Pregnancy

Overview
Pregnancy itself is not automatically a disability under the Americans with Disabilities Act (ADA). However, a pregnancy-related impairment—including one caused or aggravated by pregnancy—may qualify as a disability if it substantially limits one or more major life activities.

Separately, the federal Pregnant Workers Fairness Act (PWFA) requires covered employers to provide reasonable accommodation to qualified applicants and employees with known limitations related to pregnancy, childbirth, or related medical conditions, unless the employer can demonstrate that the accommodation would cause an undue hardship.

Pregnancy and the ADA
A pregnant employee may have rights under the ADA when she has a physical or mental impairment related to pregnancy that substantially limits a major life activity. Examples may include pregnancy-related high blood pressure, gestational diabetes, severe nausea or vomiting, anemia, sciatica, pelvic conditions, depression, anxiety, or a pregnancy-related lifting or mobility limitation.

The ADA requires a covered employer to provide reasonable accommodation to a qualified individual with a disability unless doing so would cause undue hardship. The ADA generally applies to employers with 15 or more employees, including covered local-government employers.

Pregnancy-related impairments should be assessed individually. A city should not assume that a limitation is too temporary, too minor, or too common to qualify for protection under the ADA or PWFA.

Pregnant Workers Fairness Act
The PWFA applies to employers with 15 or more employees, including state and local governments. It took effect on June 27, 2023. The EEOC’s final PWFA regulations, found at 29 C.F.R. Part 1636, took effect June 18, 2024.

The PWFA requires a covered city to provide reasonable accommodation for a qualified applicant’s or employee’s known limitation related to pregnancy, childbirth, or a related medical condition, unless the city can show undue hardship.

Unlike the ADA, the PWFA does not require the limitation to meet the legal definition of a disability. The limitation may be minor, temporary, episodic, or associated with an otherwise normal pregnancy. Examples may include fatigue, nausea, morning sickness, frequent urination, swelling, gestational back pain, a temporary lifting restriction, lactation, or recovery from childbirth.

A limitation may be known when the applicant or employee communicates the limitation and a need for a work-related change. The employee does not need to use legal terms such as “PWFA,” “reasonable accommodation,” or “disability” to begin the process.

Qualified Employees
Under the PWFA, an applicant or employee is generally qualified if the person can perform the essential functions of the position with or without reasonable accommodation.

The PWFA also provides an important additional protection. An employee may remain qualified even if she is temporarily unable to perform one or more essential functions of the job, if:

• The inability to perform the essential function is temporary.
• The employee will be able to perform the essential function in the near future.
• The inability can be reasonably accommodated without undue hardship.

For pregnancy-related limitations, “in the near future” generally means up to 40 weeks. This may require a city to consider temporarily suspending an essential function, modifying work duties, providing light duty, changing a schedule, temporarily reassigning duties, or providing leave where those options are reasonable and do not create undue hardship.

Other Protections
Pregnancy-related employment issues may implicate several overlapping laws. Depending on the facts, a Tennessee city may need to comply with:

• The Pregnant Workers Fairness Act.
• The Pregnancy Discrimination Act and Title VII of the Civil Rights Act.
• The Americans with Disabilities Act.
• The Family and Medical Leave Act, when the city and employee meet applicable coverage and eligibility requirements.
• The PUMP for Nursing Mothers Act following childbirth.
• Applicable Tennessee anti-discrimination laws, city policies, collective-bargaining obligations, and leave provisions.

The PWFA does not replace these laws. A city should apply the law or policy that provides the greatest protection in the particular circumstance.

Common Accommodations
A city should consider accommodations based on the employee’s individual limitations, job duties, requested change, available alternatives, and the city’s ability to demonstrate undue hardship. Potential accommodations include:

• Closer or accessible parking.
• A chair, stool, or other seating for work that normally requires standing.
• Permission to stand when work normally requires sitting.
• Additional or more frequent restroom breaks.
• Additional breaks to eat, drink water, rest, or manage symptoms.
• Permission to keep water nearby and drink as needed.
• A flexible work schedule or modified start and end times.
• Time off for prenatal, postpartum, or medical appointments.
• Temporary lifting restrictions or modified physical duties.
• Light duty or modified duty.
• Temporary reassignment of particular duties.
• Temporary reassignment to a vacant position, when appropriate.
• Modified work equipment, ergonomic tools, or assistive devices.
• Modified uniform, dress-code, or personal protective equipment requirements.
• Telework or remote work when feasible for the position.
• Modified travel, including limiting overnight travel when reasonable.
• Temporary suspension of an essential function, when the PWFA requirements are met.
• Paid or unpaid leave, including leave for childbirth recovery or a related medical condition.

Light duty, temporary reassignment, reduced schedules, and leave are not automatic entitlements in every case. However, the city must consider them through an individualized process and provide an effective reasonable accommodation unless it can establish undue hardship.

Predictable Accommodations
The EEOC has identified four accommodations that, in virtually all cases, will be reasonable and will not create an undue hardship:

• Allowing an employee to carry and drink water as needed.
• Allowing additional restroom breaks.
• Allowing an employee to sit when a job normally requires standing, or stand when a job normally requires sitting.
• Allowing breaks to eat or drink as needed.

Supervisors should not deny these requests casually or require unnecessary medical documentation. They should promptly refer the request to the city’s designated HR representative.

Documentation and Interactive Process
The city should respond promptly when an applicant or employee requests a work-related change because of pregnancy, childbirth, lactation, or a related medical condition. The city should engage in an individualized, interactive process to understand:

• The employee’s limitation.
• The work-related change requested.
• The essential functions and operational requirements of the position.
• Potential effective accommodations.
• Whether a proposed accommodation would create undue hardship.

The city may request reasonable supporting documentation only when it is necessary to determine whether the employee has a PWFA-covered limitation and needs an accommodation. Documentation generally should not be required when:

• The limitation and need for accommodation are obvious.
• The employee has already provided sufficient information.
• The request involves a predictable accommodation, such as water, restroom breaks, seating, or breaks to eat or drink.
• The accommodation relates to lactation and the city already knows the employee is breastfeeding or expressing milk.
• The employee needs an accommodation because of an urgent pregnancy-related condition and the need is obvious.

Medical information and accommodation records should be maintained confidentially and separately from personnel files, consistent with ADA confidentiality requirements.

Light Duty and Modified Schedules
The PWFA changed the analysis of light duty and modified schedules for pregnancy-related limitations. A city may be required to provide light duty, modified duty, temporary reassignment, a reduced schedule, or a temporary suspension of an essential function when the accommodation is reasonable and does not create undue hardship.

The earlier rule under Young v. United Parcel Service, Inc., 575 U.S. 206 (2015), remains relevant under Title VII and the Pregnancy Discrimination Act. Under that framework, a city generally may not treat a pregnant employee less favorably than other employees who are similar in their ability or inability to work. The PWFA goes further. It may require affirmative reasonable accommodation even if the city does not offer the same accommodation to a non-pregnant employee.

Safety and Fetal Protection
A city may not require a pregnant employee to take leave, transfer involuntarily, or stop working because the city believes a job may pose a risk to the fetus. Fetal-protection policies that exclude women from jobs because of potential harm to a fetus are generally unlawful sex discrimination under Title VII. See International Union, UAW v. Johnson Controls, Inc., 499 U.S. 187 (1991).

The city should address workplace hazards through lawful, gender-neutral safety practices, including appropriate training, equipment, personal protective equipment, and safety procedures. It should not make paternalistic employment decisions based on assumptions about pregnancy, fetal health, future medical conditions, strength, stamina, attendance, or ability to work.

If an employee identifies a pregnancy-related limitation or requests a workplace change, the city should engage in the PWFA interactive process. Potential accommodations may include modified duties, a schedule change, temporary reassignment, a temporary suspension of an essential function, telework where feasible, or leave. The appropriate accommodation depends on the individual circumstances and undue-hardship analysis.

Leave Before Delivery
An employee may need leave before delivery because of a pregnancy-related limitation or medical condition. Leave may be a reasonable accommodation under the PWFA and may also be protected under the FMLA, city leave policies, short-term disability coverage, or other applicable laws or benefits. The city should not automatically require an employee to take leave simply because she is pregnant, has medical restrictions, or cannot temporarily perform an essential job function. The city should discuss effective alternatives with the employee and provide a reasonable accommodation that enables the employee to remain at work when one is available and does not create undue hardship.

If leave is the effective reasonable accommodation, the city should coordinate the PWFA process with FMLA administration, applicable paid-leave provisions, disability benefits, and city policy.

Supervisor Direction
Supervisors should promptly contact HR when an applicant or employee mentions pregnancy, childbirth, lactation, a pregnancy-related medical condition, medical restrictions, or a need for a work-related change.

Supervisors should not:

• Require an employee to use specific legal words to request accommodation.
• Deny a request because the condition is temporary, common, or related to a normal pregnancy.
• Demand medical documentation before permitting obvious or predictable accommodations.
• Force an employee onto leave, light duty, or reassignment without an individualized discussion.
• Remove an employee from duties because of concerns for fetal safety.
• Retaliate against an employee for requesting or using an accommodation.

The city should document the request, promptly evaluate accommodation options, consult the employee, and maintain appropriate confidentiality.