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A note about language​​:

​​At Fertifa, we use terms like ‘man’ and ‘woman’ that refer to an individual’s sex that was assigned at birth, but we understand that not everyone identifies with their biological sex. We're here to support anyone who identifies as a man, woman, gender non-binary, gender non-specific or anyone who defines themselves, their gender, or their sexuality in any way we've not mentioned. We want to make our content as inclusive as possible, but we're learning all of the time. Please don't hesitate to reach out if you feel that we can make Fertifa more inclusive and representative of you. This guide mentions and describes pregnancy loss, miscarriage, and stillbirth, including the signs and symptoms. We know this can be difficult for some people to read about, so please be aware if this is something that might affect you.

Miscarriage and pregnancy loss can have a profound impact on a person’s life and wellbeing, and this impact is especially seen when there is a lack of workplace support. Even if you have experienced pregnancy loss yourself, or have a close friend or family member who has, you may feel unsure of what to say or how to support a colleague.

However, as a manager or HR professional, if you work with someone who has gone through pregnancy loss, you play an important role in making their time at work as easy as it can be after such a life-altering event.

For some people who have experienced pregnancy loss or miscarriage, continuing to work or returning to work can be challenging. For others, a supportive culture and feeling valued at work can be helpful in getting back to work.

Remember, an individual’s experience with loss during pregnancy and miscarriage is unique and personal to them. This guide will not be able to cover everything that someone might be thinking or feeling if they’ve had a loss, but rather it aims to help HR teams and managers better understand pregnancy loss, the impact it can have on someone’s personal wellbeing and work life, and how to support someone through it.

You don’t need to be a medical expert to be supportive. Make sure you educate yourself so you understand what your team member is going through and listen to them and their situation so you can be supportive whilst still respecting boundaries. Most people are just looking for people with empathy to lend a listening ear.

Support in the workplace can help employees get through what is already a very difficult and emotional time. Workplace support for pregnancy loss demonstrates a company’s value in its employee's wellbeing and commitment to promoting a compassionate, open, and inclusive culture. From a business perspective, establishing a positive working culture is important in retaining and attracting the best people and developing an environment where employees are supported through all reproductive health challenges. In many countries, including the UK, employers also have a legal responsibility to provide reasonable adjustments, such as parental bereavement leave. It’s important to be aware of these to ensure you are compliant with all your legal obligations.

1 in 5 people who experienced a pregnancy loss received no support from their manager and only 40% felt their manager showed an understanding of the associated challenges.

Only 25% of employees received paid parental bereavement leave following baby loss, and just 37% have formal pregnancy loss bereavement policies.

Approximately 20,000 women in the UK will experience pregnancy loss whilst at work.

70% of people who didn’t feel supported by their line manager following pregnancy loss said that support would have been beneficial.

What are the different types of pregnancy loss and what can they look like?

15% of couples experience infertility and 1 in 4 pregnancies end in pregnancy loss. 1 in 100 women suffers from recurrent miscarriage.

Pregnancy loss is often referred to as a silent tragedy as people don’t speak about it openly. It’s important to understand the different types so that you can best know how to support people through their individual situations. Depending on the type of miscarriage, the stage of pregnancy, and numerous other factors, different people will need different types and levels of support. It’s not a ‘one-size-fits-all’ approach. As a manager, an understanding of the terminology will help you be better informed if someone on your team asks for support or opens up about a baby loss. We’ve seen firsthand how someone can feel more supported if the people around them actually understand what they are going through.

Miscarriage and baby loss can take a considerable physical toll on a person’s body, and it can take a considerable emotional toll on them and their partner too.

Early miscarriage

Pregnancy loss within the first 12 weeks (the first trimester). This is the most common type of pregnancy loss. Most miscarriages are early miscarriages. Some of the symptoms include bleeding, stomach pain or cramping, tissue or a gush of fluid coming from the vagina. If someone experiences symptoms of miscarriage, they need to contact their GP or midwife, or visit their nearest early pregnancy unit straight away.

Late miscarriage

Pregnancy loss after 13 weeks and before 24 weeks (the second-trimester). It can also be called a second trimester loss. 1-2% of pregnancies end in late miscarriage. Some of the symptoms include vaginal bleeding, stomach pain or cramping, liquid coming from the vagina and the baby’s movements stopping, slowing down or changing. Some people will go into premature labour and give birth spontaneously, and for some people, doctors will need to help the person give birth, with medication or surgery.

Stillbirth

Pregnancy loss after the 24th week. This is when a baby is born and has already died. 0.5% of births in the UK end in stillbirth. The baby may die during labour or may die in the uterus and the mother will need to give birth to the baby. Labour may start naturally after a baby dies or it may be started with medication, or they may need surgery. Anyone who experiences a stillbirth will be entitled to normal parental rights and benefits, including full maternity, paternity and parental leave and pay.

Whilst processing what has happened, there are also lots of difficult choices that need to be made. Some people may wait for the miscarriage to happen naturally, some may take medication to help progress the miscarriage, and others may have surgery.

Complete or incomplete miscarriage

A pregnancy ends and the person starts to experience symptoms like cramping, spotting, or bleeding. This often requires a visit to the hospital or early pregnancy unit. With an incomplete miscarriage, the miscarriage starts but not all of the pregnancy tissue comes away. This might require multiple visits to the hospital or medical intervention. With a complete miscarriage, the pregnancy tissue detaches from the womb completely and there is usually no need for medical intervention.

Ectopic pregnancy

A person becomes pregnant but the embryo implants in the wrong place outside of the uterus, often in the fallopian tubes. Ectopic pregnancies are non-viable so the pregnancy will need to end and will usually require surgery. If left untreated it can lead to an emergency situation and can be life-threatening. This affects approximately 1% of pregnancies.

Missed miscarriage

The pregnancy stops growing but there are no symptoms, such as bleeding or pain. This is often discovered during a routine ultrasound scan, such as an early pregnancy scan or routine dating scan, at around 8-12 weeks. Usually, the parents are told during the scan, so it can be very difficult and shocking. Whilst dealing with the emotional toll, they will also need to decide on the medical management options for the missed miscarriage.

It can often be a long process. People may receive the news the pregnancy has come to an end but have not yet fully miscarried. They can be stuck in limbo, managing all the medical care and medical appointments they need, and these can last weeks. Lots of people find they need extended time off for this.

Chemical pregnancy

A pregnancy starts to form but does not continue, usually due to chromosomal defects, and the individual experiences bleeding after a positive pregnancy test, usually before 5 weeks. A pregnancy is confirmed with a home pregnancy test, but the test becomes negative and ends early on. This is still considered a miscarriage but is sometimes also referred to as a chemical pregnancy, which can be quite upsetting for some people.

Molar pregnancy

The pregnancy does not form properly because there is too much or too little genetic material. From the point of conception, a molar pregnancy is non-viable so will not go forward. It usually has to be removed surgically. It is often picked up during a routine ultrasound scan at around 8-14 weeks. It often requires quite extensive treatment and specialist medical intervention which can follow on for up to a year afterwards.

Recurring miscarriage

Recurrent miscarriage is when someone suffers from two or more consecutive miscarriages. 1% of women are affected by recurrent miscarriage. Miscarriages can be very traumatic, and multiple miscarriages can take a big emotional toll on a person or couple. Lots of people experience grief, anxiety, and hopelessness.

The physical and emotional impact that pregnancy loss can have on an individual

Pregnancy loss is a very personal journey for each and every individual. It does not matter how long a person has been pregnant, they will often feel a real connection with the pregnancy inside of them. The partners of someone who experiences pregnancy loss will feel an emotional impact too, but this can sometimes be difficult to express as they are not the ones physically going through it.

There is no right way to feel during this distressing time and people will express their emotions in different ways, sometimes appearing a lot more reserved, angry, or anxious than usual. Others may find difficulty in other aspects of their life, for example, finding it hard to make decisions. They would have had to make lots of very difficult decisions in a short amount of time, leading to decision fatigue.

Grief is one of the most common feelings after a loss, both for the loss itself and also grief for the future they had envisioned. Many people also experience deep sadness alongside grief. Lots of people feel confused about why this is happening and about grieving someone they’ve never met. Others might feel frightened about the current situation, as well as wondering if it will ever happen again. Some people experience anger about why this has happened to them, whilst others become very numb and don’t know what to feel. Guilt is a common feeling after a miscarriage. People might think it’s their fault or wonder what they did wrong to lead to pregnancy complications. Some people may also feel like they’ve failed somehow. These are usually irrational feelings but can still deeply affect someone. If you’ve experienced pregnancy loss, it’s important to know it was not your fault.

Sometimes miscarriage and baby loss can lead to, or exasperate, problems with mental health, like anxiety or depression. 29% of people who go through pregnancy loss experience symptoms of PTSD.

Along with the emotional impact of a pregnancy loss, individuals will also need to manage the physical changes their body is going through. Some of the common symptoms of miscarriage include cramping or pain in the lower tummy, vaginal bleeding or spotting, and fluid or tissue discharge from the vagina.

In some cases, the pain can be very severe and the bleeding very heavy. Sometimes people experience prolonged vaginal bleeding lasting for several weeks. Some people may also experience other symptoms or side effects including chills, nausea, diarrhoea, confusion or memory loss, and dizziness.

The physical changes to a person's body after a loss can have a large emotional impact on them too. It is a signal to say the pregnancy is no longer there and can serve as a reminder of their loss. Depending on the type of pregnancy loss or miscarriage, the person may need medical or surgical intervention and it can take some time to physically recover.

Unless you have a dedicated pregnancy loss policy, if the loss is within the first 24 weeks of pregnancy, an employee is entitled to take sick leave and any time off taken should be considered a pregnancy-related illness. This will follow your company's regular sickness policy. The employee, whether it’s their partner or the person who physically experienced pregnancy loss, may also be entitled to compassionate leave.

31% of women experience severe reproductive health issues, which can complicate fertility and fertility treatment.

How can I support my employees?

When grieving a pregnancy loss, people will most often need support, understanding, and kindness, not solutions. - Tommy's

Pregnancy loss and miscarriage is a sensitive topic, but you don’t have to have experienced it yourself to support someone. You just need to be honest and ask what you can do to help.

Educate managers

Train and equip managers with the tools to be there for people in a distressing time. This could be specifically related to pregnancy loss, or broader training for managers on loss and grief. Make sure you are also educating managers on the policies you have and how to use them. Give managers practical tools like conversation starters, to know how to open these important conversations.

Educate employees

Firstly, help your employees understand and recognise that pregnancy loss happens, the different types of pregnancy loss, and how it might affect them or their colleagues. As a second step, make sure the policies you have are clearly communicated to all employees, so if someone does need to make use of them, they are aware of how to access the support.

Support groups

When dealing with sensitive topics like pregnancy loss, lots of people find value in support groups. It lets them know they are not alone in experiencing these emotions and connects them to people who have had similar experiences. Consider a dedicated person in HR or another employee representative to help run an employee support group.

Be guided by the person you are supporting. If they don’t want to talk about it, that is the right decision for them at that time. Sometimes the grief can hit someone months or even years later. Allow the person to share their story on their terms when they are ready.

Listen to the individual

One of the most important things you can do as a manager or leader is to listen to the individual to hear how they are affected and what they need. What one person may appreciate, another may find upsetting. Be guided by them in terms of the kinds of support, how often they want to check in, and what they want communicated to the rest of the team.

Follow up

Make sure you are checking in regularly with the individual to make sure they are coping okay, especially after they return to work. Sometimes grief hits us at unexpected times and recovery won’t be linear. Try to be aware of significant dates, such as their baby’s due date, and understand that if they become pregnant again, it will be a difficult time.

Know your company policy

It’s crucial to know your company policy as best as you can so that you can give someone direct and clear advice if they come to you asking for support. If your company has an employee assistance programme available, make sure to clearly outline that so that your employees know it's available. Make sure you know what they are entitled to in terms of time off, and where to go if they need further support. If policies are not actioned properly, there is no use in having them in the first place.

If you're looking for tips on putting a pregnancy loss or baby loss policy in place, check out our step-by-step guide here.

Acknowledge someone has had a loss

You don’t need to go into much detail, but acknowledging someone has had a loss can mean a lot. Remember this applies to partners too. Try something simple like ”I’m very sorry about your loss. We don’t have to talk about it if you don’t want to, but know that I’m here if you need anything.”

Give the person time to process

This may mean taking the load off an individual or delegating some of their tasks for a short period so that they can grieve what is happening whilst phasing their return to work. Don’t expect grief to blow over quickly. Schedule regular check-ins and give the person the opportunity to share or not to share as time goes on.

Don't make assumptions

Don’t assume that everyone will need the same kind of support. It’s best to ask the individual what support they need from you and act accordingly. It's also important to remember that not everyone will feel impacted by a miscarriage. It’s okay if it was a pregnancy loss out of choice or if the individual doesn't feel impacted by this.

Consider the partner

Remember that men and non-birthing partners are affected too. Often men and non-birthing partners will return to work more quickly after a loss and, whilst supporting their partner, might not have had time to process their own grief. Acknowledge what they have been through and let them know it’s okay to request more time or additional support should they need it.

What to say and what not to say

We all have the best intentions when comforting someone who has experienced a loss, but sometimes if you don’t know what to say and want to fill a gap, comments can come across as insensitive or not thought through. You don’t know the journey someone has been on to get to this point, so be mindful of what you are saying.

Acknowledge someone has gone through a loss and offer your sympathy

“I’m very sorry for your loss.”

“Whatever you are feeling is valid.”

“Grief has no timeline, it’s okay to take your time.”

“How are you feeling today? I’m here if you need anything.”

”You did nothing wrong.”

Try not to be dismissive, comments like this can be very disheartening

“Don’t worry you can have another.”

“At least you already have children.”

“It wasn’t meant to be.”

“Everything happens for a reason.”

“You are young, and you can try again.”

The dos and don'ts

Normalising the conversation around a very sensitive topic can be difficult. Creating a safe space for emotional conversations to take place is an important first step.

Some things to avoid

Don’t make assumptions about someone’s situation. Everyone will feel and cope differently with loss so try not to compare their experience to another person’s.

Try to avoid telling people what to do or what to feel grateful for, and avoid trying to ‘cheer them up’, unless you've been asked to do so.

Don’t avoid your colleague or employee for fear of saying the wrong thing. This can be very painful and isolating for those experiencing grief.

Avoid making ‘Lunch and Learn’ or awareness events on miscarriage mandatory. While it’s important to educate everyone on the topic, you don’t know what someone has been through in the past and what might be too difficult for them to revisit at this time.

Some things that might help

Educate yourself as the more you know, the better understanding you’ll have about what your team and colleagues might be experiencing.

Signpost to resources that can help someone in a distressing situation if you’re not the right person for that.

Be mindful of baby-related announcements in the workplace and other events that might cause emotional distress.

Be considerate of a colleague whose partner has suffered a miscarriage.

Remember to use a trigger warning when discussing pregnancy loss in communications with your teams.

The experience of pregnancy loss is sadly something so many people will go through. The best way that you can help bereaved parents in this incredibly difficult and distressing time, is to offer them a supportive environment, a compassionate workplace, and to be a supportive manager for them. By learning, setting up a pregnancy loss policy and bereavement policies, and keeping communication open, you can make sure everyone feels valued, and is getting the support they need.

If you're looking to put pregnancy loss support in place at your company, don't hesitate to reach out to us. We're always here to help 💜