fertility

Need to know:

  • Physical, mental, and financial health and wellbeing benefits can play a role in supporting staff with gynaecological conditions and fertility issues.
  • Developing a supportive culture and providing line manager training can help to remove barriers to employees seeking assistance through the workplace.
  • Flexible-working arrangements can help staff manage these health issues during flare-ups or when they are undergoing or recovering from treatment.

In June 2017, the Work Foundation published its More than “women’s issues”: women’s reproductive and gynaecological health and work report, which focuses on four areas of women’s reproductive and gynaecological health: endometriosis, infertility, pregnancy and health, and menopause. The report calls for greater understanding and recognition of these issues and their impact on women’s health and work, and an end to them being seen as simply 'women’s issues'. This was followed in July 2017 by the research report Menopause transition: effects on women’s economic participation, which was undertaken by the University of Leicester for the Government Equalities Office.

These reports highlight conditions that some employees may feel uncomfortable discussing or seeking support for in the workplace. So what can employers do to make sure staff are able to access the medical or emotional support they might need, just as they would with any other health issue?

Medical benefitsHealthcare benefits such as private medical insurance (PMI) can provide employees with access to treatment for gynaecological conditions such as endometriosis. Most standard UK PMI policies will also cover underlying medical issues that may be related to infertility, but tend not to cover investigations into the causes of infertility or treatment, such as IVF.

However, an employer could build IVF treatment into its benefits package through arrangements such as a large self-funded healthcare scheme, like a health trust, says John Dean, managing director at Punter Southall Health and Protection. “I think in the future, if you go forward 10, 15 or maybe even five years, some leading, visionary [organisations] will start doing that,” he adds.

To help control costs, the benefit could be capped at a certain number of IVF cycles and limited to once per policy lifetime use, for example. If an organisation chooses to offer IVF treatment as a benefit, then it should also ensure that there are no exclusions around pregnancy complications associated with assisted reproduction in the medical coverage it provides to staff, adds Dean.

While infertility treatment is not a regular feature of domestic PMI, international policies tend to be more comprehensive. Through these, multinational organisations can support the gynaecological and reproductive health of employees and their dependents while on international assignment, with some organisations also opting to cover infertility treatment, such as a limited number of IVF cycles, explains Dr Peter Mills, associate medical director at Cigna Global Health Benefits. This might be included within more comprehensive international PMI policies or as an optional add-on.

Wider wellbeingWhether an employee is undergoing treatment for gynaecological conditions or fertility issues through a health benefit or the NHS, the wider toll that health problems can have on an employee inside and outside of the workplace should not be ignored. Christine Husbands, managing director at RedArc, says: “The emotional side is just as important and is often the area that gets overlooked.”

There are a number of tools that will already be at an employer’s disposal that will facilitate access to emotional and mental wellbeing support, such as employee assistance programmes (EAPs), and other services that are offered alongside healthcare and group risk benefits. This could include counselling and access to nurse-led services that offer practical information and emotional support to employees. These kinds of services have the added benefit of providing staff with a confidential support system outside of their family and workplace, which can help them as they navigate through diagnosis, treatment, and recovery or management of a condition.

In addition to expert help services, employees can also access a range of online resources via healthcare providers, such as informational articles about pregnancy, says Nicola Mohns, head of intermediary and corporate marketing at Axa PPP Healthcare.

Some reproductive health issues can also result in financial strain for employees, for example, if they are self-funding fertility treatment. Indeed, the Fertility Network UK’s Survey on the impact of fertility problems, published in October 2016 in association with Middlesex University, found that concerns about funding, impact on work, and treatment uncertainty were among the top three worries for respondents undergoing fertility treatment.

Rachel Western, principal at Aon Employee Benefits, says: “If [an employee is] going through IVF treatment it’s a huge financial commitment, and [it’s] understanding the financial impact that can be having.”

Financial stress can, in turn, affect an employee’s wellbeing and their performance in the workplace, so mechanisms that offer financial wellbeing support, such as EAPs, should be signposted to staff who may be struggling.

Supportive policiesAn employee may not be aware of the range of benefits available through the workplace that can provide support for the impact gynaecological and reproductive problems may have on their health and wellbeing. Actively listing and communicating the range of conditions that benefits can support may encourage staff to access help through these mechanisms.

As well as benefit programmes, certain modifications to the physical working environment and working patterns can support staff experiencing health issues with recurring or fluctuating symptoms, such as some gynaecological conditions. This might include temperature adjustments to help women going through the menopause manage hot flushes, says Liz Walker, HR director at Unum UK. Flexible-working arrangements and supportive absence policies can also help employees manage their condition and recover from any treatment they might be undergoing.

An understanding cultureTo remove any potential barriers to employees accessing these policies and benefits, they must be accompanied by a supportive environment and effective line management. Walker says: “Regardless of what policies and practices an employer has in place, the first place [they] have to start is with an inclusive and open culture where [employees] feel they can talk about these things and be honest. Because if not, they are still having the same impact on the workplace, potentially worse, but they are being called something else or [employees] feel like they have to be disingenuous about why they might be off or why they’re having problems.”

Line managers play a key role within this supportive framework. Employers can offer line managers training to equip them with the knowledge and confidence to have empathetic conversations with employees, and to enable them to signpost staff to further support where appropriate. Husbands says: “Train line managers on what the support services [an employer has in place] provide, what scenarios they can help with, and some of the signs to watch out for with employees that may well be struggling.”

Training opportunities could also be augmented with wider awareness and education campaigns, which might be facilitated through healthcare providers or charities.

Employers could also appoint an employee or HR champion that staff with reproductive health issues or gynaecological conditions could approach for support or signposting to further information, says Walker. This would function in a similar way to mental health first aider and champion initiatives and, where possible, could involve employees who have experienced such an issue themselves. “It’s a good start to have that trusted adviser who could be embedded in the business that people feel they can go to,” says Walker. “And they can support both employees and management with these issues until [there is] a wider capability in the business.”

Read more

Jo Brewis: Employers need to know how to support staff during menopause transition

Emma Cox: What can organisations do to support staff with endometriosis?

Nicky Payne: The need for workplace support for employees having fertility treatment

Philip Richardson: Employers' legal obligations to staff undergoing IVF treatment