It’s Time To Talk About Miscarriage & The Workplace

I had a miscarriage a month into my first pregnancy, and like most women, I had no idea how to talk about it at work. I mean, really, I had no idea how to talk about it anywhere, or not without breaking down into tears. And around my boss I was especially lost about how to operate like a normal person.

At the time, I was in a senior role at a media startup being prepped for a sale and I hadn’t even told anyone I was pregnant, fearing that information would jeopardize my leadership position in the transition. So now how was I now supposed to explain this sudden, unbearable loss? It did not help that two of my coworkers were glowing with new pregnancies and that, despite all of the ER doctors assuring me I’d done nothing to cause this miscarriage, I harbored deep feelings of failure. I cried in bed for a week, feeling like I was inherently broken and exaggerating my “flu” symptoms before white knuckling my return.

Despite 10-20% of known pregnancies ending in miscarriage, women aren’t discussing them in the office. The reasons behind the silence are obvious: there’s still a lot of shame and prejudice around miscarriages, not to mention rampant workplace discrimination against both pregnant women and women who’ve miscarried.

But I still wonder if I could've saved myself weeks of anguish — and years of shame — if I’d had a language for discussing my fractured mental state with the coworkers I trusted.

Anyone who’s suffered a miscarriage can tell you the basic facts about the experience. Medically defined by the spontaneous loss of a fetus in the first 20 weeks of pregnancy, miscarriages happen most often when a fetus develops abnormally. Although early pregnancy loss is normal and relatively common, research shows it can often lead to depression, anxiety, and even post-traumatic stress disorder (PTSD).

I still wonder if I could've saved myself weeks of anguish — and years of shame — if I’d had a language for discussing my fractured mental state with the coworkers I trusted.

Alongside my grief, I experienced a range of symptoms that made it hard for me to concentrate on my work. Distractibility, fatigue, and difficulty making decisions were just a few of my common acute symptoms of pregnancy loss, as described by Postpartum Support International, a Portland, Oregon-based organization that offers resources for emotional difficulties related to pregnancy. “Those are the very qualities we also hope never to encounter at work,” says Wendy N. Davis, President and CEO of Postpartum Support International. Davis adds that when a woman's workplace is "business as usual," the typical isolated feelings experienced in miscarriage are only exacerbated.

Forcing a facade of normalcy compounds the loss, yet there’s no common language for discussing recovery at work. This secrecy is part of a larger trend when it comes to psychological issues: 76% of U.S. employees admitted to struggling with their mental health in a 2019 Harris Poll for the American Heart Association, and 63% of those surveyed never discussed their diagnoses with supervisors.

Talking to Davis, I realized I wasn’t alone in witnessing my work persona implode after a miscarriage. Luckily experts have a wide array of advice for navigating the workplace in the aftermath of pregnancy loss.

Grant yourself permission to heal.

As I found out firsthand, the physiological transition back to a pre-pregnancy baseline is turbulent. This is in part because of the pressure women can feel to prove themselves at work, regardless of personal circumstance. Miscarriages are a case where taking the time to recover —even one day off — can help stave off more serious issues later.

“We have a lot of unnecessary secrecy, shame, and stigma related to pregnancy not going perfectly,” says Davis, “and we tend to second guess the bare minimum of what we need to recover.” Her advice is to take time off right after it happens, if possible. “When people try to push through that recovery, they don’t recover as well, and problems tend to emerge later.”

Use a script if that feels most comfortable.

Davis offers her psychotherapy clients numerous scripts for the workplace. For women who don’t want to share a vulnerability of this magnitude, she says, “We don’t have to give every detail.” In that case, she suggests saying something like, “I’m going through a medical issue and my doctor has requested that I take time off.”

Another option is to tell a manager or team that they’ve suffered a miscarriage, and while they’re choosing to be at work, they won’t be functioning in their normal capacity. “You can say, ‘I’m grieving, my concentration is going in and out, I’m more tired than usual, and sometimes I’m going to cry. I don’t want you to worry because I can take care of myself, but I want you to know this is happening to me,’' says Davis. She adds that partners affected by pregnancy loss can use similar language with their managers and teams.

At the very least, Davis says, women could consider asking for help from teammates and supervisors, just as they would if they were recovering from a broken limb or the flu. “You could say, ‘I want to do as much as I can, but I’m not working at 100 percent right now. Could we talk about how to reorganize some of this work for the next month or so?”

Know your workplace rights.

The aftermath of miscarriages disproportionately affects low-wage women, who historically haven’t been able to take time off without risking reduced wages or unemployment. While miscarriage leave is becoming more common in white collar sectors like tech, professional and low-wage workers often experience two very different realities, says Dina Bakst, co-founder of A Better Balance, a New York-based advocacy group for working families. “Workers in America shouldn’t have to win the boss lottery to have basic protections,” she says.

The federal Family and Medical Leave Act (FMLA) provides up to 12 weeks of unpaid leave for serious health conditions, including miscarriage. However, it only applies if your company has 50 or more employees within a 75-mile radius, you’ve worked there for at least a year, and you’ve clocked at least 1,250 hours in the past 12 months—all significant barriers for low-wage workers.

New protections are now in place through the Pregnant Workers Fairness Act (PWFA), which recently went into effect after a decade-long fight led by A Better Balance, requiring employers with 15 or more employees to provide "reasonable accommodations" for pregnancy-related conditions, including miscarriage, unless it would cause undue hardship. State and local laws may provide additional rights, such as paid sick leave, temporary disability insurance, or other types of leave, which vary by location. A Better Balance offers a number of helpful online resources and a free, confidential legal hotline to help navigate specific situations.

For those who simply cannot afford to stay home, Dr. Kiley Hanish, founder of Return to Zero: HOPE, a nonprofit providing inclusive and holistic support to people experiencing pregnancy and infant loss, suggests finding trusted allies who can help steer conversations away from triggering issues. “If you’re in a space where you go into an emotional state, having a plan in place of what you’re going to do helps,” she says. Even a trip to the bathroom to splash cold water on your face can release some pressure, she says, as can bringing comforting items from home such as essential oils, tea, or music.

Consider the value of setting a precedent for those who can’t.

For people who feel safe speaking up about miscarriages at work, experts stress the larger positive impact this can have on workplace policies generally. You could be a future ally for someone else in your position. “A lot of people really don't have the privilege of being honest. We all have to work together to push on more corporate policy and public policy to improve that for all employees,” says Davis. She adds that people in leadership and HR roles can particularly help normalize both the existence of miscarriages and policies supporting recovery from them.

Release yourself from the pressures of expeditious healing.

Grief works on a continuum, which means you may feel the impact of a miscarriage weeks, months, or even years after the experience, says Erica Chidi, author and health educator. “The rupture of grief is normal,” she adds, “and you don’t have to solve for extinguishing it completely.” This can be challenging in an American culture obsessed with rapidly returning to a fantasy baseline with both pregnancy and pregnancy loss, she adds. “There’s this idea of ‘I’ve gotta get back to me’ and do it really fast,” says Chidi. “That’s a counterintuitive approach. The quicker you learn to be down and do less, the quicker you actually heal.”

Jennifer Maerz is a journalist, editor, and essayist who lives in Portland, OR. Her work has appeared in Rolling Stone, Cosmopolitan.com, and Money.com, among other places.

Postpartum Support International provides a helpline for non-emergency situations at 1-800-944-4773 or www.postpartum.net. For specific information on miscarriage workplace rights, you can check out A Better Balance’s Fact Sheet or call 1-833-6333-222.