3.4 Conversations about wellbeing

Having conversations about personal matters in the workplace can be difficult. As an individual you may not be ready to share what might be happening in your life, for many reasons, and as a manager you may not know how to start a conversation with a member of staff to ask if something is wrong. Often it is only at the point where something ‘happens’ – such as behaviour that is out of character, poor performance or unexpected absence – that starting a sensitive conversation becomes unavoidable.

Feeling able to openly share a personal experience in the workplace can take time, and often only happens once the individual has first spoken to close friends or family, then to trusted work colleagues, and eventually to their line manager. In the case study below, we use the example of miscarriage to help you consider how you might approach sensitive conversations at work.

Case study: miscarriage and the workplace

There is increasing evidence that the COVID-19 pandemic has had a significant impact on progress in gender equality. You can explore issues affecting women in the section on Inclusion considerations for females in the Hybrid working: organisational development course within this collection.

Women’s health issues linked to fertility are common, be these difficulties conceiving, complications during and after pregnancy, or menopause. Miscarriage is a sensitive subject because the societal norm in the UK is not to disclose that you are pregnant before 12 weeks, yet many miscarriages happen in the very early stages of pregnancy. This can lead to people going through a grieving process that others are not aware of. The Tommy’s National Centre for Miscarriage Research works with universities and hospitals and is dedicated to understanding more about the reasons for, impact of and prevention of miscarriages. Research by Tommy’s has suggested that both women and their partners have experienced post-traumatic stress disorder (PTSD) around miscarriage:

In video below Esther Spring, Learning Lead - Digital and Innovation, and Dr Nick Barratt, Director, Learning and Discovery Services at The Open University, discuss her experience of miscarriage and the support she received in the workplace.

As you watch the video consider how you might approach a similar situation, and what support your organisation has in place. It could be helpful to think about how you feel, listening to what Esther experienced, as being aware of how you might feel and react could influence how you approach similar conversations in the future. Then consider Nick’s reflections of the experience, at the end of the video.

Trigger warning: Please note that this video discusses the process and impact of miscarriage in detail.

Download this video clip.Video player: hyb_4_2022_sep112a_diverse_voices_misscarriage_compressed.mp4

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Transcript

NICK BARRATT:

Esther, thanks so much for joining me. We're here to talk about the sorts of conversations that can be very difficult and awkward relating to health matters well-being, mental health, but in your case, some things that have happened to you that don't make for very easy conversations.

And so it's really to shine a spotlight on the trust and confidence we need to have in a hybrid world of having those chats, but also being a bit empathetic. And that's sometimes difficult because what we're going to talk about is something that I've got no personal experience of. Do you want to say a little bit about what's happened to you at work?

ESTHER SPRING:

Yeah, so one of the things I wanted to talk about was miscarriage in the workplace and actually, in your personal life. It's one of those hidden things that I think because culturally we don't announce to anybody we're pregnant till we pass the 12-week stage, which is a really interesting thing because actually, that impact on people losing a child. And you don't tell anybody. And for me, I've had five miscarriages. And three of them were quite-- I was quite poorly with them. And I was working during that period of time both two of the early ones I was on site and then the last one, I was working remotely. And they're really different experiences.

And I know reaching out to colleagues I was, on 15th October, is the miscarriage loss day in births. And I always post on Facebook. And last year, I posted and an ex-colleague got in contact with me and just said, I'm so glad you did that. I lost a child two days ago. And I really don't know what to do because it's not the first miscarriage.

And I had really mixed experiences when I had my miscarriages. I'd had the textbook first child. And it was a bit of a shock having a miscarriage because nobody had really talked about miscarriages after your first child. And the first one I had was, I'm going to say it was easy because it was about six weeks. And it was like, OK, this happens. Obviously, something's gone wrong here.

But I do remember that first one of not knowing where to get help and I remember googling in the morning trying to go-- is this just a bit of I'm just bleeding a little bit. It's all going to be fine. And not knowing what to do because you're reading everything, and in the back of your mind, I kind of knew what was happening. And we kind of got on with our day up until about lunchtime. It was a really weird day. We had to go up and see my family because my sister was there with her new baby. And I just remember sitting there with this new baby going, I think I'm losing my baby. And we hadn't told the family because it was post-six weeks.

And got home really didn't know what-- we ended up going to the Walking Center at the hospital with my daughter who was, I think, about a year and a half at that point. And it was just a very, very straightforward conversation. It was kind of like we all knew what was going on. He said, there's nothing else I can tell you. You're just going to have to go home. And I think I went into work probably. I think I took a day off and said, I had a stomach bug and went in the next day. So within two-day period of losing the child, I went into work. And I said nothing. I just went back into work and worked. I didn't think about it. I just kind of went, OK, it's fine.

The second miscarriage I had, I ended up in hospital. I was 11 and 1/2 weeks pregnant. I got up in the morning, and I went and did my OU exam. I just sat there and went, I know what's happening. I can't face having to wait six months to do this exam again because I was in the middle of doing my MBA. So it's all on a schedule. And so I went into my exam. And I told the examiner, I've got a stomach bug. I just want to get home and got home. Rang the doctors because like, this doesn't feel right. So I drove round to my doctor's. And he said, oh, definitely, you need to go into hospital.

I got home rang my mother-in-law because I had my daughter to look after, and she came over. I'm sitting there trying to sort out my daughter, and my mother-in-law was ringing the ambulance to say you're not going to make it in a car because-- in my mind, it was a really logical thing to do.

I ended up lying myself in the shock position by my front door because we've got steps into my house so that when I got there, the ambulance could just get me out. And I just remember the person said, we're really glad you did that. We weren't going to get into your house. When we were in the-- we went up to the gyny area, and that's a weird expense because you have to walk through the area where people have got their new babies.

I had a male nurse, and he was amazing. It was just very calm, organised. Ended up staying. Again, it was like I just went home at 4:00 in the morning. I was like, I've got to get back. I've got my daughter. And that's the other thing, when you've got a child it's you've still got to get on with life. And I think I ended up taking probably three or four days off because I really wasn't well.

And when I came into the workplace, and it was in the days where you still had your sick notes. Handed it over to the office assistant and we were in an open-plan office. And she misread it and congratulated me on being pregnant. And it was a bit of one of those weird ones. I had to say, actually, I've lost the child. And in some ways it was really good because it out in the open of what happened because most of the office heard about it.

And I had about seven other ladies just say I've lost one and one of them had lost a child at seven months, and one had had a stillborn. And it changed the dynamics from the first time, where I just didn't say anything, to there are open conversations about it. And my line manager at the time, she was amazing.

It was very much, take the time you need. People covered me for going to meetings because I really wasn't in a great state. And I had lots of complications afterwards. So I had to go back and forth just to doctor's appointments. But it really changed, being able to talk about it, and that I wasn't the only person who had done this. And it just took a long time. I think I was on antibiotics, off and on, for about four months, which also impacts other health issues. And it was just a really surreal time of, you're trying to function at work. You're trying to be a mum to your child.

I think the other side that didn't really get talked about is, the impact on my ex-husband. We just didn't talk about it. I think we talked about it at the time, and it just became something we didn't talk about. And we were focusing on me getting healthier and then trying for another child. Me, it was very much I wanted a second child. And it took about three and 1/2 years before I got pregnant with the second child, but in that time, I'd had two What I call chemical miscarriages, where you're five days late, and it's not quite the point, in those days, where the pregnancy tests were accurate enough. You had to wait five days.

And I remember having a period at work and sitting there in the toilet just going, oh, I'm not pregnant. I have to come back to my desk and all those emotions again, of we've got to cry again. So when I finally got pregnant, and I think that this was the thing that really surprised me of having had kind of enjoyed the first pregnancy.

I hated being pregnant. I woke up every day thinking, am I going to lose her? Towards the end, we had problems because she just wouldn't move till about 10:00 at night. So I ended up having to go in every 48 hours for monitoring. The workplace was amazing. I had really good line managers. And by that time, I'd swapped roles.

So my first line manager had been a female. And then my second one was a male, and they equally were-- I was just very, very lucky. I had really good line managers. And my second daughter, she was induced a week early because I was under consultant because of all the problems. And it's all those things that you're having to cope with, as well of you come into work, you do your workplace, and everybody thinks everything's fine.

But in the back, there's all of these things going on that you just don't see, and some days you'll be fine. Some days you won't. You're worrying about things. I had people take me for coffee. And both males and females, actually, and it was really good the different perspectives.

And some of the males I've spoken to, they'd been through it as well. And really different perspective. For them, it's not just about they've all equally lost a child, but they've also had to see their partner go through something quite traumatic. And it's nothing they can help them with because it doesn't happen. There's no physical thing to them that happens, but that mental impact on, I think, both partners is quite a big thing.

My last miscarriage, I, for various reasons, ended up seeing a counsellor for lots of reasons. And funnily enough, when I spoke about the miscarriage. She just asked me the question, have you ever talked about how you actually felt? And I said, no, I just got on with things. And we started talking.

And it's been really interesting talking about it because I hadn't realised how much it actually impacted me and particularly, the last one of-- I lost a child. And I didn't talk to anybody about it. I lost a child. It's a child, actually, I would have kept and really wanted. And my life could have been different.

And it's all these things those subtle things are what people say. My mum's a midwife, was a midwife, and she said, it would be a genetic thing. There would have been something that that child wasn't viable. And you have to remind yourself you haven't done anything wrong because I think there was a lot of guilt for me of had I done something wrong, had I not done this, had I been more careful. And that goes back to when I was pregnant with my second child.

I cut out caffeine. I was really careful with what I ate. I didn't drink at all. It was just, I literally went into complete overdrive of what can I do to protect this pregnancy. And it does have a really big impact of I, potentially, I have had PTSD out of it. And that's been really difficult. And because it was remote, nobody saw what was going on. And it wasn't something I felt comfortable talking about because of the circumstances.

And I just didn't know them very well. So I just kind of got on with everything until I spoke to a counsellor. And I hadn't realised the days were literally like I couldn't concentrate because you just go, I don't really know how to deal with this. I don't know how to explain it to everybody. And you have people going, oh, you're right. And it's like I don't even know how to tell you what's going on.

I ended up having a conversation with one of my work colleagues who said, I've had I've had health issues and everything else. And I think I made an off-the-cuff comment about something to do miscarriage. And she just said, actually, I've had multiple miscarriages. I've got loads of complications. I'm exhausted, and while I know they've spoken to their line manager about it, it's actually, what can we do to actually help because there is a real mental capacity load of-- after that, the other miscarriage.

Actually, at the time I didn't, but there was a period of time about a year ago actually, I just needed time off. And I didn't feel like I could take that time off because of all the associations that you feel like you're letting somebody down. That it's going to reflect badly on your-- it's going to reflect badly on how you are in the workplace that you're not capable of doing your work.

And I think that's probably the really difficult thing with mental health issues is, a lot of the time, what you really need is time off to just process everything and not being able to worry about work. And be able to focus on your home life. And being able to feel comfortable taking that time off, is quite challenging. And you can't force somebody to take time off.

And I've had it in the past where people have said, I think you need time off. And I just wouldn't do it. And I look back now and go, I really wish I had because it wouldn't have impacted my career. It wouldn't have impacted what people think about me in the workplace, but actually, what does impact me is, if I'm not actually able to do my job competently, people start thinking you're not very good at your job. That you're missing things. And they don't see what's going on in the background because they've got no comprehension of what's going on.

And I think for employers and line managers, the challenge is how do you have different conversations with people because ultimately, you can't force somebody to take time off, but how do we make it much more acceptable to say, they're not having an operation. But there's a real need for somebody to take time off and enable that in different ways.

One of the things that worries me about how we're set up at the moment is, we quite often just say, we've got the Employer Assistance Program, but what does that mean? Because it feels like we're just kind of passing it over the fence to somebody else to deal with and actually, are we enabling people to have the right conversations with people. And what does that support look like?

Because equally for me, work was a salvation. It gave me something to focus on. And I really needed it, but equally, I recognise I've got to do a balance now of I'm working too much. And I'm in such a bad habit of doing it. It's how do I take that back and work differently. And that's on me. That's my accountability issues of taking responsibility for my own workload, but I know what's triggered it. It was just a distraction. It was easier to focus on work because there's not that much emotional attachment to it even that having to deal with what's going on in the rest of my life.

And it's a really interesting one, but the miscarriage one is it's so hidden because people don't know what to say. People don't know how to talk about it. And that hidden thing of, it's not just about the miscarriage. It's about what goes on afterwards and made the decision to have my tubes cut. I decided I'm not going to have another child.

And I didn't want to go through miscarriage again because the chance that I-- it was unlikely I'd have been able to carry a child to full term. And I just decided I don't want to be in that position ever again. And it was really difficult. And that was all going on about in the background of the workplace. And it was a really difficult decision, because it's not just dealing with a medical issue.

Again, it was a mental thing. So if I'm making the decision not to have any children now, even though I am of an age where I really don't want any children. And we talk about menopause earlier of what does that look like. And everybody has completely different experiences of it. And I have no idea if I've been through it or not. And I don't know because of having the operation if it's going to be different.

But I have days where my head is all over the show. And there's a proper head fog of you can ask me a question and two minutes later I will not know the answer. So there's really interesting things I think with particularly, on women's health, that a lot of them are unseen. And then, I think again, it's what's the impact on partners and children as well.

Because it does have an impact. And I'd say, equally, these are things even within your family environment, they can be really difficult to talk about because some of this, you can't explain how you feel or what you're actually going through.

NICK BARRATT:

I mean, what a harrowing story. It made it very clear to me I have no empathy with what you've just described. And I guess most of my colleagues wouldn't either. Just full of admiration for your courage to talk about it so honestly. And that, I think, is one of the big lessons I will take away from this.

Just trying to have those conversations spot the signs that someone needs that little bit of help or space or a combination. But what struck me, was that sense of the workplace being all encompassing. The fear of being judged if one is ill or not getting the support one needs.

We spend most of our time in some sort of work environment. And actually, that's where we need the most support. And it sounds like you've been really lucky with some of your line managers, but that's luck, not design. And so if we are thinking a bit more about what sort of world we want to be working in and living in, these sorts of really hard conversations we need to be better at having them, or the point you made about being online, creating that trust, whether that's an online trust or ideally, a face-to-face trust.

To be able to say, actually this is happening to me right now. This is who I am because of what I'm going through. This is not something I've chosen to do. It's something that is happening to me, and I need your support. That support from a line manager that sometimes they're not aware of and aren't skilled to deliver, but it's as much their support responsibility as it is yours.

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Having watched the video, and considering Nick’s reflections, how might you approach sensitive conversations, and what support issues might you encounter in a hybrid or remote-only workplace? You may wish to make notes in the box below: