Trigger warning: pregnancy loss, stillbirth
After my first pregnancy loss (an ectopic pregnancy that required emergency surgery), I took two weeks off work to recover physically and cry in the comfort of my own home. During that time, I called my company’s HR department to inquire about bereavement leave (because I really did not want to use a year’s worth of sick days and vacation time) and the HR woman said, “Well, bereavement leave is only for, like, real people.”
I was, in a word, dumbfounded. Then infuriated. I was already overwhelmed by the intensity of pain I felt for a child I had never met. Then, with one succinct sentence, this woman (who I had also never met) managed to completely invalidate the grief I was beginning to allow myself to feel.
Unfortunately, my experience is not uncommon. After Elizabeth O’Donnell’s daughter, Aaliyah, was born still on December 1, Elizabeth’s employer, the District of Columbia Public Schools (she’s worked as a teacher for the past 7 years), said they could not offer her paid family leave since she is only “caring for [her]self.” She went through 48 hours of labor and a surgery, during which she lost a liter-and-a-half of blood, but she cannot get paid leave, leave she would have received had her child lived. “Being ineligible for paid family leave when I indeed experienced the qualifying event of birthing a child made it feel as though my child never existed and that what happened to her, and me in the process, didn’t matter,” Elizabeth told me.
If “family leave” is only for parents bringing home a living baby, and “bereavement leave” is only for mourning human beings who die after spending time on Earth outside of a womb, then we need paid leave specific to stillbirth, miscarriage, and other types of pregnancy loss. It is too monumental of a life event—physically, emotionally, and often financially—to deny people this right.
It’s commonly reported that one in four pregnancies end in loss. With this rate, it’s safe to say that in a workplace like mine (with hundreds of people), at least one woman is going through pregnancy loss at any given time. For some, these losses are intense medical events, like Elizabeth’s. Two of my four losses were ectopic pregnancies, which posed a risk to my life—one required the aforementioned surgery, the other required a shot of a drug regularly used for cancer (because it’s good at killing cells). I had a “missed miscarriage” (the embryo had passed without my knowing) that involved bleeding for weeks before I was deemed unpregnant. And I lost my son, Miles, in the second trimester, which involved yet another surgery (and a whole lot of heartache).
Even if a pregnancy loss does not have serious medical issues, there are emotional issues to consider. According to the largest-ever study to assess the psychological impact of early-stage pregnancy loss, 29% of women who had experienced a miscarriage before 12 weeks or an ectopic pregnancy had posttraumatic stress one month after their loss. Approximately one in four women had moderate to severe anxiety, and about one in ten had moderate to severe depression. According to a 2016 review of the psychological effects of stillbirth, bereaved parents had significantly higher rates of emotional disorders including depression, general anxiety disorder, social phobia, agoraphobia, and anger, as well as a sense of failure, long-term guilt, symptoms of PTSD, and suicidal ideation.
When my co-authors and I wrote “All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss,” we wanted to explore the devastation of pregnancy loss. For me, it was an attempt to make sense of my personal experiences, to answer a lingering question: Why is this type of loss so crippling? There is the loss of the baby, of course, along with the loss of the dream of motherhood, the imagined future; but there is also a loss of innocence, a loss of faith, a loss of control. These losses are compounded by society’s shortcomings when it comes to grief, in general, and pregnancy loss, specifically.
David Kessler, renowned author and founder of grief.com, has said, “We are a grief-illiterate society.” We want to fix things. We want to rush people past their sadness. This is why if you’ve had a pregnancy loss, you’ve probably been told, “Everything happens for a reason!” or “Just try again! One of them will stick!” Platitudes like this fail to acknowledge and witness the griever’s pain. It’s no wonder women describe pregnancy loss as lonely, despite the fact that millions of people have experienced it. When our core feelings are shut down (by platitudes or insensitive HR people or cold-hearted employers), we retreat, our grief complicated by the fact that others will not validate it, will not confirm it—and our babies—as real.
After each of my losses, nobody told me I was entitled to any kind of leave. So, when I ran out of sick days and vacation time, I came into work, often still bleeding during meetings and feeling like I’d been hit by a truck. I expended a lot of energy acting like I was fine because it seemed that’s what others expected of me. It was exhausting. Most days, I went to my car at lunch time to take a nap. A couple times, I curled up under my desk. These are privileges, I realize—the sick days, the vacation time, the car in which to nap, the office with a door. What about the women who don’t have these? What about women who must take time off unpaid? What about women who are on their feet all day, or performing physical labor?
It’s worth noting that some women may take comfort in the predictable and stable routine of the workplace after a loss. But many of us who return to work are not ready to be there. In her book about the loss of her son, Teddy, Elle Wright says, “The thought of going back, facing everyone…quite frankly made me physically sick.” Most of us have to go back though. Most of us have to do the best we can, while being painfully aware that, as Rebecca Dube writes in “Miscarriage at Work,” “U.S. workplaces have not caught up with the growing recognition that miscarriage is a loss that takes time to mourn.”
U.S. workplaces will not catch up to this reality unless enough people demand they do so. We are a country that cares about productivity and bottom lines. A woman sitting at her desk despite being in the midst of physical and emotional turmoil keeps up the appearance of productivity. But the bottom line is that her health should be top priority. The bottom line is she will be a better employee when she’s had time to heal.
There are other countries that offer leave to employees following pregnancy loss. In Korea, for example, women are granted maternity leave in the case of miscarriage or stillbirth, with the leave time based on the number of weeks of pregnancy. The leave is paid, and an employer is not allowed to dismiss an employee during leave. A policy like this needs to exist here. The fact that it doesn’t makes me question the common assertion that we are the greatest country in the world.
We don’t have to call it “family leave” or “bereavement leave” if those terms are indeed reserved for separate, rigidly-defined circumstances. This type of leave can, and should, have its own name. We can call it Pregnancy Loss Leave, or PLL. Better yet: Paid Pregnancy Loss Leave, or PPLL. Corporate America loves a good acronym. Whatever we call it, it needs to be readily available and easily accessible. And, ideally, it should be extended to the woman and her partner—because pregnancy loss affects both people. Currently, company and government policies imply that it affects no one. Currently, those policies reinforce the idea that people should suffer in silence. And suffer they do.
We need to do better—because women’s health matters, because each baby matters, because grief matters. A society is defined by its policies. If we want to promote empathy, as so many of us say in these trying times, we have to start with how we treat our people. We have to start with the policies that define our daily lives. Imagine a world in which we, collectively, embrace people who are grieving. Imagine a world in which we, collectively, say, “Take your time. Your pain deserves all the space it needs.” The greatest revolutions, as they say, start small.
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