When a pregnant employee reports sick, the first management question should not be whether an absence warning is due. Establish whether the illness is pregnancy-related, record it correctly, check the individual risk assessment and identify whether the statutory maternity-leave trigger has been reached.
Identify whether the sickness is pregnancy-related
Pregnancy-related sickness can include nausea and vomiting, tiredness, headaches, back pain, bleeding and physical or mental health difficulties connected with the pregnancy. The effects and required absence vary substantially between individuals, so managers should not compare one employee's experience with another's.
The employee should report sick through the usual procedure and receive the sick pay to which they are normally entitled. The manager should sensitively confirm whether the absence is pregnancy-related because that affects recording, absence-management decisions and, later in pregnancy, the start of maternity leave.
Do not press for unnecessary clinical detail. Ask what the employee is able to explain, whether healthcare advice affects work and when contact would be helpful. If the connection is unclear, a fit note or occupational-health advice may assist, but the employer must still follow the normal evidence rules and protect confidential health information.
Acas: sickness and difficult pregnancies ↗ · Related guide: managing employee health conditions →
Record the absence separately from ordinary sickness
Acas says pregnancy-related absence should be recorded separately from other sickness absence and should not count towards review or trigger points in the organisation's absence policy. A system that simply adds every sick day to one total can create an unlawful and avoidable decision later.
Use a clear pregnancy-related absence category with restricted access. Record the dates, reported reason, pay treatment, evidence received, agreed contact and any workplace action. Keep the information available for maternity calculations without displaying sensitive medical details to people who do not need them.
Exclude the absence when managers review attendance warnings, probation, performance ratings, promotion, training opportunities or redundancy criteria. A neutral-looking attendance threshold can still produce unfavourable treatment because of pregnancy.
Acas: rights during pregnancy ↗ · Equality Act 2010, section 18 ↗
Apply the normal fit-note rules without creating barriers
For sickness lasting seven calendar days or less, the employee can self-certify and should not be required to provide a fit note. For an absence lasting more than seven calendar days, the employer can require a fit note from a registered healthcare professional.
A fit note stating that the employee may be fit for work can inform a discussion about amended duties, hours, equipment or a phased return. It does not replace the employer's pregnancy risk assessment and does not allow a manager to make their own medical diagnosis.
Where the absence is recurring but short, discuss whether the employee has advice from their GP or midwife and whether occupational-health input would help. Obtain consent for any medical report and ask focused questions about work capability, restrictions, likely duration and helpful controls.
Connect sickness management to the pregnancy risk assessment
Employers must consider risks to women of childbearing age in the general workplace risk assessment. Once a worker has notified the employer in writing that they are pregnant, the employer must complete an individual risk assessment covering their specific work and needs.
Discuss the duties, workplace, hours, travel, workstation, manual handling, chemicals, infection, violence, temperature, fatigue, lone work and emergency arrangements that are actually relevant. Take account of recommendations from the employee's doctor or midwife. Record the findings, share them with the worker and review the assessment as the pregnancy progresses or circumstances change.
Sickness can be a review trigger. Repeated back pain may point to workstation, driving or handling changes; severe fatigue may affect hours, breaks or night work. The assessment should distinguish a workplace risk requiring controls from an illness requiring time off. One does not cancel the other.
Homeworking can be one possible temporary arrangement, but it is not an automatic health-and-safety conclusion. Check the home workstation, equipment, confidentiality, communication and work demands, and record the agreed scope and review date.
HSE: pregnancy and new-mother risk assessments ↗ · Related guide: DSE assessments for hybrid workers →
Follow the control hierarchy where work creates a significant risk
If the assessment identifies a significant risk to the worker or child, first control or remove it. If that is not possible, adjust the working conditions or hours. This could mean different start times, more frequent breaks, removing a hazardous task or changing travel, depending on the evidence.
If adjustments cannot avoid the risk, an employee should be offered suitable alternative work where available. It must be appropriate and on terms and conditions, including pay, that are no less favourable. A nominal alternative that creates unreasonable travel, unsuitable duties or reduced pay may not satisfy the requirement.
If neither step is possible, the employee must be suspended on full pay for as long as necessary to protect their health and safety or that of their child. Health-and-safety suspension is not sickness absence and should not be placed into the sickness-trigger calculation.
Review the employee's work before deciding the next step.
HR + SAFETY can coordinate the pregnancy discussion, individual risk assessment, medical input and temporary work arrangements without treating homeworking or sickness as an automatic answer.
Discuss a pregnancy absence caseCheck the four-week maternity-leave trigger
If an employee is absent because of a pregnancy-related illness during the four weeks before the week their baby is due, statutory maternity leave starts automatically. Acas states that it starts on the day after the employee's first day off sick.
Confirm the expected week of childbirth, first pregnancy-related sickness day and resulting maternity start date. Tell the employee, HR and payroll promptly so sick pay ends and maternity pay begins where they are eligible. Update the planned maternity dates and issue the required written confirmation.
Ordinary sickness during the same period does not activate this rule merely because the employee is pregnant. The reason for absence therefore matters. If the facts are uncertain, discuss them sensitively and obtain appropriate evidence rather than guessing from the timing.
GOV.UK: maternity leave start date ↗ · Related guide: neonatal care leave →
Prevent pregnancy-related detriment and dismissal
The Equality Act 2010 protects against unfavourable treatment because of pregnancy. Employees also have protection from detriment and automatically unfair dismissal related to pregnancy, regardless of their length of service. These protections apply to the reason and effect of a decision, not just the wording used in a letter.
Managers should not question commitment, reduce opportunities or accelerate a process because pregnancy has complicated staffing. Apply genuine performance or conduct standards using evidence that excludes protected absence and accounts for agreed changes to work.
Review any proposed warning, probation decision, redundancy score or dismissal with HR before action. Check the absence coding, risk assessment, medical advice, adjustments and maternity dates, and ensure the decision-maker has accurate information without unnecessary health detail.
Ten-point pregnancy-related sickness checklist
Give managers one process linking absence reporting, HR records, risk assessment, medical advice and payroll. That prevents a well-intended safety adjustment from being misrecorded as sickness and stops protected absence from reappearing later as an attendance problem.
- Ask sensitively whether the reported illness is pregnancy-related.
- Follow the normal sickness-reporting and sick-pay procedure.
- Record pregnancy-related absence separately with restricted access.
- Exclude it from ordinary absence triggers and attendance scoring.
- Use self-certification for seven calendar days or less.
- Obtain a fit note after seven days and focused health advice where needed.
- Complete and regularly review the individual pregnancy risk assessment.
- Adjust work, offer suitable alternative work or use paid safety suspension in order.
- Check whether sickness falls within four weeks of the expected birth week.
- Review any warning, selection or dismissal decision for pregnancy-related detriment.
Pregnancy-related sickness needs its own record and decision route. Establish the reason, apply normal evidence and pay rules, keep it outside ordinary triggers, review the individual risk assessment and activate maternity leave correctly if the four-week rule is reached.
This guide provides general information for UK employers. It is not legal advice and should not replace advice based on the facts of a specific matter.