People manager guide: Supporting employees through pregnancy loss

Pregnancy and baby loss can be a very difficult time and can have a major impact on someone’s health and wellbeing.  Everyone is different, and therefore will have different needs after pregnancy and baby loss. Their needs might be practical, such as adjustments or time off, or they may need more general wellbeing or emotional support. 

Managers therefore need to take a flexible and open-minded approach. There is no one single way to support an employee who has experienced a loss of this kind. Demonstrating an open, respectful, kind and empathetic approach will help the employee to talk to you openly about their situation and their unique needs.

Related manager behaviour 

The key behavioural areas which will assist you in supporting people are:

Building and sustaining relationships, including showing empathy, concern and consideration for all employees, taking an interest in them as individuals and offering opportunities for people to speak to you one-to-one.

Providing knowledge, clarity and guidance, including giving advice and guidance if an employee needs it – for example, around the organisation’s policies and support to help them cope with their loss and its impact on work, including adjustments that can be made.

Being open, fair and consistent, which will help you bring respect and openness, consistency, kindness and fairness to managing both the person who has experienced the loss and the rest of the team, even when you are under pressure yourself.

Exercises 1, 2, 4 and 5 offer advice on how to develop these behaviours.

This guide provides advice on how to manage and support employees who have experienced pregnancy or baby loss. How you respond as a manager will make a big difference to how effectively your team member will be able to fulfil their role and how supported they feel.

Pregnancy and baby loss is often a hidden issue within the workplace. People may be reluctant to tell their manager or colleagues that they are trying for a baby for fear of being overlooked for career opportunities or being seen as not committed at work.

Offering compassionate support can have a significant impact, helping someone to balance work demands with recovery and the grief of loss. If employees feel supported and can access helpful adjustments at work, resources and/or flexibility, they are more likely to feel able to carry on working to the best of their ability. Conversely, having to negotiate appeal for time off and pay can add to someone’s emotional distress. This can result in them needing to take a longer period off work or even leaving the organisation.

Remember, it’s not just the mother or birth parent who may require support; their partner’s feelings often get forgotten, and they are very likely to be grieving too.

Sadly, it’s estimated that one in four pregnancies in the UK end in loss during pregnancy or birth. This includes around 250,000 miscarriages every year in the UK and around 11,000 emergency admissions for ectopic pregnancies. These numbers are estimates as there is no formal, centralised record of miscarriages in the UK.

We use the term ‘pregnancy or baby loss’ to refer to many different types of loss.

A miscarriage is the loss of a baby during the first 24 weeks. Further definitions include an early miscarriage (before 12 weeks) and late miscarriage (after the first 12 weeks of pregnancy, but before 24 weeks). An ectopic pregnancy happens when a fertilised egg attaches itself somewhere outside the uterus. Although very rare, another kind of pregnancy loss is molar pregnancy, when a foetus doesn’t form properly in the womb. Some people also experience termination for medical reasons.

A stillbirth is when a baby dies before or during labour after 24 completed weeks of pregnancy.

There were 1,719 neonatal deaths in England and Wales in 2020, which is when a baby dies within 28 days after they are born.

Some people may have the distressing experience of more than one pregnancy or baby loss, including recurrent miscarriage. In the UK recurrent miscarriage means having three or more miscarriages in a row, affecting around one in every hundred couples trying for a baby.

Sources: Tommy’s and Miscarriage Association.

Make sure you understand your organisation’s framework for managing and supporting employees with experience of pregnancy or baby loss. This includes:

• health and people management policies
• procedures for making workplace adjustments and managing sickness absence/return to work
• specialist support such as occupational health, an employee assistance programme and counselling services, if available.

Related manager behaviour 

This relates closely to the behaviour area Providing knowledge, clarity and guidance.

Look at Exercise 4 for advice on how to develop this area.

Pregnancy and baby loss covers a huge range of experiences, but it’s important to remember that, no matter when a pregnancy or baby is lost, it can be devastating for both parents. Everyone’s experience of grief will be personal to them, and so appreciating individual needs and responding in a sensitive and flexible way is key. Unfortunately, one employee may also experience different types of loss or multiple losses, and the support someone needs may change over time. The key point is to not assume what support people will want and be guided by the individual.

Organisations should offer support to anyone experiencing pregnancy or baby loss, including adoptive parents, foster parents and surrogates. It’s important to not assume someone’s personal situation or family make-up.

Access the CIPD’s resources on

Compassionate bereavement support and Supporting mental health at work .

Related manager behaviour 

It’s important when supporting someone who has experienced pregnancy or baby loss to take a flexible, individualised and compassionate approach. This relates closely to the behavioural area Building and sustaining relationships. Exercise 5 offers advice on how to develop these behaviours.

Even if they are a good and empathetic manager, the language around loss can be very specific and good intentions can land poorly without specific guidance and understanding of the situation.

Rosie Leverton, Head of Corporate Partnerships, Tommy’s

It can be difficult to know what to say to someone who has experienced pregnancy or baby loss. Some people worry about saying the wrong thing and so say nothing at all, which could feel very isolating for someone.

As soon as you are aware that someone you manage has lost a pregnancy or baby, it’s important you acknowledge it. They may or may not want to talk about the situation in detail, but acknowledging that it has happened is very important. Saying ‘I’m very sorry for your loss’ and asking open questions such as ‘how are you?’ will help them feel they can talk to you about their situation if they need to or want to.

Developing your capacity to build and sustain relationships, particularly around showing concern for people and interacting with them in a friendly way, can help with this.

Related manager behaviour 

This relates closely to the behaviour area Building and sustaining relationships. Look at Exercise 5 for advice on how to develop this area

Comments that could be helpful:

• ‘I’m very sorry that you have lost your baby.’
• ‘This must be really difficult for you.’
• ‘I don’t know what to say.’

Things not to say:

• ‘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 to hear. Also refrain from offering advice; even if this is meant to be helpful it may be unwelcome. 

Source: Miscarriage Association.

When appropriate, it’s important to have a sensitive and supportive discussion about the employee’s needs. You might find the conversation checklist below helpful.

Conversation checklist 

• Avoid interruptions: switch off phones; ensure colleagues can’t walk in and interrupt.
• Be caring and show concern for the employee’s wellbeing.
• Ask simple, open questions, such as, ‘How are you doing at the moment?’
• Ask, ‘What support do you think might help?’
• Avoid judgemental or patronising responses.
• Speak calmly.
• Maintain good eye contact.
• Listen actively and carefully.
• Encourage the employee to talk.
• Be prepared for some silences and be patient.
• Focus on the person, not the problem.
• Avoid making assumptions or being prescriptive – the individual is the best person to know what support, if any, may help them.
• Thank the employee for talking to you about their loss.
• Follow up in writing, especially agreed actions or support.

This checklist has been adapted from the CIPD and Mind’s people manager’s guide to mental health.

Confidentiality

Assure the individual that any conversation is confidential, but it’s also important to discuss what information, if any, they would like communicated to work colleagues about their loss.

Related manager behaviour 

This relates closely to the behaviour area Being open, fair and consistent. Look at Exercise 1 for advice on how to develop this area.

It’s possible that someone could miscarry at work or experience serious pregnancy related symptoms that concern them.

If anyone is concerned about their pregnancy, if they feel something is wrong or they are worried about their baby, they should be encouraged to get medical help. The NHS has advice on the symptoms of pregnancy and baby loss and when/how to seek urgent medical help. 

If it’s a medical emergency, the individual will need to go to hospital. You should offer practical support, such as asking the employee if you can contact their partner or another family member or friend, as well as calling an ambulance or taxi. Depending on the circumstances, the individual is likely to feel very distressed and will need emotional support.

If an employee finds out that their partner is losing a pregnancy/baby, or is experiencing worrying health symptoms related to pregnancy, they will want to leave work to be with them. Hopefully, the organisation should have provision for this in their policy or guidance. If in doubt, contact your HR team or manager.

You will need to have awareness and sensitivity around certain events that could be upsetting, such as Mother’s Day or Father’s Day, pregnancy announcements and baby showers. Make sure you actively support team members who may be living through very contrasting personal situations. This doesn’t mean that an employee who is expecting a child can’t share their experience and anticipation, but you and other colleagues need to show compassion and sensitivity if you know another team member has not been so fortunate.

For example, you could anticipate certain events that could be upsetting for someone who has lost a pregnancy or baby, and have a conversation about how best to support them. You could develop an agreement around pre-warning, allowing the individual to excuse themselves or be busy elsewhere at points that could be particularly upsetting.

Absence management policies and procedures should be flexible and take into account the potentially far-reaching impacts of experiencing this kind of loss, for both partners.

Very often, an employee who experiences pregnancy or baby loss during the earlier stages of pregnancy may not have told you they were expecting. Therefore, informing you of their loss could be particularly challenging for them.

Experiencing pregnancy or baby loss at any stage can affect people’s health and wellbeing in a number of different ways, including their mental and physical health. For the mother or birth parent, there may be ongoing physical health issues after a pregnancy loss that require future time off for medical appointments or treatment. It is important to take a flexible approach to these needs. These absences should be excluded from any absence management policy monitoring process if you have one.

Being offered time away from work to deal with the effects of their loss and grief can help individuals to deal with these impacts.

Many employees will need to take time off work to deal with such an emotionally upsetting, and often traumatic, event. One employee’s experience of this kind of loss can be entirely different from another’s. Therefore, you should be responsive to people’s unique needs where they or a partner have experienced pregnancy or baby loss and offer leave according to your organisation’s policy. This could be specific paid/unpaid leave for pregnancy/baby loss and/or compassionate or other special leave.

If someone is absent due to pregnancy or baby loss, have a sensitive conversation with them about how best to keep in touch during their absence. This should be approached with empathy and without the employee feeling any pressure to return to work before they are ready.

Employees are more likely to return to work safely and productively following a period of sickness absence if they are well supported during their absence and on their return. How you manage these situations will make a difference to whether the individual makes an effective return to work.

You should plan and carry out a return-to-work meeting to help ease the employee back into work when ready. Although these sorts of meetings are often undertaken only when someone has been away from work due to ill-health, it can be beneficial in these circumstances, whatever form of leave was officially taken. An effective return-to-work meeting can build trust with the employee and support their smooth return to work. This should be planned before someone returns so that they know what to expect and have the opportunity to think about any issues they would like to raise, such as potential adjustments.

It’s best to advise someone in advance what to expect at a return-to-work meeting and make it clear that this is a supportive process to help them make a successful and lasting return to work, as well as address any ongoing health and wellbeing needs. It’s important to remember that an employee returning after a loss like this could feel overwhelmed and self-conscious, particularly if they have been absent for a while. Many people could benefit by having a phased return or working from home as well as possible adjustments to their workload and/or duties.

The CIPD guide on managing a return to work after long-term absence sets out some guiding principles to follow when navigating the key steps to managing an effective return to work:

1. maintaining communication while absent
2. preparing for a return to work
3. supporting the employee and manager during the immediate return
4. supporting the employee and manager on an ongoing basis on return.

Employees are more likely to return to work safely and productively if they are well supported during their absence and on their return, so how you manage these situations will make a difference to whether the individual returns effectively and sustainably to work.

Related manager behaviour

The behavioural areas that will help you manage absence effectively to support the individual and help them to achieve a safe and productive return to work are:

Building and sustaining relationships: see Exercise 5 

Being open, fair and consistent: see Exercise 1 and Exercise 2

Providing knowledge, clarity and guidance: see Exercise 4 

Some employees may require adjustments to their job role, work environment or work schedule following their experience of pregnancy or baby loss.

It’s important to talk to the employee as they will be in the best position to know what adjustments or support can help. These will depend on many factors, including the nature of the employee’s job and their unique needs. One employee’s experience will be very different compared with another’s and so there is no uniform set of adjustments that an organisation can put in place. As the symptoms of loss and grief can be unpredictable and change over time, different work adjustments and/or support may be needed at different times.

It’s important to consider the ‘softer’ range of adjustments that could make a difference, such as allowing for more frequent breaks during someone’s work schedule, or access to a quiet space.

Flexible support and/or adjustments for employees can include a combination of approaches, for example:

• ensuring they are not working excessively long hours
• permission to excuse themselves from triggering situations
• temporary/informal changes to their work schedule (for example, short breaks, leave for appointments)
• flexible working arrangement (for example, working from home, reduced hours or extended leave)
• changes to an employee’s role or responsibilities (for example, a reduced workload or temporary change in duties)
• changes to the work environment (for example, relocation of desk to a quiet space).

Related manager behaviour

Providing knowledge, clarity and guidance: Exercise 4 offers advice on how to develop this behaviour.

Return to work is often seen as a one-off event, but many people who have experienced pregnancy or baby loss will need ongoing support:

• Have regular conversations: Have regular conversations with employees about how they are coping and what support they might need. As part of those conversations, discuss how any support or adjustments are helping the employee.
• Take health and wellbeing into account when considering performance: Approach performance conversations supportively and positively. Take any health- and/or wellbeing related issues fully into account where there is underperformance on the part of an individual. Identify any extra support the person may benefit from, such as more training or supervision.
• Consider the impact on other members of the team: Make sure that other team members are being supported if they have additional work because of sick leave, a phased return or changes in duties.

Depending on the individual circumstances, there may also be ongoing medical appointments.

Relevant manager behaviour

This relates closely to the behaviour area Being open, fair and consistent. Look at Exercise 1 for advice on how to develop this area.

It’s important to understand what your role is for supporting people who have experienced pregnancy or baby loss. This also means maintaining clear boundaries. For example, you are there to support people and to put in place any workplace adjustments they may need, but you are not a medical expert or counsellor.

Supporting someone who is experiencing a difficult situation like loss can be challenging. It is worth considering what specific support is available within your organisation that you can draw upon if needed, like expert advice from HR or from occupational health if available. You might also want to explore how to develop your capability to remain calm under pressure and your capacity for self-compassion and self-care.

It could be that you feel unable to support a team member who has experienced pregnancy or baby loss. If this is the case, talk to HR or your own manager about the situation. Your wellbeing is just as important as the employee’s, and there should be other colleagues such as HR who will be able to step in and provide support.

Make sure you signpost team members to helpful services and resources, if your organisation offers them, such as occupational health and employee assistance programmes, or point to external sources of support. Below are some useful UK resources.

Miscarriage Association : provides free support and information to anyone affected by miscarriage, ectopic or molar pregnancy, via its helpline, live chat and email services and through in-person and online support groups. 

Tommy’s : the UK’s largest pregnancy and baby charity, funding research and supporting parents through pregnancy complications, miscarriage, stillbirth and premature birth. Tommy’s offers pregnancy and baby loss e-learning modules for people managers and HR toolkits to build support for employees through any pregnancy journey, including those that end in loss. Visit Tommy’s [EXT]pregnancy and parenting at work hub  for more information.

Mind : Mind provides advice and support to empower anyone experiencing a mental health problem. They campaign to improve services, raise awareness and promote understanding.

National Bereavement Care Pathway (NBCP) for pregnancy and baby loss : led by Sands, the NBCP seeks to improve the quality and consistency of bereavement care received by parents from the NHS after pregnancy or baby loss

NHS : Miscarriage. 

PANDAS HR toolkit : for businesses and organisations to support employees who may be affected by perinatal mental health conditions.

Petals : Petals is a baby loss counselling charity.

Sands : Sands is a stillbirth and neonatal death charity in the UK. Sands exists to reduce the number of babies dying and to ensure that anyone affected by the death of a baby receives the best possible care and support for as long as they need it. 

The Lullaby Trust : The Lullaby Trust raises awareness of sudden infant death syndrome (SIDS), provides expert advice on safer sleep for babies, and offers emotional support for bereaved families.