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Your prenatal care provider can help you get what you need at work.

Liz Morris's picture

As a pregnant woman, there’s much to experience, much to do, and much to learn. You’ll navigate everything from whether you can still eat your favorite deli meat and change your cat’s litter, to the principles of your birth plan.  Thankfully many women can count on dedicated prenatal care providers for guidance on issues ranging from vitamins and checkups, to complications and risks. But there’s something your prenatal care provider – despite the best of intentions – may miss.

Most women continue working into their pregnancies. And many can do so safely without any adjustments in how, where, or when they do their jobs. But many other women do need to make changes at work to be able to continue working safely and comfortably.  Although the accommodations women need are typically minor – extra bathroom breaks, a stool to sit on, time off for visits to the doctor - one-quarter of a million women are denied an accommodation each year. At a time when women’s incomes are hugely important to most families, leaving work is not a viable option; and women shouldn’t have to over a simple bathroom break.

So what does all of this have to do with your ob-gyn? A lot, it turns out. Prenatal care providers are regularly asked to write notes to their patients’ employers to seek the reasonable accommodations pregnant women may need to continue working safely. Although written by care providers trying to help, sometimes these notes lead employers to send pregnant woman out on unpaid leave, to terminate their health insurance, or even to fire them from their jobs.

How could this be? The pregnancy accommodation laws are complicated, and often healthcare providers must have knowledge of the law to write an effective work accommodation request letter.  Using the wrong language can cause trouble for pregnant women at work. On the other hand, healthcare providers can increase the likelihood a pregnant woman will receive an accommodation by using key language to trigger legal protections.

Unfortunately healthcare providers typically have received no training on how to write legally appropriate and effective work accommodation notes for their pregnant patients. But this is changing.

The Pregnancy Accommodation Working Group, an initiative of the Center for WorkLife Law at the University of California, Hastings College of the Law, is a team of lawyers, doctors, and other professionals who are committed to helping pregnant women at work. Together, this team developed downloadable guidelines healthcare providers can follow to write effective work notes.  There is a unique guideline for each state (because the laws differ from state to state). And for the majority of states, prenatal care providers may also access an interactive online tool to generate an effective work note by answering questions about their patient’s condition and medical needs.  

Pregnant women can download the guidelines and share with their care providers to increase the likelihood that they get the help they need at work. For example, a woman with gestational diabetes may receive extra breaks to eat snacks, or a woman with severe back pain may be given a stool to sit on as she rings up customers. (The website where the guidelines are housed, Pregnant@Work ( also provides other valuable resources for pregnant women, and their employers and lawyers.)

In a perfect world, prenatal care providers would explain what a pregnant woman needs to work safely, and employers would simply provide it. Alas, we do not live in a perfect world: Although many women receive the accommodations they need, too many women are not so lucky. If you are pregnant and need changes at work, providing the downloadable note-writing guidelines to your healthcare provider may mean the difference between losing a job and health insurance, and maintaining your family’s economic security.


Have questions? Contact the Center for WorkLife Law’s free legal hotline for more information. Email or call (415) 703-8276. 

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