Skip to main content

Pregnancy and Healthcare

Health Insurance Medicaid & Medicare

This article explains employment protections for pregnant employees, health insurance during pregnancy, and options for parental leave.

Here, learn about protections under the federal Pregnancy Discrimination Act and Texas law, the availability of insurance coverage during pregnancy, and parental leave options. 

This article was compiled from content written by the Texas Young Lawyers Association, the U.S. Equal Employment Opportunity Commission, Texas Health and Human Services, Texas Workforce Commission, and the U.S. Department of Health and Human Services. It has been lightly edited for style. 

Revised by on February 26, 2023. 

What kind of employment protections do I have during pregnancy?

As long as a pregnant woman is able to perform the major functions of her job, firing or not hiring her because she is pregnant is against the law. It's against the law to dock her pay or demote her to a lesser position because of pregnancy. It's also against the law to hold back benefits for pregnancy because a woman is not married. All are forms of pregnancy discrimination, and all are illegal. 

Pregnant women are protected under the Pregnancy Discrimination Act. It says that businesses with at least 15 employees must treat women who are pregnant in the same manner as other job applicants or employees with similar abilities or limitations. 

The Family and Medical Leave Act also protects the jobs of workers who are employed by companies with 50 employees or more and who have worked for the company for at least 12 months. These companies must allow employees to take 12 weeks of unpaid leave for medical reasons, including pregnancy and childbirth. Your job cannot be given away during this 12-week period. 

State laws also protect pregnant women's rights. 

Texas law prohibits businesses with fifteen or more employees from discriminatory treatment of pregnant employees and requires reasonable accommodation for employees with disabilities.  

Disability laws can come into play for a pregnant employee if the pregnancy becomes complicated and results in something that can turn into a disability, such as gestational diabetes. 

Also, Texas municipal and county employers must make reasonable efforts to accommodate employees who are partially physically restricted by pregnancy. This may include making a temporary work assignment within the employee’s office. 

Can a health plan refuse to let me enroll because I'm pregnant?

No. In the past, insurance companies could turn you down if you applied for coverage while you were pregnant. At that time, many health plans considered pregnancy a pre-existing condition. 

Health plans can no longer deny you coverage if you are pregnant. That's true whether you get insurance through your employer or buy it on your own. 

What's more, health plans cannot charge you more to have a policy because you are pregnant. An insurance company can't increase your premium based on your sex or health condition. A premium is the amount you pay each month to have insurance. 

How can I get health insurance while I'm pregnant?

First, see if your employer—or your partner’s employer—offers health insurance. You will probably get the most coverage at the best price from a health plan offered by an employer. That's partly because most employers share the cost of insurance premiums with employees. 

Can I get Medicaid during my pregnancy?

Pregnant women in Texas might be able to get free health coverage during their pregnancy through Medicaid for Pregnant Women or the CHIP Perinatal program

Medicaid provides health coverage to low-income pregnant women during pregnancy and up to two months after the birth of the baby. 

CHIP Perinatal provides similar coverage for women who can't get Medicaid and don't have health insurance.

Who is eligible for Medicaid for Pregnant Women or CHIP Perinatal?

To get Medicaid for Pregnant Women or CHIP Perinatal, you must be a Texas resident. You must be a U.S. citizen or qualified non-citizen to get Medicaid for Pregnant Women. 

If you have other health insurance, you are not eligible for the CHIP Perinatal program. 

When you apply, you’ll need to answer questions about your family's monthly income to see if you can get Medicaid or CHIP Perinatal. 

What services are available through Medicaid or CHIP Perinatal?

Both programs cover services like: 

  • Prenatal doctor visits. 

  • Prenatal vitamins. 

  • Labor and delivery. 

  • Checkups and other benefits for the baby after leaving the hospital. 

To learn more and apply for Medicaid or CHIP Perinatal, visit the Medicaid for Pregnant Women & CHIP Perinatal page on the Texas Health and Human Services website.  

Does my employer have to provide maternity or paternity leave?

The Family and Medical Leave Act (FMLA) permits eligible employees to take up to twelve weeks (and upwards of twenty-six weeks in some cases) of job-protected leave from work for certain “qualifying events.”  

The FMLA does not require that the leave be paid.  

Employers may require their employees to use other types of leave such as paid time off (PTO), sick time or short-term disability, which may be paid or unpaid depending upon the employer’s policies. 

The FMLA only applies to employers with fifty or more employees within a seventy-five-mile radius for twenty calendar weeks in the current or preceding calendar year are covered employers under the Act. 

The FMLA also covers public agencies, public and private elementary and secondary schools regardless of the number of employees.  

To be eligible for FMLA leave, an employee must have been employed for the twelve months preceding the leave and worked at least 1,250 hours during those twelve months. The employee must also work at a worksite having at least fifty employees within a seventy-five-mile radius. 

For more information, read the Family and Medical Leave Act page provided by the U.S. Department of Labor

What are “qualifying events” under the FMLA?

Qualifying pregnancy, maternity, and paternity-related events include:  

  • Birth and care of your newborn or adopted child;  

  • Placement of a child by the State for foster care;  

  • The need to care for your child with a serious health condition; and  

  • A serious health condition that makes you unable to perform the functions of your position. 

For more information, read the Family and Medical Leave Act page provided by the U.S. Department of Labor

What are my obligations to my employer if I want to take FMLA leave for the birth of my baby?

If you are planning to take FMLA leave following childbirth or adoption, you should: 

  • Provide at least thirty days written notice to your employer prior to taking leave. In circumstances where such notice is not possible, you should provide notice of the need for FMLA leave as soon as possible.  

  • Provide medical proof of the need for FMLA leave. Note, your employer may request second or third medical opinions at the employer’s expense.  

  • Make arrangements to ensure that your benefits are not interrupted while on FMLA leave, and address issues regarding the use of accrued paid time off, sick leave, disability leave or other leave that the employer may require you to exhaust prior to taking, or may run concurrently with, FMLA leave. 

  • Be aware that employers may also require an occasional “check-in” to verify your FMLA status and intent to return to work.  

What are my employer’s obligations once I return from FMLA leave?

Generally, at the conclusion of a qualified leave period the employer must reinstate you to your former or equivalent position, with the same terms and benefits.  

Employers may not treat female employees with infants or young children less favorably than other employees.  

To learn about laws protecting nursing or lactating employees, visit Pregnancy and the Workplace: Know Your Rights

What can I do if I think my employer is violating my rights?

  • Keep good documentation. Make requests and complaints related to pregnancy or leave in writing and document your employer’s response. Include names, dates, and record as much detail concerning the situation or conversation as possible. Keep medical documentation concerning your pregnancy, childbirth or any serious health conditions you or your child experience. 

  • Follow your employer’s policies for making a complaint. Many employers have written policies in place for making a complaint or otherwise addressing pregnancy and leave related issues.  

  • File a charge of discrimination. If you believe you are being discriminated against because of pregnancy, childbirth or a related medical condition, file a formal complaint with Texas Workforce Commission (TWC). When you submit an employment discrimination complaint with TWC, it is automatically submitted with the EEOC.  

Related Articles