A national survey has revealed that UK employers are failing to deliver appropriate workplace policies to support women’s reproductive healthcare needs. As identified in the Government’s recent ‘Vision for Women’s Health Strategy’ the UK has suffered decades of gender health inequality and the survey found that many respondents either didn’t have or weren’t aware of any specific workplace policies to support those suffering from miscarriage, the menopause or infertility.

Covid has fast tracked a focus on HR and trends towards enhanced perks and support for employee mental and physical health, with the delivery of improved training and benefits for employees and many large corporates making noise in this space, but this doesn’t appear to have extended to women’s health. The results revealed that over half of employers (48%) have no official policy in place to support employees undergoing IVF treatment despite the fact one in six now require the help of a fertility expert to conceive, and only 4% of employers provide appropriate training for HR directors or line managers.

For those facing miscarriage only 12% of employees surveyed were allowed time off for a miscarriage before it becomes a legal maternity right at 24 weeks. Over 60% of women said they would feel uncomfortable talking to a line manager or supervisor if menopausal symptoms were impacting their performance at work, and almost 90% of employers didn’t provide any sort of menopause policy for women – shocking when a study in 2019 found 14 million workdays were lost to the UK each year due to menopause symptoms.

The survey* to explore both the policies and culture around how employers approach fertility and women’s health in the workplace. The survey collected both quantitative and qualitative data on the state of UK workplace policies for those going through reproductive health issues.

With the Department of Health now developing a strategy to improve women’s health outcomes, Dr Geeta Nargund, Medical Director at CREATE Fertility and Senior NHS Consultant, is leading the call for women to be supported in the workplace through their life course events, from menstruation to menopause, to promote their health and well-being and help close the gender health gap.

Her calls to action include:

• Training in reproductive and women’s health issues for HR staff and line managers
• Supporting women throughout their fertility journey with paid leave and partial funding
• Workplace strategies and flexibility to support women suffering menopause symptoms

Fertility treatment: overlooked – The survey results make clear that fertility issues remain largely ignored, despite the fact over 53,000 patients now undergo IVF each year in the UK (2019 HFEA data). Only 20% of respondents are offered paid leave for IVF and only 16% were offered flexible working when requiring time off for appointments or to recover from treatment, showing that despite some larger brands and professional service firms recently announcing enhanced fertility polices the reality is that most employers remain far behind the curve when it comes to providing adequate support for those going through treatment.  Less than 3% respondents were offered a reduction in hours or duties while undergoing IVF treatment, a statistic borne out by a number of the qualitative responses that revealed individuals are forced to rely on their annual holiday to cover appointments or feel obliged to return to work directly following procedures, despite the emotional and physical distress.

Pregnancy loss: largely ignored – A devastating loss at any point during pregnancy, miscarriage can cause major distress to both women and their partners. Currently, loss of pregnancy that occurs past 24 weeks legally grants workers time off under their maternity rights, but only 12% of women knew of policies that covered pregnancy loss before this time, such as paid leave or counselling. A further 44% were unsure if there were any policies in place, and identified a lack of inclusive culture when it comes to talking about these issues in the workplace.

Lack of training and conversation – The survey also revealed that only 4% of employers provided any form of training for HR directors or line managers to help familiarise them with the emotional and physical challenges an employee might face during IVF. Respondents shared many experiences of feeling unable to share their fertility treatment journey with managers, or when they did so not receiving a clear understanding of what support or time off may be needed, leading to feelings of loneliness and isolation during an already difficult time. Encouragingly, 65% of respondents said they feel comfortable sharing with their employer that they are going through IVF treatment, which suggests that there has been some cultural shift in how employers feel about sharing fertility issues, even if this is not matched by policy and formal support.

Menopause: neither seen nor heard – For a phenomenon which affects roughly 50% of the population, the survey reports alarmingly little engagement with menopause symptoms in HR rubric. Only 12% of respondents had a menopause policy or HR clause in place at work and a further 40% replied that they would not be comfortable discussing symptoms that were impacting performance at work. These responses demonstrate the misalignment of the scale of these issues and the policies in place to deal with them, leaving women to feel they are issues they simply must put up with and withstand.

Commenting on the findings, Dr Geeta Nargund, said: “Infertility is defined by the World Health Organisation as a disease, yet as our survey shows it is not regarded in the same way as other essential medical issues. The number of women and couples using IVF continues to rise and for same-sex couples or single women fertility treatment is often essential to starting a family. I would like to see more employers put official policies in place to support women undergoing fertility treatments such as IVF, which involve multiple visits to fertility clinics, in order to ease their treatment burden. To tackle this and all the women’s health issues touched on in our survey, it is vital that all employers and HR professionals introduce dedicated training on how to support their employees, including making sure they feel they can approach and talk to their employer about their experiences and needs. More support is needed such as ensuring sufficient flexibility is introduced to allow them to make essential appointments.”

Louisa Symington-Mills, Founder & CEO, Cityparents, added:“Forward-thinking employers are focused on the attraction and retention of the best talent and clearly recognise the need to support their employees’ personal lives as well as their professional careers. This piece of research shines an important spotlight on female health issues, and while some findings are encouraging there is evidently still much progress needed around the day-to-day practical and emotional support employees need on their journeys to parenthood.”

Gwenda Burns, chief executive of leading patient-focused charity Fertility Network UK, commented: “Our research as the national charity shows most people experiencing fertility problems are reluctant to speak to their employer about it because they fear it may have a detrimental effect on their career. We know too many end up reducing their hours, taking sick leave or leaving employment as a result of their fertility struggles and a lack of support and understanding from their employers – this is bad for both staff and business.  It is shocking that, despite infertility being defined as a disease, the vast majority of firms do not have a workplace policy referring to fertility treatment; so many people have told us of their distress on discovering their employer considers having IVF to be a lifestyle choice, rather than a medical need, and lump it together with things like cosmetic procedures – with the result that employees cannot take time off work for treatment and instead have to use annual leave or unpaid leave.

Fertility Network believes it is essential employers support staff facing fertility challenges and that doing this is good for business as well as for employees. Firms are beginning to recognise this: we’ve been working to educate employers about fertility issues for decades and have seen a surge of interest in recent years with more and more firms, including Tesco, Barclays, Sony, Unilever and HSBC, joining our Fertility In the Workplace initiative which helps companies implement a fertility policy and ensures staff and managers understand the impact of fertility and treatment so they can support those around them.”

*CREATE Fertility and Cityparents