Pregnancy or baby loss: Guide for people professionals on providing workplace support

"I just felt that no one really understood how much I was suffering mentally and physically and I felt a pressure to return to work."

– Respondent to CIPD employee survey 

Pregnancy and baby loss is typically a ‘hidden’ issue in the workplace. Therefore, the importance and benefits of a supportive work environment haven’t been widely discussed.

Some employers may see pregnancy and baby loss as personal issues that have nothing to do with the workplace. Some employees may also feel this way and choose not to share their experience, which should be respected. However, having a framework of support in place gives people the choice of accessing support if they want to.

Pregnancy and baby loss is unfortunately more common than many people think. It’s therefore highly likely that a sizeable number of your employees will have experienced such a loss while in employment.

Pregnancy and baby loss is an important workplace wellbeing issue and needs to be recognised as such. Such loss can be emotionally draining and impact people’s physical and mental health. Very often, employees will be returning to work while still grieving, which can be a daunting and isolating experience. Support and understanding at work can make a significant difference to how someone copes. Conversely, having to negotiate and appeal for time off and pay can add to someone’s emotional distress.

There are various reasons why pregnancy and baby loss tend to be hidden issues. As well as the societal taboo around discussing such loss, there’s a persistent high level of pregnancy and maternity discrimination at work, which influences how comfortable people feel sharing their experience. 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. Our employee survey found that of the people who said they hadn’t told their employer about their pregnancy or baby loss, 19% said this was because they were concerned about the possible impact on their career. As well as preventing any discrimination due to personal and family circumstances, it’s in employers’ interests to create inclusive and supportive working cultures that attract and retain valuable talent.

The CIPD’s aim in producing this guidance is to be as inclusive as possible in our definition of pregnancy or baby loss. We use the term ‘pregnancy or baby loss’ to refer to many different types of loss, including miscarriage (the loss of a baby during the first 24 weeks), stillbirth (the loss of a baby after 24 weeks), termination for any reason, ectopic pregnancy, molar pregnancy, chemical pregnancy, embryo transfer loss, and neonatal loss.1 We refer to pregnancy and baby loss to try and be as inclusive as possible of many different experiences, but we appreciate that individuals may prefer a specific term or phrase and that should be respected.

We believe any support provided should be underpinned by the principles of compassion, empathy and inclusivity. Organisations should offer support to anyone experiencing pregnancy or baby loss, including adoptive parents, foster parents, intended parents and surrogates.

It’s important to not assume someone’s personal situation or family make-up. Furthermore, policies should be inclusive of partners; their feelings often get forgotten, and they are likely to be grieving too.

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 and their wellbeing needs will be personal to them, and so appreciating individual needs and responding in a sensitive and flexible way is key. Unfortunately, one individual 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.

We know employers come in all shapes and sizes, with different working practices and environments. This guide is designed to support any employer wanting to develop a supportive approach. 

For employers, there is a clear rationale for action. Making employer support available sends an important message that the organisation values employees and their health and wellbeing, and recognises the difficulties they are going through.

Just like with any other wellbeing issue, effective support can help people remain in work and perform well. In our employee survey, on the whole, respondents who felt very or quite supported by their organisation/ manager/colleagues report a positive impact on each of the outcomes from the support they received. The strongest impact from all three sources of support was on people’s mental wellbeing.

In contrast, around a quarter (24%) of employees considered leaving their job because of their experience at work in relation to pregnancy or baby loss. In addition to the loss of talent, skills and experience, employees exiting the workforce can significantly add to HR professionals’ workload and organisational cost in terms of recruitment and training. Furthermore, the long-term absence or exit of one team member can have a significant knock-on effect for other team members, affecting their workload, motivation, engagement and wellbeing.

Offering compassionate support can have a significant impact, helping someone to balance work demands with recovery and the grief of pregnancy or baby loss. If employees feel supported and can access helpful adjustments at work, resources and/or flexibility, they are more likely to feel able to work to the best of their ability.

Developing an effective framework of support can help ensure employees who have experienced pregnancy or baby loss are managed fairly. It demonstrates that the organisation cares about its people as well as helping it to retain valuable skills and talent.

Promoting wellbeing and inclusion in the workplace is an important aspect of good people management – it’s about valuing and supporting everyone as an individual. Those experiencing pregnancy or baby loss should feel supported and included in their working environments and feel able to seek help and/or adjustments where needed. This kind of culture can have far-reaching benefits in supporting employees through many different and challenging life events.

"Understanding and patience is so important. In particular, understanding that the pain from loss can last for a long time and anniversaries are important to support too. Even when there is early pregnancy loss."

CIPD employee survey respondent 

There are still taboos in society about both bereavement and pregnancy/baby loss. For example, our research shows that only around a quarter (24%) of senior decision-makers reported that their organisation encourages an open and supportive climate where employees can talk about issues like pregnancy loss or fertility treatment to a great extent (see Figure 1 in the CIPD report, Workplace Support for Employees Experiencing Pregnancy or Baby Loss). The resulting silence and stigma about these challenging life events inevitably spills over into the workplace.

Employers can play an important role in breaking down these taboos. Employees working in supportive and compassionate environments are more likely to feel able to discuss a wellbeing issue or a traumatic life event, to ask for help when needed, and to make an effective return to work. When managers manage well and build trust-based relationships with their team, they help to create an environment that is open, respectful and kind, in which people feel ‘psychologically safe’. This means individuals feel able to speak up about a health or personal issue without fear of criticism or discrimination, and in the knowledge they will be listened to and receive support and understanding.

Organisations should aim to build a culture of psychological safety, where good working conditions and supportive conversations are prioritised and mental health and physical health are given equal standing. Too often, pregnancy and baby loss is not part of the narrative in organisations, and ensuring that it is explicit in policies, training and guidance will help to guide people how to behave as well as letting people know the support that is available.

Employers should communicate a compassionate and inclusive attitude towards pregnancy and baby loss, so that all employees know that their employer is supportive. Developing a policy which recognises pregnancy and baby loss as a health and wellbeing issue is a good starting point, but organisations should also consider how they communicate with employees. Think carefully about tone to ensure that it’s compassionate and supportive, and the language is appropriate and inclusive.

Developing awareness and understanding among managers and colleagues can help to build a compassionate and supportive culture. Information and education should be included as part of any relevant training for managers. There should be clear signposting to internal and external sources of support.

Some employees might not want to approach their manager, so other options should be available. This may be through HR, an employee resource group or a wellbeing specialist, if you have one. 

Many employers have employee assistance programmes (EAP) that can be a confidential source of help and advice. Other routes of support can also help if a manager feels unable to support their team members on this issue, and there should be support in place for manager themselves.

See the CIPD's guidance on compassionate bereavement support for more practical information on how bereavement and grief can affect people and how to build a supportive and open culture. 

"Baby loss is an incredibly difficult time. I didn’t think it would affect me as much as it did. Three months later and I’m still having low days. My manager hasn’t been very helpful. Even though he is a man, it’s no excuse. He has already begun to treat me differently. For example, we have a work trip in six months and he said that he didn’t expect me to attend as I might be pregnant again. I found this very triggering. My colleagues have been wonderful, though, very understanding and supportive."

Respondent to CIPD employee survey

It’s vital that organisations integrate their support for people experiencing pregnancy or baby loss within their framework for creating a mentally healthy workplace. Creating an open culture of support will help ensure that people experiencing pregnancy or baby loss will feel more comfortable raising any issues and asking their manager for support. This should flow from an organisation’s culture to encourage openness and inclusion around mental health issues where people feel able to talk about how they are feeling and seek support if they need it.

The CIPD/Mind people manager’s guide to mental health provides practical advice on how to develop a mentally healthy workplace.

Partners will often be providing practical and emotional support as well as grieving themselves. It’s likely that partners will return to work sooner after a loss and suppress their grief, often at the expense of their own wellbeing. They are also less likely to proactively seek support. The workplace can play an important role in giving partners time and space to grieve that they may not otherwise have, as well as potentially signposting to specific support they may not otherwise find. It’s important to consider this perspective and the needs of partners in your promotion of available support, as otherwise employees might see the policy as only relevant to employees physically experiencing the loss.

"It was an incredibly difficult time with mental health for my partner and I. I prefer that it stayed private due to the level of support/stigma that I was given from the outside world. There is plenty of support for women but not men."

Respondent to CIPD employee survey

Organisations should be sensitive to any cultural or other diversity considerations or differences. For example, individuals from certain cultures or backgrounds could feel less comfortable talking about bereavement and loss. It could also be the case that someone who talks about their experience of pregnancy or baby loss may not have previously shared a same-sex relationship.

It’s important not to make assumptions and to take the lead from the individual in terms of what they would like to share and what support they might need. No one should feel pressured to discuss their loss if they don’t want to. However, they should still be able to access support. The onus should be on the organisation to create an open and supportive culture where people can talk and seek support if they want to.

There needs to be awareness and sensitivity around certain events that could be upsetting, such as Mother’s Day or Father’s Day, pregnancy announcements and baby showers. Organisations should ensure that managers actively support employees who may be living through very contrasting personal situations. This doesn’t mean that employees expecting a child can’t share their experience and anticipation, but managers and colleagues need to show compassion and sensitivity if they know another colleague has not been so fortunate. For example, supportive managers might have conversations about how best to support someone, including having an agreement around pre-warning, allowing the individual to excuse themselves or be busy elsewhere at points that could be particularly triggering.

Implementing a policy and/or framework is not a one-off event. It’s important to continue promoting the organisation’s policy and support framework and reinforce compassionate messaging around the topic. Otherwise, it can slip off the agenda and employees won’t know where to turn for support when they need it. Opportunities for awareness-raising include health and wellbeing days and national awareness days, including Baby Loss Awareness Week . Talking about the value of a supportive workplace and signposting to specialist professional sources of support will also raise awareness.

To encourage awareness and empathy, organisations could hold workplace training sessions on how to support employees who have experienced bereavement. Such sessions should highlight the support available. They could also cover helpful language and behaviour tips when supporting a colleague. When arranging training, organisations need to be mindful about the involvement and potential impact on any employees who could have experienced pregnancy or baby loss.

Organisations can also signal their intent to support employees through pregnancy and baby loss through communications and sensitive awareness raising activities. The Miscarriage Association encourages employers to make a formal pregnancy loss pledge which can be communicated to employees as a visible signal of a supportive environment. 

It can be difficult to know what to say to a colleague 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 who has returned to work after a loss. It’s important to be guided by the individual experiencing the loss, and some people may choose not to discuss it. This should be respected, but colleagues can still ask how someone is, showing they care but giving the individual the choice and space in how to respond.

The Miscarriage Association provides useful pointers of what to say to someone after pregnancy or baby loss.

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.

Source: Miscarriage Association

People professionals are ideally placed to develop a proactive framework to support employees affected by pregnancy or baby loss. They have the strategic oversight to understand which policies are relevant or need to be developed, as well as the ability to ensure that effective support is in place.

"Patience and human understanding is important when supporting staff through this experience. The emotional support coupled with paid time off and an adjusted workload from my manager consulting with me were just what I needed. I was treated like a human instead of a robot and there was an understanding that I knew most about how best to manage my health and thus was consulted on what my options are and what is the next best thing to do."

Respondent to CIPD employee survey 

People professionals should also be in a position to:

• develop a policy that outlines the support available and is written in a compassionate and supportive way
• ensure that senior management view pregnancy and baby loss as a legitimate workplace wellbeing issue
• integrate appropriate education and training provision into manager development interventions – a policy is not complete without a plan to embed it and ensuring managers are capable to implement it.

The framework that employers develop will have a direct influence on how compassionate and supportive the climate is and how capable and confident managers feel to support people.

Creating a framework to support employees experiencing pregnancy or baby loss means recognising this is a health and wellbeing, inclusion and diversity, and people management issue. The organisation needs to develop a holistic approach, and align relevant provision across policies and practices in all of these areas to be effective.

The first step is to audit the existing provision to evaluate what support is already available, and where there are gaps. For example, do you have an employee assistance programme (EAP) or access to counselling services, and does your people management approach and training stress the importance of what are often termed the ‘softer’ management skills, including compassion, inclusiveness and empathy?

Developing a dedicated, transparent and readily accessible policy or plan will:

• offer an opportunity to engage with employees on the issue and show the organisation regards pregnancy or baby loss as an important issue
• provide clarity for managers and employees, for example by setting out key responsibilities, entitlements and sources of support
• prompt HR to systematically audit the organisation’s existing provision related to pregnancy or baby loss and think strategically and practically about how to develop the most effective framework
• enable HR to collaborate with its occupational health (OH) service, if it has one, and any EAP partners, to develop an organisational framework that’s informed with specialist input and fully integrated into OH policies and practices
• encourage consistency in how the organisation and individual managers support employees and offer time off and access to adjustments
• establish the framework for evaluating the impact of the organisation’s provision.

A policy covering pregnancy or baby loss should be consistent with the organisation’s wider people management policy provision, and cover key areas, including:

• • statement of principles, including how the organisation is committed to supporting employees experiencing pregnancy or baby loss; how its intention is to be inclusive in recognising that partners can also be significantly affected, and that support should be made available to anyone experiencing baby loss during pregnancy, including adoptive parents, foster parents, intended parents and surrogates, and covering all types of pregnancy or baby loss
• explanation of pregnancy and baby loss, to promote a basic understanding among all employees about the prevalence of pregnancy and baby loss, the types of loss, and potential impacts on health and wellbeing
• key responsibilities, setting out which employee groups have responsibility for implementing specific aspects of the policy, including senior managers, managers, HR, employees and OH
• pay and time off, with detail on the provision available for people (including partners), such as number of days’ paid leave, time off for appointments
• links to internal and external sources of support, such as OH, EAP, counselling services, any internal employee networks and external support groups and specialist charities, as well as relevant policies such as flexible workingactivities and initiatives to be implemented under the policy, such as manager training.

There needs to be sensitive alignment between policies on pregnancy and baby loss and pregnancy/maternity leave. The organisation’s maternity/paternity framework also needs to consider any implications following someone’s experience of pregnancy or baby loss. For example, thought should be given to employees who disclose pregnancy after a previous loss (or recurrent loss) and who might need more support through any subsequent maternity journey. Some people who have experienced a previous loss may be uncomfortable early on discussing maternity leave and other arrangements related to their pregnancy. It’s important that organisations have this nuanced and sensitive approach to supporting an individual’s unique needs.

Not every organisation will decide that having a standalone policy is appropriate for its culture or people management framework. It may prefer to incorporate provision across its existing policies, where relevant, and develop dedicated manager guidance and training to bring this policy provision to life. The positioning of the policy and its framing needs careful consideration to ensure that it is perceived as supportive and compassionate.

Our research shows a quarter (25%) of employers who cover pregnancy loss/miscarriage within a wider policy include it in their wider health and wellbeing policy and 17% include it in their parental bereavement policy. However, the main approach (41% of employers) is to include provision in their policy on maternity/paternity/shared parental leave. This is not the ideal place to have information about employer support for employees experiencing pregnancy or baby loss and could feel insensitive. 

It’s important to listen to employees themselves about how the most effective provision can be developed and what it should look like. The organisation should tap into any employee networks and/or volunteers, such as those championing health and wellbeing or equality, inclusion and diversity issues.

Some employee volunteers or networks may have lived experience of pregnancy or baby loss, and their feedback, if they are comfortable to provide it, will be invaluable in terms of helping to inform areas such as:

• the kind of policy provision and support that will be most helpful
• helpful external sources of support and networks
• appropriate language and tone
• how best to build awareness of the topic and the support available.

If the organisation involves employees with lived experience, this should be approached with the utmost sensitivity, and appropriate wellbeing support should be made available throughout the process. People should not feel under any pressure to contribute at any stage.

Remember, however, that these groups may only represent a small part of a larger community affected by pregnancy or baby loss. First, not all employees affected by pregnancy or baby loss will necessarily join an employee network and so it won’t capture all employees’ experiences and views. Second, partners may not be equally represented on employee networks or resource groups.

Everyone will experience loss differently, have different needs and therefore find different forms of support useful. It’s essential to treat everyone as an individual and not assume what they may need. Instead, be guided by them through a sensitive and supportive conversation.

Although the support someone requires will be individual to them, our research findings suggest that paid leave and manager support are two particular areas that employers may want to consider investing in.

In any conversation, HR professionals and/or managers should be proactive and tell the employee what support and policies are available, for example the type of leave they could take. This means people don’t need to ask for support at the outset. The next step is to ask, ‘How else can we support you?’ This approach will hopefully set the groundwork for the employee to feel more confident to ask for help that suits their circumstances and needs. It’s also important there’s an ongoing dialogue, as needs will likely change over time and there is no set timetable for dealing with loss and grief.

Ideally, people management and health-related policies and practices should contribute to a compassionate, inclusive and flexible workplace ethos. This is particularly important when drafting and communicating policies on issues as sensitive as pregnancy and baby loss, where employees have experienced such emotionally distressing events.

With this in mind, consider the following about your policies and practices:

• Are they written in a way that can be understood by everyone, using plain English and a tone and language that’s compassionate and demonstrates care? All too often policies use formal, legalistic language that employees don’t understand or makes them feel like a number in a system rather than a person the organisation values and wants to support.
• Are they fully inclusive? In the case of pregnancy or baby loss, is it clear that the policy covers every type of loss, including miscarriage, termination for any reason, ectopic pregnancy, molar pregnancy, chemical pregnancy, embryo transfer loss, still birth and neonatal loss? Is the policy inclusive of anyone experiencing pregnancy or baby loss, including adoptive parents, foster parents, intended parents and surrogates? Policies should be inclusive of partners, who should be able to access an equal level of support.
• Do they make clear that time off and/or work adjustments are available and how to access this provision? Ensure there’s clarity on the type of leave on offer and that it’s okay to take it. It’s good practice for organisations to provide work adjustments to support any individual who needs them.
• Are they flexible? Adopting a flexible and responsive approach to supporting health and managing absence should be a core element of an effective framework. For example, the use of trigger systems and disciplinary processes around absence can place additional pressures on employees experiencing challenging wellbeing issues like pregnancy or baby loss. Organisations should avoid having a rigid approach to absence management and treat absences related to pregnancy and baby loss outside any trigger system to ensure employees aren’t unfairly penalised for taking any genuine sickness absence.
• Do they allow for an individualised approach to be effectively implemented? For example, are managers capable and confident to make decisions and take action where it is in the best interests of the employee, the team and the organisation, without seeking additional sign-off from senior management or HR?
• Are they consistent across the organisation? People management practices should reflect an individualised approach to supporting health and wellbeing. But to promote fairness it’s important that there is consistency in how these are implemented by managers on a day-to-day basis across the organisation.
• Do they tell people what needs to be done and how to do it? Many policies will outline what needs to be done in practice, but few provide information about how this can be done to achieve the best outcome. For example, guidance on when, where, how to prepare and what to ask would help managers and employees hold better return-to-work conversations.
• Do they equip managers with the knowledge, skills, abilities and confidence to support employees who have experienced pregnancy or baby loss? Managers have day to-day responsibility for managing people and supporting their wellbeing, and so they can be the first port of call for employees who have experienced pregnancy or baby loss. They need to have the capability and confidence to implement the organisation’s policies, hold sensitive discussions and signpost to expert sources of help where needed.

Updating your organisation’s policies and practices to incorporate these considerations will hopefully give employees who have experienced pregnancy or baby loss the support they need and demonstrate that they are valued, benefitting both the individual and the organisation.