Name Once Known

Is the new baby loss certificate the final step for miscarriage services or the start of a bereavement revolution in the workplace?

By Hannah Auld

Infant Crooks. That was the name Nina Crooks received on the hospital-issued condolence card, after a miscarriage that left her permanently disabled.

"His name was Marcus," Nina said. "No one remembers that except me, really. I remember his name every time I am in pain. Every time I think I have failed."

Nina is one of the millions of women who have experienced a pregnancy loss before 24 weeks. Under UK law, despite her loss, she was entitled to no form of paid leave.

Twenty years after her miscarriage, the government has issued baby loss certificates to acknowledge the passing of these babies. For some women, the certificate offers closure. Yet for women like Nina, who are still experiencing the consequences of their loss, the scheme feels like a plaster covering a much bigger issue:

"How is this compensation, when it feels like both of us died that day?" said Nina.

Marcus' feet were the size of a 10 pence coin at birth.

Marcus' feet were the size of a 10 pence coin at birth.

PART 1

A Miscarriage Injustice

The legalities of miscarriage in the UK

One in four women in the UK will suffer a miscarriage, according to the NHS. This was the unfortunate reality of 53-year-old Nina Crooks, who lost her son in 2001, 20 weeks into her pregnancy.

“My first pregnancy was easy, so miscarriage was something that I never even considered. Everything was fine one minute and the next I remember fighting to stay awake in the back of an ambulance. I thought I was going to die.”

Nina had experienced a very rare haemorrhagic miscarriage, which not only led to the loss of her baby, but a life altering disability. According to The Miscarriage Association around a quarter of women who experience a miscarriage will experience experience a long-term illness such as depression or PTSD.

Nina Crooks is one of the 25% of women who have experienced a long term illness after miscarriage. In this Op-Doc, Nina explores her journey with grief and the impact on her life after her loss. Subtitles available on Youtube.

As well as suffering from postnatal depression and postnatal psychosis, Nina developed several neurological disorders, due to the impact of her trauma. The shock triggered fibromyalgia and functional neurological disorder (FND), which left her housebound and relying on benefits.

Despite the severity of her illnesses, Nina was legally never entitled to paid leave from work or compensation for her permanent dismissal from her role.

“I worked in airport security" Nina explained. "I took three weeks off paid with my sick leave entitlement but that ran out. When I couldn’t return to work, I had to leave the company. It was as if they couldn’t be bothered to deal with me because I was no longer useful.”

In the UK, a baby lost before 24 weeks is considered a miscarriage and any loss after qualifies as a stillbirth. A stillbirth at 24 weeks, allows the mother to take a maximum of 52 weeks statutory paid maternity leave. If the same baby is lost at 23 weeks however, the mother is entitled to nothing.

Danae Shell is a Lawyer and the founder of ‘Valla’, the Edinburgh-based DIY platform for people who want to resolve an employment issue but cannot afford a law firm.

Many of Danae's clients are women who feel they have not been supported by the company they have been working for during their miscarriage. “This is definitely a problem that so many people are facing all of the time," Danae said. "Pregnancy and maternity is in the top three areas people come to us about."

Under the 2010 Equality Act, 'Pregnancy and Maternity' is a protected characteristic so treating a woman unfavourably due to the loss of a baby at any period, is an offence. Yet, past attendance, there is little financial aid that a company is legally required to give for any pregnancy related absences or illness before 24 weeks.

Danae Shell believes that the system does not cater fairly to women who experience a miscarriage as opposed to a still birth.

Danae Shell believes that the system does not cater fairly to women who experience a miscarriage as opposed to a still birth.

Nina explained that she felt like she fell into this bracket.

“It was like being in financial limbo," Nina said. "My company did not discriminate against me when I lost my baby, but they also didn’t have to pay me. I couldn’t go to a lawyer because they were not doing anything illegal, even though it felt like I was being robbed.”

“It’s not a fair system," Nina continued. "I want to work but I rely on government funding, ironically the same government who refused to cover my leave all those years ago.”

Marcus was born at 20 weeks.

Marcus was born at 20 weeks.

Danae Shell (left) is the co-founder of 'Valla', the online legal platform that helps workers to resolve issues by representing themselves. (credit: Danae Shell)

Danae Shell (left) is the co-founder of 'Valla', the online legal platform that helps workers to resolve issues by representing themselves. (credit: Danae Shell)

PART 2

Sorry For Your Loss

The introduction of miscarriage certificates


credit: Laura Buckingham

credit: Laura Buckingham

Bex Gunn (left) and Laura Buckingham (right) have recently celebrated their 175th episode of the successful podcast.

Bex Gunn (left) and Laura Buckingham (right) have recently celebrated their 175th episode of the successful podcast.

On the 22nd of February 2024, the government launched the baby loss certificate scheme. The voluntary scheme was created to support parents who had experienced a miscarriage, allowing families to receive a birth certificate to acknowledge the loss of a baby before 24 weeks. 

Whilst the certificate offers no promise of financial support, its creation came as a great surprise to those on the frontline of bereavement care for women.

Clare Worgan is the Head of Training and Strategic Planning at baby loss charity, Sands. After her own stillbirth of baby Alice in 2017, Clare chose to help women like herself. The charity supports thousands of women annually who have been affected by pregnancy loss.

Clare said: "We work with the NHS and policy makers around improving care. We also provide training, guidance and data to workplaces so they feel equipped and able to support women.”

Discussing miscarriage statistics is notoriously hard due to the number of women who do not report their miscarriages. Cross comparisons from Sands surveys found that the number of miscarriages recorded in 2021 had an estimated range of 40,000 women because the charity could not gather the data.

The number of woman estimated by Sands to have not reported their miscarriage, is larger than the number of neonatal and stillbirths in 2021 combined.

The number of woman estimated by Sands to have not reported their miscarriage, is larger than the number of neonatal and stillbirths in 2021 combined.

Clare explained: “We still have this culture of not telling people we are pregnant after 12 weeks and so a lot of people may not have told friends and family about it, let alone their employer.”

For Clare, the introduction of the certificates offers a tangible way to mitigate the grief women are experiencing whilst waiting for support.

“Now, women across the UK will have a free and officiated document to register their loss," said Clare. "It's a brilliant initiative: It acknowledges an event that has been dismissed as ‘one of those things’. It can be really significant for those waiting for help. It is something we will be informing our mothers of, in the future.”

When discussing miscarriage, Sands breaks down the feelings of losing a child into several categories, as loss itself is nuanced. For those who have had miscarriages, the most common feeling is not grief, but isolation. 

This initial feeling of isolation was the shared emotion of podcasters, Bex Gunn & Laura Buckingham. The pair were inspired to start their award winning podcast ‘The Worst Girl Gang Ever’ after the loneliness they experienced, having both miscarried. Bex experienced her first miscarriage in March 2020.

Bex Gunn explained that her loss was a complete shock.

Bex Gunn explained that her loss was a complete shock.

Bex explained: “I was so naïve for thinking that I was immune from miscarriage because I already had kids. I went for my first scan without even thinking about it."

Bex was offered little help after her loss, and in an effort to process grief, she took to social media.

Bex said: "I thought to myself I can’t be the only one struggling with this pain and complete darkness, so I decided to write about my experiences as honestly as I could. I had a piece published by the Metro which was shared to social media and it went viral.”

Bex later created a support group, which Laura joined, after experiencing her seventh miscarriage. Laura explained that prior to finding Bex, she had been stuck living in the baby loss world.

“This was also in 2020, my first son had turned one and he was eighth pregnancy. All my miscarriages had been before 12 weeks," said Laura. "It had taken over my life for quite a long period of time."

After speaking for some time online, the pair decided to create a podcast. Laura said: “We chose the name, ‘The Worst Girl Gang Ever’ because the miscarriage club is one that no one would ever choose to be a part of. Yet, we stand shoulder to shoulder, stronger together.”

In their most recent podcast, the pair were able to speak with MBE Zoe Clark-Coates, who's experiences of baby loss, fuelled the creation of the certificate.

MBE Zoe Clark-Coates suggested the certificates after regretting her own grieving process. (credit: TWGGE)

MBE Zoe Clark-Coates suggested the certificates after regretting her own grieving process. (credit: TWGGE)

For the podcasters, the certificates were a light at the end of a seemingly dark tunnel.

Bex chose to order one of the certificates. “I got mine a couple of weeks ago," said Bex. "I felt like the application process was kind. The first sentence of the certificate was 'We are sorry for your loss'. I felt this was such a progressive way to manage the whole concept of acknowledgement.”

Laura still has not decided whether or not she will be applying for a certificate. However, she emphasised the positive impact that the initiative had started.

“When the worst happens and it is completely disregarded by society, it's crushing," Laura said. "It leads to shame and it's all swept under the carpet. The certificates not only provide recognition but bring the stigma of miscarriage to the foreground.”

Part 3

The Bloody Truth

Is a piece of paper enough?

Lara scrolled through her TikTok page. Her most recent post surrounding pregnancy loss had just hit 1.6 million likes. The caption read: 'When we think of pregnancy, we think of the American dream, when in reality, most women are struggling with something.'

Lara Basini Millar is not only a viral TikToker. She is the Recruitment and Retention Midwife for Chelsea and Westminster Hospital, which has one of the largest maternity units in the country. Part of Lara's role is supporting the 3000 women who are admitted every year, due to miscarriage.

When Lara started her midwifery journey in 2006, she admitted that treatment towards miscarriage was lacking. “To put it bluntly, when I started, there were just freezers," Lara said. "There would be a chest freezer like the ones you keep ice-cream in and I would put the dead babies in there."

“This was not just after 4 weeks as well, this was at full term," continued Lara. "There has, of course, been a massive change: There is no way you would walk into a hospital in the UK and find a baby in a chest freezer.”

The General Medical Council (GMC) follows far stricter guidance, including ‘best practice’ towards miscarrying mothers, then when Lara first started. Now, Lara feels that despite the GMC catching up, the rest of the working world has not.

Lara Basini Millar has garnered over 2.2 million likes and 120,000 followers on TikTok.

Lara Basini Millar has garnered over 2.2 million likes and 120,000 followers on TikTok.

“If you miscarry at 24 weeks, your baby will have fingers and toes. That's what women are dealing with. How are you supposed to just get on and go back to work?”

Lara’s hospital works closely with Tommy’s, a charity which opened the UK’s first National Centre for Miscarriage Research. It found that in 2022, 38% of people who had a miscarriage felt they could not tell their boss and 60% never told their colleagues. 

“There are 30,000 hospital admissions every year because of miscarriage but there are even more who will never come forward," said Lara. "I am seeing around 10% of these women and it's always the same. We still haven't moved enough with what people think about baby loss."

Doctors working with the GMC suggest any loss past 12 weeks, require at least a month of rest due to the risk of infection and retained products. Mentally, Lara explained the grief could last so much longer.

“In the UK, we see ‘cracking on' as healthy and this includes employers," said Lara. "I think people are over the moon with the certificates because it's validating their loss, but we still haven't moved enough with what people think about miscarriage or the care women need."

A baby at 24 weeks (pictured) is around 30cm big.

A baby at 24 weeks (pictured) is around 30cm big.

Part 4

George's Law

A new hope for grieving mothers

Angela Crawley MP (left) and Keeley in the lobby of the House of Commons with copies of the Miscarriage Leave Bill. (credit: Keeley Lengthorn)

Angela Crawley MP (left) and Keeley in the lobby of the House of Commons with copies of the Miscarriage Leave Bill. (credit: Keeley Lengthorn)

After her second miscarriage, lawyer Keeley Lengthorn drafted a baby loss policy to be implemented at her law firm, Taylor Rose LTD, entitling women to three days paid leave for baby loss before 24 weeks. 

She was inspired by New Zealand’s Parliament vote on the 25 May 2021, allowing mothers and their partners three days of bereavement leave after a miscarriage.

“I couldn’t believe it was not already a policy," Keeley said.

Keeley was pregnant for the third time when her firm, Taylor Rose LTD, finally implemented the policy. A few months later, Keeley became the first woman in her firm to use the law, after she lost baby George at 21 weeks.

After using the policy herself, Keeley saw first-hand the change that had to be made.

Keeley said: “George weighed a pound. My labour was 18 hours. I got to bath and dress him and to cuddle him. He had blonde hair and big feet. The fact I left him at the mortuary on Thursday night and went to stop my milk on Friday morning when the law says I should have been working, is completely beyond anything I can ever imagine.”

Keeley had posted online about the policies she had implemented within her firm on social media which led to hundreds of questions about her experience.

“People kept asking about what I had done, and the more people asked, the more I knew what had to be done in terms of changing the law," explained Keeley. "It was around  June 2022 I began calling all employers to implement baby loss policies within their businesses."

In June 2022, Keeley met with MP Angela Crawley to put forward George's Law. The law, if passed, would entitle all women to three paid days of miscarriage leave.

Alongside a GoFundMe which raised £30,000, the draft was taken to parliament and George's Law was mentioned in its first reading, which was successful. Postponed at its second reading due to the Queen’s death, it was heard again at the beginning of 2023.

Keeley Lengthorn expressed her high hopes for the law.

Keeley Lengthorn expressed her high hopes for the law.

Keeley explained: “You can give those certificates to your employer but it doesn't do anything in terms of paid time off. If we had George's Law alongside the certificates there would be BOTH holistic and practical aid in place for mothers who miscarry."

Currently, the Bill is pending review. Keeley believes there is still a long way to go, but that the progress being made is far more important than the baby loss certificates. 

"Of course the certificates are a fundamental change in terms of bereavement loss care we have had in decades and it's amazing. There have been so many women who have reached out and said that it's brilliant," Keeley said. "However, the progress we are making - it's not enough.”

Part 5

Expecting

The future of safeguarding miscarriage

Since the second reading of 'George's Law', business network, Business in the Community (BITC) released their Top 50 Employers for Gender Equality 2023. Of companies selected, 32% would not disclose their baby loss policies and 28% did not have any bereavement policies for loss before 24 weeks.

It is hoped by Keeley, that in lieu of George's Law, more companies will decide to implement their own in-house baby loss schemes. Already, it seems some companies are joining the movement.

“I am pleased to say it still has gained traction with businesses such as Monzo, Channel 4 and ASOS," said Keeley. "They have all implemented their own in-business policies which are around two weeks long.”

Although the information on how many women have applied for the certificates is currently unavailable, it is hoped that eligibility for the certificate will be expanded.

Keeley is waiting to hear the results for the second reading of George’s Law. When asked on her hopes for its future, her message was simple:

"His name is known by me," said Keeley. "I hope that in the future others will know it too. It will be a name that offers comfort in times of loss."

(credit: Keeley Lengthorn)