Written by Jennifer Elworthy. Reviewed by Jenny Wordsworth. 

Jennifer Elworthy is a Career and Fertility Coach, supporting women to navigate their careers alongside loss, fertility challenges and treatment. She’s also Director of Engagement at Fertility Matters at Work, the UK’s leading training provider for fertility-friendly employers. 

Download Jen’s free guides, ‘How to Talk to Your Manager About IVF’ and ‘How To Stay Productive When You Can’t Think Straight’, here. 

AN OVUM note: 

A note before you read: this piece describes miscarriage, ectopic pregnancy, surgery and the grief and anxiety that followed. If that feels like too much today, it will still be here later. Support is listed at the end, and you can go straight to it.

“Hi, it’s me. I’ve had a miscarriage. Yep, another one.”

“Hi, it’s me. I’ve had a miscarriage. Yep, another one. I’m sorry, but I won’t be back at work this afternoon like I said I would. I’m not sure what’s happening next; I’m waiting to pick up medication. Yep, ok, yep, thanks. I’ll be in touch. Yes, yes I’m fine, just sad. Please don’t tell anyone. Ok, bye.” 

This was the call I made to my manager when I was standing in line at the pharmacy at St Thomas and Guy’s Hospital, waiting for the medication that would induce a full miscarriage. I’d told my boss I was going to be late to work, but he was expecting me at my desk by lunchtime. I’d already had an ectopic pregnancy (resulting in life-saving surgery and a lost fallopian tube) a few months earlier, so the Early Pregnancy Unit had me under regular monitoring. This pregnancy was in the right place; I felt sick all day and night, my levels were rising, and early scans showed a strong heartbeat, so there was no need to worry. But I was worried. It was all I could think about. And I was right to, because at 9 weeks the words I heard during a scan were “I’m so sorry. There’s no heartbeat.” Another ectopic pregnancy followed a few months later. 

I thought, “If I can’t even do something as basic as have a baby, how on earth can I be good at my job?”. 

The ways in which my miscarriages impacted me were varied. There was the physical side, of course. That meant a rollercoaster of hormones from being pregnant and then not being, three times in 12 months. Invasive surgery to stem the mass internal bleeding, save my life and remove a fallopian tube, meaning I struggled to sit up straight, let alone walk, for a few weeks. And of course, with one tube left, my chances of conceiving were reduced, and then the remaining tube was damaged by the second ectopic, leaving little hope for a future pregnancy. 

While my physical recovery became the priority, I managed my grief. The pressure I put on myself to cope with everything I was going through compounded my depressive and anxious feelings and my plummeting confidence. I was having regular panic attacks in public places; traffic noise made me skittish, and I found little things like going to the supermarket a real challenge. I began to avoid talking to friends and family because hiding away felt easier than trying to understand how the world kept spinning when I’d lost three babies.

Work became tough too. I had always considered myself a confident, ambitious, able person with a clear direction for my career, but I was riddled with self-doubt and anxiety. In my darkest moments, I thought, “If I can’t even do something as basic as have a baby, how on earth can I be good at my job?”. 

I needed the loss of my unborn babies to be recognised

I know now that my grief didn’t need to be managed. That avoidance and putting on a brave face in public - telling everyone I was ok when I definitely wasn’t - made things worse. It needed to be free, to be allowed to show up, to explode or sob while my body recovered physically. I needed the loss of my unborn babies to be recognised, but instead I faced comments like “At least you know you can get pregnant” and “It wasn’t meant to be”. All well-intentioned, but they cut deep, leaving me feeling like my grief wasn’t real. 

There were many colleagues who got it right, though. One handed me a chocolate bar, saying, “I don’t know what to say, but I’m sorry, and I got you this.” Another checked in regularly, in very gentle ways like asking if I fancied a walk around the block or a cup of tea. My manager asked me what I needed, which was control of my diary and the flexibility I needed for medical appointments and therapy. I also wanted to work on exciting projects, to focus on work as a way to rebuild my confidence, and he gave me those things too, which led to a big promotion. 

I talk about my coaching as coming from ‘the scar, not the wound’.

It’s been over ten years since my first loss and the pain is still there. It’s not as intense, or perhaps there’s just more space around it so it doesn’t feel as sharp; it doesn’t cut me in the same way. I talk about my coaching as coming from ‘the scar, not the wound’. The pain will never disappear; the grief isn’t being managed, but the scar means I understand what my clients are going through. 

If you’ve had a miscarriage too, or maybe many, please know that whatever you’re feeling is real and appropriate. Baby loss is one of the hardest things I’ve ever been through, but the moment I let myself grieve, when I let it exist as part of me rather than fighting it, everything else, oddly enough, felt a little more manageable. 

Recent government policy changes regarding pregnancy loss and bereavement leave

For the first time, the law will recognise pregnancy loss before 24 weeks, including chemical pregnancies and unsuccessful embryo transfers, and for partners and the other biological parent too. That is a real step forward.

But the leave is unpaid, while leave after 24 weeks is paid. Nobody who has just lost a pregnancy should be left working out whether they can afford the time to grieve. Employers should treat April 2027 as the minimum, not the goal: ideally pay the leave, write an inclusive policy and make sure line managers know how to respond. That is a real step forward in recognising grief that is often invisible.

A further OVUM note: 

Miscarriage has sat outside almost every formal protection other losses get. This doesn't close that gap, but it's a step forward in creating a workplace that appropriately recognises pregnancy loss. We will continue to advocate for better policies, through donations to relevant organisations, partnerships, and work with communities. 

There is further support available: 

• Tommy's midwives are there for anyone affected by pregnancy or baby loss on 0800 0147 800, Monday to Friday, 9am to 5pm, or by email at midwife@tommys.org.

• Fertility Action can help if you've experienced loss as part of a wider fertility journey. They host a range of support groups and events for those struggling with a fertility journey. 

• If you lost a baby before 24 weeks, you can request a free baby loss certificate through the government’s Baby Loss Certificate Service here. It’s entirely optional, but many parents find it a comforting way to have their baby recognised.

Key takeaways

• Grieving and managing are not the same thing, and workplaces need to understand the difference. 

• Real support is specific. It’s asking questions about what you need, acknowledging your loss and checking in. 

• Baby loss needs to be acknowledged and grieved. There have been recent steps forwards in government policy, but there is still a lot more to be done.