Inclusion in Practice: How Employers Can Support Employees Through Fertility, Miscarriage and Early Pregnancy Loss

Overview

This week (3 - 7 November) marks National Fertility Awareness Week with a timely opportunity for employers to explore steps to turn a largely unspoken area into a source of inclusive advantage and cultural change through the implementation and use of supportive practices, policies and initiatives.

Why consider fertility, miscarriage and early pregnancy loss as an employer?

Studies and surveys from various organisations (such as Fertility Matters at Work, Pregnant then Screwed, the Chartered Institute of Personnel and Development (CIPD) and the Fertility Network UK) have produced the following statistics: 

• Around one in seven couples in the UK have difficulties conceiving, making it very likely that most UK employers with a medium to large workforce will have employees dealing with infertility challenges right now.
• Fertility challenges disproportionately affect women and those in same-sex relationships, both physically and emotionally. One survey found that fertility treatment affected physical health in 16% of women compared with 11% of men, and emotional wellbeing in 15% of women compared with 12% of men.
• In the CIPD (2023) fertility survey, 35% of employees with lived experience of fertility treatment believed this was a taboo topic in the workplace.
• A 2023 survey by Pregnant then Screwed found that 24% of people who told their boss they were going through fertility treatment experienced unfair treatment as a result.
• A 2016 Fertility Network UK and Middlesex University survey found that 90% of respondents undergoing fertility treatment reported feeling depressed.

The business case

Whilst the statutory framework in the UK does not currently provide for entitlements for leave for fertility treatment, miscarriage or early pregnancy loss, developments such as the proposed Fertility Treatment Employment Rights Bill and the extension of bereavement leave to cover pregnancy losses before 24 weeks (under the Employment Rights Bill) suggest that the law is beginning to change in this space.  

In the meantime, employers may wish to consider ways of staying ahead of the curve through the implementation or review of existing fertility and family-related practices and policies.

UK employers also have the opportunity to become ‘Fertility Accredited’ and we are seeing a growing number of large employers (including a number of large banks) seeking out this accreditation.  Achieving the accreditation allows employers to promote it as part of their culture, brand and for attracting talent, signalling that inclusion around fertility, miscarriage and early pregnancy loss is, therefore, not just about compliance; it’s about culture.

Sophie Creese, Co Founder of HeyFlow, which helps organisations take steps to improve inclusion in the workplace, says: “including fertility in a wider reproductive health strategy isn’t just about policy – it’s a strategic advantage. By addressing this overlooked retention hotspot, organisations can close blind spots in the talent lifecycle, creating a more inclusive culture and better outcomes for employees and the business.”  How an employer builds such a strategy is not simply a case of including a policy permitting employees time-off to attend fertility-related appointments – it is likely to be much more involved than that and could include the following steps:

Raising awareness, fostering a supportive culture, removing the taboo

Raising awareness through training of managers and HR teams is a crucial first step. Training should cover how fertility treatment, miscarriage and early pregnancy loss can affect individuals — physically, emotionally and practically, for those impacted personally and for those supporting them. 

Language also matters.  Inclusive terms such as ‘partner’ help ensure inclusion of men and also same-sex couples (and helps describe other routes to parenthood, for example via adoption or surrogacy).  Normalising open, sensitive conversation (without pressuring disclosure) can help employees feel safer to seek support.

Allowing platforms for those who have been through or are going through fertility and other pregnancy-related challenges (and opening that platform to all, including the mother or hopeful mother, the father or hopeful father and / or others involved in the process) can support further conversations and information-sharing opportunities.  It might be that talking about these processes is too painful for many employees, but sharing outcomes can go some way to removing any perceived taboo around the topic, improving employee experiences and demonstrating an open culture. 

Introduce or update fertility, miscarriage and pregnancy-loss policies

Whilst there is currently no requirement on employers to introduce or extend the benefits offered under existing policies (but this should be kept under review in light of upcoming changes in miscarriage bereavement leave, as noted above), if minded to do so, a comprehensive policy might address the following areas:

• Allowing reasonable time off for fertility appointments and recovery – this might be paid;
• Addressing miscarriage and early pregnancy loss with sensitivity;
• Inclusion of partners, surrogates and intended parents;
• Setting out confidentiality, wellbeing support and flexible-working options; and
• Using inclusive language.

One often overlooked benefit of introducing a policy is to ensure consistency of approach and to avoid managerial discretion or unequal treatment. 

Provide practical flexibility and leave

Paid time off for fertility treatment is an obvious choice for many employers seeking to increase benefits in this area. However, not every benefit needs to cost. Offering flexibility around appointments, working hours or remote work can make a significant difference to the employee experience.

The Equality and Human Rights Commission (EHRC) recommends treating IVF-related absences sympathetically, even where they are not legally protected. Extending similar consideration to partners recognises the shared impact of these experiences.

Offer benefits that go beyond compliance

We are seeing more employers introducing fertility and reproductive health benefits covering fertility investigations, IVF, egg freezing, counselling and miscarriage support.  Whilst the introduction of these benefits in some sectors has been seen as a means to keep people in the workplace longer before starting their families, such potentially negative press is likely to be far outstripped by the possibility of attracting and retaining talent in a competitive labour market.  

Unfortunately, not all employer benefit providers / insurers will cover fertility benefits. Employers can, however, utilise specialist fertility benefits providers to ‘bolt-on’ or enhance their current benefit package.  Such providers offer benefits such as payments towards IVF treatment, fertility tracking devices and doula assistance – all benefits that could help to retain key employees, generate goodwill and remove some financial stress. 

Equip managers and HR teams

Line managers play a vital role in creating a safe environment for disclosure and support. They should be equipped to respond when a member of their team shares their experience confidentially, and to handle time-off requests and provide flexibility without stigma.

Monitor, review and evolve

Regularly reviewing policies, training and employee feedback ensures that support remains relevant and effective. Employers should track take-up rates and awareness, particularly given the CIPD finding that over half of employees are unaware of the fertility support their employer provides.

Monitoring can also help measure the impact on retention, engagement and wellbeing, thus demonstrating that inclusion initiatives deliver tangible results.

Practical next steps for employers

Fertility Matters at Work (Become a Fertility Friendly workplace - Fertility Matters at Work), the body recognising employers in the UK with fertility accreditation, notes that employers should undertake a holistic review of policies and practices as well as the implementation of a series of supportive initiatives.  Such steps can include:

1. Auditing policies for references to fertility, miscarriage and early pregnancy loss.
2. Analysing data, feedback and wellbeing outcomes. Reviewing regularly.
3. Engaging HR, managers and employee networks to understand staff needs.
4. Implementing or updating fertility, reproductive-health, miscarriage and baby-loss policies.
5. Communicating support clearly and training managers to respond sensitively.
6. Implementing flexible working and paid leave options.
7. Staying alert to legislative change and update the approach accordingly.

For any support with the legal issues raised in this article, please reach out to Carlene Nicol - Burges Salmon.