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Morning sickness? Prenatal check-ups? What to know about new rights for pregnant workers

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Morning sickness? Prenatal check-ups? What to know about new rights for pregnant workers
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Morning sickness? Prenatal check-ups? What to know about new rights for pregnant workers

2024-04-20 21:04 Last Updated At:21:20

Pregnant employees have the right to a wide range of accommodations under new federal regulations for enforcing the Pregnant Workers Fairness Act that supporters say could change workplace culture for millions of people.

The Equal Employment Opportunity Commission, the agency in charge of enforcing the law, adopted an expansive view of conditions related to pregnancy and childbirth in its proposed regulations, including a controversial decision to include abortion, fertility treatment and birth control as medical issues requiring job protections.

The rules, which were adopted on a 3-2 vote along partisan lines, were published Monday and offer extensive guidelines for addressing more routine difficulties of pregnancy, such as morning sickness, back pain and needing to avoid heavy lifting. Labor advocates say the law will be especially transformative for pregnant women in low-wage jobs, who are often denied simple requests like more bathroom breaks.

Here's what to know about the law and the EEOC regulations.

Congress passed the law with bipartisan support in December 2022 following a decade-long campaign by women's rights and labor advocates, who argued that the 1978 Pregnancy Discrimination Act did little to guarantee women would receive the accommodations they might need at work.

The law stated only that pregnant workers should be treated the same as other employees, not that they deserved special consideration. To get their requests met, many pregnant workers therefore needed to demonstrate they had physical limitations covered under the Americans With Disabilities Act, often creating insurmountable hurdles.

The new law treats pregnancy and related conditions as themselves deserving of “reasonable accommodations” and places the burden on employers to prove “undue hardships” for denying any requests.

The law applies to employers of at least 15 workers. The EEOC estimates it will cover roughly 1.5 million pregnant workers in any given year. The EEOC regulations published April 15 are set to go into effect in June.

The EEOC's 400-page document encompasses a wide array of conditions and relevant advice for employers.

It states that workers are entitled to unpaid time off for situations such as prenatal appointments, fertility treatments, abortion, miscarriage, postpartum depression and mastitis, an infection that arises from breastfeeding. This includes workers who are not covered by federal family leave laws and those who have not been on the job long enough to accrue time off.

Workers can ask for flexible working arrangements to deal with morning sickness, such as a later start time, clearance to work from home or permission to carry snacks in workplaces where eating is typically prohibited. If they can't sit or stand for extended periods due to sciatica, which is common in late pregnancy, they can request a schedule adjustment so their commutes happen during less crowded hours.

The regulations also allow workers to be exempted from tasks such as climbing ladders or heavy lifting. If those duties are essential to their jobs, they can still request a temporary dispensation, according to the EEOC.

Employers don’t have to accommodate workers exactly as requested but they must offer reasonable alternatives. They cannot deny a request without clearing a high bar to prove doing so would cause “undue hardships” for the organization’s finances or operations. They cannot force workers to take unpaid leave if a reasonable accommodation is available.

The EEOC emphasizes that it “should not be complicated or difficult” for pregnant workers to request accommodations. Workers don't have to make requests in writing, use specific words, cite any laws, or in most cases, provide documentation such as doctors' notes. Employers must respond quickly and have a conversation about how to reasonably accommodate a worker’s needs.

Still, legal experts advise both workers and employers to document the process. A Better Balance, the non-profit that spearheaded the 10-year campaign for the law's passage, advises workers to familiarize themselves with their legal rights and be as specific as possible about their limitations and the changes they they need.

Workers who believe a request was denied illegally can file a complaint with the EEOC. They have 180 days to do so, though the deadline can be extended in some states.

The EEOC included abortion among the conditions covered under the law. The rules state, however, that employers are not obligated to cover expenses related to the procedure or to offer health insurance that does.

The EEOC regulations argue that including abortion is consistent with the agency's longstanding interpretation of other laws under Title VII of the 1964 Civil Rights Act, including the Pregnancy Discrimination Act.

But the decision drew condemnation from Republican lawmakers who had championed the law's passage. The five-member EEOC's two Republican members voted against the regulations.

In a statement explaining her dissent, Commissioner Andrea Lucas said the agency broadened the scope of the law “to reach virtually every condition, circumstance, or procedure that relates to any aspect of the female reproductive system" in ways that "cannot reasonably be reconciled with the text" of the law.

Melissa Losch, a labor and employment attorney at the New Orleans-based firm McGlinchey Stafford, said she expects the regulations to give rise to further litigation. Losch cited the example of a worker living in a state with a restrictive abortion law requesting time off to undergo the procedure in another state. The EEOC rules provide “no good answer” about whether granting such a request would conflict with restrictive state abortion laws, she added.

On February 27, a federal judge blocked enforcement of the Pregnant Workers Fairness Act for Texas state employees, a ruling that came in response to a lawsuit filed by Texas Attorney General Ken Paxton. Paxton argued the law was unconstitutional because it was part of a spending bill that passed in the House without a majority of members present, and the judge ruled in his favor.

Gedmark, of A Better Balance, said she was optimistic the Biden administration would prevail in its expected appeal of the ruling. In the meantime, federal and private sectors workers in Texas are covered by the law.

But in her dissenting statement, Lucas warned that if the Texas case or any future lawsuits succeed in overturning the law, the EEOC's divisive rules have “all but extinguished” the chances of a bipartisan effort to reenact it.

Employers have been obligated to abide by the Pregnant Workers Fairness Act since it took effect on June 27, 2023, though the EEOC regulations provided guidance on how to do so.

The law swiftly made a difference to many low-wage workers, according to Gedmark.

A Better Balance, which operates a helpline, has “heard an overwhelmingly positive experience from workers,” she said. Last summer, the organization worked with some women whose employers stopped resisting requests for accommodations as soon as the law took effect, Gedmark said.

Some workers reported their employers were still operating under the old legal framework, handing them pages of disability paperwork to fill out in response to requests.

The EEOC said it received almost 200 complaints alleging violations of the law by the time the fiscal year ended on Sept. 30, 2023.

Gedmark said the success of the law will depend on enforcement and raising awareness.

“If workers don’t know about the law and don’t know about their rights, then it really undermines the purpose of the law,” she said.

The Associated Press’ women in the workforce and state government coverage receives financial support from Pivotal Ventures. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

FILE - The emblem of the U.S. Equal Employment Opportunity Commission is shown on a podium in Vail, Colo., Tuesday, Feb. 16, 2016, in Denver. Pregnant workers have the right to a wide range of accommodations under new federal regulations for implementing the Pregnant Workers Fairness Act. The regulations take an expansive view of conditions related to pregnancy, from fertility treatments to abortion and post-childbirth complications. (AP Photo/David Zalubowski, File)

FILE - The emblem of the U.S. Equal Employment Opportunity Commission is shown on a podium in Vail, Colo., Tuesday, Feb. 16, 2016, in Denver. Pregnant workers have the right to a wide range of accommodations under new federal regulations for implementing the Pregnant Workers Fairness Act. The regulations take an expansive view of conditions related to pregnancy, from fertility treatments to abortion and post-childbirth complications. (AP Photo/David Zalubowski, File)

NEW YORK (AP) — In the last two years, bird flu has been blamed for the deaths of millions of wild and domestic birds worldwide. It's killed legions of seals and sea lions, wiped out mink farms, and dispatched cats, dogs, skunks, foxes and even a polar bear.

But it seems to have hardly touched people.

That's "a little bit of a head scratcher,” although there are some likely explanations, said Richard Webby, a flu researcher at St. Jude Children’s Research Hospital in Memphis. It could have to do with how infection occurs or because species have differences in the microscopic docking points that flu viruses need to take root and multiply in cells, experts say.

But what keeps scientists awake at night is whether that situation will change.

“There's a lot we don't understand,” said Dr. Tom Frieden, a former CDC director who currently heads Resolve to Save Lives, a not-for-profit that works to prevent epidemics. “I think we have to get over the 'hope for the best and bury our head in the sand' approach. Because it could be really bad."

Some researchers theorize that flu viruses that originated in birds were the precursors to terrible scourges in humans, including pandemics in 1918 and 1957. Those viruses became deadly human contagions and spread in animals and people.

A number of experts think it’s unlikely this virus will become a deadly global contagion, based on current evidence. But that's not a sure bet.

Just in case, U.S. health officials are readying vaccines and making other preparations. But they are holding off on bolder steps because the virus isn't causing severe disease in people and they have no strong evidence it’s spreading from person to person.

The flu that's currently spreading — known as H5N1 — was first identified in birds in 1959. It didn’t really began to worry health officials until a Hong Kong outbreak in 1997 that involved severe human illnesses and deaths.

It has caused hundreds of deaths around the world, the vast majority of them involving direct contact between people and infected birds. When there was apparent spread between people, it involved very close and extended contact within households.

Like other viruses, however, the H5N1 virus has mutated over time. In the last few years, one particular strain has spread alarmingly quickly and widely.

In the United States, animal outbreaks have been reported at dozens of dairy cow farms and more than 1,000 poultry flocks, according to the U.S. Department of Agriculture. Four human infections have been reported among the hundreds of thousands of people who work at U.S. poultry and dairy farms, though that may be an undercount.

Worldwide, doctors have detected 15 human infections caused by the widely circulating bird flu strain. The count includes one death — a 38-year-old woman in southern China in 2022 — but most people had either no symptoms or only mild ones, according to the U.S. Centers for Disease Control and Prevention.

There's no way to know how many animals have been infected, but certain creatures seem to be getting more severe illnesses.

Take cats, for example. Flu is commonly thought of as a disease of the lungs, but the virus can attack and multiply in other parts of the body too. In cats, scientists have found the virus attacking the brain, damaging and clotting blood vessels and causing seizures and death.

Similarly gruesome deaths have been reported in other animals, including foxes that ate dead, infected birds.

The flu strain's ability to lodge in the brain and nervous system is one possible reason for "higher mortality rate in some species,” said Amy Baker, an Iowa-based U.S. Department of Agriculture scientist who studies bird flu in animals. But scientists "just don’t know what the properties of the virus or the properties of the host are that are leading to these differences,” Baker said.

Unlike cats, cows have been largely spared. Illnesses have been reported in less than 10% of the cows in affected dairy herds, according to the USDA. Those that did develop symptoms experienced fever, lethargy, decreased appetite and increased respiratory secretions.

Cow infections largely have been concentrated in the udders of lactating animals. Researchers investigating cat deaths at dairy farms with infected cows concluded the felines caught the virus from drinking raw milk.

Researchers are still sorting out how the virus has been spreading from cow to cow, but studies suggest the main route of exposure is not the kind of airborne droplets associated with coughing and sneezing. Instead it's thought to be direct contact, perhaps through shared milking equipment or spread by the workers who milk them.

Then there's the issue of susceptibility. Flu virus need to be able to latch onto cells before they can invade them.

“If it doesn't get into a cell, nothing happens. ... The virus just swims around,” explained Juergen Richt, a researcher at Kansas State University.

But those docking spots — sialic acid receptors — aren't found uniformly throughout the body, and differ among species. One recent study documented the presence of bird flu-friendly receptors in dairy cattle mammary glands.

Eye redness has been a common symptom among people infected by the current bird flu strain. People who milk cows are eye level with the udders, and splashes are common. Some scientists also note that the human eye has receptors that the virus can bind to.

A study published this month found ferrets infected in the eyes ended up dying, as the researchers demonstrated that the virus could be as deadly entering through the eyes as through the respiratory tract.

Why didn't the same happen in the U.S. farmworkers?

That's a hard one to answer, experts said. Perhaps people have some level of immunity, due to past exposure to other forms of flu or to vaccinations, Richt suggested.

A more menacing question: What happens if the virus mutates in a way that makes it more lethal to people or allows it to spread more easily?

Pigs are a concern because they are considered ideal mixing vessels for bird flu to potentially combine with other flu viruses to create something more dangerous. Baker has been studying the current strain in pigs and found it can replicate in the lungs, but the disease is very mild.

But that could all change, which is why there's a push in the scientific community to ramp up animal testing.

Frieden, of Resolve to Save Lives, noted public health experts have been worried about a deadly new flu pandemic for a long time.

“The only thing predictable about influenza is it's unpredictable,” he said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

FILE - A dead sea bird lays beside a dead sea lion on the beach at Punta Bermeja, on the Atlantic coast of the Patagonian province of Río Negro, near Viedma, Argentina, Monday, Aug. 28, 2023. Government experts suspect that bird flu is killing sea lions along Argentina's entire Atlantic coastline, causing authorities to close many beaches in order to prevent the virus from spreading further. (AP Photo/Juan Macri, File)

FILE - A dead sea bird lays beside a dead sea lion on the beach at Punta Bermeja, on the Atlantic coast of the Patagonian province of Río Negro, near Viedma, Argentina, Monday, Aug. 28, 2023. Government experts suspect that bird flu is killing sea lions along Argentina's entire Atlantic coastline, causing authorities to close many beaches in order to prevent the virus from spreading further. (AP Photo/Juan Macri, File)

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