Fertility struggles: The impact to careers
93% said of women said that their career had been impacted in some way by their struggles to conceive and bring home a baby.
Anecdotally, we hear all the time and know from our own experiences the impact that fertility journeys can have on careers. We wanted to try and get a sense of just how many felt this way and so in September 2022, we polled our Instagram fertility community and even we were blown away by the results. We expected the outcome to be that more people will have been impacted in their career than not, but not by such a significant percentage. We also know that there is an undisclosed narrative about the negative impact treatment has on careers, for women in particular, which we hope these results and associated insights will shine a light on.
Have your struggles to conceive and bring home a baby impacted your career?
- Yes, my career has been impacted in some way – 93% (132 votes) 93% 93%
- No, my career hasn’t been impacted – 7% (10 votes) 7% 7%
With 142 respondents within 24 hours, a staggering 93% – all respondents women – said that their career had been impacted in some way by their struggle to bring home a baby. We wanted to understand why and how people felt their career had been impacted and so we asked some follow-up questions to gain more insight. These highlighted some stark commonality between experiences which we’ve reflected in this blog as a way to really bring to life and bring out of the shadows what the reality is for those in the workplace on a difficult journey to conceive.
Many respondents expressed how their fertility journey has left them feeling ‘stuck’ in their role and unable to progress or move jobs.
One person responded, “I couldn’t leave when my role was restructured into one less senior”, whilst another shared that she was “Stuck in a job I hate with no progression, always hoping that next month will be the month.”
The ‘stuck’ feeling is not just apparent in jobs that are ‘hated’; many often say how a fertility journey can leave you feeling like your life is, ‘on hold’ or ‘on-pause’, waiting and hoping to become pregnant so that the next chapter can begin. The uncertainty as to when and also if it will happen contributes significantly towards this feeling.
This feeling is a central theme in the responses, with one sharing, “I feel unable to change my position at work, meaning I’m trapped by my circumstances” and another that “my whole life including my career is on hold whilst TTC (Trying to Conceive) and IVF.” Anyone who has balanced fertility treatment and work will know all too well of the amount energy it takes, and more often than not anything that is ‘non-essential’ in life falls by the wayside. This can mean friendships, social events, self-care, holidays.
Practically, for women in particular, repeated negative pregnancy tests perpetuate the reluctance to willingly change jobs for fear of losing out on maternity provision. With the cost of living rocketing this will be a valid reason why people stay where they are, even if they are not happy. When those hoped-for blue lines don’t appear, what follows is another month of disengagement at work, with no progression and the fear of change, just in case next month is the month it finally happens. Many spend years thinking ‘what if’ and we are often asked at FMAW whether people should look for a new job opportunity or move careers, with many feeling uncertain in knowing what the best thing to do is during the wait.
In addition, it’s worth noting that where there is more work pressure it can have negative impact on trying to conceive and with fertility having a clear link to mental health and wellbeing, combining this with the pressures of assisted reproductive treatment can potentially become a counter intuitive situation that only serves in people feeling even more ‘stuck’.
Emotional and Physical impact affecting work
Fertility Treatment not only brings a physical impact, the medical procedures, tests, monitoring, medications and side effects, but in most cases it also has a profound impact to mental health, which can impact individuals at work. Our 2020 survey found that over 68% felt that their treatment had a significant impact on their mental and emotional wellbeing, a theme which came through quite significantly in our findings relating to career impact.
Treatment impacts confidence, commonly individuals can experience feelings of ‘failure’ and a loss of control as attempts to have a baby don’t end with success. Whereas with most things in life, effort = success, in the case of trying for a baby, you can put in all of the effort in the world and still end the journey with no baby. One respondent shared with us how she was “struggling emotionally which has impacted my confidence to progress” and another shared how she “was torn between work, the ever increasing demands and IVF” meaning her “confidence plummeted.”
We know from our own research that almost 70% take sick leave from work whilst going through fertility struggles and that the main reasons are associated with mental health struggles such as anxiety, stress or depression. One woman shared that the impact to her career was due to the grief of baby loss where she was “on sick leave both after losing my daughter and again due to the physical and emotional side.” We also know that sickness absence is used as a means for some to attend appointments whilst hiding treatment from employers, in the fear that it wouldn’t be supported.
It goes without saying that when other significant events are happening outside of work that you are not usually performing at 100%. Emotional impacts of fertility journeys affect performance, with one woman sharing how she was “not performing as well as I used to in my job due to the emotional exhaustion and stress.” With these associated mental health impacts comes low self-esteem, a lack of confidence and self-deprecation, which will also have an impact on work. I know from my own experience that I felt guilty for needing to take time for appointments and fears about what others thought about my commitment to my job. Worries how others perceive you when they don’t understand what you are going through only enforces the negative thinking, with one respondent sharing that she “just left a job because they grew tired of my ‘emotions’.”
What we do know is that people are stepping down at work, they are stepping out of work and they are being impacted to an extent that 93% are feeling an impact to their career. Support and recognition is imperative during this life event to provide validation to its significance. We believe that employers providing emotional support alongside flexibility to help practically manage fertility treatment at work can relieve a huge burden.
Physically, fertility treatment can be intense with medical appointments being frequent, often unpredictable and entirely dependent on your own body’s reaction to the medication. No two IVF cycles are the same, but all will require some level of flexibility and absence to attend clinic appointments. Treatment can make planning and also travel difficult, which can lead to a loss of opportunities, as one woman told us of the impacted to her when she “wasn’t able to travel for work” and so she “missed conferences and meetings.”
The pandemic has provided an interesting insight into the benefits of homeworking and flexibility to support during treatment cycles, with 83% of those surveyed in 2020 saying that Covid-19 had actually made balancing work and treatment easier.
Impact on hours and pay
The link between people having fertility treatment and the effect on the gender pay gap may not seem obvious when you first think about it, but where women are left feeling stuck and unable to progress, there is no doubt going to be an impact to earning potential, demonstrated in these responses; “It meant I stayed in a job much longer than I wanted to for job security and understanding while going through treatment and also chasing the idea of maternity pay one day” and “My career is on hold. I had to step down from promotion as I didn’t have the headspace.” Due to the nature of treatment often being more invasive for a woman, it’s inevitable that any impact as a result of fertility treatment to day to day work will be felt more by women, exacerbating the already growing gender pay gap.
I myself took a sideways move out of the succession pipeline into a less demanding role where I could reduce my hours to four days a week. I’d always thought I’d consider working part time when I’d had my children, whereas I needed to do so just to help me cope with the struggle of trying to have children in the first place. Managing multiple rounds of IVF and dealing with the grief of miscarriage and fertility loss made the whole process felt like another full time job. I’m not alone in this, one respondent told us that she had to have a “change of hours due to employer not allowing time off for hospital appointments / procedures etc.”, with others, like me, making the change to “not put myself forward for promotion and requested to go part time to deal with stress.”
Not only are women reducing their hours to cope with fertility treatment, but they’re also leaving their jobs, with our 2020 research showing that a staggering 36% had considered leaving their jobs as a result of fertility treatment. This was a huge theme within our responses, with almost all of these women having some form of impact to their pay as a result of going through assisted reproductive treatment. Some decisions were made to lessen the burden and demand, with one telling us that she “had to take a huge step down in my career and take something less demanding” whilst another said that she “had to leave my career and take a huge pay cut”. Promotion opportunities were forfeited due to “not able to take on a promotion as mental health so poor from IVF failure, trauma and hormones.” Some also find it difficult to get back into work whilst treatment is uncertain as we were told by one respondent who told us, “I left my job and was unemployed for two years.”
One may argue that these women have stepped down or left their jobs by choice, but for someone who has been there and understands the very real pressures, as well as the lack of recognition, understanding or appropriate support in workplaces, it often it feels like there is no other choice for these women in this position by circumstance.
Poor management and lack of flexibility
Poor management and constraints around flexibility for someone going through treatment can lead to them leaving their job. We know from our 2020 research that 72% of workplaces don’t have a fertility policy in place and that, of those who did, only 1.8% of those policies actually met people’s needs. Without effective policy and guidance as a starting point, it’s no surprise that a lack of understanding, poor management and, sadly, discrimination also came out through our qualitative findings of this snap research.
One told us that she, “Had to leave my job of 10 years as I requested 2 weeks off and was told my manager was ‘disappointed’” whilst another shared how she left “due to being micromanaged after miscarriage disclosure.” It’s no wonder that over 61% of those we surveyed in 2022 felt unable to talk to their employer about their fertility treatment, especially as we regularly hear about a lack of understanding, flexibility and empathy at work. We were told how one woman changed her job after, “an insensitive male boss asked me for annual leave for my IVF”. This is an all too common reality for many, meaning that women (the ones who are most affected practically by the nature of fertility treatment) are being asked to use up all of their annual leave in order to attend medical appointments. These comments are just a snippet of what we hear at FMAW, across work level, age and industry, with the common misconception in the workplace being that fertility treatment is an ‘elective’ procedure, sometimes even likened to cosmetic surgery. Fertility treatment is not a lifestyle choice, it is the only choice for some when they want a baby. We know from personal experience that no one would choose to go through it and it is certainly no holiday.
It’s not only impacting those who are leaving their jobs, but there are also impact to those wanting to secure new jobs who often deliberate over the difficult question of whether to disclose to a new employer for fear of discrimination. One woman told us how “a friend wanted to hire me, then didn’t when she knew I was doing IVF”. Others feel they have been discriminated against in terms of promotion opportunities and pay rises, all due to them going through fertility treatment. One respondent shared that they were impacted in “not going for promotion” as well as being “blocked for pay advancements”, an experience reflected by another who said that they were “not being considered for promotions despite 9 years experience.”
The bottom line here is that organisations are losing talent, women are being disproportionally impacted as a result of fertility treatment and careers are being impacted by the disconnect the needs of individuals and the support that employers are offering.
So, how can we support the 93% whose careers are being impacted due to them needing help to try and have a baby?
Despite being in its fifth decade, fertility treatment is still shrouded in secrecy and equally met with ignorance and apathy from those who have never come across it. It isn’t validated in a lot of social settings and this is reflected in the majority of workplaces. A lack of any statutory provision means that it is a hushed voice in a sea of many worker demands, with employment law not even recognising it, therefore it isn’t seen as a legitimate ‘reason’ to need time off work.
Complex fertility journeys are uncertain, unpredictable and will inevitably involve varying levels of stress for each individual. No-one can control the outcome, but what an organisation can do is remove the workplace burden and treat employees fairly and consistently. That means recognising it as a life-event and a medical need within appropriate policy, raising awareness and opening up conversations, providing flexibility to attend appointments, ensuring managers are given appropriate training and guidance, offering emotional support and empowering employees to continue to feel valued and supported through this difficult time. Work is a key part of our identity, with the majority wanting to stay at work through treatment and continue to do their best, we need workplaces to empower and enable them to do so.