Today should have been a joyous one, with my wife and I expecting our first child at the ripe old age of 41.  As a man, the day feels a somewhat abstract affair.  The vagaries of the pandemic meant that I wasn’t permitted to attend any of the appointments with the midwife.  I wasn’t permitted to attend the appointment at the hospital where our suspected miscarriage was first identified.  To begin with, I wasn’t permitted to attend the follow-up appointment where the loss of our child was confirmed.

The pregnancy was something I could only really relate to via the physical and emotional changes visible in my wife.  That perhaps changed on that second appointment at the hospital, where I was told to wait outside the building until my wife was called in by the nurse, at which point I could join her and we could face the inevitable together.

Except that didn’t seem to percolate down, as initially the security guard at the front door would not let me in because I didn’t have an appointment.  Having managed to convince him there was another “gatekeeper” at the door to the maternity ward (yes, couples suffering from miscarriages are placed in the same waiting room as couples with perfectly healthy children).  She wasn’t keen to admit me to the ward either, and it was perhaps at this point of having to explain numerous times that a few meters away my wife was being told that we had lost our baby that things became so very real.

Dealing with grief

Of course, grief has been an all too common bedfellow for too many of us throughout the past 18 months, but whereas the wall-to-wall coverage of Covid-19 has made it all to evident the risks we face, it always seems to come as a surprise that 20% of pregnancies fail to make it to full term.

Indeed, the topic is such a taboo that Meghan Merkle wrote an op-ed for the New York times barely two months after our own miscarriage that both attempted to lift the lid on just how common this is and also to start a more forthright conversation about it.

If we can generally accept that it’s a topic that society as a whole doesn’t really talk about, then it’s probably realistic to say that it’s something that is spoken about even less in the workplace.  It’s a silence that doesn’t feel right, either from a compassionate sense or indeed a practical one.

I know from personal experience that for some time my mood veered from extremely irritable and snappy to depressed and miserable.  My wife and I both received tremendous support from the Petals charity, but it felt far harder to raise the topic in a professional context.

Professional impact

The pandemic has introduced (or reinforced) the importance of compassionate leadership, so this is perhaps one area that managers need to be more aware of.  Recent research from Tommy’s National Centre for Miscarriage Research, which is a research partnership between Imperial College London, the University of Warwick, the University of Birmingham, and four hospitals from across the UK, found that miscarriages cost the U.K. nearly £500 million per year.

What’s more, this figure is almost certainly a gross underestimate as it only covers direct health costs and lost productivity.  It’s also notable that the analysis focuses exclusively on the impact of miscarriages on women, as though men suffer no consequences from the loss of a child they were presumably looking forward to spending a lifetime with.

The psychological effects are considerable, however, with the risk of suicide quadrupling after a miscarriage, the chances of depression doubling, with a similar spike in the chances of suffering from anxiety.

The Stevenson/Farmer review on Thriving At Work highlighted the considerable cost mental health problems have in the workplace, but also highlighted the desire among most employees to keep such issues from their boss.

“We found that in many workplaces, mental health is still a taboo subject and that opportunities are missed to prevent poor mental health and ensure employees who may be struggling get the support they need. In many instances employers simply don’t understand the crucial role they can play, or know where to go for advice and support,” the authors say.

Providing support

Earlier this year New Zealand began to offer paid bereavement leave for couples who have suffered a miscarriage. The idea of the bill is to allow partners to come to terms with their loss without having to take sick leave.  Life insurance firm YuLife has followed suit with a policy providing similar paid bereavement leave to employees who suffer from miscarriages.

While these developments are most certainly welcomed, the New Zealand legislation provides a paltry three days of bereavement leave, with the YuLife plan doing marginally better with the provision of five days bereavement leave.

By putting such a fixed “bereavement window”, it runs the risk of providing a timeline within which you’re allowed to grieve before returning to normality again.  The grieving individual is sent home to do their suffering on their own out of sight and out of mind, after which the issue will be tucked under the carpet never to be spoken of again.

From personal experience, one of the most challenging aspects of post-miscarriage grieving has been the speed with which those around us expect us to move on and return to normality.  With the psychological fallout from events such as a miscarriage potentially enduring for weeks or months, we need managers willing and able to tackle grief with the same willingness that they currently celebrate birthdays and other joyous occasions.  This is especially so as the “conspiracy of silence” that surrounds grief can compound the suffering as it creates a harrowing sense of isolation.

Getting it right

A lot of what we experience at work revolves around the concept of reciprocity.  As research from Warwick Business School showed last year, when we feel like our employer has our best interests at heart, then we reciprocate by giving our all.  Productivity rises, loyalty rises, employee engagement rises.

The flip side, of course, is that if we have a “fairweather” boss who is only interested in what we can do for them or when the situation is easy, that period of isolation is not forgotten.  The grief becomes disenfranchised and what is a normal process of withdrawal becomes even greater, further eroding performance and loyalty to the organization.

While it’s easy to portray grief as a linear process as we move slowly through the “five stages” popularized by David Kessler and Elisabeth Kübler-Ross, the reality is far more freeform as we experience highs and lows, good days and bad.  While managers are typically not trained in how to handle grief, now more than ever it is perhaps time that they become familiar with the process and how they can support employees going through it.

I spoke with Sankalp Chaturvedi, Associate Professor (Organisational Behavior & Leadership) at the Imperial College Business School, about some things managers and policymakers can do to better support grieving employees.

1. “Create systemic policies to support gender equality and create a psychologically safe work environment for their employees (irrespective of gender) to feel attached to the organization. During miscarriages or bereavement, both parents feel the pain and it continues for a much longer time than one or two days. Organizational policies like these can have a positive impact on job satisfaction, organizational commitment, and retention of their employees.
2. Government/ political leaders should institutionalize miscarriage and bereavement-related policies for the firms, like some recognized mental health issues. Currently, even the public health systems (like NHS) are limited by the official government guidelines for miscarriages which restricts them to allow it only via annual sick leave allowance. Unfortunately, there is no statutory bereavement leave. Grief on bereavement is a psychological process and it needs a let-out mechanism for employees to recuperate from the loss.
3. Leaders can encourage timely and open conversations about miscarriages and bereavement issues which is probably better managed in a one-to-one setting. Active listening by leaders can be an extremely powerful technique to manage the conversation. This could enable a better leader-follower relationship and lead to positive organizational outcomes for both parties but more importantly, anchor an official mechanism for employees to share openly without fear of the issue being misunderstood or stereotyped. Leaders should try to make it easier for people who are suffering psychologically. Research also suggests that if people are not able to grieve appropriately, it could lead to severe mental health issues.
4. Emotional intelligence and empathy have consistently shown to be essential ingredients of effective leadership to manage a crisis.  Miscarriage and bereavement are moments of crisis for the concerned employees. Contrary to the public view, empathizing strengthens leadership, as leaders seem more human and authentic for all. This authenticity helps in improving trust between the leader and followers.”

On the right track

It would be churlish to be overly critical of the efforts from YuLife, and the New Zealand government, and it is generally positive that bereavement leave for miscarriages has been brought into line with bereavement leave for other forms of loss.  This has been such an unspoken topic for so long that all progress has to be commended, especially as many continue to lag far behind even these initial steps.

Equally, however, it’s important to remember that while paid leave for miscarriages may help the mother to deal with the various biological processes she must go through, it’s very unlikely to be sufficient to allow the couple to fully process their loss. As such, the leave should be viewed as the starting point in a longer-term intervention to support that employee.

The longer-term interventions may include the provision of therapy, or it may simply be regularly checking in as a manager to make sure that they’re doing okay. What’s vital is to show patience so that the individual feels supported and not rushed through the grieving process.

It’s unlikely that a linear path to recovery will be followed, with good days interlaced with sad days, angry days, and ambivalent days. Ambivalence can be particularly difficult, not least as it can emerge without us really being aware of it. This turbulence can undoubtedly be difficult for managers but it’s equally difficult for the individual themselves. We’re generally well aware of where we’d love to be emotionally, and can be critical of ourselves for not being there sooner. From our manager, we just want patience and understanding to help us back to our true selves.

It’s pleasing to see not only greater openness about miscarriages in the past year, but also a greater sense of compassion in leadership throughout the pandemic.  It’s clear that we need our workplaces to become more humane environments, and a greater awareness and management of grief in the workplace is likely to be a central part of that.