Miscarriage and pregnancy loss are difficult topics to discuss in the workplace, steeped with feelings of anguish, shame, and uncertainty. Although miscarriage in the first trimester occurs in about 10 to 15 percent of known pregnancies and in approximately 20% of all pregnancies, it’s rarely talked about in society at-large. People who experience miscarriage are at higher risk for anxiety and depression, and one study found that four in ten women reported symptoms of PTSD three months after pregnancy loss. 

The anguish of losing a pregnancy cannot be understated—and returning to work, when colleagues and coworkers anticipate joy and celebration, can be emotionally crushing. Here’s what you need to know about supporting your employees through the tragedy of pregnancy loss.

How does pregnancy loss impact mental and physical health?

Pregnancy loss can be extremely traumatic, whether it’s classified as a miscarriage or a stillbirth. It can significantly impact the mental and physical wellness of a family. Physically, women experience bleeding and cramps that can last up to two weeks, and it can take up to six weeks for their menstrual cycle to return to normal.

Psychologically, however, the symptoms can last much longer. According to a 2015 study, “nearly 20% of women who experience a miscarriage become symptomatic for depression and/or anxiety; in a majority of those affected, symptoms persist for 1 to 3 years, impacting quality of life and subsequent pregnancies.” Depression and anxiety can affect physical health, fertility, and interpersonal relationships, and can manifest in different ways throughout the grieving process.

“For loss like a miscarriage, oftentimes people don’t know that there was a pregnancy to lose,” says Sarah Gugluizza, a Licensed Clinical Social Worker and Maven provider specializing in grief counseling and pregnancy loss. “They’re often grieving their loss in silence while having to go about day-to-day tasks and responsibilities. It becomes a secret weight the woman has to bear as she goes through physical, hormonal, and emotional changes.”

Stigma creates barriers to seeking help

The stigma of pregnancy loss plays a large role in the way women and families grieve and cope. Traditionally, pregnancy isn’t publicly announced until after the second trimester begins一or after 12 weeks一meaning that if loss occurs before then, many pregnant people and their partners likely haven’t told friends, family, or coworkers they were expecting. On the other hand, people who experience stillbirths have to address the reality of expectations held by friends, family, and coworkers.To put it simply, there are few if any socially acceptable ways to mourn the loss. These losses are difficult to discuss, and are rarely adequately addressed or acknowledged in social settings, whether among family, friends, or at work. 

Social support is crucial during the grieving process, and due to the nature of miscarriage, women are often deprived of the empathy and understanding they need to cope effectively. If an employee hasn’t told anyone about their pregnancy, it becomes that much harder to tell their support system that they’ve lost it, too. Likewise, if the people she told were expecting good news, it can be extraordinarily difficult—and triggering—to share the reality with them.

The impact on partners

Partners can also struggle coping with pregnancy loss, too. Gendered expectations, as well as a lack of institutional support, can create a confused and distressed emotional state “to the extent that such males might feel it necessary to deny their own feelings of grief in a double-bind situation.” The reality is that the grieving process for an unborn child is innately complex: parents grieve the dreams and the possibilities of the future of which they were deprived as much as they grieve the loss itself. And although they never had the chance to meet or learn about their child, parents experience a complicated mix of grief, anger, jealousy, and even relief.

Additionally, partners may feel the additional burden of supporting their grieving pregnant partner. “Many partners have the additional stress or confusion related to wanting to help and support their partner and make sure they are protected and taken care of as they go through this difficult thing that they don't always acknowledge their own emotions,” says Gugluizza.

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Pregnancy loss in the workplace

If the result of pregnancy loss is so often mental health challenges, the consequences cannot be understated. Untreated maternal mental health issues cost the U.S. over $14 billion in losses annually in 2017, and that number is likely on the rise. Postpartum care is in many ways insufficient for mothers, and is almost nonexistent for mothers who endure pregnancy loss. Treatments, including termination, removal, and dilation and curettage, can be excessively expensive, and serve as grim reminders of what the family just endured. Returning to work without support, and often without ever having spoken of the pregnancy in the first place, can often result in prolonged mental health issues. This can have profound effects on performance, productivity, and ultimately retention.

“Coping with this type of loss can cause distractibility, difficulty concentrating, irritability towards workload, coworkers and superiors, feelings of jealousy, feeling burnt out, loss of motivation to attend work and/or complete tasks,” says Gugluizza. And, because pregnancy loss is often mired by shame and secrecy, employees may find it difficult to share with coworkers or managers the nature of their struggles, and might go to great lengths to obscure their grief. 

Supporting pregnancy loss with digital family health

Some employers are expanding their leave policies to accommodate pregnancy loss, but this is far from common practice. And for the reasons we outlined above, time away from work may not be enough to overcome the struggles grieving parents face. Your employees will need a combination of physical, mental, and emotional health support. They need their physical symptoms managed, their mental health screened and cared for, and a measure of community acceptance to support them as they return to the office—and to normal life. 

Offering a digital family health benefit that provides your employees with access to on-demand mental healthcare, referrals to in-person care, educational content, and community support can help address their unmet needs. Pairing this with a leave policy and manager training can go a long way in supporting employees through unexpected tragedies. Here’s how:

Access to mental healthcare

One of the best things you can do for employees is provide them with expanded access to mental healthcare. Considering the mental health provider shortage and the exorbitant cost of mental healthcare, virtual care can effectively close these gaps.Telemental healthcare (TMH) is believed “to perform these functions more efficiently and as well as or more effectively than in-person care.” Likewise, specifically for perinatal and postpartum mood disorders, TMH was found to have “significantly decreased postpartum depression symptoms.” 

Community support

Because so many who face pregnancy loss suffer in silence, community support is crucial. Not everyone has strong enough working relationships to seek support—and it’s hard to put that burden on teammates, managers, and people teams. Offering benefits that emphasize community support, through forums, classes, support groups, and care advocacy, can ensure your employees always have someone to talk to.

Supporting reproductive health with Maven

Maven, the world’s largest virtual care clinic for women’s and family health, offers continuous support for women throughout their maternity journey, from prenatal planning and fertility, to postpartum and parenting. Maven’s pregnancy loss track features relevant content, as well as 24/7 access to mental health providers, career coaches, nutritionists, and more, who can help aggrieved families cope and find balance among the pain. 

To learn more about how Maven can support your employees, check out our solutions page.

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