Health & Wellbeing
Sick Leave Due to Pregnancy
Pregnancy is deemed as a protected characteristic under UK legislation, as is pregnancy-related sickness absence. This is governed by strict rules on discrimination, sickness recording, health and safety, and maternity protections. Organisations who mishandle pregnancy sickness risk claims under the Equality Act 2010, increased costs, and significant reputational damage. Conversely, good management, clear processes and early support protect both the individual and the organisation.
According to the NHS, pregnancy-related illness is common, with symptoms such as nausea, back pain, fainting and fatigue affecting many pregnant individuals at different stages. This means that pregnancy related sickness must be recorded separately from other absences and must never be used in disciplinary procedures or redundancy scoring. As well as this, organisations also have specific health and safety duties, including the need to conduct and review a pregnancy risk assessment under HSE regulation.
With this in mind, it is important for organisations to realise the risk of mismanaging pregnancy related sickness and absence, particularly in the face of incoming changes under the Employment Rights Act 2025. There needs to be a greater review of risk management, adjustments, absence rules as well as policies and systems to support pregnant individuals to provide safety and remain legally compliant.
What is a pregnancy related illness?
A pregnancy related illness is any medical condition caused by or aggravated by pregnancy, including both physical and mental health conditions. NHS and occupational health guidance state that symptoms commonly include:
• nausea and vomiting
• backache
• tiredness
• stomach pain
• headaches
• fainting or dizziness
• bleeding (requiring immediate medical advice)
Pregnancy related mental health conditions such as antenatal anxiety, low mood or trauma also fall under this definition and must be treated with the same seriousness as physical illness.
Common mental health conditions that drive absences
Whilst there are a myriad of reasons and conditions such as PTSD, OCD, bipolar disorder, etc. that can drive mental health related absences, the most common causes are stress, anxiety and depression.
In some cases, causes can be driven by workplace conditions and expectations. Whether it is heavy workloads, stressful environments, or a lack of support, organisations and their leadership teams may not only be missing the key signs of poor mental health.
To ensure mental health is supported, HR and leadership teams need to know the key indicators and symptoms to look out for. These may include:
• Fatigue
• Social withdrawal
• Performance dips
• Regular lateness
• Emotional volatility
• Team interactions
Failing to address this may not only lead to more absences, it can also disrupt team morale, dynamics and engagement.
Why this matters to organisations
Under the Equality Act 2010, pregnancy and maternity are protected characteristics. Any unfavourable treatment linked to pregnancy related sickness is classed as pregnancy discrimination, regardless of length of service. Solid and compliant practices for pregnancy-related sickness is to:
• Record instances of sickness separately to general sickness absence
• Exclude pregnancy related sickness from triggers for absence management
• Never use pregnancy related sickness in disciplinary or redundancy processes
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Reasons for sick leave during pregnancy
There could be several medical and safety related reasons for sickness absence during pregnancy, that may include:
• Hyperemesis gravidarum (severe vomiting)
• Nausea and morning sickness
• Musculoskeletal pain
• Fatigue and sleep disruption
• Bleeding or suspected complications
• High blood pressure
• Pregnancy related fainting
Employers must differentiate between pregnancy related sickness and nonpregnancy sickness, as only the former is protected from typical sickness management procedures.
Work-related contributing factors
Organisations must assess and control workplace risks that may contribute to pregnancy sickness, including:
• heavy lifting
• prolonged standing
• long working hours
• lack of rest breaks
• exposure to biological/chemical hazards
Adjustments may be required to maintain safety and comfort at work.
Sick leave when pregnant – what are the employee’s rights
1. Sickness reporting rights
Pregnant employees follow the organisation’s standard sickness‑reporting process, but with additional protections.
2. Separate recording of pregnancy‑related sickness Organisations must record pregnancy related sickness separately and ensure it does not count towards:
• absence triggers
• disciplinary action
• redundancy scoring
• capability processes
3. Fit-note requirements Organisations and their leadership teams can self-certify for 7 days. From day 8, they may require a fit note, which can now be issued by:
• GPs
• Nurses
• Physiotherapists
• Pharmacists
• Occupational therapists
4. Pay during sickness absence Pregnant individuals may qualify for:
• Statutory Sick Pay (SSP)
• Contractual sick pay (if offered)
Normal SSP rules apply except during the last four weeks before the expected week of childbirth.
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Pregnancy related sickness absence and employment rights
Automatic maternity leave start According to UK pregnancy leave rules: “If a pregnant individual is off sick with a pregnancy related illness in the four weeks before the expected week of childbirth (EWC), maternity leave starts automatically from the first day of absence.”
Protection from discrimination Organisations and their leadership teams must not: • Reduce workplace hours
• Deny any positional promotions
• Treat the pregnant individual unfavourably
• Dismiss or discipline an individual due to pregnancy absence Any such action is automatically discriminatory under UK legislation, regardless of service length.
Health and safety protection Organisations must conduct a pregnancy risk assessment under the Management of Health and Safety at Work Regulations 1999, and make reasonable adjustments such as: • Changes to work hours
• Reduced physical demands
• Additional breaks
• Remote working options
• Temporary role changes
If risks cannot be removed, the organisation and their leadership teams must offer suitable, alternative work or medically suspend the individual on full pay.
Recording pregnancy related sickness
Organisations should: • Keep pregnancy-related sickness absence separate from routine sickness
• clearly document reasons for absence
• Ensure reporting systems do not wrongly categorise these absences
• Avoid using pregnancy sickness in Bradford Factor or absence scoring systems
Data protection considerations
Pregnancy and health data are “special category data” under GDPR and must be handled: • Confidentially
• Securely
• On a strict need-to-know basis
Managers must not share details beyond legitimate HR or safety requirements.
Reporting sickness in the later stages of pregnancy
If someone is off work with a pregnancy related illness in the 4 weeks before the expected date of childbirth (EWC), maternity leave starts automatically the day after the first day of absence. This may be delayed only if the organisation and individual both agree, but once maternity leave has begun, maternity pay replaces sick pay.
What organisational HR and leadership teams should do immediately: • Confirm whether the absence is pregnancy related (and record it separately)
• If it falls in the 4-week window, start maternity leave and switch to maternity pay from the next day (notify payroll and confirm in writing)
• Maintain a compliant pregnancy risk assessment throughout late pregnancy; review as circumstances change
Normal evidence rules still apply to fit-note evidence in later pregnancy. Individuals must self-certify for the first 7 calendar days, then a fit note from day 8. Fit notes can be issued by doctors, nurses, pharmacists, physiotherapists, or occupational therapists.
How organisations can mitigate pregnancy related sickness
Complete and keep under review an individual pregnancy risk assessment. Once notified in writing that a worker is pregnant, you must assess risks specific to their role; consult them, consider medical advice, and review regularly as pregnancy progresses. If significant risks remain, take the statutory sequence of actions: adjust duties/hours → offer suitable alternative work on the same terms → suspend on full pay for as long as necessary.
Use practical adjustments to stabilise attendance. It is best practice highlight common risk drivers (e.g., lifting, prolonged standing/sitting, long hours, exposure to hazardous substances) and positive control measures such as extra rest breaks, schedule changes, reduced physical tasks, or temporary role changes without an individual's reducing pay/terms.
Record pregnancy related sickness separately and exclude it from triggers. Ensure your organisation does not count pregnancy related absences towards review points, disciplinary action or redundancy scoring.
Safeguard against discrimination. The EHRC reminds organisations that it is unlawful to treat someone unfavourably because of pregnancy or a pregnancy related illness; ensure managers understand the protected period and documentation standards.
Give clear guidance to HR and leadership teams in order to provide effective and efficient routes for escalation. Reinforce duties around risk assessments, paid time off for antenatal care, and the automatic maternity leave trigger to avoid errors.
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Rights for the individual
Protection from discrimination It is unlawful to dismiss, discipline, reduce hours, deny and individual a promotion, or otherwise treat them unfavourably because they are pregnant or are struggling with a pregnancy related illness.
Paid time off for antenatal care Organisations must provide paid time off for antenatal appointments; partners have the right to unpaid time off for up to two appointments.
Automatic maternity leave in late pregnancy If an individual is absent from the workplace with a pregnancy related illness in the 4 weeks before the EWC, maternity leave starts automatically (day after the first day of absence).
Risk assessment and health & safety On written notification of pregnancy, organisations must complete an individual risk assessment, adjust work to remove risks, and if risks remain, offer suitable alternative work or suspend on full pay.
Fit note and evidence rules Standard sickness evidence rules apply: self-certify for the first 7 days; from day 8 provide acceptable medical evidence (fit note). Fit notes may be issued by doctors, nurses, pharmacists, physiotherapists or occupational therapists and can be digital.
How an Employee Assistance Programme can help with pregnancy related sickness
Using HA | Wisdom Wellbeing’s industry leading, clinically accredited Employee Assistance Programme (EAP), your organisation is better equipped to meet its legal duties and prevent absences by providing unmatched wellbeing support and resources.
How our EAP can support pregnant individuals and reduce pregnancy related sickness absence: • 24/7 counselling & mental health support for antenatal anxiety, trauma or stress to address conditions and issues that organisations and their leadership teams require expertise on.
• Management consultation line to guide compliant decisions on recording pregnancy related sickness separately, risk assessment actions, and the 4 week maternity trigger
• Rapid clinical clarity via a Virtual GP so that individuals are able access to medical support and referrals to bypass long NHS waiting lists and get the necessary assistance when in need.
• Using Occupational Health Assessments, HR and leadership teams are better informed on necessary, reasonable adjustments to cultivate a safe working arrangements where symptoms or risks are uncertain.
• SpeakUp confidential support line: if someone reports unsafe practice (e.g., being pressured to attend work despite identified risks), route concerns through our confidential service, enabling leadership teams to review workplace culture, behaviour as well as risk assessment processes and controls.
Together, these pathways help organisations to not only comply with UK legislation and HSE guidance, it also helps prevent discrimination and reduces absence times by addressing health, safety and psychological needs early.
Conclusion
Pregnancy related sickness requires a different legal, procedural and ethical response from other types of absence. Under UK law, pregnancy and maternity are protected characteristics, meaning employers must treat all pregnancy related illness with heightened care and follow strict statutory rules.
Handled well, pregnancy related sickness management protects organisations from risk, strengthens trust amongst the workforce, and supports a healthy working environment. The right systems, training and support help leaders act with care while remaining fully compliant with UK employment law.
FAQs
1) What counts as a pregnancy related illness in the UK? Pregnancyrelated illness includes any medical condition caused or aggravated by pregnancy—such as nausea, vomiting, back pain, fatigue, headaches or bleeding. This might include symptoms morning sickness, tiredness, headache, backache and bleeding as common examples.
2) What are an employer’s legal duties when a worker is pregnant? Under the Management of Health & Safety at Work Regulations, employers must carry out an individual pregnancy risk assessment, remove or control risks, and if risks remain, provide alternative work or suspend on full pay.
3) Who can issue a fit note during pregnancy? Fit notes can be issued by GPs, nurses, pharmacists, physiotherapists and occupational therapists, according to the UK’s medical evidence guidance.
HA | Wisdom Wellbeing
HA | Wisdom Wellbeing is the UK and Ireland’s leading EAP provider. Specialising in topics such as mental health and wellbeing, they produce insightful articles on how employees can look after their mental health, as well as how employers and business owners can support their people and organisation. They also provide articles directly from their counsellors to offer expertise from a clinical perspective. HA | Wisdom Wellbeing also writes articles for students at college and university level, who may be interested in improving and maintaining their mental wellbeing.
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