PLACES | Pregnancy Loss (under 24 weeks) in Workplaces:Informing policymakers on support mechanisms

Executive summary This research The PLACES Project - Pregnancy Loss in Workplaces: Informing policymakers on support mechanisms - was funded by the Department of Children, Equality, Disability, Integration and Youth, and conducted by researchers from University College Cork and University of Galway between September 2022 and September 2023. The aim of this project was to examine the workplace experiences of pregnancy loss before 24 weeks gestation, and to identify relevant needed supports. Background Pregnancy loss affects approximately one in every four pregnancies, most often before 12 completed weeks of pregnancy. Pregnancy loss at any gestation can have physical impacts on the pregnant woman, and emotional and social impacts on the woman and her partner. Most women of reproductive age are in paid employment; as such, workplaces are an important context to consider in pregnancy loss experiences. In the Republic of Ireland, women are entitled to maternity leave of six months duration if they experience a stillbirth after 24 weeks of pregnancy. There is no statutory leave entitlement for pregnancy loss before this time. Methods This project drew on a number of methods to gain a broad and deep understanding of workplace experiences of pregnancy loss. This included a search for relevant research; a review of international statutory leave for pregnancy loss; a sample of pregnancy loss policies across companies in the Republic of Ireland; a national mixed-method survey with 913 participants responses included; and a qualitative interview study with 13 participants. Key findings There is a significant gap between the needs of individuals who experience pregnancy loss and the supports available to them in workplaces. This has an impact on the wellbeing of individuals, their physical and emotional recovery from pregnancy loss, and their return to work. Most women across high-income countries, including the Republic of Ireland, are without leave entitlements or legal protection which would enable them to take PLACES | Pregnancy Loss (under 24 weeks) in Workplaces: Informing policymakers on support mechanisms viii sufficient leave from work following a pregnancy loss. Women who experience termination of pregnancy, or partners of the woman experiencing the loss, are even less likely to be entitled to time off work. As such, most individuals rely on sick leave or other general leave entitlements to take time off work. Some individual companies or countries across the world provide leave specifically for early pregnancy loss. Among these policies, there is huge variation regarding who is eligible for this leave, or how long this leave from work is. Our findings suggest that most women need leave from work. The amount of leave needed depends on a variety of factors, including the physical impact or clinical management of the loss; the gestation of the pregnancy; and personal factors such as history of recurrent loss or emotional response to the pregnancy loss. Women who experience termination of pregnancy, similarly, require time from work, to recover from the physical process, and sometimes the emotional effects, particularly those who experience termination of pregnancy for medical reasons. Partners also need some leave from work, in order to support the woman who has lost the pregnancy, and to deal with their own loss. Our primary research suggests that there is still a level of secrecy and stigma attached to pregnancy loss, especially earlier losses and termination of pregnancy. This can prevent people sharing their loss or seeking support, particularly in the workplace. Participants across the international literature and in our primary research often described fear of dismissal from work, or discrimination regarding career progression. Indeed, some individuals internationally, and in the Republic of Ireland, did face dismissal or sidelining for promotions as a result of their absence or decreased productivity following pregnancy loss. Within workplaces, individuals, and particularly managers, are often uninformed about pregnancy loss and ill-equipped to support workers during these experiences. This very often led to negative workplace experiences following pregnancy loss. These experiences include a lack of empathy and support; harsh treatment regarding absence or workload; insensitive comments and questions; and distressing exchanges in the workplace. Across the literature, and our primary research, a small number of individuals left their employment due to their experiences following pregnancy loss. Policy implications Based on the above findings, we put forward the following recommendations: PLACES | Pregnancy Loss (under 24 weeks) in Workplaces: Informing policymakers on support mechanisms ix Recommendation 1 A statutory right to paid leave should be introduced for pre-viability pregnancy loss, regardless of the gestational stage or the reason for the loss. This should be subject to medical certification. This would play two roles: first it would allow for a period of recovery, and second it would show societal recognition of the impact of pre-viability pregnancy loss. Recommendation 2 Any leave introduced should be of sufficient duration to meet the needs of those affected, which are presented in this report. In the other jurisdictions examined, the model of pregnancy loss leave introduced was influenced by the existing statutory leave frameworks, all of which are more generous than in the Republic of Ireland. The duration and scope of any leave in the Republic of Ireland would have to be considered in the context of existing statutory paid leave provision. Current statutory paid sick leave is three days (to be increased to 10 days by 2026), while the statutory entitlement to leave following a stillbirth after 24 weeks of pregnancy is 26 weeks maternity leave. Payment of maternity benefit is subject to having the requisite PRSI contributions, and there is no statutory entitlement to receive payment from the employer while on maternity leave, although employers can choose to pay employees while on maternity leave. The needs of people experiencing pre-viability pregnancy loss will vary, and any statutory provisions introduced will need to have regard to this. Recommendation 3 A statutory right to paid leave for pregnancy loss should also be introduced for partners. According to international literature and the findings of primary research detailed in this report, this leave is needed in order to process their own loss and to support their partner (including the care of any children). Recommendation 4 If, in accordance with the recommendation above, statutory paid pregnancy loss leave is introduced, it should be added to the list of family care-related leaves which are covered by the Unfair Dismissals Act. The statutory wording introducing any such leave should also make clear that such leave is covered by equality law and less favourable treatment on the basis of taking such leave is prohibited under the gender ground as a pregnancy-related issue. PLACES | Pregnancy Loss (under 24 weeks) in Workplaces: Informing policymakers on support mechanisms x If statutory paid pregnancy loss leave is not introduced, then guidance should be issued to employers to clarify that any less favourable treatment of an individual for taking existing leave entitlements following pregnancy loss is covered by the provisions of employment equality legislation and would amount to discrimination on the gender ground as a pregnancy related issue. Recommendation 5 Given the individuality of each persons experience of pregnancy loss, patient and public involvement in the development of policies and practices which promote positive workplace cultures and environments is recommended. Recommendation 6 The implementation of leave entitlements should be carefully considered by workplaces. Procedures on notification, submitting certification, and requesting leave should be developed with sensitivity to the needs of individuals experiencing pregnancy loss. This includes considering the need for privacy and compassion, as well as allowing reasonable time to notify the employer. Recommendation 7 Additional supports and accommodations should be made available to workers experiencing pregnancy loss. An organisational framework, including policies and practices regarding how to support employees experiencing pregnancy loss, clearly outlining the organisational ethos positioning regarding this issue and highlighting the different measures and supports available to staff, should be a priority in organisations. For this purpose, clear guidance should be provided, by relevant Government Departments, to organisations on how to develop and implement such frameworks, encouraging each employer to apply and adjust these to their workplace contexts in the most suitable way. Further to Recommendation 5, involvement of individuals with lived experience of pregnancy loss and relevant stakeholders (e.g. external organisations and individuals groups specialised in this issue) is essential for an adequate development of policies and practices in this field, as well as their successful implementation. PLACES | Pregnancy Loss (under 24 weeks) in Workplaces: Informing policymakers on support mechanisms xi Recommendation 8 Information about leave and support entitlements for pre viability pregnancy loss needs to be clear, publicly available and accessible, to ensure that individuals can easily inform themselves about these, and avail of such supports when needed. Recommendation 9 Political leadership is needed to drive changes in public awareness and perceptions surrounding pregnancy loss in general, and specifically relating to workplaces and how to support workers in this regard. This requires various actions, such as the inclusion of education around pregnancy loss as part of overall sexual and reproductive health education within schools, antenatal curricula, and through other channels settings, and in national policies and action plans (across all Government Departments, including Health; Children, Equality, Disability, Integration and Youth; Education; Enterprise, Trade and Employment; Justice; Social Protection)