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My Obstetrician Got Me Fired: How Work Notes Can Harm Pregnant Patients and What to Do About It

Jackson, Rebecca A. MD; Gardner, Sigrid MD, MPH; Torres, Leah N. MD; Huchko, Megan J. MD; Zlatnik, Marya G. MD; Williams, Joan C. JD

doi: 10.1097/AOG.0000000000000971
Contents: Current Commentary

Prenatal care providers are frequently asked to provide employment notes for their patients requesting medical leave or changes to work duties. Writing employment notes correctly can help patients negotiate for and obtain medically indicated workplace accommodations, allowing them to continue to work and earn an income. However, a poorly written or poorly timed note can jeopardize a patient's employment and salary. This commentary provides an overview of pregnancy-related employment laws and guidance in writing work accommodations letters that allow pregnant women to keep their jobs while maintaining a healthy pregnancy.

Skillful writing of employment notes for pregnant patients helps them to avoid conflict with their employers, being forced out on leave too early, and employment termination.

Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California; the Department of Obstetrics & Gynecology, University of Utah School of Medicine, Salt Lake City, Utah; and the University of California Hastings College of the Law, San Francisco, California.

Corresponding author: Rebecca A. Jackson, MD, 1001 Potrero Avenue #6D, San Francisco, CA 94110; e-mail:

Financial support for the UC Hastings Pregnancy Accommodations Work Group was provided by the NoVo and W.K. Kellogg Foundations and by contributions of several law firms.

The authors thank members of the UC Hastings Pregnancy Accommodations Work Group for their input on the manuscript.

© 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.