My clients often ask me for a toolkit, tools or strategies that can help them keep performing normally during an “abnormal time” in their lives. They want to make sure their performance at work will not be affected. They are looking for quick solutions to help them process what is happening, adjust to the situation, and ensure their normality isn’t disrupted.
And it keeps me wondering: Is it something we place on ourselves internally – the belief that we should keep going, keep performing and not allow what is happening in our personal lives to affect our work? Or is it something we take from the outside – from our workplaces, managers, organisational cultures, or even the wider expectation that professionalism means carrying on as usual regardless of what is happening behind the scenes?
I believe, in reality, it is often a combination of both.
There is a problem with that starting point of that first question. It assumes that someone’s physical, emotional and cognitive resources should remain unchanged while they are experiencing something that research tells us can be physically demanding, psychologically distressing and difficult to combine with employment.
It assumes that the goal should be to return to normal as quickly as possible, or to protect normality at all costs. Perhaps instead of continually asking people how they can keep functioning as normal, we need to ask a different question:
Is normal performance actually a reasonable expectation during an abnormal period of someone’s life?
Infertility is not a niche workplace issue
Infertility affects a significant proportion of the working-age population.
Around 17.5% of adults globally (approximately one in six people) experience infertility during their lifetime (WHO. Infertility prevalence estimates).
For many people, this means infertility treatment is taking place alongside careers, leadership responsibilities, projects, deadlines and everyday working life.
Treatment does not happen neatly outside office hours. There can be scans, blood tests, medication, procedures and appointments whose timing cannot always be controlled.
But the practical side is only part of the story. People undergoing fertility treatment can experience significant emotional, cognitive, relational and social challenges. The guideline was developed after a systematic review of the evidence and contains 120 recommendations relating to psychosocial care during infertility treatment (Gameiro, S., Boivin, J., Dancet, E., et al. ). In other words, this is not simply: “I have an appointment at 10 am, and I’ll be back at my desk by lunchtime.” Someone might physically return to their desk, but it tells us very little about what else they are carrying inside.
We already know fertility treatment can affect people’s working lives
Payne, Seenan and van den Akker surveyed 563 people undergoing fertility treatment while working. Most who reported absence from work felt that treatment had an impact on their work and career prospects. These experiences were also associated with greater psychological distress. In his survey, workplace policies and support from colleagues and employers were associated with lower psychological distress
So if treatment itself is affecting people’s work and if the environment around them can make that experience better or worse, perhaps performance is not simply an individual resilience issue. however lots of people may interpret a temporary change in their capacity very differently.
“I can’t concentrate like I normally do.” or “I’m not as productive.”
“I’m letting my team down.”
“I should be able to deal with this.”
For someone who has always been a high performer, that can create another problem on top of the treatment itself: The pressure to make sure that nobody notices.
Pregnancy loss doesn’t end when somebody comes back to work
The same assumption about “normal” can occur after pregnancy loss, some type of unspoken timeline – something terrible happened, we took some time away, we returned to work, we are better.
But research suggests emotional recovery can continue considerably beyond the initial loss.
A large study followed women after miscarriage and ectopic pregnancy.
One month after early pregnancy loss:
- 29% met screening criteria for post-traumatic stress;
- 24% reported moderate-to-severe anxiety;
- 11% reported moderate-to-severe depression.
Nine months later, those figures had fallen but had not disappeared: 18% still met screening criteria for post-traumatic stress, 17% for moderate-to-severe anxiety and 6% for moderate-to-severe depression. (Farren, J., Jalmbrant, M., Falconieri).
So when somebody comes back to work after a miscarriage, being physically present does not necessarily mean they have returned to their previous psychological state. And yet we can easily treat their return date as the point at which normal performance should resume.
What about partners?
Pregnancy loss affects more than just the person who physically goes through it and the evidence suggests that partners can be affected too.
192 couples following miscarriage or ectopic pregnancy found clinically relevant post-traumatic stress, anxiety and depression in some male partners, although rates were considerably lower than among women physically experiencing the loss (Farren, J., Jalmbrant, M., Falconieri, N.,)
I think that matters in a workplace context.
A man might return to work immediately because physically nothing has happened to his body. But psychologically, something may have happened to his life. He may also be trying to support his partner while processing his own loss. Again, outwardly normal does not necessarily mean internally unaffected.
Perhaps we confuse capacity with capability.
If someone finds it harder to concentrate during IVF, it doesn’t mean they have suddenly become less intelligent.
If an experienced manager has less emotional energy in the weeks following pregnancy loss, it doesn’t mean she has suddenly become a less capable leader.
If someone’s productivity changes during an extraordinarily difficult period of their life, it does not automatically tell us anything about their long-term performance or commitment.
And yet we often measure people against exactly that standard:
Employees are worried about exactly this
CIPD research gives us another indication of what is happening inside workplaces.
Its UK research into fertility challenges found that 47% of employees had not told their manager or HR about their fertility challenges, investigations or treatment.
Among the concerns identified, 26% were worried about the possible impact on their career, while 19% worried their employer would not understand or support them.
Almost one in five (19%) had considered leaving their job because of their experience at work while going through fertility challenges, investigations or treatment.. That raises a very uncomfortable question.
If someone believes that saying, “I’m going through IVF and I’m struggling,” might affect whether they receive the next promotion, important project or leadership opportunity, are we really dealing with an individual performance problem? Or are we dealing with a psychological-safety problem?
Support and performance might not be opposites
Sometimes there is an understandable concern in companies that conversations about support mean removing accountability.
But supporting someone does not mean sending the message “Don’t worry about doing your job.” It does not mean assuming that somebody undergoing fertility treatment cannot lead an important project. It does not mean automatically removing responsibilities. And it certainly doesn’t mean treating people experiencing infertility or pregnancy loss as fragile.
Support means recognising the circumstances in which somebody is currently working.
And there is some evidence that this can actually help performance.
In CIPD research on pregnancy and baby loss, among employees who felt supported by their employer, 60% said that support had positively affected their mental wellbeing and 55% said it had positively affected their ability to perform well in their job.
It suggests we may be creating a false choice between: supporting the person and supporting performance.
Sometimes supporting the person is exactly what enables them to continue performing.
If you’re the employee going through it, what can you actually do?
The responsibility for creating supportive workplaces shouldn’t sit entirely with the person going through infertility or loss.
But there are things employees can consider that may make work more manageable.
1. Stop measuring today’s capacity against your capacity before this happened
Perhaps instead of asking yourself:
“Why can’t I work like I normally do?”
ask:
“What is realistically possible for me at the moment?”
A difficult week or month does not redefine your professional capability. Think about the work that genuinely matters right now rather than trying to maintain every previous standard simply because it has always been your standard.
2. Find out what support actually exists
Before assuming you have to manage everything on your own, check what support your organisation offers. Many companies provide access to platforms such as Unmind or KaraConnect, where you can speak with professionals who can support you through a difficult time.
Depending on the employer, that support might include fertility-treatment policies, pregnancy-loss leave, compassionate leave, sick leave, flexible working, remote working, employee assistance programmes or flexibility for medical appointments.
3. Remember that disclosure is not all or nothing
One of the hardest decisions can be whether to tell your employer. But there is a large space between saying nothing and sharing every detail of your treatment.
You might simply explain:
“I’m going through medical treatment at the moment. There may be some short-notice appointments and periods when I need additional flexibility.”
Or, following a loss:
“I’ve experienced a pregnancy loss. I want to continue working, but I may need some flexibility over the next few weeks.”
You can consider what your manager actually needs to know in order to support you and what you would prefer to keep private.
4. Ask for something specific
Managers may genuinely want to help but not always know what the right support looks like. Not every manager has been trained or has experience in supporting someone through infertility or pregnancy loss. It can therefore help to think about what would make a meaningful and practical difference for you.
It could be: flexibility around clinic appointments; working from home after a procedure; temporarily avoiding very early meetings; moving one deadline; having someone else cover a particular meeting; protecting time to receive medical calls; or simply knowing you can take a difficult day off without having to justify every detail.
You do not necessarily need less responsibility. You may simply need different conditions to do the same job for a period of time.
5. Plan for uncertainty rather than trying to eliminate it
Fertility treatment is difficult to plan perfectly. You may not know exactly when a procedure will happen or how you will feel afterwards. Instead of trying to create certainty where there isn’t any, think about contingencies.
What could someone else pick up at short notice?
Which deadlines have some flexibility?
Which meetings genuinely need you?
What work would be useful to complete before a treatment milestone?
Creating a little space can be very different from putting your entire career on hold.
6. Don’t make work your only measure of whether you’re coping
If anxiety, low mood, intrusive thoughts, grief or difficulty concentrating are significantly affecting you, consider speaking with a qualified professional. Check what support your organisation already offers. Research shows that many employees still underuse the wellbeing services available to them. These platforms often give access to a wide range of professionals, and if the first person doesn’t feel like the right fit, you can always try someone else.
Maybe normal shouldn’t be the goal
We all understand that businesses need work to be done. Teams have responsibilities. Employees remain accountable. None of that disappears because someone is experiencing infertility or pregnancy loss. But recognising accountability does not require us to pretend human capacity is constant, because life isn’t constant. Sometimes somebody can give everything they normally give. Sometimes they can’t.
And perhaps the healthiest organisation isn’t the one where personal circumstances never affect performance. Perhaps it is the one where people can experience an extraordinarily difficult period without believing that they have to disguise it in order to protect their career. Where someone can temporarily have less capacity without being seen as less capable. Where flexibility doesn’t automatically translate into assumptions about commitment. And where needing support for a period of time doesn’t erase years of strong performance.