Pregnancy accommodation laws – UWPRC Small Grants Projects

UWPRC staff recently met with Drs. Jessica Pac and Alejandra Ros Pilarz, the Principal Investigators of one of the 2020 Small Grant projects to learn more about their project, The Effects of State Pregnancy Accommodation Laws on Maternal and Infant Health.

During the last 50 years, the number of pregnant mothers joining the workforce has grown dramatically. However, policies that protect them as members of the workforce have not kept up with that increase. Today, only 27 states have laws requiring employers to provide reasonable accommodations to pregnant women. These laws allow pregnant women to continue to work, and to do so under safe conditions. This means women can stay employed longer, continue to earn a necessary income and have access to benefits, including health insurance and maternity leave. These laws thereby help to prevent negative health outcomes for both mothers and infants.

This project will provide new evidence about how state laws around pregnancy accommodations impact the health of mothers and children.

How is your work related to prevention research?

There is a lot of research on the importance of women having paid family leave after giving birth and it has been shown to improve their ability to maintain employment. Through maintaining employment and through the wages that they receive for paid leave, there are benefits for health outcomes as well – both for the mother and the child. After women give birth, paid family leave is available. Prior to giving birth, some women may have unpaid family leave and disability insurance (in some states) that provides leave. We know, however, that low-income women are less likely to have employer-based leave, and temporary disability insurance is only available in five states. If women are not able to take protected leave during pregnancy, that could result in higher rates of preterm birth and other negative outcomes after birth.

We suspect that, similar to paid family leave, pre-birth leave operates through employment. We know that access to pregnancy accommodations is really important, especially for women working in jobs where you have to be physically active or stand for long periods of time (service industry, warehouses, factories). We want to investigate what benefits – in terms of maternal and infant health – might add up prior to giving birth, particularly in vulnerable women. We anticipate that some outcomes will have potentially larger effects on some subgroups, e.g., women in different industries and certain employers. For example, to what extent might employers provide accommodations to not only follow pregnancy accommodation statutes but also because they know the potential negative consequences for their employees.

Dr. Alejandra Ros Pilarz
Dr. Alejandra Ros Pilarz

There has been growing advocacy around the need for a federal pregnancy accommodation law. Currently, employers are only required to provide accommodations if they also do so for other workers with disabilities. So a lot of women do not get these accommodations to help them stay employed safely during a pregnancy. Some states have begun passing pregnancy accommodation laws primarily since the beginning of the 2010s (there are some that have had them for longer) as a response to women who are leaving jobs prematurely as a result of lack of accommodations, or those who continue working unsafely and face negative outcomes like miscarriage, pre-term birth, and other health consequences for the pregnant mother and her child. Seeing this need and the growing advocacy around it motivated us as well. We know that these disparities in maternal and infant health outcomes are affected by race, income, mother’s education, etc. and a lack of accommodations could be contributing to that. We want to test to what extent these laws have made a difference in the states that have passed them.

What does pregnancy accommodation look like?

This is industry-specific. In jobs where significant heavy lifting is required, a pregnancy accommodation law would mean that a pregnant woman could either lift less or not lift at all but still keep her job. If there is a lot of walking required, she may be allowed to sit more than others. Employers could also provide access to water and water bottles. We have noticed that while pregnancy accommodation laws do not specifically allow for leave, states that are more likely to enforce pregnancy accommodation laws are also more accommodating regarding paid sick days and pre-birth leave to allow women time for healthcare appointments.

Do you see a role for community partners in your work?

We have proposed to work with the UWPRC to identify community partners to work with. We think it would be beneficial to have something specific to share with potential community partners so that they could provide feedback. We also believe it would be helpful to get their input on opportunities for disseminating our findings.

Dr. Jessica Pac
Dr. Jessica Pac

What stage is the project currently on?

We are currently analyzing some initial data and hope to have preliminary results to share in the next month or so. There is still some additional data that needs to be collected. We hope to submit our preliminary results to some upcoming conferences.

What are your next steps?

Our next steps once this project is completed depend on what we find. If our findings line up with our hypotheses, we will advocate for pregnancy accommodation laws not only in the states that don’t have them but on the federal level. The House passed a federal pregnancy accommodation law this year and we believe there is a growing momentum towards this. We think that our findings, if as expected, will be a tool for advocacy and to garner support for the passage of a federal law.

We are also applying for additional funding to explore some of these ideas in greater depth, especially the effects of the laws on labor force participation, employment, and earnings. We will explore questions like how employers respond to pregnancy accommodation laws, in terms of outcomes such as wages and health insurance, and whether other policies such as paid sick leave moderate these effects. Furthermore, we are interested in looking at outcomes beyond health, such as overall economic well-being of families and access to health insurance.

Why is this important work? Does it tie into health issues in Wisconsin?

Maternal and child health is important – prenatal and postnatal health has lifelong implications for child health. The perinatal period is an important time for both mothers and children to make sure they have protections for their health. In Wisconsin, there are significant disparities in maternal and infant health by race and other demographics and these laws could reduce those disparities.

Wisconsin does not have a pregnancy accommodation law and findings from our study could be used to advocate for such a law.

The disparities between Black and White mothers, and Black and White infants are pretty extreme in Wisconsin compared to other states so it’s fertile ground for implementing pregnancy accommodation laws.

We have persistently high rates of infant mortality and other inequities in Wisconsin. The lack of pregnancy accommodations could be a reason behind the mixed results of previous attempts to reduce these inequities. Such inequities are dependent on things like employment, access to leave, and the accommodations needed in order to get healthcare. One thing that makes our project unique is that our mechanism for prevention itself isn’t through healthcare – it’s through employment. When improving infant outcomes and maternal outcomes, context and environment matter.