People who suffered pregnancy loss say silence and stigma cuts off emotional, financial support
Limited info about physical process, recovery support means families 'go into it blind'
This story contains graphic details and references to pregnancy loss that some readers may find distressing.
When the beginning of a miscarriage brought on bleeding and cramping, Laura Payton turned to the internet to find out what else her body might be about to go through.
She was disappointed with the lack of information she found.
"We don't talk about the gritty details," said Payton, a writer and government employee in Ottawa.
"It's one thing to say I had a miscarriage. It's another thing to understand that it can be painful for some women, and it can be pretty horrifying," she told The Current's Matt Galloway.
"I mean, in some cases you might see recognizable tissue that looks like a fetus or a baby."
Payton was 13 weeks pregnant when she suffered the miscarriage, which happened over several days in December of 2019. She ended up in the emergency room, experiencing labour pains. While she was changing out of blood-soaked clothes in a washroom cubicle, she looked down and realized the fetus had passed.
While she understands the process can differ from person to person, Payton said having a broader sense of what to expect might have reduced her fear and anxiety. Months later, she wrote about her experience online, hoping that other families won't "have to go into it blind."
The Society of Obstetricians and Gynaecologists of Canada estimates that 15 to 20 per cent of pregnancies end in miscarriage, usually before eight weeks gestation, but including up to 20 weeks. Pregnancy loss after that time is defined as a stillbirth, which Statistics Canada estimated occurred in roughly 8 out of 1,000 pregnancies in 2018.
Payton thinks the silence around loss is partly that "pregnancy is considered a happy thing — and there's this idea that you don't want to taint it with the idea there could be a loss."
Friends and family may not want to press for detail, she added.
"You just want to support them and be there, and so there's less discussion because of that."
Journalist Andrew Waterman experienced that reluctance when his wife had a miscarriage in 2019. He wrote about their experience, but when he met with friends soon after, no one mentioned it because they were unsure if he wanted to discuss it.
"It was funny because of course I wanted to talk about it — I just published an article about it," said Waterman, a reporter for The SaltWire Network in St. John's.
It was a marked difference from the flood of messages he and his wife received about the article online.
"Everybody knows someone, but no one seems to talk about it."
Silence cuts off support
The silence around pregnancy loss also keeps people from accessing support in recovery, said Stephanie Gilbert, an assistant professor of organizational management at Cape Breton University.
Gilbert has been conducting research into how workplaces support employees affected by the issue, and has recently interviewed 36 people about the challenges they faced returning to work after a loss.
While her research is yet to be published, she found that experiences "vary wildly from one person to the next, and largely would depend on who your boss is."
"People who have really compassionate managers might feel really supported. Others might not even feel safe telling their manager that they're having a loss at all," she said.
In many cases, no time off is taken at all, particularly for people who are self-employed or in precarious work, she said.
She found that leave options aren't communicated clearly, which means many don't realize they may qualify for federal support.
If a pregnancy ends before 20 weeks, sickness benefit might be available. After 20 weeks, you might be able to access maternity benefits, which Gilbert said could mean 15 weeks of paid leave through employment insurance.
Gilbert's research grew from her own pregnancy loss, at 37 weeks.
What most people do is just say, 'Well, you know, I've got a few days of sick leave ... I'll just do that and then I'll go back to work.- Stephanie Gilbert
She remembers a clear, concise email from her HR department, conveying condolences, but also explaining what benefits she qualified for. The email included a number to call, and information on accessing counselling through her workplace.
"That email saved me a lot of grief in not having to go digging for that kind of information," she told Galloway.
"Rather than do that digging, what most people do is just say, 'Well, you know, I've got a few days of sick leave, I've got a few days of vacation, I'll just do that and then I'll go back to work,'" she said.
While not everyone qualifies, there are people who "aren't benefiting from programs that do exist," she said.
Changes could reduce distress
Gilbert thinks the federal government could partner with HR professionals to increase awareness of those programs, standardizing the information people are offered.
In a statement to The Current, Carla Qualtrough, the minister of Employment, Workforce Development and Disability Inclusion, acknowledged the need for improvement.
"The pandemic has shown that Canada needs a more modern and inclusive EI system so that it better reflects the changing ways in which Canadians work, including providing coverage and support for the self-employed," the statement said.
Last month, New Zealand approved three days' bereavement leave, becoming one of a handful of countries to enshrine leave after a pregnancy loss in law. The U.K. offers two weeks' paid leave if a pregnancy is lost after 24 weeks, while the Philippines offers 60 days paid leave.
In April 2018, Conservative MP Blake Richards put forward a motion calling for more federal support in the event of a pregnancy loss. A report from the Standing Committee on Human Resources was tabled in Feb. 2019, making seven recommendations.
Gilbert said she supports the recommendations, including ways to make it easier to report the death of your child.
That would mean grieving parents don't inadvertently receive things like reminders to apply for a birth certificate, she said.
"That kind of thing can be quite distressing," she said.
The federal government issued a response to the report, but was recently criticized by Richards for leaving its recommendations "gathering dust."
Gilbert said she's only seen one other study on pregnancy loss related to work, from the early 2000s. She hopes her work can fill a gap when it comes to research "that can inform practice and policy change."
Payton and Waterman were both unaware of the supports that Gilbert described, and hoped that sharing their stories might help families facing a loss in the future.
"If more people are talking about this and if my article encourages people to share their experiences and to approach each other when they need help, then that's a way I can bring a little bit of meaning out of something that was incredibly difficult for our family," Payton said.
Written by Padraig Moran. Produced by Ines Colabrese.
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