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Losing a baby at 20-24 weeks of pregnancy

Going back to work after losing a baby before 24 weeks

Entitlement to maternity and paternity leave and pay

One of the particularly difficult aspects of losing a baby before 24 weeks of pregnancy is that many parents are not eligible for maternity/paternity pay or leave. The rules state that only parents whose baby is born dead after 24 completed weeks of pregnancy or whose baby is born alive at any gestation but who dies shortly after birth are entitled to maternity and paternity rights and benefits. If a baby is born dead before 24 weeks of pregnancy, parents are not entitled to these same maternity and paternity rights and benefits. 

Only a few parents we spoke to were eligible for maternity or paternity pay and parental leave as their baby was born alive but died shortly after birth. Those parents who did get leave found it gave them time to decide when they were ready to return to work and reduced the burden of financial pressures. Camille’s baby was born alive and she had six months maternity leave and felt it was definitely what she needed. However although these parents were eligible for parental leave and pay, many employers were not clear of the different rules of entitlement. Several mothers had problems proving they were entitled to their maternity leave.
 

Asun appreciated her maternity leave as it gave her time to heal and meant she didn’t have to worry about having a long period of sick leave on her CV.

Asun appreciated her maternity leave as it gave her time to heal and meant she didn’t have to worry about having a long period of sick leave on her CV.

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But at least he gave me - he was born naturally. Which - He was born alive, so we have time together.

And he's given me this time off, as well to recover. So he has been kind to Mummy. Yeah. 

How do you think it would have been without that maternity leave?

[Sigh] I don't know. I don't know. Because. The thing is, it [sigh]. Being off sick for a long time, it doesn't look good on your CV. So it would have been more difficult. I don't know if I would be off now. Because I'm taking six months. 

I'm back in July. And not only that, of course it's just that I guess the healing process you need to go through is - it's pressure, somehow. Because you have, you have in the back of your mind, 'oh, I must get back to work'. So I guess you can’t fully - you can’t take it on your own time, I guess. And I think it's not fair. Because for me it would have been the same. But if he had been born dead, I wouldn't have had maternity leave. And it would have been a matter of three hours. Because he was born quarter to ten. If he had been born after midnight, I would have had maternity leave because he was twenty four weeks. But for me, those three hours - they don't make any difference. So for me, it would have been the same. 

But it would have meant I wouldn't have had the time to heal or recover, or started to come to terms with what happened in my own time, and without pressure there. So I want to think it was him, who gave me the time. Because he did. Yeah, because he - if he had been born after midnight, he was - he would have been twenty four weeks already, and they will have had to resuscitate him, or try to. And that would have been a very different picture for me, as well. Because I didn't want him to suffer.
 

Camille was a student midwife and had to argue for her entitlement to maternity leave.

Camille was a student midwife and had to argue for her entitlement to maternity leave.

Age at interview: 26
Sex: Female
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And what about - You touched on being a student midwife. So, were you a student at the time? There wasn't any work that you needed to not - that you were having to take time out from, or?

Yes. I was a student at the time. Obviously I was - When I was admitted, I was pretty much signed off, [laugh] - they knew that I was there, so they knew I wasn't going to come to work. 

[Laughing] Mmm.

And then after she was born, I did actually go back to placement. That was about seven weeks later. Which, I started in the community, thinking that that was going to be easier than going back to the hospital.

Except that I didn't think that at that time - I would have been twenty eight weeks pregnant, which is when you have one of your midwife's appointment. And I realised that when people came in with due dates very, very close to mine. And I particularly remember one of, one of the ladies just coming in, and starting saying how she was excited because she was having a little girl. And the midwife didn't even - it didn't even cross her mind to say, "Do you want me to do that one?" She just let me get on with it. And I literally just had to smile and pretend that I was excited for her, and palpate, and listen to her baby's heartbeat, and do all her checks, and. I managed to do a couple of days. Going to the bathroom to cry. And after that, I was on my way home, I was driving the car, and I literally wanted to drive into a wall. And at that point I knew that it was not the time for me to go back to work. So I actually went straight to my GP, and said that I was scared. And he said that the fact that I was reacting like that, and coming to see him, he wasn't worried. Because he could see that I was aware of everything, and nothing was going to happen. But he said obviously, "Don't go back to work." So, after that I asked the university whether I could be entitled to maternity leave, because although my pregnancy ended before twenty four weeks - because she was born alive, she's actually classed as a neonatal death. Which, in terms of things like child benefits, that makes a huge difference. I wouldn't have got anything - Like I could get something, basically. Like somebody who'd had a stillbirth. Whereas if she'd been born dead, that wouldn't - I would have two weeks off work. I suppose it's sick leave, I think you get. And when I contacted the university, they said that because it was under twenty four weeks, it was two weeks. And then I argued with them, saying "Actually, it's a neonatal death, it's not a miscarriage." And they said, "We don't know." [Laugh]. I don't think they've ever come across anything like that before. So they had to decide - they had to ask the board of university, I don't know what. Anyway, in the end, they granted it. And they said I could have maternity leave. So I took six months off. Which was good. Because that's definitely what I needed. And then after that, I decided that there was absolutely no way I could go back to the place where my daughter died, and deliver somebody else's baby. So I asked the university to be transferred to another hospital. Which at the time, they said they couldn't. And I said, "Well, that's really sad then, because that means my training is ending here." And actually, they did manage to move me. So I managed to finish my training in a different hospital. Which was probably - apart from giving birth to her - was probably one of the hardest things I've ever had to do. And the most heartbreaking thing. Because it used to be such a joy, to hand over a newborn baby to their happy parents. And it wasn't, it was just so completely heartbreaking and in my face, that’s not what I got, and a lot of flashbacks, as well. 

But I did it. I did it, thinking of her the whole time. And I think that really helped, making me think that I was doing this for her. That really got me through it.
Most of the parents we spoke to were not entitled to parental leave and pay because their baby was not born alive and so they had to take sick leave from work. Many spoke about feeling “huge pressure” to return to work. Parents also found having to visit their GP to extend their sick leave stressful. This was eased for Vikki Z as the hospital provided her with a sick note for a month. 

Parents often spoke about how unfair the system seemed, as they would have received parental leave and pay if their baby had been born just a few weeks, days or even hours later or had shown signs of life. For Lindsay this reinforced her feeling that society didn’t recognise the impact of her loss. Liz felt maternity leave would have allowed her to have “a bit more breathing space and recovery time”. Sarah felt that “for the sake of ten days… I had a completely different, you know, chance of recovery than everyone else”. Fathers’ access to paternity leave was also affected
 

Courtney went back to work after two weeks as she wasn’t entitled to maternity leave. She found it very hard returning to the place where her miscarriage had started.

Courtney went back to work after two weeks as she wasn’t entitled to maternity leave. She found it very hard returning to the place where her miscarriage had started.

Age at interview: 30
Sex: Female
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So, when we lost, two weeks later I went back to work. Because it is a second trimester loss, again it isn't counted as a stillbirth. You don't get any rights. You don't get any help. So you do have to just go back to work. You're lucky if your company gives you bereavement time, which mine was two weeks.

And, so I went back to work after two weeks. And it's literally the worst thing you can do. Because -

Going back to work?

Yeah. Especially with mine - my miscarriage started at work. And there was four of us all pregnant at the same time. So I was going back to work and sitting with the three other girls who I was two weeks ago, who were talking about their pregnancies. And I'm there, not pregnant.

So the whole situation was really tough. And - But again, you don't get that support that you would , like some - For instance, if you are counted as having a stillbirth, twenty four weeks later, then I'm entitled to taking part of my maternity cover. And it amazes me. Because I think to myself, 'right, I was four weeks away from that'.

If I was one day away from that, would I still not get it? And you wouldn't. You would still not get it. Even though, twenty four hours later, you'd be entitled to that. So there's no - You'd be at exactly the same stage. Like there's, there's just - there's something that needs to be allowed during that. Because it doesn't matter when you lose, you're grieving the same amount. 

And, you know. All - You're not grieving just because you lost, you're grieving because of the future that you'd planned. So it's really different. So I had to go back to work, and - and just get on, get on with everything. And I think that really takes a toll on you. 

Because how can you grieve when you're not given that time? For instance, with the people from my friends that - from my counselling group that have lost in their third trimester. They've got their maternity cover. Almost fifty percent of them are pregnant again. 

And I a hundred percent believe that's because they were given the time, and that space to be able grieve properly. And be able to wallow for a few weeks. And you know, not - sometimes you don't want to do anything, you want to just wake up in bed and cry the whole day. 

And I think that's perfectly fine. But you've got to be given that time to do that. And there's something that's said about that, definitely. You know? If you're given time to understand your emotions, understand your feelings, and grieve - then you can move on with your life a lot faster. It's a lot healthier. It's a lot better. Whereas a lot of the people that I know that have lost in the second trimester, that have to go back to work and have to just be like get on with their lives, and people are just like 'oh, you're not over that yet?' Sort of thing.

You know? 'It's a miscarriage'. Or someone will say to you, "I had a miscarriage." And you think, 'oh, I was so close, though' [laugh]. And It's different. It's different. It's a lot - takes a lot longer. I see it. Definitely see it. 
 

Carly felt a huge financial pressure to return to work as she was not eligible for maternity pay or sick pay and felt demeaned by having to ask for a sick note.

Carly felt a huge financial pressure to return to work as she was not eligible for maternity pay or sick pay and felt demeaned by having to ask for a sick note.

Age at interview: 30
Sex: Female
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Well, I think maternity leave - for me particularly, it was difficult because my work don't - I only work part-time because I had [my son]. So I was only working sixteen hours a week. And my workplace don't pay sick pay. So I couldn't get any financial help.

Whereas obviously if I'd been able to take maternity, then I could have - It's not about the money, it's just you need that to live. So I ended up getting statutory sick pay off the government, which - it isn't, you know, very much. And it was almost demeaning having to go and ask for it, and keep asking for a sick note, and having to go back and explain why you need a sick note. If you'd been allowed to have maternity, you could have had that time to recover from labour - which is significant in itself - and then the grieving process goes on for months and months. And I ended up going back to work after three months, but you know, in hindsight I wasn't ready at all. Like I go to work and I'd sit in the cupboard and cry. You know?

I was - but I felt like I had to go back to work, because I didn't have - I didn't want to keep on asking for a sick note. So I just said, "I'm just going to go back." But really, I should have been entitled to my maternity. You know? I was preparing for it already. 

But I think - I think if I'd had maternity, you know, it would have been a worry off my shoulders. To not feel pressured to go back, and have that breathing space. And, but it - it just didn't happen like that. But I think that it should. You should get your maternity. Even if it's half maternity. Even if you got six months, or - you know - just a bit of time to recover. Because not only have you been through delivering a baby, you've got - you know - grief. It's, you know - it's - It takes a long time to get back to a bit of normality after something like that happens to you.
While many parents felt taking time off work after the birth was essential, others were pleased to get back to work and keep “busy, busy, busy, busy”.
 

Kerry went back to work after three days. Working long nights was her way of coping.

Kerry went back to work after three days. Working long nights was her way of coping.

Age at interview: 47
Sex: Female
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So I was booked off three weeks. I went back after three days. And I was working long nights, because I was working for a partner who was really busy. That stage. So I was working until eleven at night because I had no other commitments. And with [partner]'s work, he would work overtime. I actually landed up bleeding, from all of the extra stress of it. But that was - For me, that was just my way of getting through, and coping. I wasn't having to think about what happened. And I just - that's why I think that I blocked so much out.
While returning to work was extremely difficult, for some parents it was a “welcome distraction” and helped get a feeling of “normality”. For Sarah who worked as a teacher, going back to work helped her mind to focus on something as her job felt “all-consuming”. Kirsty described going back to work as horrendous but couldn’t see what else she could do as “I can't sit down and dwell on it. I'm a doer, and that's how I deal with things“.
 

Emily and Mike found their employers supportive in taking time off work and after six weeks Emily felt ready to get back into a routine.

Emily and Mike found their employers supportive in taking time off work and after six weeks Emily felt ready to get back into a routine.

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Emily: Yeah, six weeks I had in full. Tough. But I popped in, in between, just to say hi to everyone. Because I didn't want my first day to be the first time they'd seen me since she was born. So I just popped in, to sort of say hi, and saw all the girls. So that was quite nice. And again, terribly supportive, and kept in touch. But.

Mike: Well, I went back to work, and it was just - It was pretty hard. And then my boss just said "Look, just - you don't need to be here, we've kind of got it covered." So then I stayed for the extra two weeks that you were off as well. 

Emily: Yeah.

Mike: And he was, that - he was like, "Yeah, that's fine." So again, it was six weeks for both of us.

Emily: But again, I just wanted to get back. By that stage, I was ready to get back into a routine, and kind of get on with things, really. Because it just - We weren't achieving anything by the end of it, were we? If the funeral had been earlier, I think we probably would have gone back to work earlier, actually. But, because that sort of dragged out.
Support from employers

Parents’ experienced varying support from their employer and colleagues. Many were extremely positive about the response of their employer, who encouraged them to take whatever time they needed. But other parents had a less positive experiences. Some mothers were pressurised into returning to work as they weren’t eligible for maternity leave. In contrast while Joelle felt ready to return to work, she was extremely upset when her manager told her that she didn’t think Joelle was emotionally ready to return.
 

Collette felt that her employer’s experience of infertility made her extremely sympathetic about the difficulty of coming back to work.

Collette felt that her employer’s experience of infertility made her extremely sympathetic about the difficulty of coming back to work.

Age at interview: 41
Sex: Female
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My boss is amazing. I've obviously worked for her for the entire time that I was trying to have a baby. So she - And she herself struggled to have children, and had given up, and then fell pregnant. So she was like - almost like the perfect person to work for [laughing], because she knew. 

She'd been through everything too. And she had given me all the time I had needed, and days off like - I couldn't have asked for a better, better place for this all to have happened. But she - I sent her a text message telling her what had happened. And she just said, "Do what you need to. You don't have to call, you don't have to worry about school. Do what you need to." And I never heard from her for months. She just left me alone. She didn't badger me about 'when are you coming back?' And it was me that eventually called her and said, "I think I'd like to come in, just for a morning. And maybe see -." Because obviously I think a lot of parents - especially the parents of the kids that I was teaching - were very concerned, and wanted to send cards, and get in touch. And I think she'd sort of said, "Well, I think maybe leave her alone for now. And then you can maybe in a couple of months when she's feeling better." And I wanted to kind of see them, and just - and they were amazing. I met up with the staff, which - I don't know how I feel about that, actually. I had a - I kind of met after school, with all the staff. And they - they wanted to know. I think they wanted to have the meeting to find out how they could best support me. But it was very hard. It was so hard to sit there, and - I spoke about my son, I took pictures to show them. And I just cried for the two hours I was there. But I guess it was - It was really important for me - for me, to let them see the real, the reality of it.
 

Vikki felt pressured by her manager about returning to work and ended up leaving her job.

Vikki felt pressured by her manager about returning to work and ended up leaving her job.

Age at interview: 33
Sex: Female
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And then I remember phoning her after I found out that there was no heartbeat, and saying "I won't be in work. This is what's going to happen. I'm going to give birth. And then I'm not going to come back. I'll be in touch with you." And she insisted on phoning me every single week. It was a Monday morning thing. She'd phone me every Monday morning. We'd be on the phone for about half an hour to an hour, just talking about what had happened with regards to the funeral arrangements and everything. Because I'd said to her at that point that I want to have the funeral first, and then I'll come back to work. And, yeah. I remember - every week, I'd dread that phone call. And she'd be asking for my certificates to be - my signed-off certificate from the doctor to be sent in, my sick note to be sent in. And that's fine. But I remember kind of her pressing, "When are you going to come back? When are you going to come back?" And eventually I think I went back July. Realising that I'd need to change my hours, if I was going to be able to do the school run. And not having anybody else available to do it. We'd worked out that my partner's work said that he could work from home on the two days that I'd need to work, and he could take my eldest daughter into work, into school. Which is fine. And then I'd need to leave work early to go and pick her up. And they wouldn't change my hours. They wouldn't agree to change my hours to the ones that I needed. Which I found very unfair [laugh]. So I said I had to leave. They didn't leave me with any choice, other than to do that. I was very bitter about it all, very angry. And angry because I shouldn't have been in that position in the first place, but angry because they weren't that flexible.
Going in to work for the first time

The first day back at work was very difficult for most parents and their experiences of colleagues’ behaviour was mixed. For some popping into work before their first day back eased their return. Parents found the return to work easier when their employer understood more about their loss. For Kelly, writing a letter to her manager explaining her experiences helped colleagues support her when she went back to work. Nesta appreciated a suggestion from her midwife of trying to anticipate some of the questions colleagues might ask her when she went back to work. Sam wished her employer had something to read to help them understand what she was going through.

Changing career

Other parents we spoke to felt they had returned to work too soon. This often had longer term impact with many mothers taking a second longer period of sick leave. Others decided to leave work and change career. Helen Z worked for a company making baby clothes and found it too hard to return. Others moved into less pressurised jobs because they needed time to reflect. Helen resigned from her job as a lawyer because it was so demanding and worked as a teaching assistant at the local school.
 

Vikki Z described the difficulty of being back at work as a teacher working with young children and how it led to her having a breakdown.

Vikki Z described the difficulty of being back at work as a teacher working with young children and how it led to her having a breakdown.

Age at interview: 38
Sex: Female
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So, just carried on with life. But it was awful life [laugh]. But nobody knew how terrible it was, I don't think, until I think when I sort of had a bit of a breakdown. I didn't realise I was. But I remember finding work really, really difficult. Because obviously I'm looking after a class of thirty children, and well trying to teach a class of thirty children, young children. And I just found my patience sort of wearing thin. And I wasn't being as, yeah, as patient as I should have been, and I was snapping quite easily, and just felt like I wasn't concentrating on the job, and my mind was elsewhere. And what was really difficult is the teacher in the class next to me, she was pregnant - we were due within a few weeks of each other - and the closer she got to her due date, the harder it was. At first it was okay. But the closer - So, yeah. We were due in April. End of March, beginning of April. And the closer it got to that time, the more I couldn't deal with it. And that - I think that is actually what brought it on. And I mean, it's not her fault - it's not her fault. But if she hadn't have been there, I think maybe [laugh] I would have been able to carry on. But I couldn't. I just, I just had a bit of a breakdown, really. And [my husband] ended up ringing the hospital, and just saying "What can I do?" I didn't realise he'd even rang them. But they put him in touch with the - a counsellor called [counsellor’s name], at the hospital. Who, who actually just, that's her job, to deal with things like this. And then, so yeah. I went to see her pretty much the next day. And she said to take more time off work. So I took more time off work. And that was the process I think, then. You know, after getting to rock bottom, after carrying on like as normal for so long - because this was probably March time. 

Yeah, so carrying on - It was the due, it was that due date coming up that was really the difficult thing, really. Yeah. So the carrying on as normal, as I could do, for that time. You know [laugh], like always having no fun, but I was - I was doing everything that I would normally do in life, because that's what I to do for the kids and everything, really. Yeah. And then it just - just had a bit of a breakdown, and had to, and stopped. But that point was good really, because actually that was when I actually started getting better. But it just took me a long time to realise that that - that coping strategy was not really a good, a good strategy whatsoever.
 

Sam found returning to work at a nursery extremely stressful.

Sam found returning to work at a nursery extremely stressful.

Age at interview: 26
Sex: Female
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In fact, I went back to work. And I remember, I walked in to - Because like I said, I worked with children. And I was based in the baby room. And I'd said to my manager, "I really don't think I can face that." And then she went, "Oh, it's alright." The person that did like the secretarial jobs, she was off. So she said, "You can do that for the week, and - you know - ease yourself in." And I was like 'okay'. And.

How long was this after? 

This was a week and a half. Because I was off from the Wednesday, and I got a two week sick note. But I actually went back on the Monday. So it's - yeah, about a week and a half. And so I went back in. And on the Monday, she got me to deliver papers into the baby room, which I literally just opened the door and dumped them on the side. On the Tuesday she asked me if I could cover lunches in there. And I was like "Oh, I really don't know how I feel about it." But she'd never had children herself, so I don't think quite got what it was that I was feeling.

And made me do lunches in there. And she's not the sort of person that you could say no to. And I - you know. Half an hour doesn't seem like a very long time, but when you've got screaming babies all around you, and you haven't got your own, it was actually the hardest thing I ever did. And. Looking back now, I'm quite proud I made it through the half an hour. I did make it through. And then it was like every day she was asking me to do a little bit more. By the time I got to the Thursday, I was a complete emotional wreck. I was bursting into tears constantly. And she couldn't - she couldn't fathom why. She did not - she was so disconnected from it, she didn't understand it. And I - On the Thursday night, I barely slept. And my Mum rang. My Mum rang in on the Friday and said, "Sam will not be coming to work, she will be getting a sick note. If I'd have known you were going to put her back in the baby room, she wouldn't have been coming back anyway." But mainly because my partner had rang my Mum and said, "This is what's happening. And Sam won't ring in sick tomorrow, so you need to do it for her, because I'm already at work." Because he - He started work before I did, so he knew that I'd just go to work. And my Mum did.
 

Sharon felt she couldn’t cope in her high pressured job and decided she needed a break.

Sharon felt she couldn’t cope in her high pressured job and decided she needed a break.

Age at interview: 45
Sex: Female
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And I took three weeks off work, and then went back to work. Just very much of 'well it's happened', and - and I went back to work. And I struggled with it. And for the probably the next [sigh] twelve months, I - the feelings of the gap and the loss actually seemed to get worse. To the point that I couldn't cope with work. I threw myself into work but then couldn't cope. And I remember driving down the motorway thinking 'this has got to stop, somehow this has got to stop'. And, and thinking that how could I stop this? And I thought 'this, this is - this is wrong'. And I didn't really have any help. And then I, yeah. So then after that I decided I couldn't really cope. I had a very high pressured job. And I gave up my job to do teacher training, because I just felt I needed a break. 
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