HG & Work: Practical Considerations

HG is very hard - often impossible - to work through for many of us. The first trimester is often the hardest because symptoms tend to be at their worst, and you may not have found the right combination of treatments yet. 

You may be able to return to work once your symptoms are under control with the right treatments; you may also be able to return part-time or doing a slightly different role. If you have a job that involves being on your feet and/or in public a lot, it may be a lot harder for you to continue working your usual hours, or at all. If you have an office job, or one that can be done mostly remotely, you may have more flexibility. 

Things that can help you manage HG and work, to discuss with your employer: 

• Remote working 
• Flexible working hours to avoid busy commutes and/or allow you to plan your day around your symptoms. 
• Reduced workload e.g.: shorter days; fewer projects; longer deadlines. 
• More private working area, with space to rest when necessary
• Closer access to bathroom; more remote from strong-smelling areas of the workplace (such as kitchen), which can trigger vomiting.

At 6w pregnant, I had to tell my manager about my HG. We discussed my workload, remote-working, flexible working hours, and an open door should I need anything further. It was a huge relief to offload some tasks, to rest when needed, and honestly simply to get sick in peace. 

By 5 months, I was still vomiting around 8-10 times a day but with medication I was able to eat and drink a small amount which kept me out of hospital. I would not have been able to drive to work or to be present in the office due to frequent and unpredictable vomiting, extreme tiredness, an aversion to smells, and a general feeling of ill-health that only those who have experienced HG can understand, but with remote working I was able to return to work. For me, despite feeling incredibly unwell, the schedule was a welcome distraction, and I found it helped my mental health.     - Rebecca

Your rights

Citizens Information is a good source of general information on sick leave and what you are entitled to during pregnancy. In the Republic of Ireland, you have a number of legal protections against discrimination because of pregnancy. You can read more about these from the Equality Authority here https://www.workplacerelations.ie/en/publications_forms/guide_to_maternity_protection_acts.pdf 

You are entitled to paid time off to attend:

• antenatal appointments, including unscheduled medical appointments due to pregnancy
• antenatal classes, including travel time

While you may not have planned to tell your employer early in pregnancy, you are more legally protected as soon as you do tell them. It is of course your choice, and your GP or hospital doctor should be able to give you medical certificates without disclosing any details of your illness. 

If you are employed in the public sector, you have some extra entitlements, read more about those here:

https://healthservice.hse.ie/staff/leave/sick-leave/ https://www.nsso.gov.ie/en/services/sick-leave-in-the-civil-service/ 

In 2024 the “Leave Our Leave” legislation was passed, enabling women to defer maternity leave if they have a “serious health condition” in pregnancy. It was originally campaigned for by the Irish Cancer Society, but is written to apply more widely to other serious health conditions i.e. any condition which:

(a) entails a serious risk to the life or health, including the mental health, of an employee, and

(b) in order to address the risk, requires necessary medical intervention that is ongoing for a period of time to be carried out. 

This requires signoff by a "relevant medical practitioner". However we haven’t yet got any clarification on how this might work in practice for women with HG. If you think this may apply to you and are having trouble accessing this, or getting information, please contact us on support[a]hyperemesis.ie. 

What can employers do to help?  

• Believe your employee about how difficult HG is, and respond with empathy and compassion. Don’t compare it to normal pregnancy nausea, imply she is weak or exaggerating, or that her illness is not valid. 
• Give her information regarding paid sick leave and/or signposting to appropriate illness benefits, and in a format she can refer back to e.g.: email, written documentation (not just verbally). If you need sick certs or other documentation from her healthcare providers, ask her in plenty of time. If her benefits run out or change at a certain number of days/weeks of time off sick, flag this to her in advance. 
• Discuss and support your employee’s needs to work around her symptoms. For example, if possible: Offer a reduced workload; Offer flexible working hours; Facilitate remote working; Change her work duties and/or work area.
• Keeping in touch: Symptoms may change throughout pregnancy and therefore accommodations may need to change too - an accommodation needed at 16w may not be needed at 26w, or something that worked well at 24w may not work at 34w. If she is not able to work at all, respect the timings in her medical certificates - don’t contact her “just in case” or put her under pressure to return. If you do need to contact her, text or email first as she may not be able to talk on the phone at short notice (nothing like a unplanned call from your boss when you’re throwing up!).
• Respect her privacy: she likely told you about her pregnancy earlier than she planned to because of HG. Don’t share details on her condition or that she is pregnant without her specific permission: keep it factual and to what other staff need to know for work purposes e.g.: “[Name] is likely to be ill for a few months. She is getting treatment but in the meantime she will be off/working remotely/working part-time”.  

I was off work for two months while I tried various combinations of medications to get the symptoms under control. When I did return, at first I was only able to work from home 3-4 hours a day before I would have to go to bed due to nausea, and while I did have more good days and could work for longer as the pregnancy went on, it was essential to have the flexibility to rest in the middle of the day or join a meeting virtually (camera and sound off!) as any day could be a bad one for symptoms.

I would not have been able to work every day in the office due to the energy it took to leave home, the commute (too nauseous to safely drive, too weak to cycle, terrified of throwing up on the bus due to the unpredictable movement and smells), and not having a private space to lie down or be sick. My manager was so understanding, and it made a huge difference both to my family’s finances, and to my mental health. - Lynn*, 2nd HG pregnancy