How can employers support staff who need an abortion?

Need to know….

  • Pregnancy loss policies must be flexible, especially around paid leave, as employees’ experiences will vary significantly.
  • Widening support to partners makes the benefit more inclusive by recognising they may also be experiencing loss.
  • Support for employees needing an abortion can often be delivered through existing benefits supplemented with a pregnancy loss policy, training and guides.

While many US employers are reviewing their health policies in light of the decision, more and more UK organisations are also considering what they can offer to support employees who need an abortion.

In the US, organisations such as Amazon, Google and JPMorgan Chase were quick to update their health insurance policies to reassure employees. As the decision to allow abortion is now determined on a state level, with around half expected to impose restrictions or bans if they have not already, these employers confirmed they would cover travel to states where abortion is still legal.

These global giants may have grabbed the headlines but a poll conducted during a Mercer webinar in June 2022 shows this approach is gaining traction in the US. Of the 1,203 employers surveyed, 5% already provide travel benefits for employees wishing to have an abortion, with a further 23% saying they are planning to implement them and 48% considering their options.

UK support

While employers in the US are having to weigh up the moral and ethical dilemmas associated with providing support for employees seeking abortion, this rarely influences employers in the UK, says Lucie McGrath, director, health and benefits (GB) at Willis Towers Watson. “It’s much more about showing empathy,” she says. “Since the beginning of 2021, we’ve seen a lot more interest in women’s health, fertility and inclusive benefits. I don’t know of a UK employer with a policy specifically around abortion but it is included within broader pregnancy loss policies.”

Channel 4, digital bank Monzo and Co-op are among the organisations that launched policies in 2021 but Willis Towers Watson’s Emerging trends in health care delivery survey, published in (July 2021, shows interest is growing. It found that 24% of respondents had an early miscarriage and infant loss policy in place, with a further 21% planning to introduce something in the next couple of years.

While it may be a new area for employee benefits, it is relatively straightforward to implement support for employees needing an abortion, says McGrath. “It’s often a coordination piece,” she explains. “We work with clients to help them create a structure with support networks, manager and employee training and guides but also signposting support services and benefits. It doesn’t have to involve significant investment.”

Pregnancy loss policies

A pregnancy loss policy is central to this. As well as setting out what is available to employees, this demonstrates the organisation cares about them and understands they may need additional support.

This policy should detail the benefits that can support employees as well as any paid leave that is available. Although pregnancy loss after 24 weeks triggers entitlement to maternity and paternity leave or pay, plus two weeks’ parental bereavement leave, very few abortions take place at this late stage of pregnancy.

This leaves employees in this position with very few rights. Helen Hughes, legal director and employment expert at Shakespeare Martineau, explains: “The only protection they have is under the Equality Act, which states that as they’re pregnant, they cannot be discriminated against. They can also record any time off as pregnancy-related, which should be discounted for redundancy selection.”

Flexible support

Policies also need to be flexible, as no two experiences are the same. As an example, Co-op’s policy states that it generally gives five days leave, but acknowledges that some situations may need more, or less.

Francesca Steyn, director of fertility and women’s health services at Peppy, says: “Policies should also enable employees to take time off to attend appointments. This can be a very emotional time and employees need to feel able to take time off.”

This flexibility can also be essential when someone returns to work. This is recognised in Channel 4’s pregnancy loss policy, where it states that it aims to facilitate flexible working where necessary including a phased return to work; reduced working hours on a temporary basis; and early start and finish times to avoid peak travel times.

McGrath also recommends extending support, including bereavement leave, to partners and family members affected by the loss. “We also advise employers to think about those who are not on a conventional journey to create their family and what their needs may be,” she adds.

Medical cover

Healthcare benefits can provide valuable support too. Abortion can be included on a private medical insurance policy, although cover can be limited. “Typically, UK healthcare plans will cover certain procedures classified as ‘complications of pregnancy’, including where a pregnancy is terminated on clinical grounds or due to medical necessity,” McGrath explains. “The wording can be purposefully brief and insurers will request employees contact them to pre-authorise planned treatment.”

As examples, Axa Health and WPA cover abortions when medically required, with Axa adding that, as well as care during the termination itself, this includes a specialist consultation both before and after the procedure.

More flexibility is available where an employer offers its medical benefits through a healthcare trust. John Dean, managing director of Halcyon Trustees, says: “Employers can work with the trustees to provide relevant, supportive health benefits from mental health support through to physical treatments without having to apply traditional insurer rules and wordings that might exclude abortion.”

Other healthcare benefits can provide support too. Virtual GP services are often flagged up in pregnancy loss policies as they can be a good way to access medical advice and, in some instances, referral for treatment. Similarly, WPA offers a cash plan, LifeStage Health, which covers women’s health including pregnancy and abortion.

Advice and guidance

Providing access to information and advice can also help employees make more informed decisions about their options. Services such as Peppy provide information around all aspects of women’s health, including abortion. “Our women’s health nurses can support employees as well as signposting them to other relevant services,” says Steyn. “We also have a lot of evidence-based content to help people make decisions about their options.”

There are also helplines specifically for abortion that can provide support. For example, Abortion Talk, is a charity that provides a confidential talkline for anyone who has had, or is thinking about having, an abortion. Staff are trained to listen and offer support and information. Lesley Hoggart, professor of social policy research at the Open University and co-director of charity Abortion Talk, says: “We speak to people and their partners who need support around abortion. People’s needs vary and the support can range from information through to counselling, which we can help them arrange.”

Emotional support

Alongside practical information, emotional support is an important part of the package that employers can offer. An employee assistance programme is a good starting point, although employers can also flag charities such as Abortion Talk, Tommy’s and ARC, to provide more specialist support.

Having guidance for line managers on how to deal with an employee who needs to have an abortion is also recommended. “This should run through the policy and benefits but also include information about what they should and shouldn’t say,” Hughes explains. “Sometimes people say nothing as they don’t know what to say but this can be as upsetting as saying the wrong thing.”

As this is still a very new area of employee support, what organisations offer is likely to evolve. For example, research is underway at the Open University to understand how organisations can better support individuals who need to have an abortion.

The project, Early pregnancy endings and the workplace, includes a survey of employees who have experienced termination or miscarriage in the first 24 weeks of pregnancy. This will help to inform policy around workplace support.

Further refinement may be on the cards, but offering support to employees through a pregnancy loss policy can be very powerful, says Hughes. “It’s a sign the organisation is more open and tolerant,” she says. “This can go a long way when it comes to creating a positive workplace culture.”