Expectant mother risk assessment tool

If you identify a significant risk through this process you must take action. If you cannot remove the risk, you should do the following.

Action 1 – Adjust her working conditions or hours to remove the risk.

If that is not possible:

Action 2 – Give her suitable alternative work on the same terms and conditions. This alternative work should be on the same terms and conditions, including pay.

If that is not possible:

Action 3 – Suspend your employee on paid leave for as long as necessary to protect the health and safety of her and her child.

You have a legal duty to revisit, review and revise the risk assessment if you suspect it is no longer valid or there have been significant changes to anything it relates to (including employees). Having regular discussions with a new or expectant mother is an important way to monitor any changes and address any concerns about health and safety.

Low/Medium/High

Low risk: This is where the likelihood of the risk occurring is low and the severity is low.

Medium risk: The level of likelihood and severity increases.

High risk: Likelihood that risk will occur is high and the severity of the risk is high.

Part 1: Details

Name of employee

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Job role

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Department /location

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Expected due date

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Manager completing assessment

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Date of initial assessment

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Does your employee have any previous health or wellbeing issues that could affect their pregnancy?

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PART 2: Potential hazards

Does your employee work at a desk?

[Choose either Yes or No]

☐ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Increased susceptibility to musculoskeletal disorders and deep vein thrombosis (DVT)) .

What you can do to control this risk:

[Tick as many that apply]

☐ Do a Display Screen Equipment (DSE) assessment

☐ Provide adequate adjustment to chair and desk to allow for growing bump and for additional comfort (eg providing a back rest).

☐ Give advice on posture to prevent musculoskeletal problems.

☐ Adjust working practices to avoid continuous sitting at workstation (risk of DVT)

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Is there a risk of slips, trips, or falls?

[Choose either Yes or No]

☒ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Increased risk of injury due to physical changes and or hormonal changes).

What you can do to control this risk:

[Tick as many that apply]

☐ Keep your employee’s work area tidy and floor-space free of cables and obstructions.

☐ Consider adjusting your employee’s work area if they have physical health issues that result in difficulty negotiating stairs.

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Does your employee have to lift or carry loads (sometimes or regularly)?

[Choose either Yes or No]

☐ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Musculoskeletal injury. Weakening of the skeletal structure).

What you can do to control this risk:

[Tick as many that apply]

☐ Control the amount of physical work associated with your employee’s role. Physical tasks become more difficult to achieve as pregnancy progresses.

☐ Avoid circumstances where your employee needs to carry heavy loads

☐ Other - Click here to enter text.

Date to complete action

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Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Does your employee have easy access to toilet facilities?

[Choose either Yes or No]

☒ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. A lack of access to toilet facilities can cause discomfort and could lead to infection and kidney disease, which can cause complications for a pregnant woman and the developing baby).

What you can do to control this risk:

[Tick as many that apply]

☐ Provide easy access to toilet facilities and more frequent breaks from work activity.

☐ Provide access to quiet area where your employee can rest as necessary.

☐ Consider adjusting work hours and travel to work hours to accommodate times when they are particularly tired and/or nauseous. For example, if your employee suffers from sickness first thing in the morning you may agree to change their hours to start at 10am and finish at 6pm.

☐ Other - Click here to enter text.

Date to complete action

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Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

5. Does your employee’s role require them to stand for prolonged periods?

[Choose either Yes or No]

☐ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Fatigue from prolonged standing or physical activity).

What you can do to control this risk:

[Tick as many that apply]

☐ Adjust work to avoid long periods of time standing.

☐ Provide seating if necessary

☐ Adjust the tasks your employee needs to do to provide more rest periods.

☐ Modify their role to reduce the need for physical capability, such as walking long distances (provide further detail in the text box below).

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Is your employee subject to work-related stress?

[Choose either Yes or No]

☒ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Your employee might be more vulnerable to stress due to hormonal, psychological and physiological changes during their pregnancy).

What you can do to control this risk:

[Tick as many that apply]

☐ Monitor the demands being place on them by their role and their relationships with their colleagues/manager.

☐ Review the information provided in Tommy’s Pregnancy and Parenting at Work training and resources

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Is your employee working in warm temperatures and/or higher than average humidity?

[Choose either Yes or No]

☒ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Your employee’s pregnancy may mean they have a lower tolerance to heat and humidity, resulting in discomfort or fainting).

What you can do to control this risk:

[Tick as many that apply]

☐ Control the temperature of the working environment.

☐ Where possible make sure your employee has access to fresh air for periods during the working day.

☐ Make sure your employee has easy access to fresh drinking water.

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Does your employee work long hours (more than 48 hours a week), night work, or on shift work?

[Choose either Yes or No]

☒ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Long working hours or shift work patterns can affect the health of pregnant women).

What you can do to control this risk:

[Tick as many that apply]

☐ Make allowances for tiredness and nausea at the early stages of their pregnancy.

☐ Consult with occupational health expert and your employee on a modification to their working hours (for example, adjusting working hours so they do not have to travel at peak times, changing night shifts to day shifts on the same terms and conditions)

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Is there a risk of violence or a reasonable fear of violence in your employee’s role?

[Choose either Yes or No]

☐ Yes ☐ No

The risk to your employee

Click here to enter text.

What you can do to control this risk:

[Tick as many that apply]

☐ Consider modifying your employee’s role to minimise the risk of violence to them.

☒ Make provision for staff to be available should support be required.

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Is your employee lone-working?

[Choose either Yes or No]

☐ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Pregnant women may need urgent medical attention).

What you can do to control this risk:

[Tick as many that apply]

☐ Ensure that a system of regular communication with the line manager is established, especially if the pregnancy is high-risk.

☐ If line manager is away, nominate a second point of contact who can support in emergencies.

☐ Restrict lone-working at night.

☐ Restrict lone-working in isolated areas that may be open to the public.

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Does your employee’s role require them to travel?

[Choose either Yes or No]

☐ Yes ☐ No

The risk to your employee

Click here to enter text (e.g Increased medical risk from business travel. Poor posture/prolonged sitting increase risk of deep vein thrombosis (DVT). Risk from infectious diseases in some countries. Fatigue.

What you can do to control this risk:

[Tick as many that apply]

☐ Build in adequate rest breaks during the journey for UK travel arrangements.

☐ Arrange for your employee to travel at times that suit or control their levels of fatigue.

☐ Avoid scheduling flying for your employee after 32 weeks of their pregnancy (or earlier if specified by a midwife/doctor or airline).

☐ Make sure your employee is made aware of ways to avoid DVT if they are required to fly: Carrying out regular stretching exercises on flights. Drinking sufficient fluids. Use graded compression

☐ Assess further specific international travel risks with advice from a medical practitioner / occupational health.

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Is there a risk of your employee being exposed to disease (eg COVID-19), or any chemicals that could have an adverse effect?

[Choose either Yes or No]

☐ Yes ☐ No

The risk to your employee

Click here to enter text (e.g. Exposure to certain biologicals eg bacteria, viruses, moulds, fungi.

Exposure to certain chemicals; dust, fumes, gas vapour, mist, liquids solids, fibres.

Check labels for the following warnings: may cause cancer, possible risk of irreversible effects, may cause harm to unborn children, may cause harm to breastfed children.

What you can do to control this risk:

[Tick as many that apply]

☐ Remove your employee from the working environment where they might be exposed to disease/chemicals.

☐ Other - Click here to enter text.

Date to complete action

Click here to enter a date.

Risk level after any required actions are taken

[Tick one]

☐ Low ☐ Medium ☐ High

Other risks and actions required

Click here to enter text.

Manager signature___________________________________________

Date: Click here to enter a date.

Employee signature__________________________________________

Date: Click here to enter a date.

Risk assessment update

Date: Click here to enter a date.

Reason for update: Click here to enter text.

Risks identified and actions required:

Click here to enter text.

Risk assessment update

Date: Click here to enter a date.

Reason for update: Click here to enter text.

Risks identified and actions required:

Click here to enter text.

Risk assessment update

Date: Click here to enter a date.

Reason for update: Click here to enter text.

Risks identified and actions required:

Click here to enter text.