World Health Organisation 
Statement to the International Labour Conference 
02 June 2000 

HEALTH ASPECTS OF MATERNITY LEAVE AND MATERNITY PROTECTION 

Pregnancy and childbirth are at the core of human development and adequate  
attention to the health and well-being of the pregnant woman and her infant  
is a concern for the society as a whole.  WHO affirms the human right of  
women to go safely through pregnancy and childbirth.  Most deaths of mothers  
associated with pregnancy and childbirth are avoidable and high rates of  
maternal mortality can be considered as a violation of women's right to life.  
 Breastfeeding promotes child health and development and is an essential part  
of assuring children's right to health. 

This statement provides information on women's and infant health as it  
relates to the revision of ILO Maternity Protection Convention No 103 and  
Maternity Protection Recommendation No 95.  It complements previous  
information provided by WHO to ILO on the issue in 1951 and in 1997.  WHO  
recently reviewed the scientific evidence on the health implications of  
maternity leave and maternity protection. 

Concerning HEALTH IN PREGNANCY, WHO's assessment of available evidence indicates that: 

- A pregnant woman should have the opportunity to attend a minimum of four  
antenatal care visits, the first visit early in pregnancy and one visit after  
week 36, in order to identify and manage complications in a timely manner. 

- Provisions are needed for rest breaks or alternatively shorter working  
hours during pregnancy. 

- A pregnant woman needs to work in a safe and healthy environment.  The  
mother and her infant need to be protected from noxious agents  and therefore  
an assessment of work place exposure to biological, chemical and physical  
hazards is needed.  Appropriate adjustments may be needed in the conditions  
of work for women who are pregnant to eliminate or minimize the risks as  
these noxious agents may cause spontaneous abortion, central nervous system damage, growth defects and congenital abnormalities to the infant. 

- A pregnant woman needs to have a reduced physical work load, and no night  
work during the second half of pregnancy as it may cause ill health to the  
mother, provoke preterm birth or infants with low birth weight.  Physical  
workload includes, for example, ergonomically strenuous postures (stooping  
and squatting), prolonged standing or walking, heavy lifting, and pushing or  
pulling. 

- Therefore, a pregnant woman needs complete absence from work from week 34 to 36 depending on her health status and physical workload. 

Concerning the HEALTH OF THE MOTHER AND THE INFANT DURING AND AFTER CHILDBIRTH, WHO's assessment of available evidence indicates that: 

- During delivery the woman and child need, as a minimum, a skilled birth  
attendant to manage normal childbirth, to prevent, recognize and manage  
complications in a timely way and transfer to a referral hospital, when  
needed. 

- A period of absence from work after birth is of utmost importance to the  
health of the mother and the infant.  This is conducive to both the optimal  
growth of the infant and the bonding between mother and infant.  Absence from  
work also allows the mother to recover.  The time needed depends on her  
health before, during and after birth, as well as on the health of the infant  
and whether or not the birth was complicated.  After delivery maternal health  
problems that may arise include infection, anaemia, depression, backache,  
anxiety and extreme tiredness. 

- Breastfeeding is a major determinant of infant health.  There is ample  
evidence on the advantages of breastfeeding for child health and development  
and for the prevention of child mortality and morbidity.  Infants who are  
exclusively breastfed (that is, receiving only breastmilk and no other food  
or drink) for at least 4 months have significantly less gastrointestinal and  
respiratory illness including ear infections and asthma, than those who are  
not breastfed.  Breastfeeding is particularly important for the preterm  
and/or low birth weight infant.  WHO recommends that infants should be  
exclusively breastfed on demand from birth for at least 4 and, if possible, 6  
months of age and should continue to be breastfed together with adequate  
complementary food until the age of 2 years or beyond.  Women who are unable  
to breastfeed on demand are at increased risk of stopping breastfeeding  
prematurely. 

- In conclusion, women need at least 16 weeks absence from work after  
delivery. 

Concerning SPECIAL FACILITIES AND SERVICES FOR NURSING MOTHERS AND THEIR CHILDREN: 

- Child-care facilities at or near the workplace are ideal for continuing  
breastfeeding after return to work.  If this is not possible, mothers need  
facilities where they can breastfeed or express and store breastmilk.  The  
requirements for such facilities are that they are safe, clean and private.   
The requirements are similar to those for preparing safe food: that they are  
clean and have clean water available for washing hands and manipulating  
utensils. 

- The minimum requirements to allow women to continue breastfeeding are two breaks from work daily of 30 minutes each, not taking into account time  
needed for transportation, upon return to work and for the first year of life  
of the breastfeeding child. 

Concerning ADDITIONAL PROVISION FOR MATERNITY LEAVE UNDER ABNORMAL CIRCUMSTANCES: 

- If the woman or the infant is ill, i.e. in the event of complications of  
pregnancy, she and the infant will need more extensive health care and leave. 

WHO wishes to emphasize the importance of adopting these provisions for the  
fulfillment of women's human rights to health and life.  The Convention and  
the Recommendation with these provisions included will have a major impact on the health of women and children worldwide.