Back to Work After Pregnancy Loss: An Occupational Therapist’s Insight

I can still remember how it felt to have to turn my mind to work when I was still acutely grappling with the most traumatic experience I had ever endured. My baby had died, several weeks prior, and was still in my body. What I thought would be a happy memory of seeing my 14-week-old baby on an ultrasound turned into a nightmare from which I could not awaken. It was 4pm on Friday, December 30th, 2022, before the New Year’s long weekend. I was supposed to return to work the following Tuesday – but how?

I couldn’t understand how I could be sent home, without care, with my dead baby still inside me.

It seems strange to say this, but I was lucky. My sister-in-law worked at the same company and was able to notify my boss that I had lost the baby and would not be returning to work on Tuesday. My body did not recognise that my baby had died and so I required a Dilation and Curettage (D&C) to deliver my baby. I felt abandoned by the healthcare system because I was sent home after discovering my missed miscarriage and informed that I would need to call the local abortion clinic to schedule the D&C myself. I couldn’t understand how I could be sent home, without care, with my dead baby still inside me.

The next three days remain a fog to me. I can recall feeling completely numb, but not much else. My husband tried to keep me afloat by keeping us busy, but all I wanted was to fall into bed and not get back up. When Tuesday did arrive, I still don’t know how I gathered the strength to call the abortion clinic to schedule the D&C. Unfortunately, it took several hours of repeatedly calling the clinic to get through the phone lines to be able to speak with a booking nurse. I learned after the fact that pro-life activists would take turns calling the abortion clinic as a means of keeping the phone lines busy in an attempt to keep women and pregnant individuals from being able to access care. The cruelty and injustice of this still baffles and infuriates me. Finally, I spoke to a nurse and my D&C was scheduled for the next morning.

Recovery from the surgery that delivered my baby was difficult – it challenged me physically and mentally, such that I spent the next few days in bed. I had scheduled a call with my boss on Friday – two days after my surgery – to discuss my return to work. When Friday came, I had written out what I would say to my boss. I told myself I would remain professional and was cautiously optimistic that I could return to work the next week. However, as soon as the phone call started, my voice began to shake, and tears started streaming down my face.

There was no way I could return to work as an occupational therapist who treats clients with severe depression, anxiety, and PTSD – it would be completely unethical to do so.

Again, I was lucky, my boss was a compassionate person and a father to 2-year-old twins. In addition, one of my coworkers had recently experienced a stillbirth and was off work for her recovery and healing as well. He was understanding of my grief and ensured I knew there was no pressure for me to return to work until I felt ready. As an occupational therapist, a large part of my role was to support clients who were off work due to mental health challenges and trauma, and so my boss trusted in my ability to know when I could return to work. He also allowed me to design my own gradual return-to-work plan.

I had to figure out how to remain professional and friendly with a coworker who was pregnant and due around the same time I was.

I eventually did return to work a week later, but didn’t work directly with clients for another couple of weeks. I was able to work from home when I needed and kept my office door closed most of the time. I had to navigate how to disclose my miscarriage to coworkers and explain my absence to my clients. I had to field insensitive comments from senior management and figure out how to make it look like I hadn’t just been crying in the office bathroom. I was still bleeding and cramping from the surgery and experiencing hormonal changes within this new and unfamiliar postpartum body. I had to figure out how to remain professional and friendly with a coworker who was pregnant and due around the same time I was. It took me longer to complete my work tasks because I couldn’t focus, and I struggled with brain fog. I grappled every day with figuring out how I was going to hold space and assist my clients with their struggles, when their struggles seemed insignificant compared to the fact that my baby had died (hence why I waited several more weeks before working with clients again).

In hindsight, I returned to work too early. I struggled with thoughts that I was disappointing my team members and letting others down. I struggled with the societal tendency to downplay the significance of miscarriage and felt like my grief was disproportionate to what others expect following a miscarriage. I struggled with the fact that my husband was able to return to work right after the loss and I felt as though I needed to return to work to also financially provide for our family. I wasn’t clear on what my company’s bereavement policy was and what I could request in terms of paid or unpaid time off. My experience of returning to work incorporated good, bad, and confusing elements. This lived experience now greatly informs the work I do and has shaped the clinician I am today.

While no employer can take away the grief of losing a baby, compassionate policies and understanding managers can make an enormous difference.

I ended up leaving my company a few months after my miscarriage. This was in part from the insensitive experiences I had with senior management but also due to an overwhelming need to make a change in my life. After losing my baby, I felt lost and so out-of-control of my own life. Finding a new job, with a company whose values felt like a better fit, was something I could control and gave me back a sense of agency I had lost. My decision to change companies is so reflective of workplace trends related to employee retention following pregnancy loss. The 2022 Pregnancy and Parenting at Work survey by Tommy’s found that 57% of women said they have, or would, consider leaving their job or not returning from parental leave due to lack of support during their infertility, pregnancy, loss, or parenting journey. Further, 67% of survey respondents felt their manager did not support them during pregnancy and/or infant loss.

The issues that one can experience with staying at work and returning to work following pregnancy loss are pervasive and far-reaching. My experience is just one of millions. My journey through pregnancy loss and returning to work has forever changed me- both personally and professionally. While no employer can take away the grief of losing a baby, compassionate policies and understanding managers and colleagues can make an enormous difference in how we navigate our grief in the workplace. I hope that by sharing my story, I can contribute to creating workplaces where pregnancy loss is acknowledged as the significant loss that it is, where bereavement policies are clear and supportive, and where no one feels rushed to get “back to normal”; when their world has been shattered.

The statistics show we have far to go, but each conversation, each story shared, and each workplace policy improved brings us closer to a world where pregnancy loss is acknowledged with the gravity and support it deserves.