Pregnancy toolkit

Your pregnancy toolkit

This toolkit covers your rights at work and answers our most frequently asked questions. It can be used with our maternity toolkit which covers maternity leave, pay and your rights on returning to work.

Advice on COVID-19 and pregnancy

Please see our FAQs for the latest advice around COVID-19 (coronavirus) and pregnancy.

Telling employers

Question mark

Question mark You don't need to tell your employer about your pregnancy or maternity leave until 15 weeks before your baby is due. The 15th week is known as the ‘qualifying week’. However it is important to check your employer’s maternity policy for exact notification requirements.

It is often a good idea to tell your employer you are pregnant.

Once they are aware, your employer;

  • should immediately take into account any risks identified in your workplace risk assessment including any specific risks to new and expectant mothers (read from the HSE here)
  • should not subject you to unfavourable treatment
  • must make any reasonable adjustments if required
  • must record any pregnancy-related sickness separately to ‘normal’ sickness absence
  • must allow you paid time off for antenatal care appointments.

Question mark You do not have to tell a prospective employer that you are pregnant when you are applying for a job. The fact that you are pregnant should not be taken into account when determining who gets the job. If it were taken into account and you were treated less favourably it would be viewed as discrimination.

Contact us for further advice if you think you have been discriminated against because of your pregnancy.

Time off for appointments

Pre natal  for journey

All pregnant women are entitled to a reasonable amount of paid time off for antenatal care appointments (including parent-craft and relaxation classes) made on the advice of a registered medical practitioner, midwife or health visitor. This is regardless of how long you have worked for your employer.

Your employer may request proof of the appointment, for example a letter or your appointment card.

The amount of paid time off should include travelling time and waiting time at the hospital or clinic.

Read more about time off for antenatal appointments on Acas.

Partners do not have a right to paid time off for antenatal appointments. There may be allowance for paid leave in the contract or local maternity/ paternity policy. If there is no allowance within the contract, the partner of a pregnant woman will be entitled to take unpaid time off work to accompany the woman to up to two antenatal appointments (with an allowance of 6.5 hours for each appointment).

A “partner” includes the spouse or civil partner of the pregnant woman and a person (of either sex) in a long-term relationship with her. It also extends to those who will become parents through a surrogacy arrangement, under certain circumstances.

Read more about partners rights on Acas.

Pregnancy timeline

Our pregnancy timeline can help you understand the important dates in your pregnancy.


Discim You are protected against pregnancy and maternity discrimination from day one of your employment (provided your employer has been informed of the pregnancy).  This lasts from the start of your pregnancy until the end of your maternity leave period.

There are three main types of pregnancy or maternity discrimination:

  1. Direct discrimination: when you are treated unfairly or unfavourably because you are pregnant, on maternity leave or breastfeeding.
  2. Indirect discrimination: when a workplace practice places women who are pregnant, breastfeeding or on maternity leave at a disadvantage.
  3. Harassment: when unwanted conduct related to your pregnancy, maternity leave or breastfeeding causes a distressing or an offensive environment for you.
Your employer has a duty of care to you as a pregnant worker. See our guidance on risk assessments. During and after the protected period you are also protected against automatic unfair dismissal under the Employment Rights Act 1996 and detrimental treatment because of pregnancy, childbirth or maternity leave or pregnancy-related illness because you have given birth. This could include depression during pregnancy and postnatal depression or conditions linked to childbirth.

Check your local policies (recruitment, maternity and sickness etc.) and contact us for further advice if you feel that you are being unfairly treated.

Further information

Maternity Action and discrimination
Equality and Human Rights
Acas pregnancy and maternity discrimination
Breastfeeding at work
Maternity toolkit.

Risk assessments

Risks All employers are required by law to assess risks to the health and safety of their employees whilst at work. These rights apply regardless how long you’ve worked for your employer.

We believe that an individual risk assessment should be carried out as soon as possible after you inform your employer of your pregnancy.

If your employer asks for proof of your pregnancy, you must provide a copy of your certificate of pregnancy from your doctor or midwife.

Each pregnancy is different but there are similarities that are likely to affect all pregnant health care workers. For example, the employer should consider:

• Physical risks
These would include movements and postures, moving and handling, shocks and vibrations, noise, and radiation. Increasing physical size may affect your ability to wear personal protective clothing. Changes in your blood pressure may mean that there has to be a provision for more frequent and longer breaks.

• Working conditions
Consideration needs to be given to;  facilities (including rest rooms), mental/physical fatigue and working hours, stress (including prenatal depression), passive smoking, temperature, working with visual display units (VDUs), working alone, travelling, the potential for violence, personal protective equipment.

• Nutrition

• Biological agents and chemical agents

• Infectious diseases

This list is not exhaustive and the potential risks will depend on you and your role. Also, pregnancy is not a static condition. A risk assessment may need to repeated or reviewed as the pregnancy develops.

Some risks, for example from chemicals and radiation are already covered by specific health and safety legislation. Please see the Health and Safety Executive for more information on these areas.

1. Discuss any work-related concerns about your health or your baby’s health with your doctor or midwife.  If they advise you that there could be a risk, ask for a letter to show to your employer.

2. Look at your maternity policy as it should cover risk assessments. If you are employed by the NHS see section 15.33 of NHS terms and conditions for England and Wales and section 15.34 of NHS terms and conditions for Scotland and Northern Ireland.

3. Write down the specific areas that you find difficult and note how they affect you physically and/or mentally.

4. Talk to your manager and request a risk assessment.

5. If the matter is not resolved, contact us.

You have the right to be notified of the outcome of the risk assessment, so ask for this if it is not given to you.

If your employer has identified a significant risk that could damage your health and safety, they will need to decide what action to take.

Your employer has a duty to reduce the level of risk so far as is reasonably practicable. If the risk cannot be reduced to a safe level then you have the right to be offered suitable alternative work. The word ‘suitable’ is a subjective term but consideration should be given to pay, status and type of work.

If there is no suitable alternative, you should be suspended on maternity grounds. You should receive your normal wages or salary for as long as the suspension lasts.

If there are any issues with the alternative work offered, please contact us for further advice.

Pregnancy and sickness

If you fall ill during your pregnancy it is important for you and your employer to determine whether this sickness is ‘pregnancy-related’. This is important because detrimental treatment due to pregnancy-related sickness absence may be discriminatory.

Any pregnancy-related sickness absence must be recorded separately to normal sickness absence. It should not be used for disciplinary or redundancy purposes or considered under absence management procedures.

Important: If you are off sick for a pregnancy-related reason during the *four weeks before your baby is due, your employer could require you to start your maternity leave at this point.
If you do not think that your absence is wholly or partly because of your pregnancy, ask your employer to reconsider their decision.

Check your local policies (maternity and sickness etc.) and contact us if you feel that you are being unfairly treated.

*Find the Sunday at the start of your Expected Week of Childbirth (EWC) from your MATB1. Count back four Sundays. This is the start of the 4th week before the week your baby is due.

If the sickness is unrelated to your pregnancy, you will normally be able to take sick leave until you start your maternity leave as planned.
In these circumstances, you will normally receive Statutory Sick Pay (SSP) or contractual sick pay right up to the date of your baby’s birth, or until the date you have notified your employer as the date you intended your maternity leave to start, whichever is sooner.

Check your local policies (maternity and sickness etc.) and please contact us if you feel that you are being unfairly treated.

Women do not just experience postnatal depression, depression during pregnancy is very common.

If you are struggling with your mental health it’s important to talk to your GP or midwife. You might also need support from your Occupational Health department (if you have one).

If you are absent due to pregnancy related depression please see our section on pregnancy related sickness and read more about depression during pregnancy on Maternity Action.

As an RCN member you can use our Counselling service for free, confidential support through challenging times.

Please contact us if you feel that you are being unfairly treated.

Please see our Maternity toolkit for information on sickness during your maternity leave. It also covers postnatal depression.

Changing your shifts

If you are pregnant and believe your current working pattern is negatively affecting your health, think about asking to change it.  As a pregnant worker you have a special status and your employer should be amenable to requests. Please also see our section on risks.

Changing direction If you want to change your working pattern:

• read your local maternity policy
• speak to your midwife or GP and get their recommendations in writing
• speak to your manager – often that is all that is required
• if needed, put your request in writing and ask for a formal response.

If the matter is not resolved, contact us for further advice.

As a new or expectant mother, you must not be required to work at night if night work could damage your health and safety, or that of your child.

If you have concerns, speak to your GP and request a medical certificate stating that you cannot work at night for health and safety reasons.

Your employer should then offer you suitable alternative work. If there is no suitable alternative day-time work available, you should be suspended on maternity grounds and you should receive your full pay.

If your employer refuses to take you off night work or if there are issues with your pay, contact us for further advice.

Changing your job

Make sure you think carefully about changing your job if you are pregnant or planning to become pregnant.

Think carefully about changing employers if you are trying to conceive or are pregnant, and be clear on what you might lose in pay or other benefits if you were to make that move.

Check your contract and maternity policies and read about eligibility criteria for Statutory Maternity Pay (SMP) and Maternity Allowance (MA).

NHS employees on fixed term

Under NHS terms and conditions, if you are employed on a fixed-term contract that is due to expire after the 11th week before your baby is due (and you have 12 months’ continuous service with one or more NHS employers at the beginning of the 11th week before your baby is due), your contract will be extended to allow you to remain in employment for the full 52 weeks of maternity leave you are entitled to.

Please see 15.83 of the NHS handbook for England and Wales and 15.42 of NHS handbookfor Scotland and Northern Ireland.

Non NHS employees on fixed term

You should not be treated less favourably than a permanent member of staff.

If your fixed term is not renewed or extended you need to consider the reasons why.
If the job or work still exists, and your contract was not renewed or extended because of your pregnancy or maternity leave, this could be discriminatory.

If, as a result of your pregnancy or maternity leave, your fixed term contract is ended early, not renewed or not extended please contact us.

Read more fixed term contracts.

When to start your leave

The decision of when to start your maternity leave can be a difficult one.

It might be helpful to;

•  calculate what annual leave you have left to take for this leave year
•  calculate what annual leave you will accrue during your maternity leave and


•  would you like to take some time before the baby is born or at the end of your maternity leave instead?
•  would you like to share your maternity leave (Shared Parental Leave (SPL) with your partner?
•  your health, you might like to rest leading up to the birth, rather than work.

Discuss your ideal scenario with your manager.

Remember, your employer has to agree when you take your annual leave. Make sure you get your agreement in writing to avoid disputes later on.

The earliest you can start your maternity leave  - is the beginning of the 11th week before your baby is due. If you have your baby early, your maternity leave will start the day after.

The latest you can start your maternity  -  if you haven't given notice to start your maternity leave, it will automatically start the day after your baby is born. If you are off with pregnancy related sickness in the 4 weeks before the baby is due, it will generally start then. You can continue working right up until your due date if you want to but check your employer's policies.

See our maternity toolkit for more information on maternity leave and pay.

The latest you can tell your employer when you want to go on maternity leave is 15 weeks before your baby is due. The 15th week is also known as the ‘qualifying week’.

To give notice you should:

•  inform your employer that you are pregnant
•  inform your employer of your due date (the Expected Week of Childbirth)
•  submit your MATB1 form which will confirm this date
•  inform your employer of the date you intend to start your leave and start receiving maternity pay, this should be provided in writing.

Check your employer’s maternity policies carefully.

If you are employed by the NHS, please see the relevant section 15 of the NHS handbook.

Your employer must tell you the end date of your maternity leave within 28 days of receiving your formal notification. A default end date of 52 weeks after the start of your maternity leave is usually used.

If you don’t give your employer the required notice for the start of your maternity leave, you may lose your right to start your leave on your chosen date.

Your employer is only required to make exceptions to this in limited circumstances.

Remember if you are off with pregnancy related sickness during the four weeks before your baby is due, your maternity leave could start early. If you do not think that your absence is wholly or partly because of your pregnancy, you can ask your employer to reconsider their decision. 

If it is not resolved, please contact us for further advice.

You can change your mind about your maternity leave start date, but there are notifications requirements you need to meet.

Check your employer’s policy, but usually you should give your employer notification of the new start date by whichever is the earlier of either:

• 28 days before the date you originally intended to start your leave or
• 28 days before the new date you want to start your leave.

Sometimes it is not reasonably practicable to give this much notice (for example, the baby is born early and you have to start your leave straight away) but for any other reason you should give your employer as much notice as possible.

Notification should be in writing if your employer requests this. Written confirmation will help avoid any dispute later on.

Fertility treatment

Fertility Although there is no legal right for employees to take time off work for fertility treatment, employers should treat fertility appointments the same as any other medical appointment.

We would hope the employer would be supportive and options could include a flexible working arrangements or a combination of paid, unpaid, or annual leave during the treatment.

You may need to take sick leave to deal with side effects, or take annual or unpaid leave for treatment appointments. You should check your employer’s leave policies for any specific provision for fertility treatment.

Managers should be sympathetic when dealing with this sensitive area.

The advanced stage of fertility treatment is between the retrieval of the ova followed by the immediate transfer of the fertilized ova.

If you take sick leave during the advanced stage in your fertility treatment and are dismissed, you may be able to claim direct sex discrimination.

Once an embryo has been implanted you are legally pregnant, therefore protected under the Equality Act 2010. See our section on pregnancy related sickness.

If the treatment is successful and you remain pregnant, you will be protected against discrimination on the grounds of pregnancy until the end of your maternity leave.

If the treatment is unsuccessful, protection will end two weeks after the end of the pregnancy - a pregnancy test is taken two weeks after implantation and if the test is negative, the protected period extends for two more weeks.

Check your local policies as some employers may give paid leave for fertility treatment and read more about your rights from Acas.

Miscarriage and still birth

Miscarriage or stillbirth can be life-changing events.

Don’t forget that as an RCN member you can use our Counselling service for free, confidential support through challenging times.  

Miscarriage or still birth before the end of the 24th week

If your baby is stillborn before the end of the 24th week of pregnancy it is treated as a miscarriage.

Unfortunately you cannot qualify for maternity leave or pay if you have a miscarriage. If you need time off work following the loss of your baby read your employer’s maternity policy.

There should be some protection for sickness absence following a stillbirth or miscarriage before the 24th week of pregnancy as this can be classed as pregnancy related sickness absence.  

Miscarriage or still birth after the 24th week

If a stillbirth or miscarriage occurs after the 24th week of pregnancy, your rights to leave and Statutory Maternity Pay (SMP) or Maternity Allowance (MA) are not affected.
This is also the case should your baby be born alive for only a very short period of time.

Do check your contract of employment and any local policies for details of any additional entitlements. 

For those employed by the NHS in England and Wales please also see the child bereavement policy in the NHS terms and conditions.

Further information

Maternity Action’ Miscarriage, stillbirth and neonatal deaths – rights to maternity leave and pay.

Premature birth

Premature birth is considered to be a birth before the start of the 37th week of pregnancy.

Sadly, if your baby is born prematurely, you are not currently entitled to any extra maternity leave or pay.

If your baby is born prematurely and you have not yet started your maternity leave, your maternity leave will start on the day after the birth.

Read more on premature births and your rights to maternity leave and pay on Maternity Action.

Don’t forget that as an RCN member you can use our Counselling service for free, confidential support through challenging times

Pregnant on maternity leave

Rights to maternity leave

Maternity leave counts as continuous service so if you become pregnant while on maternity leave, you retain the right to Ordinary Maternity Leave (OML) and Additional Maternity Leave (AML) for the second pregnancy.

Rights to maternity pay

If you are an NHS employee and become pregnant whilst on maternity leave, see section 15.22 of the NHS Terms and conditions, and our guidance on NHS maternity pay.

If you work outside of the NHS, see your contract and policies on contractual maternity pay, you will be entitled to this if you meet the qualifying criteria. If you did not/do not get contractual maternity pay, see Maternity Action for information on Statutory Maternity Pay (SMP) and Maternity Allowance (MA). 


Let's take a look at some of the terminology used in the field of maternity, paternity and adoption rights:

AfC handbook

The Agenda for Change handbook contains the national agreements on pay and conditions of service for NHS staff.


Additional Maternity Leave. All pregnant employees are entitled to 52 weeks maternity leave. AML is the last 26 weeks of that leave. 


Compulsory Maternity Leave. Women must take two weeks of maternity leave (or four weeks if they work in a factory) following the birth of their baby.


Expected Week of Childbirth. EWC is the week beginning on a Sunday in which it is expected that your baby will be born. 

KIT days

Keeping In Touch days. KIT days allow employees to work for up to 10 days during the 52 week period of maternity leave.  


The MATB1 is the maternity certificate and verifies the pregnancy and confirms the expected week of childbirth (EWC).  Your midwife or doctor will provide you with the MATB1. You will need to give a copy of the MATB1 to prove your pregnancy in order to get SMP.  


Ordinary Maternity Leave. All pregnant employees are entitled to 52 weeks maternity leave. OML is the first 26 weeks of that leave.


Occupational Maternity Pay. Your contract or employer’s policies will tell you if you are entitled to pay over and above SMP.  There may be repayment rules if you do not return to work.

Qualifying week

The qualifying week is the 15th week before the expected week of childbirth (EWC). This is around the 26th week of pregnancy. You can work out your qualifying week by finding the Sunday before the date your baby is due – or if due on Sunday, then this is the Sunday you choose – and count 15 Sundays back from there.  The qualifying week is important when deciding if you are entitled to leave and pay.

Relevant period

This is an eight week period used to calculate average weekly earnings for SMP. This period is the eight weeks ending with the last payslip you receive before the end of the qualifying week (see above). You can calculate your entitlement to SMP using the government’s calculator


Shared Parental Pay gives eligible parents the opportunity to share pay during the child's first year. It is available in Scotland, England and Wales. If you do not return to work after maternity leave, you will not have to pay this back. Use the government’s calculator to find out if you are eligible for ShPP.


Employees can start Shared Parental Leave ShPL if they’re eligible and they or their partner end their maternity, paternity or adoption leave early.  The remaining leave would be available as SPL. Use the government’s calculator to calculate ShPL.


Statutory Maternity Pay. SMP is paid by your employer, just as your wage is.  It is paid for 39 weeks. If you do not return to work after maternity leave, you will not have to pay this back. Use the government’s calculator to find out if you are eligible for SMP.


Statutory Paternity Leave. An employee must take his SPL within 56 days of the date of the child’s birth. The rules are different if a child is born prematurely (before the EWC).  SPL can be taken for a period of one week or two weeks in a continuous block. Use the government’s calculator to calculate SPL.

SPLIT days

Shared Parental In Touch days. Each parent is allowed up to 20 SPLIT days during shared parental leave. You cannot insist on working SPLIT days.


Statutory Paternity Pay. SPP is payable for the two week statutory paternity leave period at the standard rate, or 90% of average weekly earnings if lower than the standard rate.  If you do not return to work after maternity leave, you will not have to pay this back.  Use the government’s calculator to find out if you are eligible for SPP.

Maternity toolkit

Be sure of your rights by reading our maternity toolkit which has advice on leave, pay, and returning to work.

Search our advice guides

See our A-Z of advice. These guides will help you answer many of your questions about work. 

Need more help?

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If your enquiry is urgent or you need to speak to the advice team, call us on 0345 772 6100, 8.30am-5pm (weekdays) and 9am-4pm (weekends).

Page last updated - 02/06/2021