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Pregnancy and Employment in the Dental Practice by Stuart J. Oberman, Esq.

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Due to the vast number of female employees in the dental profession, the issue of employee pregnancy arises frequently. Many dentists fail to abide by federal law in their dealings with pregnant employees because they simply aren't familiar with the legislation protecting the pregnant employee: the Family and Medical Leave Act (FMLA) and the Pregnancy Discrimination Act (PDA). However, the lack of knowledge surrounding these laws can be costly and can lead dental employers straight into disputes with labor boards.

The Family and Medical Leave Act was added to Title VII of the Civil Rights Act of 1964 on October 31, 1978 and applies to employers with 50 or more employees. Covered employers must provide up to 12 weeks of unpaid leave to eligible employees for the following reasons: birth and care of the employee's newborn child, care for a child after adoption or foster care placement, care for the employee's spouse, child or parent with a serious health condition, or for a serious health condition that affects the employee's ability to work. This federal law also addresses hiring, maternity leave, health insurance and fringe benefits for pregnant employees.

FMLA provides that women affected by pregnancy, childbirth or related medical conditions shall be treated the same for all employment-related purposes, including receipt of benefits, as other persons not so affected but similar in their ability or inability to work. Employers are prohibited from refusing to hire someone who is pregnant because of her condition. The act also mandates that employers allow pregnant women to continue their work as long as they are able to perform their job-related tasks.

In addition, employers must hold the pregnant employer's job open during their maternity leave for the same amount of time that jobs are held open for employees on disability leave. The federal law also provides that health insurance provided by an employer must cover expenses for pregnancy-related conditions.

Finally, the same benefits that are provided to workers on disability leave should be given to employees on maternity leave. This includes temporary disability benefits, accrual and crediting of seniority, pay increases and vacation calculation.

The Pregnancy Discrimination Act (PDA), which applies to employers with 15 or more employees, also prohibits discrimination against pregnant women. This act guarantees that pregnant women are provided with the same opportunities and benefits as non-pregnant employees who are similarly limited in their ability to perform their job responsibilities. However, if a pregnant employee is unable to fulfill their job responsibilities, employers are not required to provide accommodations.

Furthermore, most states have enacted their own pregnancy discrimination laws. Many states have also lowered the covered employer threshold to those employers with fewer than 15 employees. For example, Iowa law mandates that employers with four or more employees grant pregnant employees leave for the period that the employee is disabled because of pregnancy. California law also requires employers with five or more employees to grant pregnancy leave.

When federal or state pregnancy laws apply to your dental office, it is important to be aware of and to adhere to certain guidelines. First, if the pregnant employee refuses or is unable to perform certain tasks, such as lifting heavy equipment or taking patients' Xrays, then the dental employer must determine what accommodations may be needed. For instance, a dental employer may shorten the employee's workweek or eliminate certain tasks such as lifting, taking X-rays, or working around hazardous materials.

However, if the accommodation would cause an undue hardship and require significant difficulty or expense for the employer (taking into consideration the number of employees at the dental office, the effect of the accommodation on expenses, the financial resources of the dental office and the impact the accommodation would have on the entire dental practice), then the employer may deny any accommodation. If the employee is unable to perform job-related tasks and the dental employer is unable to provide accommodations, then the employer must determine whether the tasks are essential to her job and if so, whether another employee may take over those tasks. If another employee is unable to perform those job-related tasks, then it may be prudent to provide an unpaid maternity leave.

In addition, when federal or state laws apply to a dental practice, the dentist must remember that it is illegal to deny employment, promotions or to fire a woman because she is pregnant. Employers should also be aware that pregnancy leave is generally without pay. However, the employee may use any paid vacation or sick time accrued as part of her pregnancy leave. Typically, pregnancy leave is four to six weeks, but it may be extended up to 12 weeks if the pregnancy involves complications. Finally, employees returning from a pregnancy leave are entitled to return to their former or a similar position at the same work schedule and pay, unless there is a legitimate business reason as to why that job is no longer available.

If federal or state pregnancy laws do not apply to your office but you wish to provide pregnancy leave either to retain a good employee or to be competitive with other dental offices, you must establish a leave policy and ensure that it is administered in a way that is consistent and non-discriminatory.

To be safe, whether federal or state laws apply to your dental office, all dental employers should take certain actions upon discovering that an employee is pregnant. The employer should sit down with the pregnant employee and inquire into the employee's plans for returning to work after delivery. It would be prudent to ask the employee about her estimated delivery date and whether she will have any health restrictions that will limit her ability to adequately perform her job functions. In addition, the employee should sign a release that states that the employee has been informed of the risks that her job poses to her health and that she accepts all responsibility for protecting herself and her child from exposure to all risks associated with her job.

Women are a protected class, and if an employee's pregnancy is handled inappropriately, the employer could end up in court, incurring costly fees and time away from the practice. Therefore, it is extremely important that dental employers familiarize themselves with the laws that apply to their practice.

Author's Bio
Stuart J. Oberman handles a wide range of legal issues for the dental profession including employment law, practice sales, OSHA and HIPAA compliance, real estate transactions, lease agreements, non-compete agreements, dental board complaints and professional corporations. For questions or comments, call 770-554-1400 or visit www.gadentalattorney.com. Also find him on Facebook, Twitter and LinkedIn.

Dentaltown Magazine
September 2025
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