Pregnancy sickness and employment

Please see below for employee and employer information which you can download and share with your place of work.

Whilst work is a large responsibility of most people's lives remember to take care of yourself primarily. Even if your symptoms come under control you do need to ease yourself back into work, doing too much at once can put you right back at square one.

Once you have told your employer that you are pregnant, they have duties to fulfil and accommodate your pregnancy and the symptoms which you are currently experiencing. If your direct line manager isn’t proving to be helpful, it is always worth contacting your HR department who can put a plan in place. You are protected by the Equalities Act 2010, and when your employer knows that you are pregnant you cannot be discriminated against, disciplined, or made redundant due to any pregnancy-related sickness or leave you take, and your employer has a duty of care and must maintain privacy and dignity at work.

There should be a pregnancy risk assessment in place at your workplace, because of you being unwell with your pregnancy you can ask for this to be adapted with your pregnancy related symptoms in mind. This can include change of duties, a request to become admin based, changing the hours of your contract, and even related to your smell triggers. If your employer cannot accommodate your needs they have to, by law, sign you off on full sick pay until they are able to accommodate them. It is also worth mentioning that any pregnancy related sick leave is not counted to previous sick leave, and if you were unwell on annual leave you can request to have this changed to sick leave. If you don’t feel mentally and physically able to work, then your GP can sign you off for as long as you need.

Information for employees

Printable version of information for employees

We are frequently contacted by people who are unable to work because they are suffering from nausea and vomiting in pregnancy (NVP) or the extreme form of this known as hyperemesis gravidarum (HG). Although many employers are sympathetic to those suffering from severe NVP or HG, we find equally that some employers are unaware of the wide spectrum of NVP and the impact that severe NVP and HG can have on a person's ability to carry out simple daily tasks, let alone their usual paid employment.

General information

Any form of NVP is an unpleasant and traumatic experience for the person concerned. HG is a condition at the severe end of the pregnancy sickness spectrum which requires medical treatment to ensure the health and wellbeing of the parent and the baby. With HG, the nausea and vomiting are so severe that the those affected lose a considerable amount of weight and become dehydrated and depleted of nutrients. It can have a profound effect on their ability to function in carrying out even the simplest of daily tasks and it is not uncommon for those suffering from HG to need help caring for themselves.

It is estimated that approximately 30% of pregnant people in paid employment need time off work due to NVP and 1 in 100-150 people will be admitted to hospital due to the severity of their condition.

You are entitled to health and safety protection during your pregnancy. Your employer should look at whether there are any risks to your health and safety, for example, standing for long periods. Your employer has a duty to make reasonable adjustments to your job and to alter your working conditions or hours of work. If there is still a risk to your health and safety your employer must offer you suitable alternative work or suspend you on full pay.

Take a look at the useful links drop down menu for organisations which can help you gain further information and support.

Your employment rights

Pregnancy discrimination

Under the Equality Act 2010, it is unlawful discrimination for an employer to treat someone unfavourably because of their pregnancy or an illness relating to their pregnancy or because they are exercising, has exercised or is seeking or has sought to exercise their right to maternity leave. This special protection applies from when a person becomes pregnant and continues until the end of their maternity leave, or until they return to work if that is earlier. This is referred to as “the protected period”.

Anyone who has suffered discrimination can bring a claim for compensation before an employment tribunal.

What is unfavourable treatment?

Unfavourable treatment could be demotion, dismissal or the denial of training or promotion opportunities because an employee is pregnant or on maternity leave. An employer is not permitted to take into account any pregnancy-related absences during the protected period for the purposes of attendance management or when deciding whether to dismiss an employee. This would also be unfavourable treatment. For this reason, any sick leave taken for a pregnancy-related illness should be recorded separately by your employer.

By way of example, unfavourable treatment for any of the following reasons will amount to pregnancy discrimination:

any absence due to pregnancy-related illness
a person's inability to attend a disciplinary hearing due to pregnancy sickness or other pregnancy-related conditions; or
performance issues due to pregnancy sickness or other pregnancy-related conditions.

Does the employer need to know I am pregnant?

Unfavourable treatment will only be unlawful if the employer is aware the person is pregnant. The employer must know, believe or suspect that she is pregnant – whether this is by formal notification or through the grapevine.

Although you are under no obligation to inform your employer that you are pregnant until 15 weeks before your baby is due, telling your employer triggers the legal protection. It is therefore in your interests to notify your employer of your pregnancy.

Do I need to show a comparator?

Unlike some other types of discrimination there is no need to compare the way a pregnant worker is treated with the treatment of any other employees. However, evidence of how others have been treated may be useful to help determine if the unfavourable treatment is in fact related to pregnancy or maternity leave.

Unfair dismissal

It is also unlawful for an employer to dismiss someone because of their pregnancy regardless of how long they have worked for the employer or how many hours they work. This is unfair dismissal and would enable the person to bring a claim for compensation before an employment tribunal.

What you can do

If you are unable to work because of NVP or HG there are some practical steps you can take:

Do not beat yourself up. You are not alone in needing time off for pregnancy-related sickness. It is important that you rest, and you cannot do this properly if you are working.

Ask your doctor to give a sick note indicating that you are unfit for work because of a pregnancy-related illness which you can then give to your employer.

If you feel that your employer does not fully understand the impact that NVP/HG is having on your daily life, and your ability to work, it may be helpful to print off some information from the PSS website and give this to your employer. Many employers may never have come across someone with severe NVP or HG and so providing some information may help them to understand what you are going through.

If you feel you have been treated unfavourably because of your pregnancy, the first step is to explain this to your employer and try to resolve the issue informally. Tell your manager what has happened or, if it is your manager who has treated you unfavourably, tell someone more senior. Keep a record of what has happened, when and where it happened and whether there were any witnesses.

If the informal approach fails, then you may wish to make a formal complaint under your employer’s grievance procedure. Your employer would then be under an obligation to investigate the matter.

The final step, if all else fails, would be to bring a claim before an employment tribunal. There is a three-month time limit for bringing a claim from the date of the last time you were treated unfavourably. So, it is important to get advice early on.

Sick pay

If you take sick leave for a pregnancy-related reason you are entitled to receive the same sick pay as other employees. If you qualify, you will be entitled to Statutory Sick Pay (SSP). If your employer normally pays contractual sick pay, over and above SSP, you should be entitled to that in the usual way.

To qualify for SSP you need to earn at least £123 (April 2022) before tax, on average. SSP is paid by your employer once you have been off work for four days in a row (including non-working days). SSP is payable for up to 28 weeks. SSP is currently £109.40 per week*.

Can my employer make me start maternity leave if I am ill?

It is normally up to you when you start your maternity leave. However, if you are off sick with a pregnancy-related illness in the last four weeks of your pregnancy, your maternity leave will normally start, unless your employer agrees otherwise.

*This information was updated in October 2023.

Pregnancy Sickness Support would like to thank employment lawyers at SGH Martineau LLP who helped to produce this information.

Information for employers

Printable version of information for employers

We are often contacted by employers seeking advice on how to deal with employees who are suffering from nausea and vomiting in pregnancy (NVP) or the extreme form of this known as hyperemesis gravidarum (HG). Although many employers are sympathetic to those suffering from severe NVP or HG, we find equally that some employers are unaware of the wide spectrum of NVP and the significant impact that severe NVP and HG can have on a person’s ability to carry out simple daily tasks, let alone carry out her usual paid employment.

The purpose of this page is to provide information and assistance to employers of those who require time off work because of NVP or HG.

The page sets out:

General information on NVP and HG.
Information on NVP and HG related absence from work.
Your legal obligations to pregnant employees, specifically in the context of NVP and HG.
What you should do if one of your employees is suffering from NVP/HG.
Where you can go for more information.

General information

Nausea and vomiting in pregnancy are very common. It is often referred to as morning sickness which is a very misleading and unhelpful description. Pregnancy sickness can occur at any time of the day and in the worst cases can last all day (and night) long. 94% of pregnancies will to a greater or lesser extent suffer with some form of nausea, vomiting, or both.

Any form of NVP is an unpleasant experience for the person concerned. HG is a condition at the severe end of the pregnancy sickness spectrum which requires medical treatment to ensure the health and wellbeing of the parent and the baby. With HG, the nausea and vomiting are so severe that people can lose a considerable amount of weight and become dehydrated and depleted of nutrients. One in 100-150 pregnant people will need to be admitted to hospital because they have HG.

Severe NVP and HG can have a profound effect on a person's ability to function in carrying out even the simplest of daily tasks and it is not uncommon for those suffering from HG to need help caring for themselves. Unrelenting retching and vomiting over a prolonged period are very traumatic experiences. It is both mentally and physically debilitating and can lead to feelings of isolation and depression as people are effectively housebound for the duration of their illness. 70% of those with HG will be bedridden and need daily extra support.

Those suffering with this condition are entitled to health and safety protection during pregnancy. You should look at whether there are any risks to your employee's health and safety, for example, standing for long periods. You have a duty of care to make reasonable adjustments to the sufferer's job and to alter working conditions or hours of work. If there is still a risk to the persons health and safety, you must offer suitable alternative work or suspend the employee on full pay. - Maternity Action

Pregnancy sickness and employment

It is estimated that approximately 30% of pregnant people in paid employment need time off work due to NVP.

The key for anyone suffering from NVP or HG is rest. HG is an episodic condition with frequent periods of recovery and relapse. It is important that they do not return to work too soon, although this may be the temptation if they start to feel a bit better. Employers should be aware that there is a significant risk of relapse if a person returns to normal activities before they are physically ready to do so.

Employers’ legal obligations

Pregnancy discrimination

Under the Equality Act 2010, it is unlawful discrimination for an employer to treat someone unfavourably because of her pregnancy or an illness relating to their pregnancy or because they are exercising, have exercised or is seeking or has sought to exercise their right to maternity leave. This special protection applies from when someone becomes pregnant and continues until the end of their maternity leave, or until they return to work if that is earlier. This is referred to as “the protected period”.

Anyone who has suffered discrimination can bring a claim for compensation before an employment tribunal.

What is unfavourable treatment?

Unfavourable treatment could be demotion, dismissal or the denial of training or promotion opportunities because an employee is pregnant or on maternity leave. An employer is not permitted to take into account any pregnancy-related absences during the protected period for the purposes of attendance management or when deciding whether to dismiss an employee. This would also be unfavourable treatment. For this reason, employers should record separately any sick leave taken for a pregnancy-related illness.

Unlike some other types of discrimination there is no need for the person to show that they have been treated less favourably than any other workers such as a man, or a woman who is not pregnant.

By way of example, unfavourable treatment for any of the following reasons will amount to pregnancy discrimination:

any absence due to pregnancy-related illness
a person's inability to attend a disciplinary hearing due to pregnancy sickness or other pregnancy-related conditions; or
performance issues due to pregnancy sickness or other pregnancy-related conditions.

Unfair dismissal

It is also unlawful for an employer to dismiss someone because of their pregnancy regardless of how long they have worked for the employer or how many hours they work. This is unfair dismissal and would also enable the person to bring a claim for compensation before an employment tribunal.

Sick pay

If an employee takes sick leave for a pregnancy-related reason, you must pay them the same sick pay that you would pay to employees who are off sick for other reasons. If they qualify, they will be entitled to Statutory Sick Pay (SSP). If you normally pay contractual sick pay, over and above SSP, they should be entitled to that in the usual way.

To qualify for SSP the employee needs to earn at least £123 a week* on average. An employer must pay SSP once the employee has been off work for four days in a row (including non-working days). If they take more sick leave in the next eight weeks, they do not have to wait for three qualifying days. SSP is £109.40 per week* and is payable for up to 28 weeks.

You are entitled to require evidence from the employee of incapacity to work. This will normally take the form of "self-certification" for absence of seven calendar days or less (i.e. a signed statement from the employee giving the dates and brief description of the incapacity). For longer periods a doctor’s note is usually required.

In theory, it is up to the employer to decide what medical evidence is required from employees and at what stage. However, for the purposes of administering statutory sick pay, you are not allowed to insist on a doctor's certificate for at least the first seven days.

*(as at October 2023)

What you should do

If one of your employees is off sick because of a pregnancy-related illness, here are some tips on what you should do:

Obtain medical evidence

As with any other illness, you are entitled to require the employee to provide medical evidence of their incapacity to work and to follow your sickness absence procedures.

Be supportive

You should be as sympathetic and supportive as you can towards a person who is suffering from severe NVP or HG. It is likely that they will already be feeling very low, and it is important not to add to their stress.

Aside from the legal risks highlighted above, in the long run this approach is also better for your business. An employee who feels they are believed and is treated sympathetically by their employer is much more likely to return to work after maternity leave as a happy and loyal employee.

Allow them to rest

Rest is a crucial element in managing NVP and HG. It is important to allow them to take the rest they need. If they start to feel a little better and does too much too soon then this can set them back and delay their recovery. So, do not put pressure on them to return to work too soon.

Keep in contact

It is a good idea to keep in touch with an employee who is absent long-term in a sensitive, non-intrusive manner.

Consider a phased return to work if appropriate

If and when the employee is able to return to work during pregnancy, consider whether there are any measures you can take to help them. For example, a sensible option is for them to have a phased return to work involving shorter days initially, rather than an immediate return to full time hours. Consider also whether it would help them to work from home for some of the time, if this is feasible, so as to avoid the additional effort of travelling to work.

This information was updated in October 2023.

Maternity discrimination

Anyone who has suffered discrimination can bring a claim for compensation before an employment tribunal.

What is unfavourable treatment?

By way of example, unfavourable treatment for any of the following reasons will amount to pregnancy discrimination:

any absence due to pregnancy-related illness
a person's inability to attend a disciplinary hearing due to pregnancy sickness or other pregnancy-related conditions; or
performance issues due to pregnancy sickness or other pregnancy-related conditions.

Citizen’s Advice details what you can do if you are not receiving maternity rights. You can be considered as receiving maternity discrimination if you have received unfair treatment even partly in relation to your pregnancy. Maternity Action has some great information on pregnancy discrimination. Pregnant Then Screwed has some very useful resources around maternity discrimination, and also a helpline you can call for advice.