Abortion Bereavement Leave is Part of Abortion Care

By Dr Nathan Hodson

Last week, changes to the bereavement policy for employees at the City of Portland, Oregon, emerged. Under the new bereavement leave policy, employees of the city government are eligible for bereavement leave following pregnancy loss, and pregnancy loss is defined broadly to include termination of pregnancy. This reflects a striking evolution of the pregnancy loss leave discourse over the last 12 months.

Some advocates claimed that it was the first city in the USA to introduce such a policy, but in fact a very similar policy was introduced by Pittsburgh, PA, in September 2021. Several UK-based employers have created similar policies, indicating a growing movement. In this blog I will briefly outline what Portland’s new regulation involves, how these policies are proliferating across employers, and describe why this bereavement leave is an important frontier in abortion rights.

The change was embedded in the city’s bereavement leave policy which allows employees of the city government to take 3 days leave for bereavement. Abortion is included “irrespective of whether deemed medically necessary”. This bold stance is humane and generous, but may also be intended to send a cultural signal; it follows a recent move by the City of Portland to create a $200,000 fund to support Texan women having abortions in the city, in response to restricted abortion access in the Lone Star State.

Some commentators have drawn comparisons with the change to New Zealand’s miscarriage bereavement law, which extended the existing allowance of 3 days bereavement leave to include miscarriage bereavement. But the New Zealand law includes a clause specifically excluding abortions so the New Zealand law is a poor comparator for the City of Portland’s policy. Besides, the Portland policy only covers roughly 7,000 people employed by the local government of the City of Portland.

A more instructive comparison is with UK employers such as Monzo, Channel 4 or Birmingham Women and Children’s (BWC) NHS Foundation Trust. In April 2021 Channel 4 introduced bereavement leave including abortion for all employees, claiming that it was a world first. As part of an employee mental health drive, Monzo subsequently offered 10 days of bereavement leave for any bereavement explicitly including abortion. In July 2021 BWC created a bereavement policy providing 10 days of bereavement leave following pregnancy loss (including abortion), or 5 days for partners, to its 6,500 employees. These policies fill a significant gap because in the UK there is no statutory bereavement leave when pregnancy arises before 24 weeks gestation.

These policies have two main sets of implications. Firstly, they are likely to indicate the future of pregnancy loss rights in the UK. The government has resisted calls to expand bereavement leave following pregnancy loss; the government’s preferred policy is for individual companies to extend pregnancy loss bereavement as an employee benefit, rather than through further statutory intervention. This approach is likely to create a two-tier system: it may help those working in competitive fields where employers offer benefits. It’s unlikely Amazon warehouse workers will benefit any time soon.

On top of this, these policies have implications for the social construction of abortion. New Zealand’s decision to exclude abortion treats abortion as wholly different from miscarriage and was guided by a desire to avoid getting bogged down in debate. Nevertheless, the rule reinforces the sense that people having abortions are experiencing an undeserving kind of pregnancy loss. At a minimum, it reflects an extreme view of abortion as always being an indifferent matter of individual preference, at worst a sense that people having abortions are doing something wrong. These are inappropriate responses to something that is a) legal, b) healthcare, and c) often not a free choice (whether for socioeconomic reasons or medical reasons).

The profound insight that the Portland policy and the others illustrate is that abortion bereavement leave is part of abortion care. People respond differently to abortions (and the circumstances around abortions vary); for many, abortion is a deeply emotional experience and if some people require bereavement leave afterwards then it should absolutely be available. Abortion shouldn’t be treated as a luxury people should be grateful for or a shame people should pretend didn’t happen. (See NICE Guidelines 1.14.3-6.) Employers, and employment law, should recognise that abortion rights must include the right to engage in any required self-care afterwards.

 

Author: Dr Nathan Hodson, Academic Clinical Fellow, Warwick Medical School

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