Too Sick to Work? Understanding Your Rights Under the Pregnant Workers Fairness Act (PWFA) and How to Request Accommodations

By the Havellum Editorial Team

There is a silent struggle happening in office bathrooms, break rooms, and parking lots across America.

It’s the pregnant employee who is only 16 weeks along but is battling severe Hyperemesis Gravidarum (extreme nausea). It’s the retail worker whose feet are swelling so badly by noon that she can barely stand, but she’s afraid to ask for a stool. It’s the executive who has been ordered by her doctor to go on "bed rest" due to preeclampsia risk, but who is terrified that taking leave now means she won’t have any time left to bond with her baby after birth.

We know the reality: American maternity leave policies are often brutal.

The fear is visceral. You worry that if you call in sick too often, you’ll be labeled "unreliable." You worry that asking for help will put a target on your back. Most of all, you worry about the math: If I use my 12 weeks of FMLA now to deal with this sickness, I’ll have to go back to work the day after I give birth.

But here is the good news that many employees—and even some HR managers—don’t know yet: The rules have changed.

With the passage of the Pregnant Workers Fairness Act (PWFA) in 2023, you have significantly more power to protect your job and your health without burning through your maternity leave.

This guide will explain exactly how to navigate this new legal landscape, how to ask for "reasonable accommodations," and why securing the right medical documentation through Havellum is the key to unlocking these protections.

Part 1: The Game Changer – The Pregnant Workers Fairness Act (PWFA)

For decades, pregnant workers fell into a legal gray area. Unless you were "disabled" under the Americans with Disabilities Act (ADA), employers could legally deny simple requests like "I need to sit down" or "I need to carry a water bottle."

The Pregnant Workers Fairness Act (PWFA) changed everything. Effective June 2023, this federal law requires "covered employers" (those with 15 or more employees) to provide "reasonable accommodations" to a worker’s known limitations related to pregnancy, childbirth, or related medical conditions.

What Does This Mean for You?

It means you don't have to be "disabled" to get help. You just have to be pregnant and have a physical limitation.

Unless the accommodation causes an "undue hardship" to the business (which is hard for them to prove for minor changes), they must grant it.
* Can they force you to take leave? NO. Under the PWFA, an employer cannot force you to take paid or unpaid leave if another reasonable accommodation can be provided that would let you keep working. This is huge. It means they can't say, "If you can't stand for 8 hours, just go on leave now," (which would waste your FMLA). They have to try to let you sit first.

Authoritative Resource (Nofollow):
* US Equal Employment Opportunity Commission - What You Should Know About the PWFA

Part 2: The Strategy – Don't Burn Your FMLA Early

One of the biggest anxieties for expectant mothers is the FMLA clock. The Family and Medical Leave Act (FMLA) gives you 12 weeks of unpaid, job-protected leave.

The trap is this: If you take 4 weeks off now for "bed rest," you only have 8 weeks left for the baby.

How to "Save" Your FMLA

To keep your 12 weeks intact for the postpartum period, you need to stay on the payroll (and off FMLA) as long as possible. You do this by asking for Accommodations rather than Leave.

Scenario: You have severe back pain and cannot commute.
* The Old Way: You take FMLA leave and sit at home, using up your baby-bonding time.
* The PWFA Way: You request a "Temporary Telework" (Work From Home) accommodation. You continue to work, you continue to get paid, and your FMLA clock stays at zero.

Scenario: You have severe morning sickness in the AM.
* The Old Way: You call in sick 3 days a week, risking termination for attendance issues.
* The PWFA Way: You request a "Modified Schedule" accommodation, allowing you to start work at 10:00 AM and end later, or allowing for frequent breaks.

Authoritative Resource (Nofollow):
* US Dept of Labor - FMLA Frequently Asked Questions

Part 3: What Accommodations Can I Ask For?

Many women are afraid to ask because they don't know what is "reasonable." Here are common pregnant workers fairness act examples that are typically protected:

1. Physical Modifications:

   • Sitting on a stool instead of standing at a register.
   • Moving a workstation closer to the restroom.
   • Exemption from lifting boxes over 10-15 lbs.
   • Permission to carry a water bottle in "no food/drink" areas.

2. Schedule Modifications:

   • Later start times to manage morning sickness.
   • Frequent breaks to eat or rest.
   • Time off for prenatal appointments (this might dip into sick leave, but cannot be penalized).

3. Job Duty Modifications:

   • Temporary transfer to "light duty" (e.g., a police officer moving to desk work).
   • Remote work / Telework for administrative tasks.

Authoritative Resource (Nofollow):
* Job Accommodation Network - Accommodation Ideas for Pregnancy

Part 4: The Mental Barrier – Guilt vs. Health

Before we discuss how to ask, we need to address why you haven't asked yet.

"Can I get fired for calling in sick while pregnant?"
Technically, if you exhaust your sick leave and don't have FMLA/ADA protection, you could face discipline. However, firing someone because of pregnancy-related symptoms is discrimination.

But beyond the law, there is the guilt. You feel like a burden to your team. You feel like you are "slacking."

Let's reframe this: You are growing a human being. Your body is doing the biological equivalent of running a marathon every single day. Prioritizing your health—and the health of your pregnancy—is not "lazy." It is your first act of parenting. The law is on your side. Use it.

Part 5: The Critical Tool – The "Magic" Doctor's Note

Here is the catch. To trigger the protections of the PWFA or the ADA, you generally cannot just ask nicely. You need medical documentation.

Your employer has the right to ask for a doctor's note that confirms:
1. You have a physical or mental limitation.
2. The limitation is related to pregnancy/childbirth.
3. The specific accommodation is medically necessary.

The Problem with "Generic" Notes
If your doctor writes: "Jane is pregnant and needs to rest," HR will reject it. It’s too vague.
To get what you need, the note must be specific: "Due to pregnancy-related pelvic girdle pain, Jane is medically restricted from standing for more than 15 minutes per hour. She requires the use of a stool."

The Offline Healthcare Nightmare
This is where the system breaks down for high-risk or sick pregnant women.
* Wait Times: You need the stool today because your feet are swollen now. Your OB-GYN can’t see you for 3 weeks.
* The Cost: You have to pay a copay just to walk in the door to ask for a piece of paper.
* The Dismissal: Some doctors, primarily focused on the fetus, may dismiss your workplace discomfort as "normal pregnancy complaints" and refuse to write specific work restrictions, telling you to just "tough it out."

This leaves you in a vulnerable position: You are suffering at work, legally entitled to help, but lacking the paperwork to prove it.

Part 6: Havellum – Your Advocate for Workplace Rights

This is where Havellum steps in. We believe that no pregnant woman should have to choose between her health and her paycheck simply because she can't get a timely appointment.

Havellum.com connects you with licensed US physicians who understand the specific requirements of the PWFA and workplace accommodations. We provide the verifiable medical evidence you need to assert your rights immediately.

Why Havellum is the Best Choice for Pregnant Workers

1. Specificity is Key (We Don't Do Vague)

When you are asking for pregnancy accommodations at work, the wording matters.
Havellum physicians can issue Custom Medical Certificates that act as a "Work Restriction Letter." We can specify limitations such as:
* "No lifting over X pounds."
* "Must have access to remote work due to mobility restrictions."
* "Requires breaks every 2 hours."
This specific language is exactly what HR departments require to approve your request under the PWFA.

2. Speed: Documentation When Symptoms Strike

Pregnancy symptoms change overnight. You might be fine on Tuesday and unable to walk on Wednesday.
With Havellum, there are no waiting rooms. You can complete your consultation online from home (or from the office bathroom where you are currently hiding). In most cases, you receive your signed, professional medical certificate via email within hours.

3. Maternity & High-Risk Support

We offer specialized Maternity Medical Certificates. Our board-certified doctors understand that conditions like Hyperemesis, Preeclampsia, and Sciatica are legitimate medical reasons for work modifications. We validate your symptoms professionally, giving you the leverage you need.

4. Verifiable by HR

HR managers are trained to be skeptical. A handwritten note on a prescription pad can look suspicious.
Havellum certificates are professional and verifiable. Every document includes a secure verification link/QR code. Your HR manager can instantly verify that the note was issued by a licensed medical professional. This transparency builds trust and speeds up the approval of your accommodation.

• Learn more about general US doctor's note requirements here: Doctor's Note Guide USA.

How to Get Your Work Restriction Note via Havellum

If you are struggling at work and need to request accommodations now, follow this process:

Step 1: Document Your Limitations

Write down exactly what you cannot do (e.g., "Cannot stand for 4 hours," "Cannot commute 1 hour due to nausea").

Step 2: Digital Consultation at Havellum

Visit Havellum.com. Select the Maternity or Custom certificate option.
Complete the secure, HIPAA-compliant intake form. Upload proof of pregnancy (ultrasound or test results) and describe your symptoms and the specific work restrictions you need.

Step 3: Professional Review

A licensed US physician will review your case. They will assess your medical history and symptoms to ensure the requested restrictions are medically appropriate.

Step 4: Receive Your Certificate

Once approved, you will receive a digital PDF certificate. It will clearly state your medical limitations and recommended restrictions.

Step 5: Submit to HR

Email this certificate to your Human Resources department with a subject line like: "Request for Reasonable Accommodation under the PWFA."
Because the note comes from a licensed provider, it triggers the interactive process required by law.

• For more advice on navigating pregnancy and work, check out our blog: How Pregnant Women and New Mothers Can Use Medical Certificates.

Conclusion: You Don't Have to "Power Through"

The "superwoman" myth is dangerous. You do not need to suffer in silence to prove your dedication to your job. The Pregnant Workers Fairness Act exists because society finally recognized that pregnant women deserve to work safely.

But rights are only theoretical until you exercise them. And to exercise them, you need documentation.

Don't let a slow healthcare system stop you from getting the chair, the break, or the remote work setup you need.

Havellum is your partner in this journey. We provide the fast, professional, and verifiable medical documentation you need to protect your body and your career.

Get your legitimate work restriction note today at Havellum.com.

Disclaimer: Havellum connects patients with licensed healthcare providers for telehealth consultations. We provide medical evidence based on clinical assessment. Havellum does not provide legal advice. If your employer denies a reasonable accommodation request supported by medical documentation, consider contacting the EEOC or an employment attorney.