Trigger warning: includes words used to describe the surgical management of miscarriage.
Society celebrates pregnant women and babies. New lives are embraced. Cards, flowers and congratulations are sent. Consider royal baby Archie…
But every year one in four UK pregnancies – about 250,000 – end in miscarriage, which is the loss of a pregnancy in the first 24 weeks. When this happens, society is silent. The joy is replaced with ‘it’s personal’ and ‘not nice to talk about’, leaving women to face the shock, grief and loss on their own. Miscarriage can be an unhappy, frightening and lonely experience.
Some of your employees are likely to have gone through miscarriage, or they will.
Several employers have asked Confidence to Return to support women after miscarriage, so I know the negative impact it can have. Professional women find themselves trying to focus on work while dealing with emotions they are afraid to express.
It is common for women to feel:
• sad and tearful – perhaps suddenly bursting into tears without any obvious trigger
• shocked and confused – especially if there were no signs that anything was wrong
• numb – she doesn’t seem to have any feelings at all
• angry – at fate, at hospital staff, or at others’ pregnancy announcements
• jealous – especially when seeing other pregnant women and babies
• guilty – perhaps wondering if she might have caused the miscarriage. (This is very unlikely. See Miscarriage Association leaflet Why Me? )
• empty – a physical sense of loss
• lonely – especially if others don’t understand
• panicky and out of control – feeling unable to cope with everyday life.
All these powerful feelings can affect work performance, especially if they are ongoing. In my view, women who suffer miscarriage should be offered the same support as employees who lose a child at full term or are affected by adult death.
Case study: exclusion from the ‘mother club’
I recently supported an employee who’d just had her second miscarriage in a year.
At the time of her first miscarriage, several colleagues announced their pregnancies. Now, after the second miscarriage, she had the heartbreak of seeing them go on maternity leave and hearing all about their beautiful new babies.
She felt under pressure and disassociated from her peers and friends because she was not part of the ‘mother club’.
She was afraid of reaching out for support, worried that they wouldn’t understand or have time to help her. And she didn't want to ‘ruin’ the celebrations of their new arrivals by mentioning her miscarriages.
This all built up into a mental health issue for this employee, and she began to take time off work for anxiety.
There’s a medical angle to her trauma too.
She had flashbacks of the procedure to remove the remains of her pregnancy from her womb under local anaesthetic. This procedure is called manual vacuum aspiration (MVA) and she found the word and its connotations very distressing, especially when used by doctors who seemed cold hearted.
(Procedures to remove the remains of pregnancy are now known as ‘surgical management of miscarriage’ or SMM, but unfortunately upsetting words such as ‘vacuum’ and ‘evacuation’ are still used.)
She was also distressed to discover that the NHS only investigates when a woman has 3 or more miscarriages in a row, known as recurrent miscarriage. She began to dread the emotional and physical trauma of another miscarriage, while feeling she would need it before being taken seriously. (Tests do not guarantee a cause will be found).
This has all left an emotional scar. In addition to her double loss, she is frightened about following pregnancies ending in the same way.
We have drawn up a plan of action to help her work through her grief, anxiety and trauma, which includes EMDR Therapy. EMDR – eye movement desensitisation and reprocessing – is a gentle psychological therapy that helps people overcome emotional trauma that is affecting their work life. EMDR offers a different, less invasive approach to talking therapies that could suit your employee better and can offer faster results.
See EMDR Therapy.
No chance of children
Last year I also supported an employee in her 40s who discovered she couldn't have children after going through several miscarriages. Her hopes and dreams of what might have been were gone.
She told me how society didn’t really have much compassion for the loss of her ‘cluster of cells’. To her, it seemed that her grief and loss was minimalised by her friends and family.
How I helped
With both women, I used grief, loss and bereavement support to give them the permission to truly grieve their losses and be able to express the pain they felt.
Gradually I helped them reach acceptance and move forward from the pain of miscarriage and losing what might have been.
Confidence to Return offers a range of bespoke coaching services, including In-Work Preventive Coaching, to support your workforce whatever life throws at them.
Key facts about miscarriage and work
• Miscarriage is the spontaneous loss of a baby any time up to 24 weeks of pregnancy. It is most likely to happen in the first three months, often before a woman has announced she is pregnant.
• With some 250,000 miscarriages – one in four pregnancies – occurring in the UK each year, it is very likely that your employees have been or may be affected.
• The exact cause of most miscarriages is not known, but some factors are known to increase the risk. Research has shown that women under stress from demanding jobs are more likely to miscarry.
• Working full time does not by itself increase the risk of miscarriage; neither does work involving sitting or standing for six hours a day or more, or lifting heavy objects or people.
• After one miscarriage, most women go on to have a healthy pregnancy. However, some suffer repeated miscarriages and a small minority never have a live baby.
(From Miscarriage Association leaflet Miscarriage and the Workplace).
If you have been affected by miscarriage, molar pregnancy or ectopic pregnancy, the Miscarriage Association has the knowledge to help.
The Samaritans: whatever you are going through, a Samaritan will face it with you.