“You have an ectopic pregnancy,” my doctor told me.
I felt the energy leave my body like a balloon deflating.
My doctor went on to explain that the embryo could not move out of my fallopian tube, and without treatment, the ectopic pregnancy would result in the tube rupturing with life-threatening bleeding. “It needs to be treated immediately,” she added, firmly.
I’d felt an intense, stabbing pain on the side of my stomach earlier that day at work. It was so severe that it caused my knees to buckle beneath me at my desk. I felt light-headed and on the verge of passing out. As this feeling waned, I tried to focus on typing. But then another dizzy spell hit. And then another.
“I don’t think this is good,” I remember thinking.
I told my manager I wasn’t feeling well, and I drove myself to the doctor. My doctor confirmed I had an ectopic pregnancy. Coupled with the pain was the disappointment that this was my third nonviable pregnancy.
To trigger a miscarriage, my doctor gave me two shots of methotrexate in the butt and prescribed several weeks of rest. The medical term for ending a pregnancy, even a nonviable one, is abortion. I only took one more day off of work, and I told my immediate manager what was happening, and they were understanding and supportive.
Instead of joining my family for holiday skiing, I hung out in the base lodge. The rest of my Christmas holiday consisted of follow-up doctor appointments to ensure my hCG levels were dropping, which indicated the pregnancy was dissolving.
I hadn’t told anyone at work I was pregnant, nor would I tell them I had to terminate that pregnancy.
At the time, I couldn’t fathom sharing my fertility struggles with my employers. Dealing with the emotional rollercoaster of failed pregnancies was difficult enough with my then-husband and I. The last thing I wanted to do was add my co-workers or bosses into the mix of grief and disappointment.
I was devastated about losing yet another pregnancy. This manifested as feeling totally numb, emotionally. Thankfully, I went on a two-week Christmas break a few days after the miscarriage. While I wanted to keep my fertility struggles private, a part of me also wished I could reach out to my colleagues for support.
A couple of years and one divorce later, I started my IVF journey with my current husband. At this point, I was running my own business, and I chose to keep my fertility journey private, again.
When I started my IVF journey, I had no idea how disruptive it would be. It included multiple pills every morning, a patch that I wore during the day, different medications that I had to mix and inject in my stomach every night, and regular (unpredictable) monitoring appointments. I was running my business at the time, and undergoing IVF meant that I had to say no to thousands of dollars in potential income and risk losing professional relationships.
I worried that I’d be seen as a less capable leader and business partner because I found myself turning down opportunities, rescheduling clients at the last minute and failing to support my business partners due to unpredictable IVF monitoring appointments.
In my work as a leadership coach, many of my clients have shared that they faced increased scrutiny when their pregnancy or fertility struggles were brought to their co-workers and employers’ attention.
One of my friends chose to tell her boss — who she viewed as an ally — about her IVF appointments. While he expressed initial verbal support, whenever she had an IVF appointment, he communicated annoyance at being inconvenienced. Another client recently told me that she was reported to HR for “drug use” on company grounds while administering her IVF shots at work. During a process that should be treated with sensitivity, this client had to defend herself to her bosses and co-workers, and she was subjected to routine drug testing.
A study conducted by the American Psychological Association shows that discrimination against women employees starts the moment she announces that she is pregnant. Women in the study reported experiencing microaggressions such as hostility, reduced eye contact and being cut off. While more than half of working mothers experience workplace discrimination, only a quarter of fathers report experiencing this.
Choosing to keep my struggles with fertility private made the most sense for me and my family. It is also a choice that I believe everyone should have across the spectrum of reproductive care — including abortion care.
In light of Roe v Wade being overturned — many companies including Netflix, Yelp, Starbucks, PayPal and Microsoft — have agreed to cover travel costs for employees to get abortion care in a different state. (Buzzfeed, HuffPost’s parent company, also has a similar provision for its employees.)
I believe this comes from a well-intentioned place of advocacy. But I worry about how this will play out since relying on company-provided benefits places the emotional burden and exposure on pregnant people to come forward and ask for these benefits.
In theory, claims could be handled through the insurance provider and employees wouldn’t need to tell their employers about requiring the abortion travel benefit, but there are other ways the company can find out.
While many companies are promising confidentiality, a Jezebel article reported that at Citi, employees will need to apply for leave, pay for the travel and abortion costs out of pocket and apply for reimbursement from insurance. In many workplaces, employers will question the reason for the leave.
The chief compliance and privacy officer at Favor, Michi McClure, further explained to Business Insider that businesses are obligated to ensure the funds are being spent as intended — and this is not possible without the employee disclosing the purpose of these funds.
It’s not difficult to imagine the type of scrutiny and microaggressions employees who choose to rely on company-provided abortion care could be vulnerable to. Qualitative studies done by the Women’s Health Issues journal found that abortion stigma in the workplace led to fears around disclosure, social judgment, social isolation and discrimination. This can adversely affect employees who have managers or bosses that are either unsympathetic or have a moral opposition to abortions.
As someone who struggled to communicate miscarriages and IVF to her colleagues, I can’t imagine the amount of psychological safety required to tell a leader why I needed a few days off for medical travel reasons.
I will repeat: I believe that the intention behind these benefits comes from a place of advocacy. But placing the onus on women and people with uteruses to come forward and ask for this care adds to the existing burdens that women specifically and historically have had in the workplace. (Obviously, trans people also face their own set of challenges at work.) Being forced to take leave and possibly facing scrutiny (or worse) from employers could impact women employees’ ability to advance in the workplace.
Because people in the United States primarily access health insurance through their employers, it’s time for organizations to reconsider their approach to supporting these team members through their entire reproductive cycles.
So much of a woman’s quality of life is related to the health of her reproductive system, and therefore it only makes sense that women (and anyone with a uterus) have full access to an entire spectrum of reproductive-related care. This should include the times when — for a variety of reasons that are only the business of the pregnant person, possibly their partner and their doctor — this care includes needing an abortion.
Ultimately, I want to live in a world that embraces medical privacy and equal reproductive healthcare, and where anyone can easily access this healthcare without fear of judgment or scrutiny.