How to talk about miscarriage and baby loss at work
Reader (Associate Professor) in Human Resource Management at Manchester Metropolitan University
Dr Krystal Wilkinson is a Reader (Associate Professor) in Human Resource Management at Manchester Metropolitan University, and her research focuses on the work-life interface, flexibility and wellbeing at work, including complex fertility journeys and perinatal mental health.
Here, she shares the findings of her research into the mental health impact that losing a pregnancy can have, how it might affect your employees’ working lives, and how you as an employer can help them cope during this difficult time. This research was funded by the Leverhulme Trust.
Please be aware this blog prominently discusses themes of pregnancy loss and miscarriage.
Our research participants alluded to considerable psychological tolls connected to pregnancy loss. This links to connections made in the literature between such loss and anxiety, depression, PTSD and suicidal thoughts. This can affect the woman or carrying parent, but also their partner. And the timings can vary, with some people most affected years after their experience.
Sadly, people can become conditioned to expect loss, which can impact their mental health in future pregnancies or even mean the end of a fertility journey, as people don’t want to risk it happening again.
Many people talked of multiple pregnancy losses over their journey
In our research on complex fertility journeys and employment, half of the individuals that we interviewed about their own experiences reported one or more pregnancy loss. Some of these people had undergone fertility treatment, such as IVF, but some had not. Many talked of multiple pregnancy losses over their journey.
There were different types of pregnancy loss we found in our research: chemical pregnancy (a type of very early miscarriage), ectopic pregnancy (when a fertilised egg implants itself outside of the womb), early miscarriage, late miscarriage, missed miscarriage (where the foetus has died or not developed, but hasn’t left the body), medical termination, or stillbirth.
This was in addition to those who mentioned the loss of a failed fertility treatment cycle, such as an IVF treatment cycle which didn’t result in pregnancy.
From discussions around this subject, it became clear that the way we talk about pregnancy loss is important. With miscarriage, some people prefer the term ‘baby loss’, as they feel it legitimises the grief or significance of the loss. Other people prefer ‘pregnancy loss’, as it helps them psychologically to think the foetus was not yet a baby.
Knowing what to sayConversations about painful subjects Trauma can overwhelm someone's ability to cope. This guide is designed to help NHS line managers encourage their staff open up about potentially traumatic things they have seen at work. By: NHS England and NHS Improvement View resource when a colleague has gone through such a loss can be really difficult. The Miscarriage Associations suggest comments that could be helpful, which include:
- “I’m very sorry that you have lost your babyDeath, bereavement and grief Bereavement is sadly something that can affect any of your employees at any time. Business in the Community (BITC) have created a webinar which explores the impact of bereavement on employees, and explains what organisations can do to help. By: Business in the Community View resource.”
- “This must be really difficult for you.”
- “I don’t know what to say.”
However, there are also some things people say that can be hurtful. Avoid saying things like:
- “Don’t worry, you’re young. You can always have another baby.”
- “It wasn’t meant to be.”
- “It was probably for the best.”
- “At least you have other children.”
Although often meant with the best intentions and with the aim of helping the person stay positive, they may be upsetting and trivialise the grief the parents are experiencing.
Feeling alone and isolated
Knowing what your colleague or staff member might be feeling could help too.
In terms of their emotional response, one person told the researchers that they felt their “whole world is falling apart”. Another reported feeling “very alone and isolatedLoneliness at work Feeling lonely isn't in itself a mental health problem, but the two are strongly linked. Marmalade Trust, a charity dedicated to helping those who are experiencing loneliness, has created this guide to help you to combat loneliness in the workplace. By: Marmalade Trust View resource“, and others used words like ‘heartbroken’, ‘depressed’, ‘angry’, ‘vulnerable’ or ‘wretched’ to describe their state of mind. It became clear that there is no ‘right’ way to feel – each individual is different; each experience is different; people cope in different ways; and these feelings can change over time.
The feelings of trauma, grief and bereavementFinding bereavement support This web page from Dying Matters provides information on finding bereavement services along with advice on how to support someone who has been bereaved, which might be helpful if someone in your workplace has lost a loved one recently. By: Hospice UK / Dying Matters View resource can be huge, yet there are perceptions that it lacks legitimacy (also known as ‘disenfranchised grief’) because it is not widely acknowledged, and it is thus somewhat silenced. There is also a perception of hierarchies of grief which doesn’t always match lived experience. Here’s what some parents told us:
“Some people perhaps didn’t get the full extent of it. Because it’s this thing about a child that doesn’t live, how can they mean as much as a child that has lived?”
‘It’s not treated as a bereavement. It’s treated at times as something you shouldn’t have done and you’ve put yourself in a position [to get hurt]. Nobody would ever say that to anybody who had just lost a loved one, ever! People don’t say, ‘I know your dad died but actually you shouldn’t really have loved them.’ Do you know what I mean? It’s not how it works’
‘The double bereavement… because people didn’t know what to say, they said nothing.”
People can feel that sympathy or support can be short lived, when they remain psychologically affected for significant amounts of time. There is ’emotion work’ required in regulating your emotions in certain spaces, including work.
A supportive and friendly working environment can make a difference
How workers react to this painful situation can be different too. Some like to continue working through their grief, as it provides a sense of routine and normalcy. However, other people might need time off from work to come to terms with their loss. And some people might like to keep their thoughts and feelings private, while others might feel more comfortable sharing their story with their colleagues.
And for some of those who chose to disclose, a supportive and friendly working environment made a big difference.
“I decided I was going to be quite open about what had happened, just because I didn’t want people to think oh, you know, she’s just, you know, she’s expecting everybody to pick up her work,” said one respondent. “So I thought, I’m just going to tell them. And loads of people said, oh yeah, that’s happened to me too, and that was really helpful, because I didn’t feel like a freak any more!”
If you are a manager or employer, there are some things you can do to be supportive. You don’t need to wait until a member of your team or their partner has experienced pregnancy loss to get started; there are some things you can do right now to prepare in case it ever happens. You might want to consider:
- Running some awareness raising events and signposting to useful organisations,
- Writing a policy so people know that taking time off is allowed,
- Introducing miscarriage/pregnancy-loss paid leave, including for partners,
- Implementing supportive return to work; phased; reasonable adjustments; wellbeing checks, with the understanding that support needs may vary over time,
- Running some manager training, so they feel confident talking about this difficult subject,
- Creating staff networks and peer-support mechanisms so staff know they can reach out to others with similar experiences, and
- Offering counselling provisions and providing time for this.
“For me with work, it’s about just remembering that it is a bereavement and therefore just because you might be back in work, doesn’t mean to say you might need to go off again,” said one respondent, talking about their experience of returning to work after pregnancy loss. “I think that’s the biggest misunderstanding for me, is that actually it’s not a linear process. Grief isn’t linear is it?”
