Pregnancy in the RAF A Guide for the Servicewoman Service Woman’s Booklet | 1 Contents Foreword by AMP 2 Introduction 3 Chapter 1 Chapter 2 Chapter 3 Chapter 4 Pregnancy in the RAF – The Next Steps Your Options Maternity Benefits and Entitlement Terms of Service Fitness for Deployment Annual Appraisals Maternity Uniform Returning to Service – RAF Fitness Test Flexible Working Arrangements Childcare Medical Issues Antenatal Appointments Common Physical Symptoms Special Health Issues Common Issues and Emotions Nutrition for Pregnancy 4 6 7 8 9 10 11 12 12 13 14 14 15 15 20 21 The Maternity Check Sheet Sources of Support - Useful Organisations 22 Q&A’s – Commonly Asked Questions 27 Further Reading 33 34 Glossary 25 Please note that this booklet will also be available electronically through the Community Support website. The electronic version will be periodically updated as required. 2 | Service Woman’s Booklet Foreword Whether you are about to become a mother for the first time, or are adding to your family, you are about to embark on a new chapter of your personal life. As AMP, I am very clear about the importance of encouraging a work/life balance that enables individuals to successfully manage Service and family commitments. As such, my Employment Policy team have been focussing on improvements to the pregnancy/maternity process, to allow you to pursue your family ambitions, while feeling confident that your return to work will also be well facilitated and supportive. In writing this booklet, we spoke with many Servicewomen who have experienced both pregnancy and maternity leave within the Service to understand better how we could provide greater support. As well as introducing this particular guide, we have also introduced a booklet for line managers to ensure that they are better placed to assist Servicewomen throughout both the pregnancy and maternity process; this will be followed shortly by a similar guide for career managers. Aware that fitness is an increasing concern for new mothers, we have changed the RAF Fitness Policy to allow Servicewomen returning from maternity leave a 6-month period in which to re-gain their fitness before they have to take the RAFFT. Furthermore, we are also working with the MOD to provide clearer guidance with regard to Servicewomen’s pregnancy and maternity rights and options. I hope that you will find the information contained in this booklet of benefit and my Employment Policy staff would welcome your feedback on 95221 6640. I wish you a healthy pregnancy and I hope that you enjoy the time you take at home to bond with your child. AMP Service Woman’s Booklet | 3 Introduction Welcome to ‘Pregnancy in the RAF – A Guide for the Servicewoman’. Congratulations! This booklet has been provided for you together with a guide to be passed to your line manager/flight commander, because you are pregnant. It contains information that is designed to help make your experience of a working pregnancy within the Service as stress free and fulfilling as possible. You will find information about managing your health and safety in the workplace, wherever that might be, as well as information to help make the decision as to whether you return to Service life after your maternity leave. A productive, enjoyable, working pregnancy in the Service is a team effort and requires communication. Your line manager/flight commander and colleagues, both civilian and military, are best placed to offer you the support that you will need in the workplace. For this to happen, they will need your help. Every pregnancy is different, and every woman will have a different experience. The people that you work with, and for, will need your guidance about your unique needs for your pregnancy. The RAF is committed to supporting your pregnancy; managing your safety, providing time off for antenatal appointments and providing as much information as possible to help you make decisions about your future within the Service. This guide should be read in conjunction with the current policy DIN (2011DIN01115)1 and the Tri Service Regulations for leave and absence, JSP 760 Chap 20.2 1 http://defenceintranet.diiweb.r.mil.uk/DefenceIntranet/Library/CivilianAndJointService/BrowseDocumentCategories/ Personnel/WorkingHoursAndLeave/Leave/Din2011din01115.htm 2 http://defenceintranet.diiweb.r.mil.uk/DefenceIntranet/Library/CivilianAndJointService/BrowseDocumentCategories/ Personnel/WorkingHoursAndLeave/Leave/Jsp760.htm 4 | Service Woman’s Booklet Chapter 1 Pregnancy in the RAF - The next steps As a Servicewoman, you are strongly advised to notify your unit Medical Officer (MO) as soon as you think you are pregnant; even if the unit medical centre will not be providing your antenatal care. Once your pregnancy is confirmed with Unit medical staffs, your Joint Medical Employment Standard (JMES) will be regraded to reflect this. The re-grading is primarily for health and safety reasons to protect both you and your unborn child and is particularly important if you are due to be deployed, because as soon as your pregnancy is confirmed you will be excused from operational duty; weapon firing; and subject to medical advice, certain other duties such as night shifts. Whilst the JMES will be changed there are 2 options open to you at this point; a. One JMES is pregnancy-specific and will inform personnel staff that you are pregnant. Most women are happy with this, but you will be asked to sign a consent form to confirm that you are. b. Alternatively, there is an option for a non-specific change of JMES which will still protect you prior to your formally notifying the Service. You are encouraged to agree to the pregnancy-specific JMES from the outset, unless there is an overwhelming reason not to do so. While the choice is yours, your pregnancy will not be secret for long! Your line manager may also need to make other decisions concerning your health and safety and has a responsibility to carry out a full risk assessment once he/she is aware of your pregnancy; therefore, it is in your interest to tell him/her as soon as possible. It may be necessary to place restrictions on your duties to ensure that the MoD can fulfil its legal obligations and responsibilities for your health and safety, and that of your unborn child, or to preserve operational effectiveness. Once you tell your Service Woman’s Booklet | 5 line manager, you should provide them with the copy of the ‘Line Managers Guide for Pregnant Servicewomen’ which you were given by the Unit medical staff. Choosing when to inform your line manager of your pregnancy can be difficult. While you are under no obligation to inform them straight away, the earlier you choose to do so, the sooner you can start working together to ensure that you have good lines of communication and that all the necessary health and safety requirements are in place. Once you have informed your line manager, you can then also discuss what options are open to you including maternity leave and pay, assignment issues, appraisal reports and, if desired, your right to leave the RAF on the grounds of pregnancy. Whatever you decide to do, you must formally notify your Commanding Officer and Career Manager of your pregnancy, by letter or email, no later than the 15th week before your expected week of childbirth, unless this is not reasonably practicable. This is usually done by a MAT B1 Form which will be issued by your doctor or midwife on or after the 20th week of pregnancy. The MAT B1 form will confirm your pregnancy and give the expected date of childbirth; it will be this date that you will use to work out the dates of your maternity leave. You will need to give your line manager a copy of the MAT B1 together with the relevant Maternity Notice Form (a copy of which can be found in 2011DIN01-115) stating whether your intention is to remain in or leave the Service. Your line manager will then pass the paperwork to PSF staff. 6 | Service Woman’s Booklet Your options There are two options available to you as a pregnant Servicewoman: Option 1 Return to work after maternity leave. This may be any of the following: • The 2 week minimum by Law • A period of Ordinary Maternity Leave (OML) – a period of up to 26 weeks’ leave to which all Servicewomen are entitled • OML and Additional Maternity Leave (AML) – a further period of up to 26 weeks’ leave which can follow on from OML • OML plus AML and/or Parental Leave3 • A period of OML, followed by Service spouse/partner taking a period of Additional Paternity Leave (APL) (Please see 2011DIN01-037 for full details of APL) To elect for any of the above within Option 1 you should complete the Maternity Notice Form at Annex A to the current DIN (2011DIN01-115). Option 2 Use a special right to leave the RAF prematurely on the grounds of pregnancy. Before deciding to leave, you must seek advice from your Unit PSF staff. This is important as leaving the Service early might affect your entitlement to, or the amount of, higher Statutory Maternity Pay (SMP) that you might receive. You may opt to leave at any time after confirmation of pregnancy is issued, but should normally give sufficient notice to allow discharge procedures to be completed. You should note that to establish an entitlement to SMP you must have completed a minimum of 26 weeks’ service as at the 15th week before the Expected Week of Childbirth. You may opt to leave under these special terms at any time up to your return to work after maternity leave. You do not have the right to withdraw notice of leaving the Service if you change your mind; normal rules on leaving the Service apply. 3 Parental leave is unpaid, does not count towards the completion of a commission/engagement and is not reckonable for pensionable purposes. Service Woman’s Booklet | 7 To elect for Option 2 you should complete the Maternity Notice Form at Annex B to the current DIN (2011DIN01-115). Once you have selected your option, your commanding officer or line manager will write to you within 28 days of receiving your Notice Form. This letter will confirm the dates of your maternity leave and the date it is anticipated that you will return (if applicable). Maternity benefits and entitlement All pregnant Servicewomen with more than 26 weeks’ continuous service are entitled to take up to 52 weeks of maternity leave. This includes 26 weeks’ OML, and up to 26 weeks’ of AML. Entitlement to additional benefits under the Armed Forces’ Occupational Maternity Scheme (AFOMS) depends on how long you have been in the Armed Forces and whether you will be returning to work after the birth of your child. The following tables provide a summary of maternity leave and pay, but you should refer to the current DIN for a full explanation of what is available. Length of Service Required to Qualify for Benefits (by 15th week before the baby is due) Leave Benefits Available All Pregnant Servicewomen 26 weeks’ OML (of which 2 weeks is compulsory) to be taken immediately after the birth of the child, plus up to 26 weeks’ AML More than 26 weeks’ continuous service (Servicewoman returning to duty) 26 weeks’ OML plus up to 26 weeks’ AML More than 26 weeks’ continuous service (Servicewoman not returning to duty) 26 weeks’ OML plus up to 26 weeks’ AML 8 | Service Woman’s Booklet Length of Service Required to Qualify for Benefits (15th week before the baby is due) Leave Benefits Available Less than 26 weeks’ continuous service You are are not entitled to maternity pay, but you may be entitled to up to 39 weeks’ state benefits (Maternity Allowance) Between 26 and 52 weeks’ continuous service Up to 39 weeks of statutory maternity pay (SMP). SMP is 90% of your average pay for the first 6 weeks, then either £128.734 per week or 90% of your average pay (whichever is lower) for the remaining 33 weeks. The remaining 13 weeks of AML (if taken) are unpaid. More than 52 weeks’ continuous service, and intend to return to duty for a minimum of 12 months after maternity leave. AFOMS pay. This is full pay for the first 26 weeks (OML), then SMP for up to 13 weeks (currently £128.73). The remaining 13 weeks of AML (if taken) are unpaid. More than 52 weeks’ continuous service, and not intending to return to duty for any period following maternity leave (Servicewoman exercising right to leave Service on pregnancy) Up to 39 weeks of statutory maternity pay (SMP). SMP is 90% of your average pay for the first 6 weeks, then either £128.73 per week or 90% of your average pay (whichever is lower) for the remaining 33 weeks. The remaining 13 weeks of AML (if taken) are unpaid. Terms of service • During OML – normal terms and conditions of service apply whether intending to leave or return to the Service. OML counts towards completion of your engagement or commission and is reckonable service for purposes such as increments, seniority, promotion, pension, annual leave and public holidays. 4SMP rate as at 1 Aug 11 – please note this is subject to change. Current rates of SMP can be found at www.direct.gov.uk. Service Woman’s Booklet | 9 • During AML – AML also counts towards completion of your engagement or commission, but only the paid element (of up to 13 weeks) is reckonable for pension purposes and the accrual of annual leave and public holidays. • Return of Service (RoS) – after a period of maternity leave, you are expected to complete a 12 month RoS. Should you start another period of maternity leave before the end of the 12 month RoS from the initial pregnancy, then the maternity leave counts towards that initial return. When can maternity leave start? You can choose to start your OML at any time from the 11th week before your expected week of childbirth. You may also take unpaid pre-natal leave between the 14th and 11th week prior to your expected week of childbirth. If your baby is born before you have started your maternity leave, your leave will start on the date your baby is born and your return date will be recalculated. Fitness for Deployment There are a number of Service-related activities and deployments when you may be asked if you know of any reason why you should not undertake such activities; pregnancy may be specifically stated as one of those reasons. You should complete these forms honestly and accurately. When your pregnancy is confirmed by the MO, the resulting JMES reclassification will render you temporarily non-deployable. If you are already deployed when your pregnancy is confirmed, the MO will conduct a clinical risk assessment. In most cases (nearly all operational deployments) this will result in you being returned to the UK with the award of a non-deployable code. Exceptionally, where it can be demonstrated that clinical risk is of an acceptable level, a limited deployable JMES may be awarded allowing for your return to the UK to be deferred to a later stage of the pregnancy. Please note that even if there appears to be adequate antenatal care, there may be insufficient obstetric care to cope with any potential complications or premature births. The Service will always consider the health and safety of you and your baby to be of prime importance when making the 10 | Service Woman’s Booklet decision to return you from deployment. The clinical risk assessment may, therefore, advise relocation on neonatal grounds before you reach 22 weeks’ gestation. If the MO has deemed the clinical risk to be unacceptable, and you should choose to contest this decision, advice will be sought from personnel and legal staffs and will require you to consent to the disclosure of the pregnancy. You should note that if you do not wish to consent to disclosure of the pregnancy, for any reason, this will result in the award of a medical non-deployable JMES and you would be returned to the UK. Pregnancy and Recruits If you are an RAF recruit, and you become pregnant after attestation and commencement of recruit training, you will be awarded the same JMES as any other pregnant Servicewoman who has completed training. Any rights to maternity leave and pay will be as per the tables listed previously, and the processes to be followed remain the same as those listed within this booklet, JSP 760 Chpt 20 and 2011 DIN01-115. Annual appraisals and career progression The RAF is committed to ensuring that, as a Servicewoman, you are not discriminated against or treated any less favourably, as a result of your pregnancy. As a period of maternity leave can mean that you are out of the work environment for up to 52 weeks, an appraisal report (AR) will be provided for any pregnant Servicewoman commencing maternity leave. This will be done by either deferring or bringing forward your annual report; this is to ensure that any reporting gaps are kept to a minimum and that any promotion board will have the most recent possible report to consider. If you are selected for promotion while pregnant or on maternity leave, you will not be overlooked for assignment to a suitable appointment in the new rank on the grounds of maternity absence. As at any time in your career, you do retain the right to decline promotion for personal reasons. Service Woman’s Booklet | 11 Change of plans? You can change your plans after you have submitted your Maternity Notice Form, but you must give 28 days’ notice. However, if you have exercised your right to leave the RAF on grounds of pregnancy you do not automatically have the right to withdraw your notice of leaving the Service and normal Service rules will apply. If you have been in receipt of AFOMS and then decide to amend your leaving date from the Service so that you would leave without completing the required period of RoS, you should be aware that you will be required to refund the difference between the full pay received during OML and the level of SMP that you are legally entitled to. Maternity uniform As soon as you have had your pregnancy confirmed, you should order a maternity uniform from clothing stores. There is no set date from which to change from normal working dress to your maternity uniform; it is designed to be worn from a point when your standard uniform becomes too tight. This is entirely up to you and will vary from person to person. Service maternity uniform is a personal choice/combination of dress, trousers, short sleeve shirts and cardigan. Unlike SD shirts, maternity shirts are designed to be worn outside of the trousers. The MVP RAF weatherproof jacket is designed to accommodate the majority of pregnancies up to going on maternity leave. If a suitable sized Service issue jacket cannot be provided, then a dark civilian top coat may be worn outdoors. Headwear should not be worn in this instance. All Servicewomen are entitled to an issue of 4 ‘tops’ be it blouses or dresses. Your choice of maternity uniform could be 4 blouses to be worn with trousers, or 4 dresses, or a combination of both. Keeping in touch days (KIT) You can return to duty for up to 10 days during your maternity leave period without bringing the maternity leave to an end. KIT days are designed to enable you to 12 | Service Woman’s Booklet undertake training and keep up to date with new developments without losing your right to maternity pay. KIT days are optional and cannot be taken during the first two weeks following childbirth. You should agree with your line management any voluntary arrangements for keeping in touch during your maternity leave. Returning to Service after maternity leave This can be an apprehensive time for you as a Servicewoman; it can be hard to leave your child, your chain of command and colleagues may have moved on, or you may have general concerns with settling back in to life with the RAF. One of the main concerns that have been highlighted by returning Servicewomen is the pressure to get back to pre-maternity fitness levels. • RAF Fitness Test – with effect from 1 Apr 11, any Servicewoman returning from a period of maternity leave will be given a 6-month grace period before having to take her RAFFT. In addition, PEd staffs are able to provide a post-maternity return to fitness package for you so that you can achieve the required fitness standards in a timely and safe manner. The SMO will sign you off as exempt from fitness testing for 6 months at your Return to Work medical at the end of your maternity leave. You should then liaise with your local PEd staffs so they can update JPA accordingly and provide you with the necessary training package. Flexible Working Arrangements (FWA) While flexible working is not a right in the Armed Forces, all Service personnel are entitled to request FWA so they may better balance the demands of personal life and Service commitments. As you return from maternity leave such arrangements may be necessary to accommodate early child care issues, or breast feeding requirements. Any request to vary working patterns should be made via your line manager. Your line manager will consider FWA where it does not impinge on operational capability. You should note that it may not always be possible for nonstandard hours to be worked due to the ways in which different arms and branches of the Services operate. Service Woman’s Booklet | 13 Flexible working does not just mean variable start and finish times; there are a number of options available to you depending on your needs and also includes career breaks or special unpaid leave. Further details for flexible working are available in 2005DIN02-012 and JSP 760 Chpt 17 and 18. Any implementation of FWA is done on a temporary basis only and a period of review should be agreed with your line manager. Remember also that the Service retains the right to cease any FWA should operational capability require it. Childcare As a Service parent you are responsible for making your own arrangements with childcare and meeting the costs involved, so you should also investigate your eligibility for Tax credits and other benefits through the Direct Gov website. Your Unit PSF staffs should also be able to provide advice on your eligibility for the Armed Forces Childcare Voucher Scheme5 which can help to spread the cost. The RAF will endeavour not to deploy both Service parents (where applicable) at the same time where this does not affect operational capability. Should issues arise with child care after you have returned from maternity, you are advised to discuss this with your line management as soon as possible. Many units have commercial crèches and nurseries on their premises, or nearby. In general, however, there is a high demand for places in nurseries and for childminders that can lead to long waiting lists. You should start investigating your options and making preliminary arrangements for childcare as early as possible. HIVEs maintain lists of local nurseries and crèches which may assist you. Do not wait until after your child is born. 5 http://www.modchildcare.co.uk/armed-forces 14 | Service Woman’s Booklet Chapter 2 Medical Issues This chapter will discuss antenatal care as well as some of the physical changes that you might experience now that you are pregnant. Whether this is your first pregnancy or one of several, it is highly unlikely that you will experience all of the symptoms and if you are already a mum, the symptoms this time around might be very different from your previous pregnancy. Antenatal appointments Regardless of your length of service, you are entitled to paid time off to attend any antenatal appointments and classes. It is important to go to all of these appointments, even if you are feeling fine or are facing a tight deadline; you need to make sure that both you and the baby are healthy and that the baby is developing normally. Let your chain of command know about the appointments in advance as much as you can so that cover can be arranged if necessary. Your line management may require a copy of any appointment letters for audit purposes. All antenatal care in the UK is shared between the unit medical centre and the NHS. Your midwife (providing care before and around delivery) and the health visitor (providing care after delivery) will supply a wealth of information and services according to your needs and those available to you in your local area. In the UK, all obstetric care (anything relating to pregnancy and childbirth) is undertaken by the NHS. Service Woman’s Booklet | 15 Frequency of appointments Provided that the MO is aware of your pregnancy your first antenatal appointment will probably be around the 10th week of pregnancy, unless there is a particular reason for you to be seen earlier than this. After that, antenatal appointments may occur along the following timelines or as directed by your midwife or MO: 0 to ? weeks 10 to 12 weeks 16 weeks 18 to 20 weeks 25 weeks 28 weeks 31 weeks 34 weeks 36 weeks 38 weeks 40 weeks 41 weeks – – – – – – – – – – – – inform the doctor that you are pregnant initial booking appointment for scans/screening review results of screening scans for first pregnancies only for all pregnancies for first pregnancies only for all pregnancies for all pregnancies for all pregnancies for first pregnancies only women who have not yet given birth Please note that these are general guidelines only and there will inevitably be deviations based on appointments available and the specifics of your own pregnancy. If there is a further medical condition, or any other concerns, your appointments may be more frequent. Make sure that you communicate well with your line management about the frequency and dates of these appointments. Common physical symptoms Pregnancy can affect your whole body and is different for everyone, so you may experience any number of symptoms or none at all! The symptoms listed are fairly common in pregnancy but if you are worried about these or any others, always discuss them with your doctor or midwife. Ensure that your line manager is aware of any physical symptoms that you are experiencing as they will have to take those in to account when completing the necessary risk assessment for you and your role while you are pregnant. 16 | Service Woman’s Booklet • Morning sickness – Despite the name, this does not just happen in the morning. It is usually worse in the first few months of pregnancy and some women will only feel nauseous occasionally, while others can be sick throughout the day or react to something very specific. You should talk to your midwife or doctor if you are feeling excessively sick or unwell. Regular snacking can sometimes help to combat the worst of morning sickness as it helps to keep your blood sugar levels stable. If you need to, talk to your chain of command about changing your hours temporarily if you find that the worst of the sickness coincides with your journey in to, or out of, work. • Bladder issues – You must drink plenty of fluids, even though you may need to go to the toilet more often due to the baby pressing down on your bladder. You may find that you leak a bit of urine when you cough, sneeze or laugh – this might be because your pelvic floor muscles have relaxed slightly to prepare for your baby’s birth. Practice some pelvic floor exercises and wear a light pad if you find that this is a problem for you. • Backache – This is a particularly common complaint during pregnancy as your weight and centre of balance shift due to the baby, and the joints in your pelvis loosen in preparation for the birth. Avoid lifting wherever possible, and check your posture whether standing, sitting or generally moving around. Try to sit upright and not recline back, as this increases the pressure on your pelvis. Stress can make backache worse so use relaxation techniques as much as you can. You might benefit from seeing an osteopath if it gets particularly bad, so speak to your doctor about this if you need to (although any private or complimentary therapies will be at your own expense). • Varicose veins – Carrying extra weight, pregnancy hormones and increased blood flow all put pressure on your veins and it is this that causes many women to suffer from varicose veins in their pregnancy. If you have any symptoms including pain in the legs, swollen, visible veins and itchiness, then check with your doctor to make sure that there is no inflammation or blood clots. Service Woman’s Booklet | 17 Avoid standing for long periods and don’t cross your legs when you are sitting down as this slows the blood flow. • Teeth and gums – The hormonal changes of pregnancy can affect your teeth and gums. Gums tend to bleed more and you may find that you get more of a plaque build-up on your teeth. If you have any concerns, it is advisable to book a dental check-up and let them know that you are pregnant. The dentist and hygienist will be able to provide advice that can help avoid some of the pregnancy related issues. • Lack of sleep – Sleep may become elusive, just as you would seem to need it most! As your bump grows, you may feel uncomfortable and restless. Your bladder may also cause you to have to get up several times in the night. Even if you can’t sleep, there are other ways that you can rest your body and mind: ∙∙ ∙∙ ∙∙ ∙∙ ∙∙ ∙∙ t ry to cut back on the amount of work that you are doing limit the number of times you go out in the week rest whenever you can avoid too much caffeine eat a varied, healthy diet take some gentle exercise, such as a walk or swim • Lung capacity – As your baby grows, the space available for your lungs to expand and contract becomes more limited. Your baby will also be making its own demands for oxygen from your body, so you should avoid prolonged or excessive exercise, or anything that makes you out of breath. If you have lots of stairs at work take a rest between floors, or take the elevator. If you should find yourself out of breath, try and stay calm as adrenaline in your body diverts the blood away from the placenta. • Dizziness and fainting – Regular breaks and access to fresh air, snacks and drinks can help prevent dizziness. If you should feel dizzy or faint, make someone around you aware and sit down with your head between your knees. 18 | Service Woman’s Booklet • Carpal tunnel syndrome – You may experience carpal tunnel syndrome (pain and numbness in the fingers), especially if you use your fingers and hands repetitively, and are involved with administrative work, or are a technician. If you suffer from this you will need to take regular breaks to rest your hands and you may need to be given alternative work for a while. • Forgetfulness – Do not be surprised if your normal ability to remember things such as appointments or conversations is reduced. It may be down to hormones or it may be that you already have a lot on your mind. You might be used to running a really busy section or managing several issues at once and now you can’t remember where you parked your car or a conversation you had yesterday. Do not worry. Accept it as natural and take things slowly; make written notes to remind you about the important things. Special health issues in pregnancy If your antenatal appointments highlight any specific health issues during your pregnancy you are advised to make your LM aware as soon as possible. Your LM will treat any information provided as confidential unless you indicate that you are happy for other members of your team to know. You should make your LM aware so that the issues can be taken in to consideration for your workplace risk assessment. There are a number of specific health issues that your antenatal check-ups may highlight: • Over 40 – As women age, the risk of miscarriage and premature labour increases and there is also an increased chance that the baby may have Down’s syndrome. However, there are a number of tests available to detect abnormalities in the baby and both you and your baby will be monitored closely throughout your pregnancy to ensure that you are both as healthy as possible. Some of the tests may require you to take a couple of days off work as a precautionary measure. Liaise with your LM if this is the case. • Depression – A case of the blues in pregnancy is common due to temporary hormonal changes but if you feel very low and your mood doesn’t lift, you must Service Woman’s Booklet | 19 tell the doctor or your midwife. You should not feel ashamed of your feelings, many women have them, and it’s important not to bottle them up. It may be that a course of counselling or other support will be of benefit. • Diabetes – If you are already a diabetic, or if you develop pregnancy related diabetes (gestational diabetes), then you will probably require more antenatal check-ups than other women. Make sure that you follow any medical advice that you are given by the doctor or consultant and take plenty of rest. You may be advised to start your maternity leave earlier than planned. Any anti-diabetic treatment will almost certainly have to be increased during the pregnancy and cut back again as soon as the baby is born. Gestational diabetes usually disappears once the baby is born but may reappear in subsequent pregnancies. • Epilepsy – Some women with epilepsy experience more seizures during pregnancy than at other times but others will find that frequency does not increase. Tell your doctor or midwife if you start to have more seizures than normal and always follow their advice. • High blood pressure – If you suffer from high blood pressure, you will need as much rest and relaxation as possible. If your job is particularly stressful you may need to consider cutting back on your hours for a while or changing aspects of your role. Keep your doctor or midwife informed about any symptoms that you may experience and ensure that your LM is aware. Stress can be a health and safety matter. • Twins and more – Two or more growing babies place additional demands on your body so you need to rest whenever you can and listen to the advice given by your health team. You will need more regular antenatal check-ups, including scans, and you may well be advised to start maternity leave earlier than if you were pregnant with one baby. 20 | Service Woman’s Booklet Chapter 3 Common Issues and Emotions • Work – Although your LM is responsible for ensuring that you have a safe and productive pregnancy while in the workplace, you will need to make sure that you communicate effectively so they are aware of your concerns. If you don’t, they will remain unsolved. If you are finding work a struggle or you feel guilty that your post will be gapped and your colleagues will have to pick up extra work, talk to your LM. • Pressure – Women, in particular, often feel under pressure to be all things to all people. Pregnancy often makes this worse! Try not to put too much pressure on yourself; listen to your body and pay attention to your emotional needs. • Financial – Starting a family, or increasing the size of it, can put a strain on your finances. You might be worried how you will cope, especially if you choose to take AML, some of which will be unpaid. Ask your Unit PSF staffs for advice on the eligibility for the childcare voucher scheme. Check to see if you are eligible for additional benefits or Tax credits and try to sort out a financial plan early in your pregnancy. If you have a partner, discuss any concerns with them. Don’t take on any added stress alone. • Labour – Many pregnant women have concerns about the labour stage, especially as the birth date gets closer. Your midwife has a lot of expertise and experience, so talk to her. If you think it will help, talk to fellow Servicewomen who have been through pregnancy and maternity in the Service. Don’t keep any concerns bottled up; they are perfectly natural. • Mood swings – You may feel as if you can take on the world one minute and the next you could be wiping away tears. This is because you have significant levels of hormones racing around your body. These up and down mood swings can put a strain on any relationship, so keep talking to those around you; explain how you feel and don’t be too hard on yourself. Service Woman’s Booklet | 21 Chapter 4 Nutrition for Pregnancy During pregnancy, you are more likely than normal to become deficient in certain nutrients due to the demands of your growing baby. As part of your balanced diet it is important that you include foods containing folate, calcium, iron and vitamin C. • Foods containing folate – good sources of folate are green vegetables such as spinach and broccoli, peas, avocado, citrus fruits and their juices, or foods fortified with folic acid. • Foods containing calcium – calcium is important for the growth and development of your baby’s bones and for the prevention of leg cramps. During pregnancy, it is recommended that you consume at least 700mg of calcium a day (equivalent to 1 pint of milk). If you are suffering from cramps you should increase your intake of calcium further as the hormones from your baby will take what it needs from your bones. • Foods containing iron – during pregnancy you are at increased risk of becoming anaemic which means that you will feel tired and lethargic. The tannins in tea can reduce the amount of iron that can be absorbed from food so you should not drink tea with meals. Foods containing iron include lean red meat, green leafy vegetables, oily fish, wholemeal bread and eggs. • Foods containing vitamin C – vitamin C helps your body to absorb iron so it is a good idea to have a source of vitamin C with each meal, such as a glass of orange juice at breakfast. Other foods that are high in vitamin C include vegetables, citrus fruits and their juices. Raw and steamed vegetables contain more vitamin C than boiled vegetables. Some foods contain a type of bacteria called listeria, which can cause miscarriage, 22 | Service Woman’s Booklet stillbirth or severe illness in young babies. The following foods should be avoided during your pregnancy, as they may contain listeria, vitamin A or salmonella: ∙∙ ∙∙ ∙∙ ∙∙ ∙∙ ∙∙ ∙∙ Unpasteurised soft cheese, such as camembert and brie All types of pate Fish containing mercury, such as shark, swordfish and marlin Multivitamin supplements containing vitamin A, and fish liver oil supplements Raw eggs and food containing raw or partially cooked eggs Raw meat and raw or cold seafood Liver and liver products, due to vitamin A Summary of what to eat during pregnancy • Eat plenty of starchy foods each day, such as bread, pasta, rice and potatoes. Where possible, choose the wholegrain option. • Eat at least 5 portions of fruit and vegetables each day. • Eat foods containing calcium such as milk, cheese, yoghurt, dried apricots, fish, beans and tofu. • Eat protein rich foods each day such as lean meat, fish, chicken, eggs and pulses. • Aim to eat at least 2 portions of fish a week, including one portion of oily fish such as fresh tuna, salmon, mackerel or sardines. • Eat plenty of fibre; this can be found in fruit, vegetables, wholegrain breads and cereals, and pulses. • Where possible, avoid adding salt to your food during cooking and at the table. • Drink no more than one or 2 units of alcohol, once or twice a week. Guidelines are always changing, so follow the advice of the day. • Limit the amount of caffeine that you consume as it interferes with the amount of oxygen going to the placenta and also reduces the amount of vitamins and minerals that your body can absorb. Service Woman’s Booklet | 23 The Maternity Checklist The following check sheet is designed as a guide only. Firm dates for completion are given where there are set deadlines, other areas suggest ASAP as the timeline is dictated by when you choose to have your pregnancy confirmed with the Service, and when you wish to inform your LM. As mentioned previously, the sooner you choose to inform your LM of your pregnancy the quicker he/she can start taking steps to assist you and ensure that the correct risk assessments are in place to protect you and your unborn child. The guideline is based on the servicewoman that is intending to return to duty following a period of maternity leave. Item Details By When Initial Notification 1 Make appointment with Unit Medical Centre to confirm pregnancy. You will be given details of the local midwife at this point and should make an appointment with them directly. Any Point 0-12 wks 2 Take the FMed 566 that the MO will give you to PSF/PEd Flt ASAP after (1) 3 Order maternity uniform via Supply. ASAP after (1) 4 MAT B1 Issued from Doctor or midwife 20 wks + 5 Take MAT B1 with statement of intention to Unit PSF. 20 wks + 6 Latest point at which to notify Service/LM of your pregnancy. 24 wks 7 Issue LM Booklet to LM at point of notification. Any point 0-24 wks Complete 24 | Service Woman’s Booklet During OML/AML 8 Take a copy of your child’s birth certificate to PSF and register your child. NB - If the father is a Serviceman, he will also need to register the child with his own PSF. ASAP after birth 9 PSF will send letter requiring confirmation of intentions from you. 15 wks in to OML 10 Hastener from PSF if you have not replied to the above 19 wks in to OML Returning to Duty 11 Attend Return to Work medical; receive further FMed 566 for 6 month exemption for RAFFT and inform Unit PEd Flt. ASAP on return Service Woman’s Booklet | 25 Sources of Support The RAF is committed to providing, wherever possible, supportive arrangements to accommodate pregnancy and maternity leave within a Servicewoman’s career. While the first port of call for any of your queries should be your Unit PSF staffs or LM, all the sources of support listed below will be able to offer either advice or counselling to pregnant Servicewomen. Armed Forces Childcare Voucher Scheme Website that provides information relating to MOD specific childcare vouchers that can help working parents pay for childcare. www.modchildcare.co.uk Childcare Link Free-phone helpline for childcare information. Tel: 0800 234 6346 www.childcarelink.gov.uk Daycare Trust Provides parents with enough information to make the right childcare choice. Tel: 0845 872 6251 www.daycaretrust.org.uk Employment Tribunals Service Tel: 0845 795 9775 www.employmenttribunals.gov.uk 26 | Service Woman’s Booklet Equality and Human Rights Commission Advice for anyone who feels they have been treated unfairly because of their sex or race. They can also provide advice to employers on good practice. Tel: 0845 604 6610 www.equalityhumanrights.com Health and Safety Executive The HSE can provide advice on pregnancy/maternity and health and safety concerns. Tel: 0845 345 0055 (0800 to 1800hrs) www.hse.gov.uk Meet a Mum Association Help for new mums, especially those with postnatal depression. Tel: 0845 120 3746 www.mama.co.uk Working Families This provides free advice and information, including a helpline and a website for families, including those on low incomes. Tel: 0800 013 0313 (helpline number) Tel: 0207 253 7243 www.workingfamilies.org.uk Service Woman’s Booklet | 27 Q & A’s How do I work out when the 15th week before the week I am due is? Each week runs from midnight between Saturday and Sunday, so if the date you are due is Sun 1 Jan, the week you are due is 1 to 7 Jan. On the calendar count back 15 weeks from the week you are due. In this example, the 15th week before you are due would be 18 to 24 Sep – which would be the latest time that you should tell your chain of command that you are pregnant. What if I fall ill during pregnancy? The normal rules for sick leave apply. You should notify your line manager on the first day of your absence and certify your sick leave in the same way as normal. However, if the illness is pregnancy related and likely to persist, special rules apply (see below). How much maternity leave am I entitled to? All pregnant Servicewomen are entitled to take up to 52 weeks’ maternity leave, regardless of their length of service. All Servicewomen must take a minimum of 2 weeks’ maternity leave immediately after the birth of their baby. How much maternity pay am I entitled to? Maternity pay is dependent on your length of service and whether or not you intend to return to service following the birth of your baby. There is a table in the main body of this booklet that summarises your pay entitlement. What if I have a pregnancy-related illness before I go on maternity leave? Your maternity leave will start automatically if you are absent from work for a pregnancy-related illness during the 4 weeks before the start of your expected week 28 | Service Woman’s Booklet of childbirth, regardless of when you actually wanted your maternity leave to start. Your maternity leave dates will be re-calculated if you find yourself in this position. What happens with my annual leave? You are entitled to take annual leave before or after the maternity leave period, but see the DIN (2011DIN01-115) if you are leaving the Service on completion of Ordinary Maternity Leave (OML). Your annual leave will continue to accrue in the normal way and can be taken with any annual leave you may already have. Annual leave does not accrue during Additional Maternity Leave (AML). If the leave year ends before the end of your maternity leave, you should make every effort to take annual leave before you go on maternity leave. If you have a problem calculating what leave you are entitled to you should consult your unit personnel management staff. What is my status when I am on maternity leave? You are entitled to any opportunities that would be available if you were not on maternity leave. OML, but not AML which is unpaid, is counted as reckonable service. You should discuss with your line manager your preference for keeping in touch so that you do not feel isolated whilst on maternity leave. When you return to duty after OML, AML and/or Parental Leave, the Services will try to meet your geographical and posting preferences in accordance with normal Service arrangements. Where do I return to after maternity leave? If you opt to return to duty immediately after OML, then every effort will be made to return you to your old post (if you so wish) provided that in doing so your return does not have an adverse and disproportionate impact on normal posting practices or operational effectiveness. If, for Service reasons, you are unable to return to your previous post, then you should seek advice from your Career Manager who may be able to offer you a suitable post in the same location. Service Woman’s Booklet | 29 Will I be deployed on return to work? If you return to work after a period of maternity leave you will typically not be deployed on operations and exercises, either overseas or in the UK, for a period of 12 months following the birth of your child – unless you have negotiated differently with your Career Manager. Once all periods of allowed deferment have finished, you will become fully liable for the full range of duties including deployments at home and abroad. Where both parents are serving, the RAF will endeavour not to deploy serving parents of dependent children at the same time where this does not affect operational capability. I have returned to work after maternity leave, but I don’t like leaving my child. Do I have to terminate my service in the usual way? Yes. On return from maternity leave you must complete 12 months’ return of service. I have decided not to return to duty after having my baby. Am I still entitled to take maternity leave before I leave the Service? Yes, you are entitled to the same amount of maternity leave as you would be if you were not leaving the Service. The amount of leave will be determined on your length of service. There is a table in the main body of this booklet that explains your entitlements. I have decided not to return to duty after having my baby. Am I still entitled to maternity pay before I leave the Service? If you remain in the Service until the 15th week before the week your baby is due you may be entitled to Statutory Maternity Pay (SMP), depending on your length of service. There is a table in the main body of this booklet that explains your entitlements. 30 | Service Woman’s Booklet Am I entitled to any resettlement options if I choose to leave the Service on the grounds of pregnancy? You are entitled to resettlement in accordance with JSP 534. Contact your Unit Resettlement Advisor for any guidance in this area. I am a single Servicewoman, what housing am I entitled to? 3 months prior to your expected date of childbirth, as a single Servicewoman you are entitled to occupy Service Families Accommodation (SFA), although you may retain Single Service Accommodation (SSA) if you prefer. You will only pay single charges up until the date of childbirth, upon which the standard SFA charges will apply for as long as you remain in the SFA. Do I get any financial help with child care? Not directly, however your Unit PSF staffs will be able to provide advice on your eligibility for the Armed Forces Childcare Voucher Scheme6. As a Service parent you are responsible for making your own arrangements with childcare and meeting the costs involved so you should also investigate your eligibility for Tax credits and other benefits through the Direct Gov website. The RAF will endeavour not to deploy both Service parents (where applicable) at the same time where this does not affect operational capability. Should issues arise with child care after you have returned from maternity, you are advised to discuss this with your line management as soon as possible. Many units have commercial crèches and nurseries on their premises, or nearby. In general, however, there is a high demand for places in nurseries and for childminders that can lead to long waiting lists. You should start investigating your options and making preliminary arrangements for childcare as early as possible. HIVEs maintain lists of local nurseries and crèches which may assist you. Do not wait until after your child is born. 6 http://www.modchildcare.co.uk/armed-forces 7 This is an NHS publication providing vital information on becoming a parent; taking care of yourself and your child; and on finding practical help and support. Service Woman’s Booklet | 31 Am I entitled to any benefits? Yes, there are various benefits to which families with young children are entitled, and additional benefits to which you may be entitled. Rules change from time to time, so it is always worth checking. In addition, there are a number of voluntary organisations that are happy to provide advice and support, many of which are listed in this booklet. You can also ask your midwife or health visitor, and/or consult the free literature (‘Birth to Five’7) that is provided by the NHS and given to all pregnant women. What rights do I have if I have a stillbirth, a miscarriage or an abortion? If your baby is stillborn after 24 weeks of pregnancy, you will have exactly the same rights to leave and pay had your baby been born alive. In very rare cases, a woman may have to terminate her pregnancy after 24 weeks. In this instance, it would be treated in the same way as a stillbirth and the same maternity rights apply. If your baby is born alive but dies soon after you have given birth, you are also entitled to all the same rights to pay and leave as if your baby had lived. If you experience a miscarriage or terminate a pregnancy before 24 weeks, then you are not entitled to any of the maternity rights. You are, however, entitled to the same access to the RAF’s normal sickness and/or compassionate procedures. If you should find yourself in this situation, make contact with your line management as soon as you are able. What other options are available to Service parents? The RAF recognises the importance of family life and there are a number of options available to help personnel achieve a better balance between work and home commitments. These include paternity leave, parental leave, adoption leave and time off for dependents. Additionally, details of arrangements for working non-standard working hours can be found in 2005DIN02-012. 32 | Service Woman’s Booklet What happens when I return to duty? Before you can return to duty you should make an appointment with your Medical Officer for a Return to Work assessment. The Medical Officer will give you a JMES which will either certify you as fit to return to work (under full or reduced duties) or suggest that you need further time to recover from childbirth. At this appointment you should also discuss with the Medical Officer your exemption from fitness tests for 6 months. Once you have received the required medical chit for exemption (FMed 566), on your return to work you should present this to Unit PEd staffs who will be able to update JPA accordingly. I have chosen to apply for, or have been selected, for redundancy while I am on maternity leave. What monies will I have to pay back? None. Following the Strategic Defence and Security Review (SDSR) of Oct 2010 and the announcement that there would be a reduction in the number of people serving in the RAF, the decision was taken that those Servicewomen who are on maternity leave when the redundancy tranches are announced, will not be liable for any financial payback. This is regardless of whether the Servicewoman is an applicant or a non-applicant. On no account will a Servicewoman be selected for redundancy solely on the grounds that she is pregnant or has recently given birth. Will I be able to breast feed on returning to duty? For some new mothers the opportunity to continue breastfeeding, either wholly or partially, after returning to work will influence the timing of their return to work. The Service will do what it can to provide private and clean facilities for nursing mothers, and time for breast feeding. While overcoming the practical difficulties can be considerable, you should be prepared to discuss this matter openly with your line manager if it is important to you. Service Woman’s Booklet | 33 Further Reading 2005DIN02-012 – Released Mar 05: Guidelines for Managing Non Standard Working Hours for Members of the Armed Forces. 2011DIN01-115 – Released Apr 11: Revised Maternity Arrangements for Servicewomen in the Regular Armed Forces 2011DIN01-037 – Released Feb 11: The Introduction of Additional Paternity/ Adoption Leave and Pay for Members of the Regular Armed Forces JSP 760 – Regulations for Leave and Other Types of Absence (Maternity Leave Chpt 20, Career Breaks Chpt 18, Special Unpaid Leave Chpt 17) JSP 534 – Regulations for Resettlement Procedure Leaflet 36 to JSP 375 – The MOD Health and Safety Handbook JSP 346 – PULHEEMS: A Joint Service System of Medical Classification AP 3392 Vol 2 Lflt 1721 AP 1269 – Medical Management and Administration AP 1269A – RAF Manual of Medical Fitness The UK Servicewomen’s Guide to Health and Performance The Work and Families Act 2006 34 | Service Woman’s Booklet Maternity Glossary AFOMS Armed Forces Occupational Maternity Scheme: an enhanced pay element paid to you by the RAF in addition to SMP. AML Additional Maternity Leave: a 26 – week period of leave that can follow on from Ordinary Maternity Leave. Antenatal Prior to birth. APL Additional Paternity Leave: a period of up to 26 weeks’ leave that can be taken by a Service father after the mother has returned to work following OML. APL & P Additional Paternity Leave and Pay. ASPP Additional Statutory Paternity Pay. CML Compulsory Maternity Leave: it is a legal requirement that you do not work for at least 2 weeks from the date of giving birth. FWA Flexible Working Arrangements: a temporary change to working hours or Service that is agreed between the line management and Service person. EWC Expected Week of Childbirth: the week, beginning at midnight between Saturday and Sunday, in which it is expected that your baby will be born (as notified on your MATB1 by your medical advisor). KIT Keeping In Touch: A maximum of 10 days, during your maternity leave, on which you may attend work (by arrangement with your line manager), which will not bring your maternity leave to an end. MA Maternity Allowance: paid by the State (subject to certain conditions), to any Servicewoman who is not entitled to SMP. MAT B1 Certificate confirming the date the baby is due, provided by midwife or doctor. Service Woman’s Booklet | 35 Miscarriage When a baby is born dead before the 24th week of pregnancy. MPP Maternity Pay Period: the period (of up to 39 weeks) during which the SMP is paid. OML Ordinary Maternity Leave: a period of 26 weeks leave to which all Servicewomen are entitled. Paternity Leave A period of up to 2 weeks’ leave for spouses/partners (including same sex partners) after the baby’s birth. Postnatal After the birth. Qualifying Period The fixed period of time during which a Servicewoman must have worked, to be eligible for certain benefits. QW Qualifying Week: the week during which you must have been employed by the Service to qualify for statutory maternity pay. The qualifying week is 15 weeks before the EWC. RoS Return of Service. SFA Service Family Accommodation. SML Statutory Maternity Leave. SMP Statutory Maternity Pay: paid to you by the RAF on behalf of the State, provided you satisfy certain qualifying conditions. SSA Single Service Accommodation. Stillbirth When the baby is born dead after the 24th week of pregnancy. Trimester Pregnancy is divided in to three stages: the first trimester weeks 1 to 12, second trimester - weeks 13 to 26 and third trimester - weeks 27 to 40. Produced by Air Media Centre, HQ Air Command. 0130_11LAL © UK MOD Crown Copyright, 2011 36 | Service Woman’s Booklet
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