This week I caught up with (read: binge watched) The Replacement, and it reminded me of a blog post I started a few months ago and never got around to finishing or posting. Returning to work after the death of your baby is so complicated and multifaceted and there is no right or wrong time or way to do it. In fact, for some people it may not be right at all. However, I know that many have asked me what helped me, so it seemed a good idea to share what I did and what I have learnt from these last few months.
I returned to work six months after Orla was born. I could have stayed away for longer; in fact with the amount of annual leave I am now entitled to with the NHS, I could have stayed off for around 14 months (not all paid). However, for me, six months felt like the right amount of time. We had been away for three months, and once we returned, I knew that I needed the structure and routine of my job. To put this need into context, work has always been a huge part of my identity and plays an integral role in my self-worth and self-esteem. I see my job as a career, a vocation if you will, and it is something that involved many years of training and many, many sacrifices. I moved all over the country, to do jobs that were at times awful and paid a pittance, lived in house shares that made me miserable and then took out a massive loan to do a Masters degree that I hoped would help get me onto the allusive and competitive Doctorate in Clinical Psychology. That then took three years of hard slog, and being single at the end of it, I spent the next few years building my career and working my way up to the grade I am today. Whereas many of my peers started families very soon after qualifying, I busied myself with changing jobs and finding myself in a senior position and managing my own team. I felt confident and competent at work, so I really wasn’t sure how I would manage the shift in identity from ‘Michelle the psychologist’ to ‘Mummy Michelle who also wants to work as a psychologist and achieve the same as she did before she became a mum’.
How naïve I was that this was all I would need to contend with.
I think another thing that was pertinent to my decision to return was that I knew that I was already pregnant. This meant that I anticipated that my time back at work would (very hopefully, since you take nothing in pregnancy after loss for granted) be limited. I didn’t want to be away from work for almost two years and I knew that the only way that I would survive this pregnancy would be to keep busy and distracted. Absolutely my ‘go to’ coping strategy. I also felt intensely responsible and guilty for my team. There was no maternity cover for my post, which meant that other people had to take on additional tasks, whilst others had to be put on hold until my return. I felt that if I could go back, even if just for a few months, I may be able to tie a few loose ends, to put some additional structures in place that would hold the service for the following months. But maybe there was also an awareness that because of this time limit, it would be more manageable? That it would be ‘just four months’. In reality, this made it all the more challenging in other ways, since I tried to cram a year’s worth of work into that short space of time, but psychologically, this potentially softened the impact of my return somewhat.
Despite normally being an incredibly private and closed person, losing Orla has blown this completely out of the water. Sharing our story, I have exposed myself and my vulnerabilities in ways that I never thought I would, or could. I was aware that many people from work had found and read my blog, so it didn’t make sense to suddenly become reticent in sharing my feelings about returning when the rest of my life continued to be laid bare.
My job is complex in that I am based across a number of services, all in different sites and organisations, so I knew that returning would be difficult – a bit like Groundhog Day, having multiple first days back with each and every team. Therefore, I felt that the best way to minimise the trauma of this would be to ensure that an email was sent to as many people as possible, outlining the plan for my return, how I was feeling and how I would like people to respond to me. I drafted and redrafted this email. I spoke with other mums who have also lost their babies for advice. And then I pressed send…
As I am about to return to work shortly, I thought it would be helpful to send a quick email so that people know how I’m doing and what to expect. Some of you may know people who have been through the loss of a child, but for me, my eyes have been opened to a whole world I never really knew existed – and I know I that before, would have struggled to know what is the ‘right’ thing to do / say.
As you all know, I will be returning to work from the week beginning the 7th November. Since I have a lot of leave to use, I will be returning on a part time basis (2-3 days per week) until at least Christmas. I can imagine that I will also need this graded return to help me manage the transition emotionally, as although coming back to work is something I am looking forward to, I also feel quite anxious about it. There may be times when I seem okay and like my old self, but there will definitely be days when I manage less well and need to take things gently. Please don’t be alarmed if I need to take myself out of a situation for a few moments; sadly it’s hard to know where and when the waves of grief will hit.
The past six months have been incredibly difficult. Sadly, I have learnt that stillbirth is actually very common despite it not being spoken about openly. One in 200 babies born after 24 weeks will be stillborn in the UK, many at full term like Orla. Shockingly, two thirds of these deaths will remain as unexplained, which is the case for us. Not having a reason for losing Orla when she was perfectly healthy and after a smooth and uneventful pregnancy is very difficult to come to terms with. However, what I have learnt is that very little funding is put into researching these deaths, which means that the UK has some of the worst rates in the developed world. Andy and I are therefore very committed to raising awareness of stillbirth as well as raising money for charities such as SANDS and Tommy’s who are the leaders in researching ways to reduce these high numbers. We have raised over £12,000 so far, mainly through the use of social media to promote Andy’s 2000 mile bike ride from Canada to Mexico. We hope that this will help other families who are going through the tragedy of losing their much loved babies. I am so proud of what we have already achieved in Orla’s name, particularly Andy’s bike ride which he completed in just 36 days, so it is also nice to be able to talk about the positives that we have drawn from our tragic loss.
Despite having gone through the most traumatic and devastating experience, please know that I really do love to talk about Orla so don’t feel afraid to mention her name. In fact, not having her existence acknowledged at all is actually more distressing. She is not ‘something that happened to us’ – she is our much loved daughter and I am incredibly proud of her, so please use her name. Sometimes I can speak openly and freely about Orla and at other times I may find it more difficult, so please be patient with me. Attached is a booklet from SANDS that helps explain how to best support a bereaved parent.
I also need to tell you that I will be returning to work pregnant with our second baby, which will mean that I will be going on maternity leave again early next year (probably early – mid March). We are obviously very happy, as we have been trying for a family for some time. However, this happy news also brings a new wave of grief for Orla, since we shouldn’t really be in a situation of bringing her younger sibling into the world less than a year after she was born. Managing such a mix of emotions is very complicated and quite isolating, so please don’t be surprised if I appear to approach the pregnancy with this baby a little differently from Orla’s.
Although there was no cause found for Orla’s death, my current pregnancy is still classed as high risk and as such I will need to go for a number of hospital visits. As much as possible, I will coordinate these with my non-working days; however, there may be times that I need to go at the last minute, particularly if I’m feeling anxious and need some reassurance. I anticipate the next few months being challenging physically, but particularly emotionally and I would appreciate your understanding with this.
For [team] in particular, I understand that this could be unsettling for the team, since I will be returning for just a short period of time. Therefore, [my manager] and I will work closely together to think about how best to manage this in order to minimise disruption. It will be good to meet up with you all individually when I’m back to see how things have been and to make a plan for the next few months that best meets everyone’s needs.
My first day will actually be at the full team away day next Tuesday, so I look forward to seeing you all then,
I’m not sure if I completely detached from the emotional aspect of returning, but I didn’t feel as overwhelmed as I initially thought I might on my first day. I had arranged to meet with key people to get set up on the various IT systems again and to obtain updates on changes. I had already met with my boss for coffee a couple of times during my maternity leave, so I felt fairly up to speed on the current state of play in the different services. I also made sure that there would be people nearby and available who I have positive relationships with, and I knew I could turn to if I needed some support.
Sadly, despite my email and preparation, there were some people who emotionally could not tolerate my return. They didn’t (and still haven’t) acknowledge Orla, our loss, or even the fact that I was away for six months. They never asked how I was, how I found settling back or how I was managing being pregnant again. Some of these were people that I had to report to, people senior to me who I felt should have been looking out for my wellbeing. People who work in a caring profession, who have to have difficult conversations with clients and staff every single day. It really was quite shocking.
I also didn’t anticipate that these people would also censor who would receive my email, trying to maintain its distribution within a fairly tight circle. I can only hypothesise why this might have been, and I do hope that it was from a place of compassion and wanting to protect me. However, this sadly meant that some people weren’t even informed when we lost Orla. This meant that, on more than a few occasions, I had colleagues approach me in the middle of an open plan office or at the photocopier, welcoming me back and asking if I had a boy or a girl and how old they were now. To have to face these conversations in such an impromptu manner, normally in between meetings, was emotionally draining. I have felt sorry for these people who have understandably felt shocked, uncomfortable – guilty even. But I have also felt sorry for me for having to face these situations when many could have so easily been avoided.
So, what have these last few months taught me?
- Returning to work may not be right for everyone, and that’s okay. Returning to work might be essential, either financially or emotionally: to have something that anchors you back to the ‘old you’. And that too is equally okay. I fall somewhere between all of these and despite thinking at first that I’d never return, I just knew that it was the right thing for me personally.
- There is no ‘right’ or ‘wrong’ time to go back. When you decide to return is personal and depends on many different circumstances. I couldn’t stay at home once we returned to the UK; I couldn’t face bumping into new friends that I had made locally with their babies growing in the way that Orla should have been. I also couldn’t remain at home as I needed to be with people – I just needed to be a psychologist again. That told me that it was the right time for me.
- Plan, plan and plan some more. I found meeting up with my manager, away from work and a few weeks before my return, helped. We thought of a provisional plan in terms of timing, roles and responsibilities and what and how to communicate to others. I had time to draft a timetable of my days, where I would be, and then ensured that I reviewed this regularly with my manager in supervision.
- That it is okay to work to live rather than live to work. To do enough rather than too much. To say no and to set limits (FYI – this is very much work in progress for a workaholic like me). This doesn’t make you a bad person or bad at your job. It makes you human and is key for a good work -life balance.
- Use all of the resources that you can. I referred myself to Occupational Health, and although they recommended pretty much exactly what my boss and I had planned, it was good to have these things ‘authorized’ by someone else. I struggle to say no, or to ask for help; therefore, having someone else say this is how things need to be was very validating and gave me permission to say what I needed.
- To transition at a pace that feels right and manageable. I was utterly exhausted when I returned to work, even though I started with just two days a week, going up to four – five days after a few weeks. Just trying to be ‘normal’ and fit back onto an old routine was exhausting. Some weeks I couldn’t do as much. Some days I needed to work from home. Sometimes I needed to say no to meetings. Other days I needed to commute outside of rush hour as the stimulation of London transport was too much. And all of this was normal, understandable and reasonable to ask for.
- To nip things in the bud. Letting stressors build up was not helpful and it was much better for me to be honest as early as possible about what I could and could not do.
- To put boundaries in place as soon as you can and try and stick to them. This is my downfall as I tend to over-extend and take on too much. And yet again, I most certainly did this, but nowhere near as much as I used to.
- Know your limits and manage your expectations of yourself. I know that I can’t work in the same way that I used to. I get tired more easily, I need to take more breaks and I have waves of overwhelming emotions that can knock me off my feet. I prefer to engage in one task at a time rather than spreading myself thinly and I need to be strict with my time. Being pregnant after loss has added an additional layer of complexity and many more complicated and terrifying thoughts and feelings (imagine trying to concentrate in a meeting when your head is constantly saying ‘have you felt the baby? Have they also died?’).
- Associated with this, new limits and expectations within your role are okay and normal. As a psychologist, I work with trauma and distress – it is the bread and butter of the job. But there are some things that now I may not be able to manage. But I am also open to the fact that my limits may also change over time. Grief and life after loss is not static and therefore ‘work me’ shouldn’t be either.
- Find people you trust and who you can check in with regularly. Both those who can help you manage a situation (i.e. your manager) as well as those that you can just let off steam with. Knowing you have someone you can turn to and say ‘WTF??’ really helps.
- Some people will ‘get it’ and other won’t. Some people will be able to talk to you about your child who died and some will not. This says nothing about you and everything about them. I have tried not to get too angry, feel too hurt or upset by this and have attempted to maintain a curious stance when trying to understand why. I’ve wondered what my loss has triggered for them, what their own experience of loss has been and also put their behaviour into the context of other behaviors (i.e. is this just how they deal with emotions and pain?). This has not completely mitigated my own hurt and anger, but it has helped to a degree
- Related to this, I have picked my battles wisely. There were some people I tackled head on with their lack of compassion and awareness, and others I just left. I weighed up how important it was to me to have their compassion against how much more effort and pain it would cost me to address it. I knew I had a limited amount of reserves in my bank, so I needed to ensure I kept them for the things that really mattered.
- Some people will be pleased with your decision to return and others will find it more challenging. Again, this is always about them and never about you. It was quite clear to me that some people viewed my return as more disruption to them rather than being helpful. And whilst I do appreciate this and think it is a valid perspective, my own personal needs (emotionally, financially and my desires) are equally as important. I viewed this in the context of many people’s attitudes to maternity leave and flexible working, which can at times be pretty unacceptable.
- Despite all of my best intentions, other people may have a view on what the best way is to manage your return work. They may have tried to keep your news quiet, they may have censored who receives your emails. And again, I have tried not to make assumptions as to what this was about.
- Be kind, compassionate and understanding towards yourself. Once back at work, many people forget what you have been through and therefore expect that you will be your old self. Again, I don’t blame them for this, as I need to communicate to them what I can and can’t do. But it is my job to learn and acknowledge what my own needs are so that I can let other people know what they are too. After all, no one can read my mind and everyone’s needs in life after loss are as unique as they are.
- It’s also okay to change your mind. Before I went back to work, I wondered if I would ever be able to work as a psychologist again. I wondered if I would still be any good – I am a changed person and I therefore felt that this meant I wouldn’t be up to it anymore. In fact, maybe the opposite is true, as I have an insight into trauma and mental and emotional suffering that I never had before. But I also feel that it is okay to change my mind again. One day I may decide that this way of working doesn’t work for me and I might want to put my professional and personal experiences to different use – and that too is okay.
As with absolutely everything in life, nothing is permanent and everything can change. What is important is that you do what is right for you – and only you can know this.