The grief of pregnancy loss, and the daunting return to work

After Michelle LaFontaine delivered her stillborn twins, Elora and Joseph, at nearly 21 weeks, she was unspeakably bereft. 

She needed time off to grieve and recover from the birth, and her employer at the time helped her cobble together bereavement leave, sick time and vacation time.

"There's a lot of grief work to be done in the early days following the loss of your baby that, you know, having to focus on work is often something that families can't even contemplate doing in the first few weeks," said LaFontaine, who lives in Whitby, Ont.

She returned to work after three weeks, but it wasn't until later that she — and her employer — learned she had actually been eligible for more paid time off through federal maternity benefits.

LaFontaine said when she did go back to her job, which involved working with families, she asked to be assigned a different caseload so she wouldn't have to face questions from her 45 clients about why she was no longer pregnant. Her employer told her that wasn't possible.

"Ultimately, the message that I received was it was coming down to the bottom line that their needs as an organization would trump my needs as a bereaved mother," she said.

A researcher at Cape Breton University is studying the experiences of people like LaFontaine who have returned to work full time after suffering a miscarriage or stillbirth.

Stephanie Gilbert, an assistant professor of organizational management at the Shannon School of Business at CBU, is researching how workplaces support employees who have suffered a pregnancy loss, and how those supports — or lack thereof — affect pregnant people and their partners.

Along with Jennifer Dimoff at the University of Ottawa and Jacquelyn Brady at San José State University, Gilbert plans to interview people and their partners about what challenges they faced after their pregnancy loss and how the miscarriage or stillbirth affected the employee's sense of identity and attitude toward work.

The team of researchers is inviting Canadians or Americans who have lost a pregnancy and returned to full-time work within the last five years to take part in the study.

Lack of studies

Gilbert said there have been virtually no studies on the topic of pregnancy loss and employment. 

"There's a huge need for more on this because, you know, pregnancy loss is incredibly common," she said.

Miscarriage — the loss of a baby up to 20 weeks' gestation — is estimated to occur in 15 to 20 per cent of pregnancies, while approximately eight out of 1,000 pregnancies end in stillbirth, when a baby dies at or after 20 weeks' gestation.

In Canada, employees who lose a baby at or after 20 weeks are eligible for maternity benefits. 

But miscarriages are a "grey area" for employers, Gilbert said. While some employers offer sick days, short-term disability or bereavement leave to help an employee recover, there are no federal regulations providing paid time off for earlier losses.

"So the supports offered, I'm guessing, vary wildly between organizations," Gilbert said.

Reaction of employers varies

LaFontaine left her job after her loss in 2005 and now works as the program manager for Sunnybrook Health Sciences Centre's Pregnancy and Infant Loss Network, which supports families in Ontario who have had a miscarriage or stillbirth. 

She would like to see the government offer bereavement leave specifically designated for pregnancy and infant loss — and one that is not based on the length of the pregnancy.

"Grief is not tied to the weeks of gestation, but tied to the attachment that the family has already experienced to the baby," LaFontaine said.

She said based on what she hears from families she works with, some employers try their hardest to be supportive and accommodate the needs of people who have had a stillbirth or miscarriage, sometimes even making a donation to a pregnancy loss organization in the baby's name.

But others are not as helpful or compassionate.

"[Some families] were kind of told, like, 'You should be over it by now,'" LaFontaine said.

Getting support can be tricky for people who miscarry in their first trimester, since many have not even disclosed their pregnancy to their employer yet.

Employees who work part-time jobs or who lack job security may also not feel comfortable sharing their situation with their employer.

Compassion, support are crucial

Supporting grief-stricken employees is key to their well-being, Gilbert said.

Through her previous research on grief, Gilbert found that employers can help their workers by allowing them to work from home or have flexible working hours, by acknowledging the employee's loss rather than avoiding the topic, and by being compassionate and empathetic.

Gilbert said supporting grief-stricken employees helps not only their well-being, but also their productivity, as grieving people can have trouble sleeping, focusing, making decisions and interacting socially. 

"So there's a lot of implications for organizations in terms of work outcomes and a business case to be made for supporting people who have gone through loss," Gilbert said.