Employer Insights

Washington Healthy Starts Act - The Complete Guide for 2026

Written by Lori Brown | Feb 5, 2026 6:00:00 PM

Requirements for pregnancy accommodations in Washington State are established under the Healthy Starts Act and include civil rights protections for pregnant employees, such as breaks and reasonable accommodations.

Here is what employers need to know about pregnancy accommodations under Washington Labor Laws.

Washington Healthy Starts Act

The Washington Healthy Starts Act currently applies to employers with 15 or more employees. However, future updates are scheduled to expand this coverage (see below).

Under this law, employers must provide pregnancy accommodations for employees regarding the following:

  • Breaks
  • Working Conditions
  • Scheduling Needs and Time Off

Pregnant employees covered by this law also have the right to certain protections. Below is a breakdown of Washington State Pregnancy Accommodations, as well as future updates to the Healthy Starts Act.

Washington State Pregnancy Accommodations at Work

Unlike some similar laws in other states, the Washington State Healthy Starts Act has some accommodations that are strictly enforced with no exceptions, while the rest only need to be provided so long as doing so would NOT constitute an “undue hardship” for the employer.

The following accommodations must be provided as needed by all covered employers, with no exceptions: 

  • Employers must provide more frequent, longer, or flexible restroom breaks. These breaks must be separate from other required breaks under Washington State Break Laws.
  • Employers must modify any no food or drink policies that impact the employee.
  • Employers must provide seating or at least allow the employee to sit more frequently if their job requires them to stand.
  • Employers must refrain from having employees lift any item that is more than 17 pounds.

The following accommodations must also be provided as needed, unless the employer can prove that doing so would constitute an “undue hardship”:

  • Job restructuring, including shifting the employee to a part-time or modified work schedule, or reassignment of the employee to a vacant position.
  • Modify or provide additional equipment devices as needed.
  • Provide or modify an employee’s work station as needed.
  • Switch the employee's duties to something less strenuous or less hazardous.
  • Provide assistance when it comes to any manual labor or lifting items greater than the lifting limit of 17 pounds.
  • Allow for scheduling flexibility regarding any prenatal visits.
  • Reasonable break time for an employee to express breast milk, each time the employee has a need to express the milk. This accommodation applies for up to two years after the child’s birth.
    • Employers must also provide a private location, other than a bathroom, for these breaks if one exists. If not, the employer must work with the employee to identify a suitable location. The employer must be open to work schedule adjustments to accommodate this need, if necessary.
  • Further accommodations may be required if they are considered reasonable under the information provided on pregnancy accommodation by the Department of Labor and Industries or the attending health care provider of the employee.

Protections for Pregnant Employees in Washington State

In addition to the above accommodations, under the Healthy Starts Act, employers cannot: 

  • Take adverse action against an employee for requesting, declining, or using a reasonable pregnancy accommodation.
  • Use the need for accommodation as a basis to deny employment opportunities to an otherwise qualified employee or applicant.
  • Require an employee to use accrued leave in place of a reasonable accommodation that the employer is able to provide.

Can Employers Ask for Proof?

Employers may require employees to present a written certification from a treating healthcare professional regarding the need for accommodations from the second list above. These are the accommodations that must be provided as needed, unless the employer can prove that doing so would constitute an “undue hardship”.

Employers cannot ask for proof of any kind regarding the mandatory accommodations. As a reminder, these are: 

  • The provision of more frequent, longer, or flexible restroom breaks.
  • The modification of any no food or drink policies that impact the employee.
  • The provision of seating or at least allowing the employee to sit more frequently if their job requires them to stand.
  • Refraining from having employees lift any item that is more than 17 pounds.

Washington State Pregnancy Accommodation Updates for 2027

Effective January 1st, 2027, the Washington Healthy Starts Act will apply to all employers in the state with at least one employee.

The following changes will also take effect regarding pregnancy accommodations:

  • Effective January 1st, 2027, lactation breaks must be paid time. This includes any travel time. Employees cannot be required to use paid leave during lactation break or travel time.
  • So long as it does not create an “undue hardship”, employers must allow for scheduling flexibility regarding any prenatal visits, AND post-partum appointments.

These updates come with the adoption of WA SB5217.

Final Thoughts on the Washington Health Starts Act

With the pending updates to the state’s pregnancy accommodations, employers must be prepared to update their handbooks and manage compliance, which can be a challenge for some employers.

Whether it’s adding the additional accommodations or complying with the law for the first time, employers can get help.

For help managing compliance, Washington businesses may want to consider turning to a Washington Payroll and HR provider. For help finding a provider, contact us today.

Guest Author: Lori Brown

Lori Brown, CEO of PayNW a leading Washington payroll and HR services company, took the reins in September 2021 from founder Mike Anderson. Growing PayNW from $500K to $13M in annual revenue, Lori has maintained a 96% client retention rate, year over year. She is a talented leader, with extensive experience in payroll, Human Capital Management, Employee Retention Credit (ERC) efforts, and more. Lori was elected to the board of the Independent Payroll Processors Association in 2021 and is a Puget Sound Business Journal 40 Under 40 honoree. She is a mom of three and has been happily married for the past 24 years.