Pregnancy-related leave refers to time off specifically connected to pregnancy — covering antenatal appointments, pregnancy-related sickness, and suspension on health and safety grounds — that exists before and outside statutory maternity leave. These are distinct legal rights under UK employment law, designed to protect the health of pregnant employees and their unborn children.
Many employees and employers confuse pregnancy-related leave with maternity leave. While maternity leave begins at the start of the 11 weeks before the expected week of childbirth, pregnancy-related rights apply from the moment the employee informs the employer of the pregnancy. Understanding these separate entitlements helps you ensure compliance and support employees properly.
Key Takeaways
- Pregnant employees have the right to paid time off for antenatal appointments from day one of employment.
- Pregnancy-related sickness is treated separately from general sickness absence and must not trigger absence management procedures.
- Employers must suspend pregnant employees on full pay if their role poses a health and safety risk and no suitable alternative work is available.
- These rights apply regardless of length of service, contract type, or hours worked.
- Failure to allow antenatal time off or to suspend when required is discrimination under the Equality Act 2010.
Time Off for Antenatal Appointments
Under section 55 of the Employment Rights Act 1996, pregnant employees are entitled to reasonable paid time off during working hours to attend antenatal appointments. This right applies from the first day of employment — no minimum service is required.
The law covers:
- Medical appointments (midwife, obstetrician, GP)
- Antenatal classes (such as NCT classes or NHS-led sessions)
- Any appointment recommended by a health professional connected to the pregnancy
The employer can request a medical certificate or appointment confirmation after the first appointment, but only if they have reasonable grounds to doubt the appointment is antenatal. The employee does not need to prove attendance at every appointment in advance.
Key Rules for Antenatal Leave
| Rule | Detail |
|---|---|
| Who is eligible? | All pregnant employees, regardless of length of service or hours worked |
| When can it be taken? | From the start of employment until the start of maternity leave |
| How much time? | “Reasonable” time — no set limit, but appointments should be during working hours where possible |
| Paid or unpaid? | Paid at the employee’s normal rate of pay |
| What counts as antenatal? | Medical appointments, antenatal classes, and any appointment recommended by a health professional |
| Can the employer refuse? | Only if the employer has reasonable grounds for believing the appointment is not antenatal |
An employee’s partner is also entitled to unpaid time off to accompany them to up to two antenatal appointments, provided they meet certain qualifying conditions under section 55ZE of the Employment Rights Act 1996. This applies to employees, partners, and civil partners.
Pregnancy-Related Sickness
Pregnancy-related sickness is treated differently from general employee sickness under UK law. If an employee is absent due to pregnancy-related illness, the absence must be recorded separately from standard sickness absence and must not be used to trigger absence management procedures, including capability reviews or disciplinary action.
This rule applies regardless of how long the employee has been with the company. If an employee’s pregnancy-related sickness occurs within four weeks of the expected week of childbirth, maternity leave and pay begin automatically, regardless of when the employee intended to start leave.
What Counts as Pregnancy-Related Illness?
Common examples include:
- Severe morning sickness (hyperemesis gravidarum)
- Pregnancy-related fatigue or exhaustion
- Complications such as pre-eclampsia or gestational diabetes
- Bed rest ordered by a medical professional
The key point is that the sickness must be connected to the pregnancy. A cold or unrelated illness remains subject to standard sickness policies.
Pregnancy Sickness vs General Sickness
| Factor | Pregnancy-Related Sickness | General Sickness |
|---|---|---|
| Absence tracking | Recorded separately | Standard sickness recording |
| Absence triggers | Must not trigger capability or disciplinary procedures | Subject to absence policy triggers |
| Pay | Statutory Sick Pay or contractual sick pay applies | Statutory Sick Pay or contractual sick pay applies |
| Effect on employment | Cannot be used as grounds for dismissal or unfavourable treatment | May lead to formal procedures |
The ACAS guidance on pregnancy and maternity discrimination makes clear that pregnancy-related sickness must be distinguished from other forms of absence.
Suspension on Health and Safety Grounds
Under the Management of Health and Safety at Work Regulations 1999 (regulation 16), an employer must suspend a pregnant employee from work if a risk assessment identifies a serious and imminent risk to their health or the health of their unborn child that cannot be avoided through reasonable adjustments.
This is not a discretionary decision — it is a legal obligation. The employer must:
- Carry out a specific health and safety risk assessment when notified of the pregnancy.
- Identify any risks in the employee’s role (for example, exposure to chemicals, heavy lifting, prolonged standing, or high-stress environments).
- Offer suitable alternative work if available, on the same terms and conditions.
- If no suitable alternative work exists, suspend the employee on full pay.
The employee cannot be required to take annual leave or unpaid leave during suspension. The suspension must be on full pay, and the employer cannot treat the suspension unfavourably in any way — for example, by passing the employee over for promotion or reducing their bonus.
Examples of Roles That May Require Suspension
- Warehouse or manual labour roles with heavy lifting requirements
- Roles involving exposure to hazardous substances
- High-stress roles with unpredictable hours (such as emergency services or shift work)
- Roles involving significant travel that may pose health risks
How These Rights Fit Into the Maternity Leave Timeline
Pregnancy-related rights exist alongside and before statutory maternity leave. Here is how the timeline typically works:
- Employee notifies employer of pregnancy — at this point, antenatal leave rights and suspension duties begin.
- Antenatal appointments — the employee takes paid time off during working hours throughout the pregnancy.
- Risk assessment — the employer conducts a health and safety risk assessment and makes adjustments or suspends if needed.
- 11 weeks before expected week of childbirth — the earliest date maternity leave can begin.
- Birth — maternity leave and pay begin (or continue if already on leave).
- Pregnancy-related sickness — if this occurs in the four weeks before the expected week of childbirth, maternity leave begins automatically.
The employee does not need to start maternity leave to access these earlier rights. They are separate entitlements that apply throughout the pregnancy.
Frequently Asked Questions
Can an employer refuse time off for antenatal appointments?
No. An employer can only ask for reasonable evidence that the appointment is antenatal — such as a booking confirmation or medical certificate — and only after the first appointment. The employer cannot refuse time off on the grounds that the absence is inconvenient, that the employee has used a certain amount of leave, or that the appointment could have been scheduled outside working hours.
Does pregnancy-related sickness affect my maternity pay?
Pregnancy-related sickness does not change your entitlement to Statutory Maternity Pay (SMP), but it can change when maternity leave begins. If your pregnancy-related sickness falls within four weeks of the expected week of childbirth, your maternity leave and SMP begin automatically, regardless of when you intended to start leave.
Can I be dismissed for pregnancy-related sickness?
No. Dismissing an employee because of pregnancy, including pregnancy-related sickness, is automatic unfair dismissal and unlawful discrimination under the Equality Act 2010. Even if the employee has been frequently absent, the employer must explore all alternatives — including reasonable adjustments and suspension — before considering dismissal.
Do I need a fit note for pregnancy-related sickness?
You do not need a fit note from a GP if your absence is short-term. However, the employer may reasonably request one, and a doctor or midwife may recommend bed rest that requires a certificate. If absence extends beyond seven days, a fit note is standard practice.
What happens if my employer does not conduct a risk assessment?
If an employer fails to conduct a pregnancy-related risk assessment and the employee is exposed to a risk, the employer may be liable for health and safety breaches and discrimination claims. The risk assessment is a legal requirement under the Management of Health and Safety at Work Regulations 1999, and the employer must act on its findings.
This article is general information, not legal advice. Consult a qualified employment solicitor for guidance on your specific circumstances and the applicable UK legislation.
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