For International Women’s Day, Stephenson Harwood Europe private client partner Suzanne Johnston talks about creating inclusive fertility policies and educating staff on the sensitive issues at play.
What should firms do to support employees dealing with baby loss or fertility issues?
Unfortunately, for most businesses there isn’t a one-size-fits all-approach as everyone’s experience of fertility issues and baby loss is different. However, a good starting point is to have policies covering fertility and baby loss. Employees then know where they stand in terms of who to speak to at the business, the confidentiality basis, and whether they will get paid time off.
As everybody is different, it’s important for the policies to be fully inclusive, which can be quite challenging. I helped draft the Stephenson Harwood policies and it was difficult to make sure every scenario is covered because there’s are many different aspects to infertility and baby loss. People sometimes forget that fertility can be a male issue as well. Male factor infertility is one of the key causes of infertility. You also have same-sex couples who don’t have any choice but to go down the IVF road if they want to have a genetic baby of their own.
The other thing to think about is those people who come out of the other end of this, and there are many, without a child. They’re childless but not by choice, so the policies do need to consider them as well.
Policies are a good starting point but there’s no point having a policy if nobody knows about it. So, there also needs to be education around them. Managers need to know about the policies and firms should consider training sessions on these issues as well.
Does Stephenson Harwood have any policies or support networks in place to help employees facing such issues?
We were one of the first firms to have a fertility policy and a baby loss policy. One of the things that is really important about these policies is that they’re fully inclusive. We’re an international law firm and they apply across all our offices. So, no matter what the cultural differences are in different countries, everyone still has access to some basic rights under those policies.
The other thing Stephenson Harwood did particularly well when it launched the policies was to offer training sessions to educate people on those policies. Part of that was around what you shouldn’t say as well as what’s helpful to say. The list of what not to say is extensive. Even very basic questions like ‘when are you going to have a child?’ or ‘are you going to have another child?’ cut very deep when you’re going through all of this. A well-meaning question like that when you’re on a knife edge can cause a complete breakdown. So, it’s very important to use the right language. Stephenson Harwood has done a good job of educating on that and allowing me a platform to talk about it. We hosted an event at Stephenson Harwood with Infertility in the City talking about fertility and baby loss related issues. It has been very supportive as a firm.
Please can you share your own experiences with these issues and how you navigated them alongside your career?
I’ve been pregnant five times and I have two living children. For me, it all started in January 2015. I got pregnant naturally but then I lost my baby at seven weeks. There was no heartbeat. My husband and I were completely clueless, we didn’t know what to expect. Then I had to have a dilation and curettage procedure (D&C). It was really devastating. Very quickly I needed to see a fertility specialist to conceive as I wasn’t ovulating.
I went to a fertility specialist who told me that not everybody was supposed to get pregnant and that maybe I should look at other options. So, I quickly went to a different doctor who gave me some medicine and injections to help me ovulate. I got pregnant again in 2015 and then I had my first baby in March 2016. She was born at 36 weeks by emergency C-section. I mention that here because another knock-on effect of fertility and recurrent pregnancy loss is that you have higher-risk pregnancies. This means that you often go into labour earlier and it also means that the actual pregnancy itself is incredibly stressful. People often think pregnancy is the end of the story but it’s really just the beginning. Often it means that you need to have bed rest and that has a direct impact on whether you can be in the office.
When I started trying for my second child, we did the same thing, but it didn’t work. I had three IUIs and two egg retrievals. I had to do those across Singapore and Malaysia because I kept having miscarriages, so I had to do genetic testing on my embryos. They don’t permit genetic testing in Singapore, so I had to do a new egg retrieval in Malaysia. I had five frozen embryo transfers and four further miscarriages. Eventually we had my son in May 2020, and again he arrived at 36 weeks, and I had to have a c-section. That pregnancy was very traumatic for me after all of the losses I had suffered.
After everything it took to get there, being very frank, I was a complete nervous wreck during the entire pregnancy. I had a lot of bleeding, and I was on bed rest for much of the pregnancy. I was an in-house lawyer for most of the time, so I was very easily able to work from home. I was also very fortunate to have a very understanding boss. A male boss, in his early 50s, who is not necessarily the person who you would think would really get it, but he was absolutely wonderful.
When you’re going through fertility and baby loss issues you have a lot of procedures. I had to have three or four operations. I had to have two D&Cs after miscarrying, and I had to administer lots of injections and medications. Really, it’s a full-time job doing all of that and it’s very grueling on your body, mentally and physically. I remember when I was doing IVF, I had to do injections at random times during the day and I hadn’t told my employer that it was going on so I would hide them in the fridge in a lunch box and then I would go and hide in the toilet to give myself an injection. It is just so utterly depressing when you’re in that position. If there had been a room available for me to do that with a fridge in it would have been a nod to it being acceptable. So, I think on a very practical level, that’s something employers can do.
Do you think health issues traditionally considered to be ‘women’s health issues’, such as baby loss or menopause, have an impact on women’s career progression?
It’s had a massive impact on my career. I was in private practice as a senior associate when I had my first baby. When I started trying for my second, I was part-time, but it became increasingly difficult to juggle private practice with all the appointments. So, I started to look for other jobs that would give me more flexibility. That’s why I ended up applying for a role in-house at a private bank. It was a full-time role, but instead of negotiating for more pay, I negotiated for a four-day week. Generally, it had a huge financial impact because IVF is very expensive, but in terms of work it has also meant I have not earned as much money, so it’s been a double hit.
I did find it easier to manage my timetable when I went in-house because you’re not client facing. In private practice if a client wants a meeting at 8am, it’s very difficult to decline unless you know them very well. In-house, your clients are your stakeholders, and you get to know them, you build up a rapport. So, I felt it took that weight off my shoulders.
For me the turning point was in February 2018. I had had an IUI, and I got a call from the clinic as I was dropping my daughter off at school. They said: ‘You’re pregnant, come in and do a blood test and we’ll see how everything is going.’ I skipped into the clinic, did the blood test, went to work, and then received a WhatsApp saying that my HCG levels had fallen and that my pregnancy wouldn’t continue. Half an hour later, I had to walk into a presentation at a client and it was the hardest thing mentally I’ve ever had to do. I still think I’m scarred by it. I shouldn’t have done it but because I hadn’t told anybody what was going on, I felt I had no way out. That’s one of the reasons I’m so vocal now because I don’t want anybody to ever put themselves through that.
When I finally got pregnant with my son, I needed constant reassurance scans. They call it ‘scanxiety’. I would be scared of going to the loo because I was worried I would find blood – there is a name for it: ‘loo fear’! There is a real psychological impact, and it did have a massive impact on my career because it was the trigger for me changing jobs. I should add that the law firm I worked for in private practice was incredibly supportive when I told them. However, I like to give 110% and I didn’t feel like I could do that in private practice because of managing my fertility journey.