NHS staff have mixed experiences of workplace support for pregnancy loss

On 22 July, the independent Pregnancy Loss Review was published, putting forward 73 recommendations to the Government. Some of these recommendations related to pregnancy loss in the workplace and the support provided. Several focus specifically on the NHS as an employer, so it can become a leading example in offering excellent bereavement support to its staff.

As part of the Government’s response to the Pregnancy Loss Review, they encouraged employers ‘to go further to actively promote a workplace where women, birthing people and their partners are comfortable to take the time that they need following pregnancy loss.’ 

They referred to existing support for employees following pregnancy and baby loss, including statutory sick leave, and highlighted protections against disadvantage or discrimination in the workplace arising from pregnancy. This includes any absence or illness caused by miscarriage, extending for 2 weeks after the end of a pregnancy.

We know every workplace is different in how they support colleagues through baby loss and were keen to hear more from those in our community, particularly – in response to these recommendations – those who have been through baby loss while working for the NHS. We’re very grateful to all those who took the time to share their experiences with us.

It was clear that current support varied significantly and often depended on the ‘luck’ of an understanding manager or workplace culture. This demonstrates precisely why we’re disappointed by the Government’s response, which contains no formal move to implement them nationally.  

Inconsistent approaches and policies

While many of you had positive experiences, with compassionate support and understanding from managers, it was disappointing to hear this wasn’t the case for everyone. Due to no current clear or robust policy across the NHS there were huge variations in the level of support received, particularly the length and type of leave given. This ranged from being granted long-term compassionate leave to only being able to take a few days using sick or annual leave.

I have a very supportive manager who encouraged me to stay off for as long as I needed. I know I was lucky to have this as leave for loss before 24 weeks is usually just in line with the sickness policy.

Currently, statutory bereavement or compassionate leave is only legally entitled after 24 weeks of pregnancy, when it is classified as a stillbirth rather than a miscarriage. With some staff only entitled to 3 days of compassionate leave per year, this has led to many who experience a pregnancy loss before 24 weeks being forced to return to work before they are ready. Many mentioned not having their absence recorded as miscarriage on their employment record; often a formal sickness absence instead.

We know this needs to change and all employers, including the NHS, should have proper policies to support their staff following a loss at any stage of pregnancy – there should be no arbitrary line in the sand for grief. 

In 2021, we launched our Pregnancy and Parenting at Work programme to give workplaces guidance on supporting their employees through pregnancy journeys. Having clear policies removes the burden from employees to negotiate leave at what is one of the most stressful and traumatising times of their life.

Staff under pressure to keep services running

Another common theme was how workplace conditions such as staff shortages and pressure on NHS services meant you felt like you couldn’t ask for time off or felt pressured to return quickly. This is deeply concerning.

I worked for the NHS when I had my second loss. I felt rushed back to work.

NHS staff burnout and retention is becoming a bigger problem. In May this year our Sands and Tommy’s Joint Policy Unit launched its first Saving Babies’ Lives progress report which showed how staff shortages and the pressure that staff are under is impacting on the NHS's ability to deliver safe, personalised, care for everyone.

The Government's recently released NHS Long Term Workforce Plan was a welcome first step in addressing some of these issues but urgently needs to be put into action.

Empathetic managers are key

A few of you who felt you received a lot of support after your loss noted how your manager or colleague had also experienced loss. This empathy and understanding they were able to give was an essential part of the positive support experiences some of you had. We believe compassionate workplaces should be the standard, and giving all managers the confidence to provide the best support lis a crucial part of this.

My manager encouraged me to take as much time as I needed and also offered me a phased return. I think everyone should be treated this way and it should be consistent, as my feeling is I got lucky having such a supportive manager and without proper guidelines, not everyone will be the same.

Need for national change

The Government’s response shows they have no current plans to introduce significant policy changes nationally, only stating that the NHS will take the recommendations into consideration. This means it is up to individual employers to offer increased support for pregnancy loss above the statutory minimum. We know that this support is lacking in many workplaces, and combined with the Miscarriage Leave Bill failing to get a second reading in Parliament earlier this year, we are disappointed to see a lack of formal policy change.

Together with our supporters, we will continue to campaign the Government on this issue so that everyone is able to receive the compassionate support and care they need while dealing with the heartbreak and devastation of baby loss.

Tommy’s Chief Executive Kath Abrahams says:

We continue to urge employers to take the initiative to develop their own baby loss policies, which should be flexible, compassionate and understand that every person's circumstances and needs will be different.
 

Our Pregnancy & Parenting at Work programme helps workplaces to support their employees through any pregnancy journey, from planning and parenting to complications and losses. If you’d like to find out more, head here.