Karigme Alpizar feels unsafe at work. The management at the Los Angeles Wendy’s where she is a cashier has never had a meeting with employees to lay out guidelines for how to keep workers protected against Covid-19. The restaurant doesn’t enforce hand-washing protocols, she said — and because they’re understaffed, no one has the time to wash their hands anyway, with some of her coworkers going a whole shift without a rinse. She has taken it upon herself to remind coworkers to wear gloves at all times.
Management also doesn’t make sure everyone stays 6 feet apart, she said. Even customers aren’t asked to stay spaced out. And until the end of March, no one was given a mask, so Alpizar sometimes used her own, although she had to make sure it was solid black to match her uniform.
“They haven’t made it a priority,” she said of management, speaking in Spanish through an interpreter.
Alpizar isn’t just worried about her own health. She’s five months pregnant with twins and worries about the impact Covid-19 might have on her babies. “Of course I’m scared,” she said.
The potential exposure at work pushed Alpizar to file a complaint with the Los Angeles County Public Health Department in April. “I am afraid. I am pregnant and I am very scared about getting sick right now because of that, but I need my job,” she wrote.
She also staged a strike with her husband, who also works the restaurant, and two other coworkers to demand greater protections. After the health department showed up in response to the complaint, she says management started providing hand sanitizer. They have also put up a piece of clear plastic in front of the cash register.
A Wendy’s spokesperson noted that Alpizar’s location is a franchise, but said in an email to Vox, “As a Wendy’s system, we believe that the safety and well-being of our team members and customers are a top priority.” The spokesperson noted that the company has implemented training to enforce hygiene practices and has created materials to encourage social distancing. It has also adopted “brand standards” that require employees to wear masks and gloves while working, and all restaurants are expected to supply them.
But Alpizar says she is “still working under fear.”
She can’t afford to do anything else. While she’s planning to take some time off once she gives birth, “I’m working out of necessity” right now, she said. Her husband’s hours at Wendy’s were reduced, so she has to bring in as much income as she can. “We have to pay the rent, the bills. And for that reason I continue to work.”
While many white-collar workers have been able to work from home to protect themselves from Covid-19, essential employees have had to keep going to their jobs. It’s potentially scary for any of them, but pregnant workers face the extra uncertainty of what exposure could mean not just for their own health, but that of their babies. They also face an uneven legal landscape when it comes to whether they have the right to extra protection at work. And as states reopen businesses and stay-at-home rules loosen, more workers are being called back to work, putting pregnant employees in a precarious position.
Pregnant people are at low risk of getting sick from the coronavirus but fear remains
There is much that remains unclear about the novel coronavirus, including how it affects pregnant people and their babies. “Unfortunately, there is a lot we don’t know,” Denise J. Jamieson, chair of the department of gynecology and obstetrics at Emory University, said in an email to Vox. “We need more carefully conducted studies of pregnant women and their infants to understand more about the disease course in pregnancy, how best to protect pregnant women and their infants, and how to manage and treat pregnant women with Covid.”
The good news is that, from what is known, pregnant people don’t appear to be at any higher risk than others of contracting Covid-19 or having more severe illness. “It doesn’t mean pregnant women cannot have serious illness,” said Emily Oster, an economist at Brown University who has written about pregnancy and Covid-19. “But it’s mostly pretty mild or moderate.”
Some common pregnancy conditions, such as gestational diabetes or hypertension, may come with a higher risk of complications from Covid-19, however, potentially putting those who develop those conditions at higher risk. Many of these conditions are more common among black and Latinx women, who also make up a disproportionate share of low-wage essential workers.
There is also the worry that even if a pregnant person infected has only mild symptoms, they could pass the virus on to the fetus. “There is increasing evidence that Covid can be passed from mothers who are ill with Covid to their fetuses,” Jamieson said. “Although the evidence is still suggestive and not definitive, I think that based on what we do know, that it is likely that this can occur.”
Still, in keeping with the overall data that indicates children are at lower risk of getting seriously sick from the virus, it appears that the infants of women who have it generally don’t contract Covid-19 themselves or have a mild illness.
Samantha Halseth, an intensive care unit nurse who is 13 weeks pregnant, considers herself lucky, even though she had been working in the Covid-19 unit at Mercy General Hospital in Sacramento. Her managers immediately took her off that duty when she told them the news. Meanwhile, her hospital hasn’t run into shortages of personal protective equipment, and it’s now also able to do rapid testing for Covid-19, so she feels relatively well protected.
Still, she wasn’t expecting to get pregnant, so she didn’t find out until she was eight or nine weeks along, which meant “I had technically cared for a Covid-19 patient before I even knew,” she said. And in some ways, she said, working with people who have tested positive for Covid-19 is a bit more reassuring because she knows they have it and she can protect herself accordingly.
In the unit Halseth works in now, however, nurses are only given surgical masks, not the more protective N95 or powered air-purifying respirators. “You do worry, ‘Holy cow, what if they do come back positive, I was just in there with just a surgical mask,” she said.
Halseth’s general outlook on life, though, is that there’s not much use getting wrapped up in fear, and at 29, she’s young and healthy. Before she got pregnant, she assumed that if she did get Covid, she had a good chance of being okay. “But obviously when you’re pregnant, it’s not just about you anymore,” she said.
There are numerous health-related shifts people make when they find out they are pregnant — from small things like avoiding deli meats to making sure they don’t lift heavy objects at work to psychologically coming to terms with parenthood itself — to protect themselves and their babies. There is “almost this visceral desire to do everything you possibly can to make sure that you have a healthy pregnancy,” noted Dina Bakst, co-founder and co-president of A Better Balance, a legal advocacy organization for women’s workplace rights.
But trying to ensure a healthy pregnancy is even more fraught in the midst of a pandemic. “We just need to respect the fact that the guidance is vague and pregnant workers, many are scared,” Bakst said.
Both Jamieson and Oster emphasize that pregnant people should take the same precautions as everyone else: wearing a mask, washing their hands, avoiding touching their faces, and reducing exposure to other people. However, those things may not be easy to do for pregnant workers whose jobs require interacting with the public.
Pregnant workers are unsure if they have the right to the protections they need
Sophia Lopez works in the kitchen of a McDonald’s in Oakland, California, and is six months pregnant. When the virus first hit her area, “nothing changed,” she said, speaking Spanish through an interpreter. Employees weren’t given protective equipment right away; in early April, management started giving out masks, but they weren’t properly protective — some were simply dog diapers, she said. Her coworkers were getting sick, but management wasn’t notifying everyone else. “At the beginning, I really didn’t want to go to work,” she said. But “I decided to go because I need to get paid, I need to survive.”
Her doctor told her that he didn’t think she should be working under those conditions, but if she had to keep going to work, she should take extra precautions. But she hasn’t been able to make any changes other than wearing gloves and a mask. She didn’t even bother asking management if there were ways to keep her more protected at work; before the pandemic, when she asked to work earlier hours so she could get more rest, her manager responded by saying she could have her hours docked instead. So she’s been on strike since May 25 along with 33 of her coworkers.
“Our organization’s highest priority is to protect the health and well-being of our employees and customers,” Michael Smith, McDonald’s owner/operator, said in an emailed statement. The company, he said, is providing PPE and requiring employees to wear it at all times, and it has installed protective barriers in the restaurants as well as implemented temperature checks. He called the claim that workers were given dog diapers “false.”
But Lopez is not the only pregnant worker concerned about workplace conditions in the pandemic. “Our work has just exploded,” Bakst said. “The fear is through the roof.”
Calls to her organization’s legal hotline for women asking about their workplace rights have quadrupled. “A lot of what we’re doing is talking pregnant women through what their options are and informing them what the law provides so they can effectively self-advocate.”
On top of the uncertainty around the medical risks, navigating the legal landscape is also challenging. Twenty-nine states have pregnant worker fairness acts, laws that require employers to give pregnant employees reasonable accommodations so that they can stay healthy while on the job. Those workplace changes could include things like more protective equipment, temporarily changing work duties to something less exposed to the public, staggering work times so that commuting is less fraught, and even telecommuting, if possible.
But some workers are going to have a harder time finding a way to stay safe at work than others. It’s more challenging “when the limitation in the ability to work and the nature of the job just really seem at odds with each other,” said Emily Martin, vice president for workplace justice at the National Women’s Law Center. “If the request is, ‘Can I have a job that doesn’t involve exposure to the public,’ and the nature of the business is such that interacting with the public is the entire job, it can be more difficult to figure out what is an accommodation that addresses that need.”
Outside of those 29 states, those who work for companies with 15 or more employees could be entitled to a modification under the Pregnancy Discrimination Act if they can prove that their employer has provided the same accommodation to a similar non-pregnant worker. The challenge is that it’s up to the employee to identify a coworker who’s gotten the same accommodation they need. Those who have pregnancy-related complications — anything from gestational diabetes to preeclampsia — could also be entitled to an accommodation under the Americans with Disabilities Act.
But federal agencies have offered little additional clarity. The Equal Employment Opportunity Commission released pandemic guidance that included information about accommodations, but nothing specifically about how to handle pregnancy during Covid-19. The Occupational Health and Safety Administration has similarly issued general guidance but not enforceable requirements. This “is a shortcoming,” Martin said. “There could definitely be a productive role for federal agencies to play in setting out what are presumptions around what is safe and what is not safe.”
The murkiness is only going to become more confusing as states allow businesses to open back up and employees are called back to work.
Susan, a pseudonym used because she fears retribution for sharing her story, has been easily doing her job for a public transportation company from home since mid-March. “I was actually told that … I was even more responsive at home,” she noted, especially since she has made herself available on email before and after work hours. “I knew it was a privilege to be able to work from home and I didn’t want to take advantage of it.”
But she’s now 15 weeks pregnant, and she’s considered high-risk as a cancer survivor with endocrine issues. So when her employer said the work-from-home program would be expiring except for those who have health-related issues, she spoke to her doctor, who recommended she keep working from home and gave her a note saying as much. And yet the human resources department denied her request in an email on a Friday, telling her she had to report to work the following Monday. “They gave me no time to feel anything other than panic,” she said.
The company later sent Susan a letter saying it doesn’t believe she has a high-risk pregnancy based on its own doctor’s recommendation, a doctor she’s never seen. “I don’t even think they could pick me out of a lineup, they don’t even know who I am,” she said. “To be so confident to say that I’m not a high-risk pregnancy and put my unborn child at risk, that’s a really unsettling feeling.”
On top of that, Susan’s employer hasn’t instituted basic protocols like temperature checks and can’t ensure that staff will wear masks. “I have never, ever once said I don’t want to work. I’ve said I’m fearful to report to work without measures put in place,” she said. “They basically said that my health and safety are not important, and that being pregnant doesn’t put me in a special category.” She’s currently using some of her meager sick time while she fights for the ability to keep working from home.
Bakst heard from a hair stylist in Washington state whose salon reopened. Her doctor had told her that because she had a high-risk pregnancy, she shouldn’t be back at work, but she was told she had to return. While salon employees wore masks, the customers didn’t have to. “She was really petrified,” Bakst said.
The lack of medical certainty can also mean an uneven response from doctors, even though they are usually an important part of the process. Without a doctor’s note specifying that a pregnant person needs to change the way she works, “it’s certainly a harder situation,” Martin said. Employers are often within their legal rights to demand documentation from a medical professional.
“We’re seeing women running into issues with their doctors,” Bakst said. One client’s doctor told her that if her employer was requiring her to go to work, then she had to do what she was told, even if she may have had the legal right to ask for an accommodation, Bakst said.
“Because the evidence about Covid-19 is sort of fast-shifting, the individual medical professionals are making different assessments of risk,” Martin said.
Meanwhile, employers may find it easier to get out of having to make accommodations. Most laws that require employers to make changes to allow pregnant workers to stay in their jobs include an exemption for “undue hardship” on a business. Bakst said she’s seeing more employers invoking this excuse, particularly given how devastated businesses have been under pandemic-imposed lockdowns. With few employees coming to work and revenues underwater, they are arguing they can’t afford to give a pregnant worker different duties or let the worker stay home.
“It’s such a class issue,” Bakst said. Low-income workers, like Alpizar and Lopez, tend to have less power at work to ask for the things they need to stay healthy.
“The precautions that pregnant workers can and can’t take — it’s just really highlighted in this pandemic … who’s able to stay healthy and safe and who may not be able to.”
Once the strike is over, Alpizar will have to return to work and hope that she and her babies continue to remain healthy. “Until I give birth, I’m going to keep going until I can’t, until my body doesn’t allow me,” she said.
Reporting for this article was supported by a grant from the Economic Security Project.
Bryce Covert is an independent journalist writing about the economy. She is a contributing op-ed writer at the New York Times and a contributing writer at the Nation. Her writing has appeared in Time, the Washington Post, New York magazine, the New Republic, Slate, and others, and she won a 2016 Exceptional Merit in Media Award from the National Women’s Political Caucus.