NEMRA - New and Expectant Mothers Risk Assessment (V2.0)

• Name of the employee:

• Employee I.D

• Branch (If applicable)

• Employee job role

• Managers Name

• Assessment completed by:

• Position

• Assessment Conducted on

  Date

• How many weeks pregnant are you?

• Estimated due date?

  Date

• Have you informed your Manager?

  Yes

  No

  N/A

• Have the first aiders been informed?

  Yes

  No

  N/A

• Have the site management/ supervisor staff been informed?

  Yes

  No

  N/A

Movement & Posture

• Do any tasks or processes involve awkward twisting, stretching or reaching?

  Yes

  No

  N/A

• Do you stand for periods of more than two to three hours without a break?

  Yes

  No

  N/A

• Do you sit for periods of more than two-three hours?

  Yes

  No

  N/A

• Are there space restrictions (for example, working behind a desk)

  Yes

  No

  N/A

• Is the workstation and chair suitable for you (DSE)

  Yes

  No

  N/A

Manual Handling

• Does the job involve twisting, stooping or stretching to lift objects?

  Yes

  No

  N/A

• Does the job involve the lifting, pushing or pulling of heavy loads?

  Yes

  No

  N/A

• Does the job involve rapid repetitive lifting (even of lighter objects)?

  Yes

  No

  N/A

• Does the job involve lifting objects that are difficult to grasp or awkward to hold?

  Yes

  No

  N/A

• Do you lift objects that have to be held away from your body and transported to another location?

  Yes

  No

  N/A

COSHH (Control of Substances Hazardous to Health)

• Are any chemicals used at work known to be of risk to women of childbearing age?

  Yes

  No

  N/A

• Are pregnant workers kept away from work that could increase exposure?

  Yes

  No

  N/A

• Are there any infection risks in the work? For example: Clearing up spilled body fluids/disposing of used syringes.

  Yes

  No

  N/A

Working Times

• Are you expected to work long hours or overtime?

  Yes

  No

  N/A

• Do you have some flexibility or choice over working hours?

  Yes

  No

  N/A

• Do your shift patterns involve early starts or late finishes? (Before 6am & after 9pm)

  Yes

  No

  N/A

• Do you work a night shift?

  Yes

  No

  N/A

Work-Related Stress

• Are there tasks which are known to be particularly stressful, for example dealing with irate customers?

  Yes

  No

  N/A

• Are colleagues and supervisors supportive toward the NEM?

  Yes

  No

  N/A

• Are you aware of what to do if you feel victimised?

  Yes

  No

  N/A

Extremes Tempratures

• Are you exposed to temperatures that are uncomfortably cold (below 16ºC) or hot (above 27ºC)?

  Yes

  No

  N/A

• Are you exposed to cold draughts even when the average temperature is acceptable?

  Yes

  No

  N/A

Work at Height

• Do any tasks or processes involve climbing up and down steps or ladders?

  Yes

  No

  N/A

• Do any tasks involve carrying items up or down stairs/ladders?

  Yes

  No

  N/A

Work-Related Violence

• In your opinion, does the site you work at have an above-average high risk of violence?

  Yes

  No

  N/A

• Is there support available if you feel threatened by a customer?

  Yes

  No

  N/A

• Are managers and supervisors aware of the extra risks posed by violence to pregnant women?

  Yes

  No

  N/A

Wellfare Issues

• Is there somewhere quiet for you to rest or lie down if needed?

  Yes

  No

  N/A

• Does the site have easy access to toilets?

  Yes

  No

  N/A

• Is there a clean, private area to express breast milk?

  Yes

  No

  N/A

• Is there somewhere safe for them to store expressed milk?

  Yes

  No

  N/A

• Is your pregnancy high risk from a personal medical perspective?

  Yes

  No

  N/A

• Did your last blood pressure indicate a risk to you?

  Yes

  No

  N/A

• Have any other medical concerns been identified we need to be aware of?

  Yes

  No

  N/A

• Details:

• Are you suffering from morning sickness?

  Yes

  No

  N/A

• Does the morning sickness affect your ability to work?

  Yes

  No

  N/A

• Are there facilities to make hot/cold drinks and to rest?

  Yes

  No

  N/A

• How do you commute to work?

  Select Walk to work Use public transport (Bus, train, taxi) Drive to work Lift share Partner/ family member takes me to work Cycle to work

  • Walk to work
  • Use public transport (Bus, train, taxi)
  • Drive to work
  • Lift share
  • Partner/ family member takes me to work
  • Cycle to work

• Is it the hospital you are having the baby in?

  Yes

  No

  N/A

• Who would you contact for emergencies?

• Are you having issues with attending medical appointments?

  Yes

  No

  N/A

• When do you think you will go on maternity leave? (Estimated date)

  Date

• Do you feel that you need additional support at this time?

• Next Assessment Date:

  Date

• Magnitude of Risk

  Low

  Medium

  High

• Reasonable Adjustments Requested or Advised

• NEM Full Name & Signature

  Sign

• Carried out by

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