Becoming Breastfeeding Friendly Scotland: report

Theme 4: Promoting a supportive return to work environment for breastfeeding women through greater awareness and application of maternity, employment and child care provisions

Recommendation 4.1: Extend and strengthen the opportunities for promoting best practice in supporting women to breastfeed when returning to the workplace and ensuring a fair deal for women going back to work in Scotland

Recommendation 4.2: Empower women to be aware of their rights regarding breastfeeding in the workplace, employment provisions and in all areas of child care

Relevant BBF Scotland Gear scores: Legislation and Policies: 1.6; Advocacy: 2.0; Promotion: 1.7

Why are these recommendations necessary?

Women's intention to breastfeed, influenced by cultural norms and context, is strongly associated with both initiation^[36] and duration^[37],^[38]. The fact that women's breastfeeding intentions are generally established by the third trimester^[39] suggests that action on strengthening a supportive return to work environment and child care provision could generate positive breastfeeding gains. However, unsupportive return to work environments are cited as key factors in women being less likely to start or continue breastfeeding or more likely to introduce solids early. The UK as a whole has not ratified the International Labour Organisation Maternity Protection Convention C183^[40] which calls for the provision of at least one breastfeeding break per day, or a reduction in working hours to allow for breastfeeding^[41]. Whilst protections exist under the Employment Rights Act 1996 and the Management of Health and Safety at Work Regulations 1999, these are more strongly geared towards pregnancy and are not explicit in their support or protection of breastfeeding, through breaks at work for example.

Rollins et al (2016) note that rather than leaving the job market, women are more likely to remain in employment but stop or not start breastfeeding. From the woman's perspective, there are multi-dimensional issues including fatigue and practicality^[42] emphasising the importance of work-time breaks and on-site rooms for breastfeeding and the provision of maternity leave^[43],^[44]. Recommendations include adequate maternity and workplace entitlements that enable women to continue to breastfeed on their return to work or education, noting the particular barriers for women working in informal sectors^[45].

Return to work or starting work with a baby usually necessitates child care provision either through a workplace nursery, community nursery or registered child-minder if the family does not have access to parental or informal support. Such facilities should also enable a baby or toddler to be breastfed at times when mothers can be at the facility. A study of breastfeeding support conducted with the UK Millennium Cohort in 2012 found that formal or informal childcare was likely to reduce or stop breastfeeding^[46].

Whilst Scotland has relatively strong maternity entitlements for families and legislation aiming to build the wider supportive environment, there are inconsistencies requiring action at a UK Government level. For example, while maternity pay is universally applied, some women receiving Statutory Maternity Pay will not be paid the 2/3 of previous earnings^[47], and there is a need to ensure everyone knows what their entitlements are and how to access and realise them. A discussion of Employment Rights within UK legislation that has implications for Scotland is appended (see Appendix 01).

In Scotland, the Scottish Government has pledged to tackle discrimination against new and expectant mothers^[48] under Gender Equality Policy through:

• creating a working group to produce guidelines for employers to ensure best practice in the recruitment, retention, training and development of pregnant workers
• including best practice information about managing pregnancy and maternity in the Scottish Business Pledge
• strengthening employer advice (including information on employment rights) to ensure that work environments are safe and healthy for pregnant women and new mothers
• recognising that Public bodies have a general duty (known the Public Sector Equality Duty) under the Equality Act 2010 that prohibits discrimination (direct or indirect), harassment or victimisation of anyone who shares one or more of the protected characteristics listed in the Act (including pregnancy and maternity). Scottish regulations^[49] were introduced to help public authorities deliver their public sector equality duty)
• developing an industry specific communications strategy around the benefits of positive pregnancy and maternity policies

Both the Equality and Human rights Commission (EHRC)^[50] and Maternity Action advocate clearer, more accessible information on maternity protections^[51]. Their recommendations include employers having better information on their legal obligations and that the ACAS guidance for employers should be updated with all Government guidance on managing new parents made more accessible. Likewise, for women, that they are provided with appropriate information on rights at work when they need it; for example, from the first antenatal appointment. To deliver this information in a way that is tailored to the community context, Maternity Action advises women's charities are funded to deliver specialist information and advice on maternity rights at work^[52] and to raise women's awareness about their entitlements.

What do we want to happen?

• Provide guidance to employers and inform mothers and families about their rights, through:
• Extending and strengthening the opportunities for promoting best practice in supporting women returning to the workplace in Scotland through robust strategic leadership.
• Improving access to accurate, consistent and supportive information and advice for both employers and employees, and child care facilities.
• Building a more supportive environment for pregnant and new mothers, highlighting and working to remove the barriers for women to raise concerns and complaints, in particular the cost and time constraints of employment tribunals.
• Quality assured processes and provisions through effective monitoring mechanisms and reporting on progress.
• Since Maternity Rights legislation sits at a UK level, build a rights-based momentum in Scotland and across UK partners, towards improving Maternity Protections: strengthening UK Statutory Maternity Payments; investigating how women are disadvantaged with low pay, in particular those who are self-employed or on zero hours contracts, and maternity benefits; providing breastfeeding breaks for women after they return to work as a part of the International Labour Organisation guidance that is not in UK law; and strengthening the law to support and value longer term breastfeeding.

How will this be done?

• Engage with existing external toolkits and actions, such as the EHRC's online toolkit^[53] for employers to support them in managing pregnancy and maternity in the workplace^[54].
• Review and update resources for employers, employees and child care facilities.
• Consider wider consultation with relevant organisations/campaigns such as Equate Scotland, Close the Gap, and the Family Friendly Working Scotland partnership^[55] and build on programmes in place, such as the Scottish Government's support for Ensuring Fairer Workplaces for Women; the Gender Pay Gap Action Plan and addressing Pregnancy and Maternity Discrimination.
• Review the evidence of what works, such as EHRC's Behavioural Insights team's (2017) report on Applying behavioural insights to reduce pregnancy and maternity-related discrimination and disadvantage to address the behaviours of employers and women.
• Explore Equality and Diversity levers to illustrate how action to build a supportive breastfeeding environment can support their achievement of Equality and diversity targets. For example, in the case of universities and colleges, Human Resources are required to demonstrate equality actions to meet ATHENA Swan standards^[56].
• When the legal opportunity arises, legislators and policy-makers analyse and address weaknesses or gaps in their existing legislation, and act accordingly to strengthen Maternity Protections, revising regulations as appropriate.

What is the likely impact of these recommendations?

• Employers and Child Care facilities will be better informed and equipped to support employees who intend to, or who are breastfeeding.
• Women will be better supported to breastfeed and overcome barriers through the provision of accurate, supportive and consistent messages about their rights, the legislation and good practice for employers and child care facilities.
• More supportive work environments will impact on women's capacity to both continue to breastfeed and return to the workplace.

Promoting a supportive environment for breastfeeding through greater awareness and application of maternity, employment and child care provisions

Aim: to strengthen awareness and voluntary action to deliver a supportive return to work environment in the workplace and childcare provision for breastfeeding women

Working with the Pregnancy and Maternity Discrimination working group, and key stakeholders, these recommendations set out to deliver the following objectives

• Build robust strategic leadership at governmental & organisational levels
• Improve access to accurate, consistent and supportive information and advice for employers and childcare facilities
• Link supportive environments to improved progress towards E&D, and H&S management
• Quality assure processes & provisions through robust monitoring & reporting mechanisms
• Highlight and work to remove the barriers for women to raise concerns and complaints
• Work towards strengthening the law to improve Maternity Protections

What will success look like?

Based on best evidence, this would result in…

• Employers better informed, equipped and motivated to support employees who intend to, or who are breastfeeding
• Women better supported to breastfeed and overcome barriers via accurate, supportive and consistent messages about their rights
• More supportive work environments with impact on women's capacity to both continue to breastfeed and return to the workplace