Navigating Pregnancy for Employees in Civilian Rotary-Wing Aeromedicine.

Women of child-bearing age make up an ever-increasing element of the aeromedical workforce in Australia and the UK. However, policy relating to the management of risk for pregnant employees in this sector is often missing or inadequate, with many women facing detrimental impacts on their career progression and financial well-being. For women who choose to continue flying, there is a lack of transparent guidance about the risks of flying within a helicopter in an aeromedical role. While grounding pregnant employees removes some risks, it is at the cost of autonomy and brings other adverse effects for the employee and employer. Updated reflections on this important topic will empower the audience to make informed discussions around pregnancy in aeromedical roles. Applying principles from literature surrounding commercial, military, and medical aviation, the risks to pregnant employees and the fetus are reviewed. These risks are complex and dynamic depending on gestation and underlying medical problems; thus, individualization of risk management is of key importance. In low-risk pregnancies, incapacitation risk is below the usual threshold adopted for safety-sensitive aviation activities. Based on available evidence we have quantified risks where possible and provide guidance on the relevant factors to consider in creating a holistic risk-management framework. The greatest unknown surrounds the risk from vibration, noise, and winching. These are reviewed and suggestions given for discussing this risk. We also highlight the need for policy providing acceptable nonflying options to remove the pressure to continue flying in pregnancy. Based on a literature review we have generated a framework for understanding and assessing risk relating to pregnant employees in the aeromedical sector. This is intended for use by aeromedical organizations, pregnant employees, and their treating medical practitioners to provide rational and sensible policy and guidance.