CNN  —  Most employers must offer “reasonable accommodations” to workers related to pregnancy or childbirth, including providing time off for an abortion, according to a final rule issued Monday by the Equal Employment Opportunity Commission. The rule clarifies the provisions of the Pregnant Workers Fairness Act, which became law last June after Congress passed it as part of a federal government spending package in late 2022. The measures apply to employers with at least 15 workers unless the accommodations would cause “undue hardship” for the employer. The law provides pregnant and postpartum workers with a variety of protections, including time off for recovery from childbirth, prenatal or postnatal appointments and postpartum depression and accommodations related to seating, light duty, breaks for food, water and restroom needs, breastfeeding and miscarriage. Employers are not required to offer paid time off. The question of including abortion in the act’s definition of “pregnancy, childbirth, or related medical conditions” sparked a flurry of comments to the commission, with about 54,000 of them urging the commission to exclude abortion and about 40,000 comments asking to include it. Children at an education and childcare center in Des Moines, Iowa, U.S., on Feb. 9, 2022. Since Covid-19 arrived in earnest in early 2020, about one-third of childcare centers have closed and some 111,000 workers have departed the sector. Kathryn Gamble/Bloomberg/Getty Images Related article Child care benefits at work: Employers are increasingly offering resources to parents with daycare needs The agency noted in the rule that the law cannot be used to require a job-based health plan to pay for any procedure, including an abortion. It specified that the act is a workplace anti-discrimination law. “With respect to abortion, the PWFA’s requirements are narrow and will likely concern only a request by a qualified employee for leave from work,” the commission said in a statement. The final rule clarifies to employers and workers who is covered, what types of limitations and medical conditions are covered and how workers can ask for reasonable accommodations. It also provides many examples of accommodations and encourages employers and workers to communicate early and frequently about the requests. Advocates have been fighting to improve federal protections for pregnant workers for more than a decade, saying that the Pregnancy Discrimination Act is inadequate and that most pregnancy-related conditions are not considered disabilities under the Americans with Disabilities Act. The US Chamber of Commerce was among the supporters of the law. “Today with these final rules, we have achieved a huge step forward for women’s economic security, maternal health, and the economy as a whole,” Dina Bakst, co-president of A Better Balance, a national legal advocacy organization, said in a statement. “The Pregnant Workers Fairness Act is a life-changing protection for pregnant and postpartum workers nationwide, ensuring they aren’t forced off the job or denied the accommodations they need for their health.”