My IVF breakdown: “Normal was going to work, but I couldn’t even leave the house”

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Sarah Hartwell Vida

Women’s blood and guts have been pushed into the corporate HR agenda and new discussions around menstruation and menopause are finally being heard. But Sarah Hartwell, corporate sales manager at Vida Homeloans, remembers it being a very different story not so long ago. Her journey into IVF and adoption shows why recent leaps forward in women’s workplace health are long overdue.

“It wasn’t really talked about.” Hartwell’s five small words encapsulate four huge events in her life, and the lives of many others who go through trauma while still managing to hold down a full time job.

IVF. A worrying growth. A mental breakdown. Adoption. It’s the kind of wild ride you’d find on the pages of a Bronte novel. “I was thinking about writing a book,” she says, “everybody writes a book about “oh, I went through IVF and now I’ve got a beautiful child”. No one writes “my life’s shit, IVF didn’t work”.

That is the story of Hartwell’s life from 2010 until she adopted her daughter, Merci, now aged 9, as a toddler in 2016. In a time before mental health hashtags, talking to your colleagues, let alone your boss, about your personal struggles was typically not a thing.

Hartwell, who was working as a business development manager at Nationwide Building Society at the time, says: “I didn’t feel I could say, “oh, I’m going for IVF, am I allowed time off?” But it’s also that you’re excited, scared, up, down. The whole process will have affected my work in some way.”

With IVF, the woman is injected with medications to encourage multiple egg development. Injections are given with a very small needle, just under the skin. It is similar to how diabetics give themselves insulin shots. But the impact on a woman’s body can be far reaching.

Side effects include hot flushes, severe mood swings, headaches, restlessness, sudden weight gain, and ovarian hyperstimulation syndrome where the ovaries swell and become painful. Enduring these symptoms is no guarantee of success. Nor is using a donor egg, as the Hartwell’s eventually had to, flying back and forth from Barcelona carrying their hopes with their hand luggage. Finally Sarah became pregnant. The couple’s joy was painfully short-lived.

She says: “It was Easter Bank Holiday. The baby started bleeding on Saturday and I ended up in a hospital in Wales because I was visiting my mum. I came out Monday and went back to work the following Monday, because I was worrying, like you do, because I’m very conscientious, that I had to get back to work. I literally just had a week off.”

According to guidance on Acas, the workplace mediators, if you become pregnant through IVF, you have all the same pregnancy and maternity rights as non-IVF pregnancies. But even now there’s no legal right for time off work for IVF treatment or related sickness, though your employer should treat these the same as any other medical appointment or sickness. Hartwell says designated time off would have helped: “It would be nice if there was some sort of allowance you could have.”

HR drives to promote openness at work about sexuality, gender identity, religion, bereavement and very recently menstruation and the menopause, have not typically included any specific handling of IVF, which can encompass all of the above and more. Hartwell hid her grief from almost everyone at work.

She says: “When they told me the baby was gone, I have never felt pain like it, in my heart.” Colleagues who she did confide in “were amazing”, but accidentally insensitive: “They say “my wife had a miscarriage, now look, we’ve got two kids”, but with IVF that might be the end of the cycle for you.” It was a similar situation when she adopted. She says: “People would say, “are you getting the child from abroad?” But there’s enough children in this country that need a mum.”

IVF cost the Hartwells £25,000, a significant portion of their life savings. But they stopped because having their hopes continuously shattered was too much. She says: “I couldn’t mentally do it anymore.” After the miscarriage, Hartwell had a breakdown and post traumatic stress disorder. She says: “I got really ill.” For the first time she was unable to work. She was signed off sick for six months.

Hartwell believes today’s corporate culture is better at supporting employees. Mental health first aiders are now commonplace. (Googling such training throws up 3 million results). She says: “Maybe if there had been more of that, to say “I’m struggling””. She trails off. At one point Hartwell didn’t know how she’d go on. She says: “You don’t enjoy anything, can’t engage with friends. I thought my whole journey of being a mother was over. You’re thinking “oh, my god, how am I going to live like this for absolutely ever?””

Eventually, Hartwell says, “one day you wake up and think, ‘“I’m slightly better””. However IVF can have a long lasting impact on employees, a fact managers need to be aware of. The drugs and miscarriage trauma caused a thyroid growth Hartwell had had removed to return. She was forced into a second period of prolonged work absence having it removed.

Despite feeling restricted in asking for time away from the office, Hartwell describes the male manager she had at Nationwide during her IVF as “absolutely fantastic”: “He was the sort of person you could talk to about anything.” After the miscarriage and breakdown, he used to come round every other week with fish and chips for her and her husband. She says: “That’s the sort of people you need.”

Hartwell wants to see men brought into the discussion around what are still widely referred to as “women’s issues” – from the menopause to reproduction or children more broadly. She says: “She has the IVF injections, but the journey is the same for him. If you miscarry, that father is going to be just as devastated. Can they go to work the next day?” She also argues for similar support during the menopause: “The wife could be going through a terrible time, with moods and everything affected. It happens to us physically, but to the male in the relationship it’s happening to them emotionally. Are they okay?”

Proving the sex of the manager is much less important than the type of person they are, Hartwell had a different experience when she adopted Merci where her manager was much less supportive. Hartwell says: “Though I talked about the adoption a lot more, including to my brokers, and I got a lot of support there, which was a big difference, I felt less supported by my manager.”

Despite this, Hartwell credits Nationwide for continuing her financial support during her two absences. She says: “I was really, really lucky. I was paid completely full pay.” Her experience also shows the value of strong workplace health policies. She adds: “There was no time they rushed me back to work. The occupational health person said, “I’ve never had anyone like you Sarah, we’re saying we don’t think you’re ready for work but you want to come back to work””. Like for many people in periods of mental or emotional uncertainty, work was Hartwell’s lynchpin. She says: “Normality was going to work. Even when I couldn’t even leave the house.”

If being a parent is tricky, Hartwell says double that for being an adopted parent: “Adoption is hard. When I chose Merci I went to what is like a mortgage roadshow, with all the county councils, all the pictures of the children. I don’t even think I told anybody, I just took it as a day’s holiday.” Merci had suffered abuse. Hartwell says: “She was terribly neglected. It’s hard juggling those problems and working full time.”

Hartwell wears her heart on her sleeve. But even she has been reluctant in the past to admit the depth of her ordeals, something managers need to acknowledge: “If I didn’t say Merci’s adopted no one would know, and then things could go really bad and no one would get it.” In some cases families of adopted children will turn up at their new home demanding custody. Hartwell says: “Can you imagine what my work would be like if that happened? But because people don’t talk about certain things it could be mistaken for being lazy, not being very good at your job or being over emotional.”

Hartwell worried when looking for another job how her absence-marked work history would be perceived. She says: “I can remember thinking, “oh my god when I apply, what are they going to say?” I’d been off for six months each time, I had a breakdown. In 2010, 2011, you didn’t talk about mental health in an interview, you felt it would affect what people thought about your ability to do your job. It makes you feel weak. It still makes me feel weak. I still struggle now.”

Without the employer’s active participation in dismantling it, a damaging culture of silence can be allowed to prevail, says Hartwell. “I’m sure every employer would say,  “if you came in to talk to us about that we could help you”. But I still think there’s that barrier, and a feeling it might get used against you.”

She admits, happily, workplace support is improving. She says: “The stigma isn’t there like it used to be. It was really the pandemic and LinkedIn becoming a popular place to talk about mental health. About being alcoholics and going sober. About suicide. When I went through this, mental health wasn’t talked about. It was an embarrassment. You tried to hide it, you know.”

Hartwell has since had counselling. Talking is a true tonic, she says: “When I was really ill, all I wanted was to talk to people that felt like me. I wanted to hear that misery, because it actually made me think it’s not just me, I’ll get better. It’s so important to see other people have been in the situation you are now. It makes you think I am going to get better, I will be better right. I will feel the same person I did six months go.”

Having finally become a parent, Hartwell says life is now complete, if not without its trials. She says: “Merci can be a little madam. She’s very competitive. But she loves horses. And as long as she’s happy. People say, “what are you going to do when she wants to find her parents?” I always give the same answer. I will drive her there. Hopefully I won’t lose her. But if it’s a choice between having her for just 15 years or being without her, it’s a no brainer.”