Sense of entitlement to workplace support for infertility treatment

Background: There are large numbers of people currently using Medically Assisted Reproduction (MAR) such as In vitro fertilisation to conceive. For example, in the UK over 40,000 people a year use MAR. Yet despite the frequency, there are no statutory entitlements to absence or flexible working, despite the long, physically and psychologically demanding MAR process. Work-life balance policy and research focus on supporting expectant and existing parents and carers and few work environments have policies in place to support MAR users. Little is known about experiences of combining employment and MAR treatment. In particular it is not clear whether MAR users feel entitled to workplace support. Sense of entitlement to work-family support is influenced by social comparisons with relevant others, which in turn influence what is perceived to be feasible, normative and fair (Lewis and Smithson, 2001). However, it is not known to whom MAR users compare themselves and whether they feel that they are as entitled as expectant and existing parents to request or take up workplace support. This paper discusses MAR users’ need for and sense of entitlement to workplace support, based on interviews with 31 women and 6 men who were using or had previously used MAR. Interviews were transcribed verbatim and thematic analysis was conducted.
Findings: MAR users found it embarrassing to disclose something so personal but most felt they had no choice because they needed to request support for time off for numerous appointments and procedures (e.g. scans, blood tests, egg collection, embryo implantation) or because they were concerned that taking time off or the emotional impact of treatment (including the effects of the drugs) would be noticed by colleagues. They drew contrasts with people trying to conceive naturally who would not have to disclose. For example, line managers and colleagues were likely to enquire about treatment progress meaning MAR users felt obliged to disclose whether or not it had been successful immediately after embryo implantation. Additionally, some people were apprehensive about the possible consequences of their line manager anticipating a future request for maternity leave, and also their managers’ concerns about having to provide support for MAR use on top of later statutory support for maternity leave. The majority of participants stressed that MAR use is a medical issue and not a lifestyle choice and often compared themselves to people with other medical issues or to bereaved people. As a result they felt some sense of entitlement to be supported in the workplace, and some participants felt that their employer had a degree of responsibility to support valued employees. However, they believed that many other people view MAR use as a matter of personal choice. They noted that workplace policy and support focus on common issues for which there is a statutory entitlement such as maternity leave. In contrast, although MAR use is increasing, it is less common. Therefore, there is limited understanding of the needs of MAR users, and there is rarely workplace policy in place to protect MAR users. Thus providing support is not normative.
Conclusions: The introduction of relevant statutory policy or at least commonplace workplace policy and practice may help to define MAR use as more than a personal lifestyle choice and support entitlement. Assuming people are prepared to disclose and there is sufficient take-up, support should become more normative.