Category: Obstetrics & Gynaecology

Categories : Obstetrics & GynaecologyTags :

Discovery May Transform What Time of Day Doctors Induce Labour

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In a discovery that could shift labour and delivery practices around the world, researchers at Michigan State University have found that the effectiveness of oxytocin, used to induce or speed up labour, depends on the time of day it’s administered, especially for patients with gestational diabetes.

The study, published in Molecular Metabolism, combined laboratory research in mice and human cells with a retrospective review of more than 2300 pregnancies. The results were striking. Women whose labours were induced in the early morning to around noon experienced significantly shorter labour durations than those induced around midnight. For patients with gestational diabetes, the timing difference amounted to as much as seven hours.

“Our findings suggest timing isn’t just about scheduling – it can affect how well a patient’s uterus responds to labour-inducing medication,” said Hanne Hoffmann, associate professor of animal science at MSU and lead author of the study.

The science behind the clock

At the centre of the discovery is BMAL1, a key circadian rhythm gene that helps control the body’s biological 24-hour clock. In mice, the researchers showed that BMAL1 helps regulate the oxytocin receptor in the uterus, which is the same receptor that synthetic oxytocin targets to trigger contractions. When the gene was turned off or suppressed, either genetically or through a mouse model of gestational diabetes, oxytocin was significantly less effective at inducing contractions.

“We were able to show that BMAL1 directly controls the oxytocin receptor, which helps explain why time of day changes the drug’s effectiveness,” Hoffmann said. “This is the first study to make that molecular connection in the uterus.”

In human cell experiments, MSU scientists observed a circadian rhythm of contraction responses to oxytocin confirming what had previously only been speculated.

Real-world implications for labor and delivery

The team also analysed labour and delivery records from Sparrow Health System in Lansing, Michigan, focusing on more than 2300 patients who were at least 39 weeks pregnant. Labour duration was compared across different time windows of the day and between patients with and without gestational diabetes.

The shortest labours occurred when induction started between 8 a.m. and noon and the longest when induction began between midnight and 4 a.m. This effect was especially dramatic in patients with gestational diabetes, suggesting reduced oxytocin sensitivity during nighttime hours.

“This isn’t about convenience,” Hoffmann said. “It’s about optimising outcomes. If we can better align medical interventions with a patient’s internal clock, we may improve safety for both mother and baby, while potentially being able to reduce the amount of a drug a woman receives.”

Hoffmann and her team are now expanding their research to a larger cohort to refine the optimal timing of labour induction. “Our ongoing work suggests that factors such as whether a woman has previously given birth and her BMI may further influence oxytocin’s effectiveness,” Hoffmann explained.

“By integrating these considerations with the time of day of drug administration, we can make labour induction safer, faster and more personalised. These simple, evidence-based steps could significantly improve delivery outcomes, lower the rates of caesarean sections and NICU admissions, and strengthen maternal and neonate recovery.”

The next phase of research will include a prospective study in collaboration with labour and delivery units to develop clear, practical guidelines for obstetricians to optimise induction timing. Ultimately, aligning medical care with the body’s natural rhythms has the potential to enhance not only birth outcomes, but the long-term health and well-being of mothers, babies and families – a cornerstone of a healthy and thriving population.

Source: Michigan State University

Categories : Obstetrics & Gynaecology Pain ManagementTags :

New Study Challenges Fears About General Anaesthesia for C-sections

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Data analysed by Penn researchers clarifies risks associated with general anaesthesia, giving patients more control over their delivery experience.

Photo by Anna Shvets on Pexels

Regional anaesthesia has long been favoured for caesarean births due in part to concerns about the effects that general anaesthesia may have on newborns during labour and delivery. Powerful societal pressures also push the idea that mothers need to be awake during delivery to witness the first cry and capture the ‘perfect’ birth moment. But for some women who undergo a caesarean birth, the pain can become excruciating, even after they received a spinal or epidural block.

Now, new research from a team at the Perelman School of Medicine at the University of Pennsylvania, finds that general anaesthesia may be a reasonable alternative for many patients. The findings are published today in Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists.

“No patient should have to experience pain during caesarean section; as an anaesthesiologist, I never want someone to feel forced to choose between their baby’s health and not having to experience the pain of surgery,” said Mark Neuman, MD, MSc, Professor of Anesthesiology and senior author of the study. “Since regional anaesthesia is so widely used, it’s common for patients to feel that a spinal or epidural block is the only safe option for caesarean section. But as our study shows, anaesthesia type during pregnancy does not need to be one-size-fits-all.”

Reducing pain during C-section delivery

The research analysed 30 years’ worth of data from multiple clinical trials, comparing outcomes between general anaesthesia versus spinal or epidural anaesthesia for C-sections. The Penn study found that, while babies born under spinal or epidural anaesthesia had slightly higher Apgar scores than those born under general anaesthesia, the differences were small and not likely to be clinically meaningful.

While the majority of patients experience good outcomes with spinal or epidural block for caesarean delivery, recent studies show that up to one in six patients who receive an epidural or spinal may feel pain during their C-section. These experiences can be traumatic and have lasting emotional impacts.

The findings come amid growing public discourse on caesarean experiences. Recent podcasts and published news stories have featured candid patient accounts of pain under spinal or epidural anaesthesia. “This study equips women with evidence-based context about the use of general anaesthesia during c-section.” said Sarah Langer, MD, a resident in anaesthesiology at the Perelman School of Medicine and lead author the study. “Childbirth is a physically and emotionally demanding process, but we do not want patients to feel like there aren’t options when it comes to their anaesthesia for c-section,”

Broadening evidence-based choices

The study found that babies born under general anaesthesia were slightly more likely to need breathing support immediately after birth, but there was no increase in NICU admissions. The research does not suggest that general anaesthesia should replace regional techniques, but it can be a reasonable option in certain cases.

“For patients who are open to regional anaesthesia, spinal or epidural block remain great first choice options,” Neuman emphasised. “But having conversations with patients about general anaesthesia doesn’t need to be taboo. Patients deserve to know they have options, and our study helps provide the evidence to support those discussions.”

The authors note that most of the trials included in the analysis were conducted outside North America, highlighting the need for more US-based research in this area. They also point to historical barriers in studying women during pregnancy, which have limited the availability of robust data.

Source: Perelman School of Medicine at the University of Pennsylvania

Categories : Mental Health Obstetrics & GynaecologyTags :

Postpartum Psychosis Should Be Recognised as a Distinct Disease, Experts Say

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An international panel of leading experts on women’s mental health is recommending that postpartum psychosis be recognised as a distinct category of mental illness and classified accordingly within standardised medical coding systems.

The recommendation, published in Biological Psychiatry, follows a comprehensive review of the scientific literature on the illness.

Postpartum psychosis is an acute and severe psychiatric illness that sets in within weeks after delivery. Most women with postpartum psychosis experience severe mood symptoms, including mania, mixed episodes, or depression with psychotic features. Impaired cognition, irritability, and agitation are also common.

The condition is considered a psychiatric emergency and, in most cases, requires hospitalisation of the mother. If left untreated, postpartum psychosis is associated with high risks of suicide and infanticide. However, if it is detected and treated in time, patients respond well to treatment and most women return to their previous functioning.

Despite being one of the most distinct clinical phenotypes in psychiatry, postpartum psychosis is not recognized in the Diagnostic and Statistical Manual (DSM-5) or the International Classification of Disease (ICD), which are used to code diseases and medical conditions for treatment and billing purposes.

The panel, in close collaboration with patient advocacy organisations and key interested partners, recommended classifying postpartum psychosis as a distinct category within the bipolar disorders chapter of the DSM and ICD.

“Postpartum psychosis is the most severe perinatal mental health problem, and yet one that is often misdiagnosed and mismanaged, with severe consequences for women, and their children and families. A proper nosological classification of this disorder is an essential step towards its correct identification and treatment”.Professor Paola Dazzan, Professor of Neurobiology of Psychosis, Vice Dean (International) at King’s IoPPN and a member of the research panel

Due to the risks to the patient and the infant, the rapid escalation of severity, and its severe and sudden course, it is imperative that postpartum psychosis is recognized, diagnosed, and treated as early as possible. To facilitate such care, the panel recommends DSM-5 and ICD-10 include the following criteria for a diagnosis of postpartum psychosis:

  • The onset of at least one of the following states within 12 weeks of childbirth, lasting at least one week and present most of the day, nearly every day, or any duration if hospitalisation is necessary:
    1. Mania/mixed state
    2. Delusions
    3. Hallucinations
    4. Disorganised speech or formal thought disorder
    5. Disorganised, confusional, or catatonic behaviour
    6. Depression with psychotic features
  • The episode is associated with an unequivocal change in functioning that is uncharacteristic of the postpartum period.
  • The disturbance in mood and the change in functioning are observable by others.
  • The episode is sufficiently severe enough to cause marked impairment in social functioning and in the care of the baby or to necessitate hospitalization to prevent harm to the patient, baby, or others.

“We have been working with the American Psychiatric Association and the DSM steering committee since 2020 to find a solution that will facilitate diagnostic accuracy and the provision of timely and evidence-based treatment to improve the quality of treatment and outcomes for women with postpartum psychosis and to prevent the tragic outcomes of suicide and infanticide. We are committed to continue this work,” concludes Dr Veerle Bergink, Director of the Women’s Mental Health Center at Mount Sinai and first author of the paper.

Source: King’s College London

Categories : Obstetrics & GynaecologyTags :

Blood Type Linked to Risk of Premature Birth, New Study Suggests

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A new study, led by clinical researchers from Imperial’s Department of Metabolism, Digestion and Reproduction and Imperial College Healthcare NHS Trust, has uncovered a link between a pregnant woman’s blood group and her risk of spontaneous premature birth, which the team hopes could in future lead to more personalised approaches to preventing early labour.

“The treatments we currently offer to prevent preterm birth have barely changed in decades. This research opens the door to more targeted, biologically-informed interventions.”

Dr Lynne Sykes Clinical Associate Professor, Department of Metabolism, Digestion and Reproduction

The findings, published in npj Biofilms and Microbiomes, draw on more than 74 000 anonymised maternity records from Imperial College Healthcare NHS Trust and data from high-risk pregnancies. The team found that women with blood groups B and O were associated with a higher risk of spontaneous preterm birth, while those from blood group A were associated with a lower risk. 

The clinical researchers believe this is because women with blood group A are more likely to carry higher proportions of a protective bacterium and show less inflammation, both associated with healthy pregnancies.

The research also found that the blood group associations vary depending on underlying risk factors, including previous cervical surgery or a history of late miscarriage or premature birth. In women whose only risk factor was previous cervical surgery, blood group B was associated with a higher likelihood of preterm delivery. In contrast, in women with a history of late miscarriage or prior premature birth, blood group O was associated with the highest risk.

The team used advanced microbiome analysis on a subset of 596 high-risk women to investigate possible biological mechanisms at work. They found that women with blood group A were more likely to carry higher proportions of Lactobacillus crispatus, a ‘good’ bacterium associated with healthy pregnancies. In contrast, women of blood group B and O were more likely to harbour a more diverse bacterial signature. In women with blood group O, a direct link was observed between this bacterial signature, inflammation, and spontaneous preterm birth.

Speaking about the findings, Dr Lynne Sykes, lead researcher and Clinical Associate Professor at Imperial College London, and Consultant Obstetrician at Imperial College Healthcare NHS Trust, said: “Although we did not establish causation, we have identified a genetic link that can influence the risk of spontaneous premature birth in women. This could potentially impact women in the future by identifying risk earlier in pregnancy and by offering more tailored interventions. While we need further research, the prospect of moving towards personalised care in this area is hugely exciting.” 

Next steps

The team demonstrated that blood group sugars are secreted into the vaginal fluid and that binding of these sugars can occur to key good and bad bacteria found in the vagina. However, one important limitation of the study was that researchers did not have “secretor status” data for participants, a genetic factor that affects whether blood group sugars are secreted in vaginal fluid. 80% of the population are “secretors”, whereas 20% do not secrete blood group sugars, so future studies that incorporate this information may strengthen the findings.

The research suggests that the ABO blood group, routinely tested early in pregnancy, could be used to help stratify preterm birth risk, especially when considered alongside other clinical factors. Importantly, the team accounted for ethnicity, known to affect both blood group prevalence and preterm birth risk, ensuring these results were not driven by population differences.

Dr Sykes added: “What excites me most is the opportunity this presents for truly personalised medicine in pregnancy, something that has been sorely lacking in our field. The treatments we currently offer to prevent preterm birth have barely changed in decades. This research opens the door to more targeted, biologically-informed interventions.”

The study also lays the groundwork for new therapeutic approaches. A clinical trial beginning this autumn, funded by March of Dimes in the US, will explore whether probiotic treatment with Lactobacillus crispatus (Lactin-V) can help reduce premature birth in high-risk women – and whether response to the treatment may vary by blood group.

Source: Imperial College London

Categories : Obstetrics & Gynaecology Substance UseTags :

Study Explores How Prenatal Cannabis Exposure May Affect Foetal Brain Development

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Researchers at UTHealth Houston are examining the biological effects of prenatal cannabis exposure and its potential impact on foetal brain development. Supported by a $3.7 million grant from the National Institutes of Health and the National Institute on Drug Abuse, the study aims to improve screening tools, public health guidance, and prenatal care strategies for pregnant people who use cannabis.

Led by Laura Goetzl, MD, MPH, a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth Houston, the five-year grant will fund the study, “Foetal neuronal extracellular vesicle biomarkers of in-utero effects of maternal cannabinoid use and human foetal brain development and neurobehavioral outcomes.”

“In recent years, cannabis use among pregnant women has increased, either recreationally or to help relieve nausea and vomiting during pregnancy,” Goetzl said. “Despite this rise, the effects on a baby’s brain are not well understood. Our hope through this research is that we can better identify risk factors and help health care providers give expecting mothers the best possible guidance.

The study will explore early biological signs, or biomarkers, to show how cannabis exposure influences a baby’s developing brain.

“During pregnancy, small bubbles called neuronal extracellular vesicles travel from the foetus into the mother’s bloodstream,” Goetzl said. “Through studying these small particles, we hope to gain valuable insight into foetal brain development without invasive testing.”

In collaboration with the University of Colorado, the research study will focus on how prenatal cannabis exposure may influence brain growth and neurobehavioral outcomes in children, including their potential for developing attention-deficit/hyperactivity disorder (ADHD) or autism later in life.

The project is supported by the National Institute on Drug Abuse of the National Institutes of Health under award number R01DA060319.

Source: UTHealth Houston

Categories : IT in Healthcare Obstetrics & GynaecologyTags :

Virtual Antenatal Care Linked to Poorer Pregnancy Outcomes

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Women who receive more virtual antenatal care during their second or third trimesters could experience poorer pregnancy outcomes, including higher risks of preterm birth, Caesarean sections and neonatal intensive care unit admissions, a new study suggests.

Increased virtual antenatal care in later pregnancy was also found to be associated with lower rates of early skin-to-skin contact with the newborn and fewer instances of breastfeeding as the first feed.

Led by King’s College London and published in the American Journal of Obstetrics & Gynecology, the study looked at associations between virtual antenatal care and pregnancy outcomes in more than 34 000 pregnancies from a diverse, South London population, from periods before and during the COVID-19 pandemic.

Women were split into four groups, according to the proportion of virtual antenatal care appointments received during their pregnancy – low and stable virtual antenatal care throughout pregnancy, high first trimester virtual antenatal care, high second trimester virtual antenatal care, and high third trimester virtual antenatal care.

Pregnancy and birth outcome data were obtained from hospital records via the Early Life Cross-Linkage in Research, Born in South London (eLIXIR-BiSL) platform, funded by the UKRI Medical Research Council (MRC).

Analyses of the data revealed that, compared with those who received a low and stable proportion of virtual antenatal care throughout their pregnancy:

  • Women who received a high proportion of virtual antenatal care in their second trimester experienced more premature births (before 37 weeks), labour inductions, breech presentation, and bleeding after birth; and
  • Women who received a high proportion of virtual antenatal care in their third trimester had more premature births (before 37 weeks), elective or emergency Caesarean sections, and neonatal intensive care unit admissions; as well as lower rates of third- or fourth-degree vaginal tears, early skin-to-skin contact with the newborn and fewer instances of breastfeeding as the first feed.

During the COVID-19 pandemic, the use of virtual antenatal care increased, to limit face-to-face contact and prevent spread of the SARS-CoV-2 virus. While research has looked at the experiences of women and healthcare providers receiving and delivering virtual care, fewer studies have focused on the impact of virtual antenatal care on pregnancy outcomes.

Our work adds an important perspective to the growing evidence base on virtual antenatal care, suggesting that the timing of its use during pregnancy may influence pregnancy outcomes.

Dr Katie Dalrymple, Lecturer at King’s and first author of the study

The findings build on an earlier study by the team, which found that virtual maternity care during the COVID-19 pandemic was linked to higher NHS costs – with each 1% increase in virtual antenatal care associated with a £7 increase in maternity costs to the NHS.

In addition to the cost implications of virtual care, the findings from the new study suggest that virtual antenatal care could come with increased risks to mother and baby. The authors conclude that careful consideration may be needed to minimise these risks before using virtual antenatal care in future health system shocks or to replace face-to-face care.

Our study findings suggest the need for careful integration of virtual care in maternity services, to minimise potential risks.

Professor Laura Magee, Professor of Women’s Health at King’s and co-senior author of the paper

Source: King’s College London

Categories : Obstetrics & GynaecologyTags :

Caesarean Delivery Linked to Higher Risk of Pain and Sleep Problems After Childbirth

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New mothers are more likely to experience severe pain that disrupts sleep and activities of daily living, as well as develop sleep disorders, if they give birth by caesarean delivery (C-section), suggests research presented at the ANESTHESIOLOGY® 2025 annual meeting.

“Sleep is often overlooked in postpartum recovery, but it is central to a mother’s physical and mental health,” said Moe Takenoshita, MBBCh, lead author of the study and a postdoctoral scholar in the department of anaesthesia at Stanford University Center for Academic Medicine. “Caesarean delivery in particular appears to increase the risk for severe pain and sleep disorders, which can lead to postpartum depression, thinking and memory problems, and fatigue, as well as disrupt bonding with their babies and relationships with family and friends.”

The study included both qualitative and quantitative analyses. For the qualitative analysis, the authors interviewed 41 mothers about their pain and sleep experiences after childbirth, 24 of whom had vaginal births, 11 who had scheduled C-sections and six whose C-sections were unplanned. More than two-thirds of the mothers who had C-sections (73% of the scheduled cesareans and 67% of the unplanned) reported severe pain that disrupted sleep and activities of daily living, compared to 8% of those who had vaginal births.

For the quantitative study, the authors analysed a nationwide insurance database of more than 1.5 million mothers who delivered babies between 2008 and 2021. They determined that individuals who have C-sections are 16% more likely to be diagnosed with a new sleep disorder (eg, insomnia, sleep deprivation or obstructive sleep apnoea) between a month and a year after giving birth, compared to those who delivered vaginally.

New mothers, especially those recovering from C-sections, should be sure to manage pain adequately, since untreated pain can worsen sleep, said Dr Takenoshita. Other measures that can help to improve sleep include regular exercise as appropriate, sleeping when the baby sleeps, avoiding caffeine or alcohol late in the day, and relaxing before bed by taking a bath or practising deep breathing.

“About one-third of U.S. births are C-sections,” said Dr Takenoshita. “Those who are planning a C-section should understand that the procedure is linked to more severe pain after delivery and a higher risk of sleep disorders. Anyone having sleep problems during pregnancy or after childbirth should discuss their concerns with their physician, who can evaluate the issue, make recommendations and refer them to a specialist if necessary.”

Source: American Society of Anesthesiologists

Categories : Obstetrics & GynaecologyTags :

Nausea and Vomiting of Pregnancy Caused by a Complex Inflammatory Response

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UCLA researchers have uncovered a link between “morning sickness” symptoms and the body’s natural, but complex, inflammatory response to biological and bodily changes during pregnancy.

According to the National Institutes of Health, up to 80% of early-stage pregnant mothers experience some nausea, vomiting and aversions to certain foods and smells. While uncomfortable, these symptoms are not typically a sign that anything is wrong with the health of the mother or the developing fetus, but rather an indication of a delicate balance unique to pregnant women. 

“During pregnancy, a mother’s immune system faces a tricky challenge: it has to protect both her and the foetus from infection, but without accidentally attacking the foetus, whose genetic identity is half-foreign because it is half derived from the father. Normally, the immune system attacks anything that seems foreign, so in pregnancy, it has to carefully adjust to keep the foetus safe while still defending against infection,” said UCLA anthropology professor Molly Fox, corresponding author of the study published in Evolution, Medicine and Public Health.

The researchers believe that this delicate balance, which protects mother and foetus, is achieved by a unique mix of inflammatory responses. They function to prevent the mother’s body from rejecting the foetus, alongside adaptive behavioural mechanisms, like nausea, that encourage the mother to avoid foods that are potentially harmful, especially in the first and second trimesters when the foetus is most vulnerable.

“Nausea, vomiting or aversions to foods or smells are not indications that something is going wrong for the mother or the foetus. It’s likely an indication that everything is moving along normally, and a reflection of the body’s healthy and helpful immune response,” said UCLA anthropology professor and paper co-author Daniel Fessler.

Methodology and findings

For the study, the UCLA-led team of anthropologists and epidemiologists collected and analysed blood samples to measure immune system molecules called cytokines. Cytokines are proteins that send signals to help the body launch a quick defence against sickness and regulate inflammation. Participants also filled out questionnaires that asked about morning sickness-related symptoms and food and smell aversions during the early stages of pregnancy. The participants were 58 Latina women in Southern California who were followed beginning in early pregnancy through the postpartum.

Sixty-four percent of study participants experienced odour or food aversions, primarily to tobacco smoke and meat. Sixty-seven percent reported nausea and 66% experienced vomiting.

The study team measured pro-inflammatory cytokines as well as anti-inflammatory cytokines. They found that women who experienced an aversion to tobacco smoke showed a noticeable shift toward a more inflammatory response. Food aversions, nausea and vomiting were also associated with a more pro-inflammatory immune balance.

An evolutionary process?

The correlation is consistent with researchers’ theory that these symptoms may be part of an evolutionary adaptation that helps pregnant mothers’ bodies minimize exposure to harmful substances, though the study’s authors caution that the evidence is not definitive and more research is needed. 

They emphasised that the study allowed the team to look at both human biological and behavioural responses during pregnancy.

“In many mammals, the foetal compartment has barriers separating it from the mother’s blood supply, where her immune cells are. But in humans, we have a unique setup – foetal cells are bathed in maternal blood. Humans have the most invasive of all placentas, burrowing deep into maternal tissue. So humans need unique strategies to prevent the mother’s immune system from attacking the foetus,” said Fox.

These immunological changes may induce nausea, which in turn encourages food avoidance that might act as an additional layer of protection, according to the researchers

“Nowadays, you will see labels on packages of ground beef or soft cheese that warn pregnant women to be cautious about these products because of the risks of foodborne illness during pregnancy. Aversions to certain odours and foods, and nausea and even vomiting, appear to be evolution’s way of achieving that same objective,” said Fessler.

Practical implications

The researchers, including first author Dayoon Kwon, who just completed her PhD in epidemiology at UCLA (and is now a postdoctoral fellow at Stanford), said that the study could help bolster recognition that nausea and vomiting are normal symptoms with biological underpinnings associated with healthy pregnancies. The study’s results could help in paving the way for common-sense workplace accommodations, such as more efficient deployment of health care benefits and other helpful resources to reduce stigma, excessive absences and lost productivity.

They also encourage other researchers to continue to look into the questions raised by the study, to not only explore the evolutionary questions, but to work toward providing clinicians with non- or low-invasive measures of prognoses.

Source: University of California – Los Angeles

Categories : Ethics and Law Obstetrics & GynaecologyTags :

Webber Wentzel Secures Landmark Constitutional Court Ruling Reforming South Africa’s Parental Leave Laws

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Webber Wentzel’s Pro Bono team represented Mr and Mrs van Wyk in a landmark case that has resulted in the Constitutional Court confirming that South Africa’s statutory four months of parental leave may be shared between both parents. The ruling marks a significant step toward gender equality in the workplace and family law.

The case challenged the unequal parental leave provisions under section 25 of the Basic Conditions of Employment Act (BCEA), which granted birthing mothers up to four months of maternity leave while limiting fathers to only 10 days.

Webber Wentzel argued that section 25 of the BCEA unfairly discriminated against fathers and placed an undue burden on birthing mothers by not allowing families to decide who should be the primary caregiver. The court agreed and criticised the 10-day leave for fathers by rejecting the cultural norms that reinforce gendered parenting roles as inconsistent with constitutional values.

The application was supported by the Commission for Gender Equality (CGE) and Sonke Gender Justice (Sonke). CGE advocated for equal parental leave for adoptive and surrogacy-commissioning parents, which the court partially granted. Sonke’s request for an equal 16-week leave for both parents was not granted.

The Constitutional Court, in a unanimous judgment delivered by the Honourable Justice Tshiqi, confirmed that sections 25, 25A, 25B and 25C of the BCEA, along with corresponding provisions of the Unemployment Insurance Fund Act (UIF Act), are unconstitutional. The Court held that these provisions violate the rights to equality and human dignity under sections 9 and 10 of the Constitution.

The Minister of Employment and Labour accepted that differentiation exists between birthing mothers and other categories of parents is automatically unfair as it is based on grounds specified in section 9(3) of the Constitution. Further, the Minister acknowledges that there is a need for reform in the current legislation pertaining to the parental leave regime contained in the BCEA.

As a result of the ruling in the Constitutional Court, the 4 months of maternal and the 10 days of parental leave will be combined into a total of 4 months and 10 days, which parents may now share as they choose. If no agreement is reached, the leave will be split equally. Where only one parent is employed, that parent will be entitled to the 4 consecutive months of parental leave.

The Constitutional Court also confirmed that the same parental leave provisions apply to adoptive parents and commissioning parents in a surrogacy arrangement.

The Constitutional Court has suspended the declaration of invalidity of the relevant BCEA and UIF Act provisions for a period of 36 months, to allow the legislature to remedy the necessary constitutional defects.  In the interim, the following principles will apply:

  • A single parent or a parent who is the only employed parent is entitled to four months’ consecutive parental leave.
  • Parents who are both employed may share the allocated parental leave of four months and 10 days between them, concurrently or consecutively.
  • An adoptive parent of a child younger than two years is entitled to four months’ consecutive parental leave.
  • If an adoption order is granted in respect of two parents, they may share the allocated parental leave of four months and 10 days between them, concurrently or consecutively.
  • A commissioning parent is entitled to four months’ consecutive parental leave.
  • Where there are two commissioning parents, they may share the allocated parental leave of four months and 10 days between them, concurrently or consecutively.

Employers are encouraged to review and, where necessary, update their leave policies and employment contracts to reflect the new parental leave framework.

“This judgment is a powerful affirmation of the constitutional rights to equality and dignity,” said Nkosinathi Thema, senior associate, Webber Wentzel. “It recognises that caregiving is not the exclusive responsibility of mothers and that both parents should have the freedom to decide how best to care for their child.”

The Webber Wentzel team comprised Ayanda Khumalo, Nkosinathi Thema and Lize-Mari Doubell. Counsel Nasreen Rajab-Budlender SC, Liam Minné and Sanan Mirzoyev appeared on a pro bono basis.

The judgment can be read here.

Ends…

Founded in 1868, Webber Wentzel is a leading full-service law firm providing clients with innovative solutions to their most complex legal and tax issues across Sub-Saharan Africa. With over 450 lawyers, their multi-disciplinary expertise is consistently ranked top tier in leading directories and awards, both in South Africa and on the African continent. Their collaborative alliance with Linklaters and their deep relationships with outstanding law firms across Africa provide clients with market-leading support wherever they do business.

Categories : Mental Health Obstetrics & GynaecologyTags :

SAHPRA Clarifies that Paracetamol is Safe to Use in Pregnancy, at Recommended Doses

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Pretoria, 28 September 2025 – The South African Health Products Regulatory Authority (SAHPRA) wishes to reassure the public that paracetamol remains a safe and recommended option for the relief of pain and fever during pregnancy, when used short-term at recommended doses.

Paracetamol is one of the most widely used medicines globally and has been extensively studied for decades. There is currently no scientific evidence that using paracetamol in pregnancy causes attention-deficit hyperactivity disorder (ADHD) and autism.

SAHPRA will continue to monitor emerging evidence on the safety of paracetamol.

Advice for healthcare professionals

Paracetamol remains a recommended safe treatment for pain or fever in pregnant women. Pregnant women should be reassured that there is no evidence that taking paracetamol during pregnancy causes autism or ADHD in children. Healthcare professionals are encouraged to provide counselling to patients about the side effects of paracetamol, as detailed in the product’s professional information and patient information leaflet (https://pi-pil-repository.sahpra.org.za/).

Advice for healthcare professionals to provide to patients

Pregnant women and those planning a pregnancy should be advised to use paracetamol only when needed and at the lowest effective dose for the shortest possible time. Untreated fever and pain may pose risks to the unborn baby, and it is therefore important to seek treatment if recommended by a healthcare professional. Pregnant women should consult a healthcare professional if pain or fever persists or if they have any concerns about medicine use during pregnancy. Pregnant women should also be advised to avoid combining paracetamol with other medicines without first seeking medical advice.

Report any suspected adverse drug reactions

Healthcare professionals and members of the public are urged to report any suspected adverse drug reactions (ADRs) related to the use of paracetamol and other health products to SAHPRA via the eReporting link available on the SAHPRA website (www.sahpra.org.za) or complete an ADR reporting form accessible via the SAHPRA website and email it to adr@sahpa.org.za. Alternatively, reporting can be done via the Med Safety App, downloadable through Google Play or the Apple App Store.

SAHPRA remains committed to ensuring the safety of medicines available in South Africa and will update the public if new scientific evidence changes current recommendations.