Pregnant drivers and the Pregnant Workers Fairness Act: lifting, pushing chairs, and schedule changes

Who the law covers

The Pregnant Workers Fairness Act applies to a private company once it has 15 employees, counted over 20 or more weeks of the current or previous calendar year. From that size on, time off granted as an accommodation must also stay out of the points in your attendance policy. The law took effect June 27, 2023, and the EEOC’s regulation at 29 CFR part 1636 took effect June 18, 2024. The EEOC’s regulatory agenda lists a proposal, planned for November 2026, to revise the rule, including how it reads “pregnancy, childbirth, or related medical conditions.” Until a change is final, the 2024 rule governs the accommodations below.

The law protects applicants and employees with a “known limitation,” meaning a physical or mental condition tied to pregnancy, childbirth, or a related medical condition that the worker or someone acting for her has told you about.

The limitation does not have to be a disability, and it can be minor or come and go. The EEOC’s own examples include morning sickness and migraines. It also covers needs tied to keeping the pregnancy healthy and time for prenatal care.

Two older laws still apply alongside it. Title VII bans pregnancy discrimination in hiring, pay, assignments, and firing. The ADA can require an accommodation when a pregnancy-related impairment, such as diabetes that develops during pregnancy, is a disability.

One detail matters at a NEMT company. The rule counts a limitation as communicated when the driver tells a supervisor, a manager, human resources, or “someone who … regularly directs the employee’s tasks.” Dispatchers direct drivers all day, so when a driver tells dispatch she cannot push chairs anymore, the company has been told. The request needs no particular words, form, or medical terms.

The driving job, task by task

The parts of a NEMT driver’s job most likely to need a change in pregnancy are lifting, pushing, long hours, and heat. These are examples of accommodations the regulation names, matched to the job. The right one comes out of talking with the driver, and some need a second person or a different trip mix that a busy board can absorb.

• Lifting and transfers. A driver with a lifting limit can come off stretcher, stair-chair, and assisted-transfer trips, or ride with a second crew member. The rule lists job restructuring and devices that help with lifting.
• Pushing chairs up ramps. Wheelchair trips can go to other drivers while she runs ambulatory trips. The rule treats temporarily suspending an essential function as an accommodation, and it presumes a pregnant employee can take the duty back within generally 40 weeks.
• Long shifts and early starts. Part-time or modified schedules are on the list, so a shorter shift or a later first pickup qualifies.
• Breaks. Restroom, water, food, and rest breaks are all named. On a board, that means real gaps between trips instead of back-to-back legs.
• Sitting all day. The rule names allowing standing for jobs that require sitting, which for a driver means time to get out and stretch between trips.
• Uniforms. New or modified uniforms are on the list.
• Desk work. Telework, reassignment to a vacant position, and light or modified duty are all named. Answering phones or taking reservations at the office can carry a driver through the months she cannot do the physical work.
• Appointments. Paid or unpaid time off for prenatal appointments counts as an accommodation.

The EEOC’s interpretive guidance uses delivery drivers as examples, and both translate directly to vans. In one, a pregnant driver told by her provider to stop lifting 30 to 40 pounds asks to join the light-duty program the employer uses for drivers hurt on the job. She is still qualified because the suspension is temporary, and the existing program accommodates it. In another, a pregnant driver of a van with no air conditioning asks for help during 100-degree weather. Her supervisor orders a cooling vest and a neck fan, and the guidance says leave is acceptable while she waits only if no other work exists. If office work was available and the supervisor withheld it to avoid setting a precedent, the guidance says that could violate the law.

What you may ask for, and what you may not

You are never required to ask for documentation, and you may ask only when it is reasonable under the circumstances. The regulation names cases where asking is not reasonable:

• The limitation and the needed change are obvious, and the driver confirms them.
• You already have enough information.
• A pregnant driver asks for one of four changes and confirms why: keeping water nearby, extra restroom breaks, sitting or standing as needed, or breaks to eat and drink. The rule says these will in virtually all cases be reasonable accommodations that cause no undue hardship.
• The request is for time and a place to pump, or to nurse where that is possible.
• Other employees get the same change without paperwork.

When a note is reasonable, keep the request to the minimum: confirmation of the condition, that it relates to pregnancy or childbirth, and the change at work she needs. It need not be a diagnosis or come on your form. You may require that it come from a health care provider, which the rule defines broadly, including midwives, nurses, doulas, and telehealth providers. You may not send her to a provider you choose. Keep what you receive confidential and apart from the personnel file, the way ADA medical records are kept.

Running the conversation from dispatch

The law calls the back-and-forth the interactive process, and the regulation says it has no rigid steps. The EEOC expects many requests to be settled in a short talk or an email. A workable routine for a small fleet:

1. Respond promptly. Whoever hears the request, often a dispatcher, passes it the same day to the owner or manager, who follows up with the driver.
2. Ask what has to change. Agree on the limitation and the adjustment if the request did not make them clear. Skip any note the documentation limits rule out.
3. Cover the gap. If the lasting fix takes time, such as a second crew member or new gear, give an interim arrangement. The EEOC warns that unnecessary delay can itself be a failure to accommodate.
4. Write down what you agreed. Record the change, the start date, and when you will check in again, and give the driver a copy.
5. Do not swap in your own fix. The statute bars requiring an accommodation other than one reached through this process, and requiring leave when another accommodation would work.
6. Leave her hours and routes alone otherwise. Taking adverse action because she asked for or used an accommodation is unlawful.

Put the routine in writing next to your attendance policy, so that time off granted as an accommodation never turns into attendance points.

Leave, and the 50-employee line

Leave can be an accommodation under the PWFA, paid or unpaid, including leave to recover from childbirth or a miscarriage. It is just never the default when another change would keep the driver working.

At 50 employees the FMLA adds its own rights, covered in our driver benefits guide. A driver is eligible after 12 months with you and 1,250 hours in the past year, at a worksite where you employ 50 or more people within 75 miles. Drivers who start from home still have a worksite: the regulation names the home base they are assigned to, or the place their work is assigned from, for transportation workers with no fixed site. Both parents get FMLA leave for the birth and for bonding during the first 12 months. Spouses who work for the same employer may be limited to 12 weeks combined for birth and bonding.

Pump breaks after the baby

Federal wage law, as amended by the PUMP Act, gives a nursing employee reasonable break time to pump each time she needs it, for one year after the child’s birth. You must also provide a place other than a bathroom, shielded from view and free from intrusion by coworkers and the public. The Labor Department’s fact sheet says even a private bathroom does not qualify.

The breaks may be unpaid if she is completely relieved from duty. If dispatch keeps her on call or on the road during the break, the time counts as hours worked. If other drivers get paid breaks, she is paid for hers the same way. A company with fewer than 50 employees is excused only when compliance would cause significant difficulty or expense for a business of its size.

A driver on the road needs a plan before her first day back. Settle where she will pump between trips and build those gaps into her schedule. The PWFA covers lactation too, and its rule says asking for a note is not reasonable when she confirms she needs time and a place to pump.

State laws that reach smaller fleets

Several states go further than the federal law or start at a lower headcount. Two examples:

• California. The state’s employment discrimination law covers employers that regularly employ five or more people (Government Code 12926). Government Code 12945 lets an employee disabled by pregnancy take up to four months of leave, requires reasonable accommodation for a condition related to pregnancy on her provider’s advice, and requires a temporary transfer to a less strenuous or hazardous position when that can be reasonably accommodated.
• Illinois. The Human Rights Act reaches an employer of even a single worker for pregnancy claims (775 ILCS 5/2-101). Section 2-102(J) requires reasonable accommodation for any medical or common condition related to pregnancy or childbirth unless it causes undue hardship. Documentation is limited to the medical justification, the accommodation advised, when it became advisable, and how long it should last, and both sides must hold a timely, good faith exchange.

Check your own state’s civil rights agency, since its rule may start below 15 employees or require a separate poster. Our labor law posters guide covers the federal and state notices.

Keeping hours and credentials straight in HealthRide

An agreed schedule change is easiest to honor when hours are on record. A driver’s punches in the driver app become her HealthRide timecard, so the hours she actually worked can be checked in reports against the shorter schedule you agreed on. If she goes on leave, her license and training expiration dates keep running, and HealthRide’s credential reminders flag any that come due so she returns ready to drive.