with chemo or other teratogenic medications
Risk of infections such as c-diff, tuberculosis, cytomegalovirus, and influenza
Physicality of working as a pregnant nurse (such as pulling patients up in bed)
Increased risk of varicose veins due to standing for long periods of time
Compression socks and stockings help pregnant nurses by preventing varicose veins due to standing for long periods of time.
During pregnancy, a mother’s blood volume increases by almost 50%! That’s a lot of extra fluid to be circulating through your body when you are on your feet for 12 hour shifts. This is also why many pregnant women develop varicose veins during pregnancy. If you are a pregnant nurse and haven’t invested in compression socks yet, its time to get a couple of pairs ASAP.
Compression stockings are often overlooked as a proactive way to prevent some of the chronic issues that come from working in a profession where you are on your feet for such long hours. Pregnant women especially benefit from wearing compression stockings or socks during a 12 hour shift for a few reasons:
Prevention of varicose veins
Improved blood flow and decreased risk of blood clots
Decreased swelling of ankles and feet
I was able to continue working as an emergency room nurse up until the beginning of my ninth month of pregnancy because I invested in a few quality pairs of toe to waist compression stockings. I wouldn’t have made it past my 6th month without them!
2. Wear good shoes
Pregnant nurses must make sure they have great shoes to support their growing belly’s.
Every nurse needs a great pair of shoes to get through a 12 hour shift. But the benefits to wearing quality nursing shoes during pregnancy it is even more important. You will be carrying an extra 25-35 pounds and your feet need support to carry that extra weight. If you thought your feet hurt working as a nurse before pregnancy, wait until you are pregnant! Keep in mind that your feet will swell a little more during pregnancy.
Working as a nurse while pregnant requires that you fuel your body with healthy nutrients to keep your energy up!
During my first trimester I struggled quite a bit with nausea and an overwhelming feeling of hungover-ness (without any of the fun the night before). I was also training to be an ER nurse, so it was more important than ever to be alert and focused.
By packing a lunch with nutritious snacks everyday I was able to keep myself energized as well as fend off nausea enough to get through each shift. I just couldn’t go more than 2-3 hours without refueling myself with something healthy to eat.
Admittedly, when I forgot to bring food with me I would eat peanut butter and jelly sandwiches from the stash we gave our patients. Although they were nothing special, for some reason they tasted amazing. Never underestimate the hunger of a pregnant nurse! I felt so much better and able to continue working afterwards.
Here are a few easy, fast, and high energy snacks to help your pregnant body stay energized through your 12 hour shifts:
You simply cannot sleep too much when you are pregnant. This is a fact.
Here is a sleep secret that got my through 12 hour shifts during my pregnancy. I would go down to the hospital meditation room during my lunch break, find a comfortable chair and literally pass out for 45 minutes. I set my phone alarm to make sure I was back to work on time. When it when it went off I was so deep in REM sleep that sometimes I didn’t even know where I was when I woke up.
The only way you are going to have the energy to make it through your pregnancy while working 12 hour shifts is to make sure you get as much sleep as you possibly can every night. 8 hours would be ideal.
5. Aim for 30 minutes of exercise everyday
Prenatal yoga can help pregnant nurses deal with stress throughout their pregnancies.
It seams counter intuitive, but exercising while pregnant will actually give you more energy to get through a 12 hour shift. In addition, exercise during pregnancy prevents gestational diabetes and hypertension.
(It is important to talk to your doctor about starting any exercise routine during pregnancy. There are rare circumstances when your doctor may not want you to exercise while pregnant.)
Non-impact exercises for pregnant nurses include:
Walking
Swimming
Prenatal yoga
Hand weights
Low impact aerobics
6. Reconsider working the night shift
Working the night shift can be especially challenging for nurses during their pregnancies. Consider switching to day shift.
The rigorousness of working 12 hour shifts as a nurse is exhausting as it is. Add pregnancy into the mix and you might find that you are even more tired than ever.
Some pregnant nurses who have already been working night shift continue with that schedule and do just fine. However, those who have rotating day and night schedules might find it especially hard to switch back to the night shift once they become pregnant.
Talk to your doctor about whether it is safe for you to continue working night shifts. Communicate with your manager about your specific health needs during your pregnancy. You may want to switch to a day shift only schedule for the duration of your pregnancy.
7. Talk to your manager about modified duty
Many facilities are able to offer modified duty for pregnant nurses who can’t be on their feet all day.
As a pregnant nurse it may be necessary to have a modified work assignment. Especially for nurses who work in rigorous units such as the emergency department. The physical demands of pregnancy might be too much for pregnant nurses already struggling with fatigue, nausea or having to carry so much extra weight.
Talk to your manager to see if there are alternative assignments you can have such as working at the monitor, organizing paperwork or auditing patient charts. If these options are not available consider the possibility of working shorter shifts or working two days a week instead of three.
Remember, always ask for help if you need it!
8. Communicate with management about your intended time to go on maternity leave
It is important to keep open communication with administration about when you intend to go on maternity leave. As a pregnant nurse, you cannot predict the future.
When I was pregnant with my daughter, I had every intention of working up until my 38th week. But when I had my appointment at 31 weeks my doctor thought it was best that I didn’t work on my feet for more 6 hours a day. While 6 hours seems like a lot in most professions, it’s not much for a hospital nurse. Sometimes we are on our feet for 10-12 hours a shift!
Yet, I still didn’t want to go off work because for some reason I felt like I was taking advantage of the system. I thought I had the grit to work all the way through. So, I waited for two weeks before I finally presented my doctors note to my manager. When I finally did, I gave it to him with tears in my eyes because I knew he would have to put me on disability at that time. My maternity leave started at that moment.
It was a good thing in the long run because I suffered a placental abruption and had an emergency c-section 7 weeks before my due date. It is wise to listen to your doctor’s advice!
9. Enjoy your pregnancy
Enjoy your pregnancy, nurse!
Pregnancy can and should be a beautiful experience, even when you are a nurse working 12 hour shifts. Far too often many pregnant nurses focus on the inconveniences and difficulties they face at work during their pregnancies But with proper precautions it can – and should – be a time filled with good health, gratitude, abundance and most of all, joy.
*Updated on 4/9/20 to include pregnant nurse precautions for COVID-19. *Affiliate links.
As an ER nurse who delivered my second baby in early 2018, I have done a lot of research about pregnant nurse precautions to be aware of when you work in a hospital. My goal was to make sure that it was safe for me to continue working in such a physically demanding environment with so many potential occupational hazards.
Fortunately, I was able to work safely right up until a few weeks before giving birth. As a per diem nurse, I did not have any maternity or disability benefits, so I wanted to save up as much money as possible before I went out on leave. Thankfully, I was able to do just that. But safety was still my number one concern. I hope this information can help other nurses stay safe during their pregnancies as well.
Talk to your OBGYN
First off, you must talk to your doctor to discuss any occupational concerns you have during your pregnancy. Continue the dialog at your prenatal appointments as you move along your pregnancy. If you have questions in between your appointments, then contact your doctor.
My goal in writing this is not to make pregnant nurses afraid to work in the hospital. I am so glad that I was able to safely work as a pregnant nurse for as long as I did. Still, there is no shortage of occupational hazards for the pregnant nurse within the hospital setting. Working safely is the number one goal.
You must communicate with management and your charge nurse about your pregnancy. They cannot help you avoid potential pregnancy hazards if they don’t know that you are expecting.
Pregnant nurse precautions and hazards to consider:
COVID-19
The novel coronavirus (COVID-19) has many pregnant healthcare providers, especially frontline nurses, uniquely concerned. Because COVID-19 is so new, there hasn’t been enough time to study its effects on breastfeeding or pregnant women. Also, many nurses who are working directly with COVID-19 patients say they don’t have enough personal protective equipment (PPE) to protect them from the virus safely. That maybe even more problematic for pregnant nurses who directly care for COVID-19 patients.
“We do not have information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19. Pregnant women also might be at risk for severe illness, morbidity, or mortality compared to the general population as observed in cases of other related coronavirus infections [including severe acute respiratory syndrome coronavirus (SARS-CoV)* and Middle East respiratory syndrome coronavirus (MERS-CoV)] and other viral respiratory infections, such as influenza, during pregnancy.”
On pregnant healthcare personal and COVID-19, the CDC stated:
“Pregnant healthcare personnel (HCP) should follow risk assessment and infection control guidelines for HCP exposed to patients with suspected or confirmed COVID-19. Adherence to recommended infection prevention and control practices is an important part of protecting all HCP in healthcare settings. Information on COVID-19 in pregnancy is very limited; facilities may want to consider limiting exposure of pregnant HCP to patients with confirmed or suspected COVID-19, especially during higher risk procedures (e.g., aerosol-generating procedures) if feasible based on staffing availability.”
Essentially, the CDC does not know at this time if pregnant women are at a higher risk when working with COVID-19 patients because the evidence is limited. As a precaution, pregnant women may want to consider working in lower-risk areas where they have less exposure to COVID-19 patients.
The most important take away is to always take care of yourself first. You can’t care for your family and your patients if you become sick.
Radiation from diagnostic imaging
In the ER and on most floor units within the hospital, patients often receive portable X-rays at the bedside. So naturally, I was concerned about radiation exposure and how it could impact the health of my unborn child. I felt it was wise to air on the side of safety by not exposing myself to unnecessary radiation during pregnancy.
If you are in an area where x-rays are being taken, you must wear a lead radiation apron to protect yourself, especially if you are within six feet of the machine. If possible, it is also a good idea to step outside the room while the image is taken.
In my nursing experience, x-ray technicians usually notify anyone within the vicinity of where imaging is being taken. I was able to leave the area for a few minutes, whether I was wearing a lead apron or not.
Key takeaways:
Notify management of pregnancy
Wear lead radiation apron
Step outside of the room when portable x-rays are taking place
Dangers from working with chemo or other teratogenic medications
There is evidence that handling some medications, such as chemotherapy drugs, can cause adverse reproductive outcomes, including fetal loss, miscarriage, infertility, and preterm births. In addition, it may cause learning disabilities in babies exposed to some drugs if nurses are exposed during pregnancy.
Wearing protective equipment, such as gowns, masks, and gloves, can minimize occupational risk to a pregnant nurse. However, it does not completely eradicate it.
Nurses working in oncology or other areas where antineoplastics are prescribed may want to speak with management about the safest way to continue working. In addition, you can insist on getting help from co-workers or management to give teratogenic medications to patients. Moving to another work area may be a consideration if safety for the fetus is still a concern.
Key takeaways:
Wear protective equipment when giving medications
Ask for help from co-workers when working with teratogenic medications
Consider temporarily working in another area of the hospital during pregnancy as your management allows
As a pregnant ER nurse, I was very concerned with the risk of infection from patients such as c-diff, tuberculosis, cytomegalovirus, and influenza during my pregnancy. Since the ER is often the first stop in the hospital for sick patients, I often didn’t know that a patient had a contagious infection until after they had been admitted. By then it was too late to protect myself if I hadn’t already.
Pregnant women need to be especially proactive with protective equipment and hand hygiene. It is ideal for all hospital employees to have their measles, mumps, and varicella-zoster vaccinations before pregnancy (most facilities require these vaccinations to work anyway). Hep B and influenza vaccination can also safely be administered during pregnancy.
As an added precaution, I made sure to change my clothes and shoes before leaving the hospital to minimize the risk of work-to-home contamination. The first thing I did upon getting home was take a shower to rid myself of any other possible bugs I could have inadvertently carried home with me.
Key takeaways:
Stay up to date in all vaccines including the yearly flu vaccine
Adhere to strict universal precautions and hand hygiene
Request job modification to minimize exposure to specific patient populations
Minimize work-to-home contamination by changing work clothes and shoes before going home
Shower as soon as you get home from work
The physicality of nursing while pregnant
Being a nurse while pregnant is exceptionally hard work. Not only are we on our feet for up to 12 hours a day, but pregnant nurses are also carrying an extra 25-plus pounds towards the latter part of pregnancy. Additionally, the extra girth makes it significantly more challenging to fit into tight spaces.
Movement becomes even more awkward for pregnant nurses due to having an altered center of gravity. Also, high serum levels of progesterone and relaxin loosen muscles, ligaments, and connective tissues. For nurses who do a lot of heavy, repetitive work requiring lifting, pulling, or pushing their risk of musculoskeletal injury is increased.
It is wise for pregnant nurses to use patient transfer equipment and to ask co-workers for help with moving patients. However, if your work situation is still too physical for you to manage safely during pregnancy, you may want to consider a modified duty in a lower risk setting with a less physical patient load.
On another note, pregnant nurses also have a higher risk of developing varicose veins due to an increase in total blood volume caused by pregnancy. The added blood volume, combined with being on one’s feet all day, leads to poor circulation, puffy legs, and swollen ankles. Compression socks or stockings can help reduce the risk of blood clots and varicose veins as well as prevent swelling.
Key takeaways:
Pregnant nurses may want to inquire about modified duty
Understand how the altered center of gravity and hormonal changes in pregnancy predispose a nurse to injury (despite using best lifting practices)
I worked in our ER psychiatric hold area several times throughout my pregnancy. There were a few incidences where I had patients verbally threaten me or begin to escalate towards violence. I always had a security guard with me, and I stayed a reasonable distance away from patients when I felt that my safety could be at risk. I was likely overly cautious at times, but it is better to be safe than sorry.
Violence against nurses is not uncommon, especially in the ER setting. Stay vigilant and keep away from any potentially threatening situations. If a patient is escalating towards violence, then leave and call for help immediately.
Working during flu season
The CDC recommends that pregnant women get a flu shot. Not only do hormone changes during pregnancy often make pregnant women more susceptible to getting the flu, but a common flu symptom is a fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby. Getting vaccinated can also help protect a baby after birth from flu through passive immunity.
My experience: The flu season in December 2017 was unusually bad. Many patients came to our ER for flu symptoms. Unfortunately, almost every nurse was infected with the flu or a cold at least once during the season. Myself, included.
At the time, I was over eight months pregnant, and I was struggling with how horrible I felt. I always get a flu shot to reduce my chances of getting sick during flu season. However, if I ever got pregnant again, I might consider starting my maternity leave towards the beginning of the flu season – especially, if I was that close to my due date.
An unexpected benefit of working as a nurse during pregnancy
One of the best gifts that pregnancy gave me was that it forced me to not be sedentary on days that I felt fatigued. (Although while you are carrying an extra 25-35 pounds of extra weight, you may not consider it a benefit).
Many studies show that not moving enough during pregnancy is bad for both mom and baby. If fact, exercise during pregnancy can boost your baby’s brain development and make them smarter. Who knew that working a 12-hour shift might promote health for both you and your unborn baby?
Good luck to you during your pregnancy and take care of yourself!
*This post contains affiliate links. For more information about my disclosure policy click here.
Is “pregnancy brain” a real phenomenon?
As I enter my 24th week of pregnancy I have found myself being unusually forgetful, feeling more mentally foggy, and even using the wrong words in conversation. More then a few times in recent days I have felt like I might even be losing my mind.
Over the years I have had many friends joke about having so-called “pregnancy brain.” But like many other things people say about becoming a Mom, I thought it was just a pregnancy myth or an excuse for lazy thinking.
The curse of the pregnancy brain
Here are a few examples of my experience recently with what I assume has to be pregnancy brain:
Two nights ago, a physician at a vendor dinner program asked me the names of some of the physicians that I work with in our emergency department. Suddenly, my mind couldn’t recall the names of anyone I work with. Literally, not one single person! Mind you, I have been working in the ER at my hospital for 9 months and know the entire department by name very well. My brain just froze.
At work recently, I was trying to think of the gelatinous, clear, rubbery food we often give patients in the hospital to eat while they are on a clear liquid diet. 10 minutes later it came to me. Jell-O. Duh!
While shopping for groceries I referred to blueberries as strawberries. Then at home I referred to our tile as carpet. Then, at lunch with friends a few days ago I stated that Zoe was going to have a little sister soon, but I’m having a boy! And it still took me a few seconds to realize it and correct myself.
Pregnancy brain has affected my writing as well. I will come up with an amazing idea that I would love to research and write about. Then when I finally sit down to organize my thoughts I can’t think of what I wanted to say. It is so annoying!
Brain changes during pregnancy
Neurons in the brain. Pregnancy doesn’t “shrink” the brain, but it does temporarily restructure it a bit. Why? Studies say it’s nature’s way of helping us adjust to motherhood and protect our babies.
A 2016 study in Nature Neuroscience showed that pregnancy causes substantial changes in brain structure. The primary changes included “reductions in grey matter volume in regions subserving social cognition.”
(For those who don’t know, grey matter is the “thinking” part of the brain, and a major component of the central nervous system. It is where our intelligence lives.)
The study found that pregnancy causes new mothers’ brains to be more efficiently wired in areas that allow them, for example, to respond to their infant’s needs or be more alert to dangers in their infants’ environment. In other words, the brain doesn’t actually “shrink,” it just restructures it self a bit.
Essentially, the loss in grey matter in the mother was due to those same brain regions responding to their babies post birth. In fact, a few studies I read stated that the loss in grey matter was directly correlated to the mothers’ attachment to her child postpartum.
At first read, it appeared as if mother nature was temporarily lowering my IQ a bit in order to help me be more attentive to my babies’ needs after they arrive. Awesome!
Joking aside, at least I have an explanation for my mental fogginess and word confusion. I am actually kind of relieved that I’m not just losing my mind!
Pregnancy brain may actually be a good thing
The same study also found that the grey matter changes actually predicted how maternally attached we are to our babies’ after birth. This was thought to be nature’s way of transitioning mothers into the ginormous changes that come with being a new mom.
This actually makes sense to me. Anyone who has been a mother knows that the life changes that come with a baby are huge. At least for a good while.
There is some good news though. They found that the grey matter reductions lasted for two years after birth. So I won’t have permanent brain damage after all. Phew!
Additional benefits to pregnancy brain
Studies are showing that maternal brain changes last two years post birth.
Laura Glynn, a professor and chair of the department of psychology at Chapman University, stated that not only does pregnancy brain exist, but there are important benefits to a vulnerable infant. For example, pregnant women are “better at recognizing fear, anger and disgust” which may aid mothers in using their emotions to ensure their infant’s survival.
In addition, Glynn stated that the pregnancy hormones estrogen and oxytocin are associated with heightened maternal responsiveness and sensitivity to the environment and infants’ needs.
There are several articles connecting pregnancy brain with gaining additional ability to be a better mother. In fact, the more I read about pregnancy brain the more I think it may not be such a negative thing after all. If it can help me be a better mother, especially in those first few crazy, sleep deprived months, perhaps I can even accept it as a blessing and not a curse.
Managing pregnancy brain
I now know that there are actual benefits to pregnancy brain. But I still need to continue my job as responsible mother of a toddler and ER nurse, and be a functional human being. So what do I do in the meantime? To be frank, the idea of pregnancy brain does seem a little depressing. It makes me feel more tired and less productive, and it doesn’t fit my active personality which really annoys the crap out of me.
Here are a few ideas I am working on that may help with pregnancy brain:
1. Exercise regularly
Evidence shows that women who exercise during pregnancy have smarter babies.
The research on the positive benefits of exercise on the brain are endless. It is pretty widely known in the medical field that exercise improves memory and thinking skills.
But, did you know that exercise during pregnancy helps your baby’s brain as well? According to a study in the Journal of the American College of Sports Medicine, children of moms who exercised during pregnancy “scored higher on tests of language skills and intelligence at age 5 compared with the kids of sedentary moms.” Apparently, moderate levels of cortisol (a stress hormone secreted during exercise) promotes brain development in your baby.
I’m sold! What is good for me is apparently good for my baby too. My goal is to continue to practicing yoga and walking at least 10,ooo steps a day. I am using the heart app on my iphone to measure my progress.
2. Have a good calendar system and to-do list
I write everything down in my iphone calendar or my do-to list. If its not written down, then it often doesn’t happen. You’ve got to have a plan because its impossible to remember everything in your head.
In addition, my husband and I have a dry erase calendar system on our refrigerator (I know we could just sync our I-phone calendars but it just helps us to see it visually). We write down all of our work and personal activities including work dinners, social events, appointments, play dates, date nights and even gym schedules. When one of us knows about a schedule update, it goes up on the board. I have 2 calendars on the fridge so we can always stay one month ahead. This system minimizes 99% of schedule confusion and almost completely eliminates double booking anything. It is a marriage win.
3. Continue to practice gratitude
I have to remind myself that there is no point in getting frustrated about nature’s effects on my pregnancy. I am so grateful to be adding a baby boy into our family in a few short months, and the physical and mental changes are worth it all. As a nurse I am all too aware of how not everyone gets to have a family or even healthy children. A healthy pregnancy is a gift.
There is a meditation app called Headspace that I sometimes use that has the added benefit of helping me find more gratitude in my life. I wrote a little about that here.
4. Get enough sleep
I am an ER nurse and the mother of a toddler, which means my only free time is during the hours when I probably should be getting more rest (after my daughter goes to bed at 7:30pm). I am really working on trying to be in bed no later then 9:30 or earlier if possible. Pregnant or not, sleep deprivation will make anyone’s brain not work at it’s best.
Not getting enough sleep can contribute to mental health disorders including antepartum and postpartum depression. In other words, the pregnant mom + good sleep = better brain health.
One way to find extra time in your life is to cut down on the amount of social media you use. You would be amazed at the amount of time gained back by completely eliminating it for a while.
What is good for mom is apparently good for baby too! It appears that both exercise and healthy food choices are good for everyone’s brain health.
Omega 3’s are good for both mom and babies’ brain health. They are important for cognitive (brain memory and performance) and behavior function.
I try to eat wild salmon twice a week and add flax seed to our morning smoothies. I also take an omega 3 supplement for pregnancy.
Accepting the joys of pregnancy (brain)
I already knew that delivering a few gorgeous babies meant making some sacrifices along the way. Understanding why these changes happen helps me accept them as a natural part of the motherhood process. The more I read and talk about how motherhood is supposed to change me, the easier it is to make positive adjustments and deal with it.
I am accepting my pregnancy brain as a blessing, not a curse, despite the occasional idiot thing I might do or say. Especially since the research says my brain will not be lost forever.
Motherhood is a mountainous emotional and physical transition so I’m really trying to lighten up on myself a bit. Mother nature sure does have an interesting sense of humor though. The least I can do is laugh at myself a little.
