Pregnant and Postpartum Workers Face Uphill Battle for Workplace Accommodations

When Heydi Fernandez returned to her job as an emergency medical technician three months after giving birth, the ambulance dispatch station where she worked had no private space for her to pump breast milk. She resorted to expressing milk at a dining table when colleagues were not eating there.

One day, the CEO of the private ambulance company made a surprise visit and introduced himself while she was pumping. "This is his first impression of me, and I was in a panic," Fernandez recalled, explaining that she told him she could not shake his hand because hers probably had milk on it. She worried the awkward encounter could affect her career. "Am I going to get fired? Or is this going to impact my future here if I move up within the company?" she thought.

Fernandez's experience reflects a broader problem. Many women face discrimination during pregnancy and after childbirth, even though state and federal laws are meant to protect them. As a result, pregnant and postpartum workers often worry about how managers or prospective employers will view them if they disclose a pregnancy or request job modifications.

"Their employer is required to provide them accommodations, if those are available, and see if there's a different job that they can do while they're pregnant," said Cortney Shegerian, co-founder of Shegerian Conniff, a Los Angeles law firm representing workers alleging pregnancy discrimination and breastfeeding rights violations. "That oftentimes is seen by the employer as a big inconvenience, as something that they just don't want to deal with."

Under the Pregnant Workers Fairness Act, which took effect in June 2023, employers with at least 15 workers must make reasonable health and safety accommodations so employees who are pregnant or have recently given birth can stay in their jobs. The law entitles workers to request a wide range of changes, including help with physically demanding tasks like lifting heavy objects, flexible scheduling for medical appointments, and reduced exposure to hazardous chemicals, according to guidance from A Better Balance, a nonprofit legal advocacy group.

The law also protects those trying to conceive through in vitro fertilization and pregnant workers with conditions such as severe nausea and vomiting, said A Better Balance President Inimai Chettiar. For nursing mothers, it guarantees breaks and a private space other than a bathroom for lactation.

"Your employer cannot force you on leave or retaliate against you for requesting accommodation," Chettiar said. "And the employer has to prove that it would be an undue hardship for them to deny the accommodation, and that's a really high legal standard. They have to prove it would cause them significant difficulty or expense."

Deciding when to tell a manager or potential employer about a pregnancy is one of the first considerations for most women. "The sad reality is that pregnant workers still need to tread really carefully, and in our experience pregnancy discrimination is still insidious and rampant," Chettiar said. "But I want to also emphasize that you do have rights as a pregnant worker."

To access the protections of the Pregnant Workers Fairness Act, an employer needs to know about a need related to pregnancy, childbirth, or a medical condition. But that does not mean a direct supervisor and all co-workers must know; some companies allow requests to be discussed directly with human resources, according to A Better Balance.

"If you do decide to tell your workplace what's going on, keep track of how it goes, take notes, put things in writing, especially if you're worried that they could retaliate," Chettiar added.

Shegerian recommends informing employers about a pregnancy when it is far enough along that you would tell friends, often after the first trimester. "Let them know, 'Listen, I'm pregnant ... and feeling fine so far but I'm due on such-and-such date, and I'm not sure about my leave yet, but I'll keep you posted,'" Shegerian said. If a doctor advises modifications to duties or the work environment, she suggests getting the specific advice in writing and letting the employer know as soon as possible.

Women may be reluctant to mention pregnancies out of fear it could put them out of the running for promotions or new jobs. A disqualification on that basis counts as discrimination under the law, Shegerian said. "I would hate for the illegal thing to happen, which is that an employer automatically says, 'This person is going to be out in nine months ... and we just don't want to deal with that, so let's take her out of the pile,'" she said.

Amy Green had three miscarriages before she started receiving daily hormone injections to help maintain another pregnancy. The shots made her feel ill, but she was well enough by the end of the first trimester to look for work as a school counselor. A 1978 amendment to the Civil Rights Act of 1964 prohibited workplace discrimination based on pregnancy, childbirth, or related medical conditions. Green still worried she would not be considered for jobs and wore a loose tank top and a cardigan to conceal her condition. She needed work, especially the health insurance.

"There's no right answer," Green said, adding that disclosing might increase the risk of not getting hired but withholding could create the impression of intentional deception. "We've built this process for women where there's no good choice."

Protections do not end with pregnancy. New mothers can request paid or unpaid time off to recover from miscarriages or for conditions such as postpartum depression. They are also entitled to breaks and private spaces for expressing breast milk.

With no space available at her dispatch station, Fernandez used rooms in hospitals to pump when she was out delivering patients. Then a manager told her that her pumping breaks interfered with the needs of hospital and patient customers. If a transport call came in while she was pumping and she could not respond immediately, it would be passed to another medical service; the manager gave Fernandez two weeks to pick a new shift.

She panicked, not knowing how she would manage childcare if her hours changed. She called a help line at A Better Balance and learned that imposing schedule changes because of lactation was considered retaliation, which both the Pregnant Workers Fairness Act and the Providing Urgent Maternal Protections for Nursing Mothers Act, which took effect in 2022, prohibit. In the end, Fernandez got to keep her original schedule.

"If my ambulance service ... is willing to accommodate my breastfeeding needs, there's no reason why any other job should not be willing to," Fernandez said.