Where the PWFA Stands Today: Key Legal Lessons for Employers

Quick Hits

• The PWFA mandates that covered employers provide reasonable accommodations for pregnancy, childbirth, and related medical conditions.
• Since the PWFA went into effect, the EEOC has initiated several lawsuits alleging violations, focusing on failure to accommodate, unlawful termination, and forced leave for pregnancy-related conditions. Most have resulted in settlements, while others remain pending.
• The EEOC received 2,729 charges of discrimination alleging violation of the PWFA for fiscal year 2024, which represents the period of October 1, 2023, to September 30, 2024. Fiscal year 2024 represents the first full year of the EEOC’s enforcement of the PWFA.

Overview

The PWFA went into effect on June 27, 2023, for employers with fifteen or more employees. The EEOC’s final rule implementing the PWFA became effective on June 18, 2024. The final rule leans on the concepts of the Americans with Disabilities Act (ADA) with which employers are likely familiar, including the definitions for key terms, such as “essential functions,” “reasonable accommodation,” “undue hardship,” and “interactive process.” However, there are notable differences between the PWFA and the ADA, including the types of “related medical conditions” qualifying under the PWFA but not under the ADA; an alternative definition of “qualified” and a potential suspension of essential job functions; and limitations on an employer’s right to request documentation.

Related medical conditions include prior pregnancy, menstruation, fertility treatments, endometriosis, the use of contraception, postpartum depression, antenatal anxiety, lactation, miscarriage, and stillbirth. While the rule initially included abortion as a related medical condition, on May 21, 2025, the U.S. District Court for the Western District of Louisiana vacated the EEOC’s final rule interpreting the PWFA to require elective abortion-related accommodations and removing abortion from the definition of a pregnancy-related medical condition.

Trends Noted From EEOC Enforcement Actions

The EEOC enforcement actions have focused on alleged noncompliance with basic concepts under the PWFA.

In a lawsuit filed against Urologic Specialists of Oklahoma, Inc., the EEOC claimed that a pregnant worker requested accommodation, including permission to sit, take short breaks, or work part-time. The medical practice allegedly required the worker to take unpaid leave, refused to guarantee her job following her return from leave, and refused to guarantee that it would provide lactation breaks after childbirth. The worker resigned. The parties settled the case for $90,000 in February 2026.

The settlement provides several notable insights for employers, including the following:

• Requests to sit and take unpaid breaks are the type of accommodation requests falling within the scope of “predictable assessments.” The EEOC’s stance is that predictable assessments, comprised of four categories of simple modifications, “will, in virtually all cases, be found to be reasonable accommodations that do not impose an undue hardship when requested by a qualified employee due to pregnancy.”
• Reasonable accommodations related to lactation include providing breaks to express milk and a space to do so. Lactation accommodations may include nursing “where the regular location of the employee’s workplace makes nursing during work hours a possibility because the child is in close proximity.”
• Leave is considered an accommodation of last resort. Employers cannot require workers to take paid or unpaid leave if another reasonable accommodation can be provided.

The EEOC also filed suit against a manufacturer in September 2024. The lawsuit alleged that a new employee at an assembly facility, who notified the employer that she was pregnant, was not excused for absences due to her pregnancy-related conditions and medical appointments and was required to work overtime, despite medical orders not to work more than forty hours per week. Because the worker was not eligible to accrue paid time off (PTO) until after a sixty-day probationary period, the employer allegedly assessed attendance points against the employee “for absences necessitated by her pregnancy-related medical conditions and medical appointments.” The employee resigned to avoid being discharged. The parties settled this dispute for $55,000 in July 2025.

Most recently, in January 2026, the EEOC filed suit against U.S. Steel where at least some of the alleged PWFA violations concern areas of ambiguity remaining under the current law and available guidance. In this case, the employee worked as a mobile equipment operator at an ore mine, and after she became pregnant, her healthcare providers restricted her from operating physically jarring equipment. While her role as a mobile equipment operator included additional duties not falling within her restrictions, the employee was allegedly denied accommodation and placed on leave for several weeks. When the employee returned, she was allegedly assigned menial work outside of her normal job duties and placed in an office under renovation, exposing her to cold air and dust. The employee suffered a miscarriage, and when she returned from bereavement leave, the employee was again assigned to jobs outside her regular role in a remote part of the mine that offered lower earnings potential.

The EEOC’s lawsuit against U.S. Steel suggests a preferred ranking of potential accommodations with the best accommodation being the removal of essential job duties. This is true even if the accommodation requires coworkers to temporarily take over the physically demanding aspects of the job.

While the PWFA makes clear that leave is the accommodation of last resort, the EEOC’s lawsuit also raises the question of whether placement in an alternative position—which is expressly recognized as a permissible accommodation—must also be of similar status or prestige and with similar earning potential to be a reasonable accommodation and thus, in compliance with the PWFA.

The fact that the employee in U.S. Steel suffered a miscarriage, requiring time off, serves as a reminder that miscarriages and stillbirths are related medical conditions falling with the scope of the PWFA. Employers may need to afford time off from work in these situations, regardless of whether the employer maintains a bereavement leave policy.

Key Takeaways

Reasonable accommodations under the PWFA may include time off for prenatal and postnatal appointments, fertility treatments, or recovery from childbirth complications.

Employers have struggled with reconciling their attendance, paid time off, and leave policies with what is required under the PWFA, including with newer employees who have not accrued PTO or employees who have exhausted their PTO. In these circumstances, employers must consider approving unpaid leave under the PWFA, unless there is an undue hardship.

Current Pressure Points

Employers frequently receive accommodation requests to work remotely during the pregnancy or thereafter as it concerns lactation. These requests can be challenging, given the PWFA’s limitations on the type of documentation that can be requested from healthcare providers. Employers are not required to accept an employee’s preferred accommodation, if there are equally effective accommodations, including on-the-job accommodations, identified through the interactive process.

Employers generally cannot require medical documentation for most lactation accommodations. Employers can request documentation, however, if the employee asks for remote work as a lactation accommodation. The documentation should state whether the accommodation is needed due to a limitation of the employee, as opposed to the child. The PWFA does not require accommodation if the limitation is related to the child.

Physical restrictions are more challenging for companies that employ individuals for physically demanding work, such as operating equipment, driving trucks, and working on assembly lines. Enforcement actions to date solidify the notion that employers cannot skip the interactive process; rather, there should be a dialogue between the employer and the employee to consider on-the-job accommodations with a preference for allowing the worker to remain in her current role through excusal of essential job functions. Alternatively, employers may wish to consider light-duty work for pregnant employees, as it is commonly offered to workers injured on the job, but this may be problematic to the extent it negatively impacts earning potential.

Next Steps

Employers may wish to revisit their policies on absenteeism as the PWFA contemplates deviation from standard processes, such that individuals requiring time off for pregnancy, childbirth, or related medical conditions are not penalized for lacking paid time off or for being absent for prenatal appointments or fertility treatments. Attention also might be paid to call-off procedures, as it is likely reasonable to require all employees to adhere to the same practices, absent unusual circumstances.

Employers may wish to train supervisors to understand the accommodation process and what is required under the PWFA, particularly as it concerns predictable assessments and lactation breaks. The PWFA restricts employers’ ability to request documentation in some circumstances, and in others, the type of documentation that can be requested is limited. Employers may wish to ensure that they do not inadvertently use healthcare provider questionnaires typically used under the ADA for accommodation requests under the PWFA, unless the situation implicates continuous or intermittent leave under the Family and Medical Leave Act. In those situations, it is permissible to utilize the Certification of Health Care Provider for Employee’s Serious Health Condition under the Family and Medical Leave Act as promulgated by the U.S. Department of Labor.

Ogletree Deakins’ Leaves of Absence/Reasonable Accommodation Practice Group will continue to monitor developments and will provide updates on the Employment Law and Leaves of Absence blogs as new information becomes available.

In addition, the Ogletree Deakins Client Portal covers developments related to the Pregnant Workers Fairness Act (PWFA) in the Federal Pregnancy, Childbirth, and Lactation and Federal Parental Leave law summaries. Premium and Advanced subscribers have access to policy templates and a step-by-step walkthrough for Pregnancy Accommodation Requests. All client-users have access to updates. For more information on the Client Portal or a Client Portal subscription, please reach out to clientportal@ogletree.com.

Tiffany Stacy is a shareholder in Ogletree Deakins’ San Antonio office.

This article was co-authored by Leah J. Shepherd, who is a writer in Ogletree Deakins’ Washington, D.C., office.

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