The Pregnant Workers Fairness Act (PWFA) requires US employers with 15 or more employees to provide reasonable accommodations for a worker's known limitations related to pregnancy, childbirth or related medical conditions, unless it would cause an undue hardship. It took effect on June 27, 2023, and the EEOC's final rule took effect on June 18, 2024.
The PWFA sits alongside Title VII and the ADA, but it's the law written specifically for pregnancy-related limitations, so a simple change like a stool or extra breaks is now a direct right for covered workers. Here's what the EEOC says employers must do, and the four requests it says will almost always be reasonable.
Who the PWFA covers
According to the EEOC, it applies to private employers and state and local governments with 15 or more employees, as well as Congress, federal agencies, employment agencies and labor organizations. It protects qualified employees and job applicants with known limitations, which the EEOC describes as physical or mental conditions related to, affected by or arising out of pregnancy, childbirth or related medical conditions.
A limitation doesn't have to be serious. The EEOC says it can be minor or modest and can come and go, such as migraines or morning sickness, or it can be a need to avoid certain chemicals, heat or tasks like lifting, bending or standing.
What an employer can't do
- Fail to make a reasonable accommodation for a known limitation, unless it causes undue hardship.
- Require an employee to accept an accommodation that wasn't arrived at through the interactive process.
- Deny a job or opportunity because someone needs an accommodation.
- Require an employee to take leave, paid or unpaid, if another reasonable accommodation would let them keep working.
- Retaliate against someone for requesting or using an accommodation, or for taking part in a PWFA proceeding.
The four 'predictable assessments'
This is the most useful part of the final rule for a small employer. The EEOC identified a short list of simple modifications that, in virtually all cases, will be found to be reasonable accommodations that don't impose an undue hardship when a pregnant employee asks for them. In plain terms, they cover carrying and drinking water as needed, taking additional restroom breaks, sitting or standing when needed, and taking breaks to eat and drink. If one of these is requested, the safest assumption is that you'll need to say yes.
Examples of reasonable accommodations
| Accommodation | Example from the EEOC |
|---|---|
| Breaks | Additional, longer or more flexible breaks to drink water, eat, rest or use the restroom |
| Policies | Changing food or drink rules to allow a water bottle or food |
| Equipment | A stool to sit on, or a way to work while standing |
| Duties | Temporary suspension of one or more essential functions |
| Physical work | Light duty or help with lifting or other manual labor |
| Time off | Leave to recover from childbirth or related conditions |
Note that temporary suspension of an essential function is on that list. The EEOC says an employee can still be qualified even if they can't do an essential function for a while, as long as that inability is temporary and can be reasonably accommodated.
Documentation: when you can ask
Employers often reach for a doctor's note by reflex. The final rule says you're not required to seek supporting documentation, and you may only ask when it's reasonable under the circumstances for you to decide whether to grant the accommodation. Even then, you can only ask for the minimum documentation that's sufficient. Asking for medical information when it isn't permitted can itself be treated as retaliation or coercion under the rule.
How to handle a request
- Treat any plain request as a request, even one as simple as needing more bathroom breaks because of pregnancy.
- Respond promptly, as the EEOC expects.
- Talk it through with the employee, which the law calls the interactive process.
- If the request is one of the four predictable assessments, grant it.
- Only ask for documentation if it's reasonable, and keep it to the minimum.
- Consider an interim accommodation while you decide.
- Never push leave if another accommodation would let them keep working.
- Train supervisors, because they usually hear the request first.
If you're putting a policy together, HR software for small businesses can track requests and decisions, and leave management software helps when the accommodation is time off.
How PWFA fits with other laws
The EEOC lists two Department of Labor laws that sit alongside it: the FMLA, which gives covered employees unpaid, job-protected leave, and the PUMP Act, which protects workers who need to express breast milk at work. Pregnancy-related accommodation claims can also still be brought under Title VII or the ADA. The EEOC also flags court orders: one stops it accepting PWFA charges against agencies of the State of Texas, and another limits investigations of abortion-related accommodation charges for employees in Louisiana and Mississippi, so employers there should check the current position.
My verdict
The PWFA asks small employers to do things most good managers already do: let someone drink water, sit down or take a break, and adjust duties for a while. The legal risk comes from refusing simple requests, demanding paperwork or pushing people onto leave. Say yes quickly to the easy requests, talk through the harder ones and write down what you agreed.
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Frequently asked questions
Which employers does the Pregnant Workers Fairness Act cover?
Private employers and state and local government employers with 15 or more employees, plus Congress, federal agencies, employment agencies and labor organizations.
When did the PWFA take effect?
On June 27, 2023. The EEOC's final regulation took effect on June 18, 2024.
Do PWFA limitations have to be serious?
No. The EEOC says a limitation can be minor or modest and can be episodic, such as migraines or morning sickness.
Can an employer require a doctor's note for a PWFA accommodation?
Only when it's reasonable under the circumstances, and only the minimum documentation needed. Employers aren't required to ask for it at all.
Can an employer make a pregnant worker take leave?
Not if another reasonable accommodation would let them keep working, unless that would cause undue hardship.
What are the PWFA predictable assessments?
Four modifications the EEOC says will virtually always be reasonable: keeping water nearby and drinking as needed, extra restroom breaks, sitting or standing as needed, and breaks to eat and drink.
What is undue hardship under the PWFA?
The EEOC describes undue hardship as significant difficulty or expense for the employer.


