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Maternity Risk Assessment

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Risk assessment form for new and expectant mothers

This assessment should be completed by both the pregnant woman and a supervisor; a completed copy should be given to the person subject to this assessment. The assessment may need to be reviewed more than once as the pregnancy or return to work develops. It should always be reviewed at the request of the new and expectant Mother.


Is this the first assessment for this pregnancy?*
DD slash MM slash YYYY

Movement and Posture

Does the job involve awkward twisting or stretching?*
Does the woman have to stand for periods of, for example more than two or three hours without a break?*
Does she have to sit for periods of more than two-three hours?*
Are there space restrictions? (For example, working behind a desk)*
Will these cause more restricted movement as the pregnancy develops?*
Are there sufficient opportunities for the employee to use toilet facilities?*

Manual Handling

Does the job involve twisting, stooping or stretching to lift objects?*
Does the job involve the lifting, pushing or pulling of heavy loads?*
Does the job involve rapid repetitive lifting? (Even of lighter objects)*
Does the job involve lifting objects that are difficult to grasp or awkward to hold?*
Are there any clients that present issues for the employee?*
Are there any client homes that present issues for the employee?*

P.P.E. and Uniforms

If the employee needs to wear protective aprons, overalls etc., are they provided in suitable sizes?*
If uniforms are obligatory, are they provided in maternity sizes?*
Are the materials used comfortable for all pregnant women to wear?*
Is the employee fully trained in COVID-19 infection prevention protocols?*

Hazardous Substances – Infection Risks and Chemicals

Are there any infection risks in the work? (For example, clearing up spilled body fluids or disposing of used syringes)*
Does the work involve handling raw meat?*
As infection risks are present, are hygiene precautions adequate?*
Are any chemicals used at work known to be of risk to women of child bearing age?*
Are pregnant workers kept away from work that could increase exposure to chemicals?*

Working Time

Is the woman expected to work long hours or overtime?*
Does she have some flexibility or choice over her working hours?*
Does the work involve very early starts or late finishes?*
Does the work involve night work between the hours of, for example, 11pm to 7am?*
Is the employee happy with current workload and arrangements?*

Sign and Submit

DD slash MM slash YYYY
Clear Signature
Clear Signature
Only required if the interview took place in person.
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