More than 10,000 women in Japan leave their jobs each year after a miscarriage or stillbirth, according to a study by researchers at Nagoya City University and other institutions.
The researchers say many women experience depression or severe emotional distress after pregnancy loss, yet workplace support remains inadequate. They are calling for stronger legal protections, expanded leave policies, and more flexible return-to-work arrangements.
The study analyzed survey responses from 1,177 pregnant women who visited Nagoya City University Hospital and its affiliated West Medical Center between September 2017 and March 2020. Participants were asked about their miscarriage history, income, health, and employment status.
Among the 571 women who had experienced a miscarriage, 52—just over 9%—said they had resigned because of it.
Based on their median annual income of ¥3.98 million (about $27,000) and Japan’s estimated miscarriage rate of 15%, the researchers projected that roughly 11,700 women nationwide leave their jobs each year after a miscarriage, resulting in an estimated annual economic loss of ¥46.6 billion (about $320 million).
Limited Leave and Workplace Support
Although there is no conclusive evidence that work-related stress causes miscarriage, the researchers’ previous surveys found that many women believe stressful events or prolonged stress contribute to pregnancy loss.
Chihiro Banno, an assistant professor of obstetrics and gynecology at Nagoya City University, said this perception may be leading some women to leave the workforce.
A separate survey by the National Confederation of Trade Unions (Zenroren) of about 1,660 women who became pregnant after 2020 found that roughly one in five had experienced a miscarriage.
Despite the physical and emotional toll, Japan’s Labor Standards Act provides no maternity leave for miscarriages before 12 weeks of pregnancy.
A 2023 survey by the nonprofit organization iKizuku, which supports people affected by pregnancy loss, found that 55% of 271 working women returned to work either the same day or within a few days after a miscarriage or stillbirth.
Even among women who lost a fetus after 12 weeks—when maternity leave is legally available—16% did not take leave, most commonly because they did not know they were eligible.
Among those who took maternity leave, about 70% said the leave period was too short. The organization believes insufficient recovery time is one reason some women eventually leave their jobs.
Lasting Emotional Impact
Banno said many women blame themselves despite the fact that most miscarriages are unrelated to anything the mother did.
“Many feel guilty and push themselves because they don’t want their work to suffer,” she said.
The psychological effects can be severe. According to a 2020 survey by Japan’s health ministry, 65% of women who had experienced a miscarriage or stillbirth within the previous five years showed signs of depression or an anxiety disorder.
Mikiya Nakatsuka, a professor at Okayama University’s Graduate School of Health Sciences, said public understanding remains limited, including awareness of recurrent pregnancy loss, a condition involving two or more miscarriages or stillbirths.
“As women experience repeated pregnancy losses, many continue to blame themselves,” he said.
He added that some women face insensitive questions from coworkers about when they plan to become pregnant again, while others are encouraged to resign after taking repeated leave for miscarriage-related treatment.
“People need to recognize that this is a common issue that can affect anyone,” Nakatsuka said. He called for expanding legal leave entitlements and giving employees greater flexibility when returning to work after pregnancy loss.
Memorial tablets commemorating babies lost to miscarriage and stillbirth. (Photo provided by a nurse)
Healthcare Workers Face Higher Risks
The problem appears particularly acute among women working in healthcare, nursing care, and childcare.
A survey conducted last year by the Japan Federation of Medical Workers’ Unions found that one in four nurses who had ever been pregnant had experienced a miscarriage. About 31% continued working night shifts while pregnant.
Among the occupations surveyed, nurses had the highest miscarriage rate at 27.9%, followed by nursing care and welfare workers at 25.7% and childcare workers at 25.2%. By comparison, the rate among general office workers was 17.5%.
Etsuko Sasaki, chair of the federation, said demanding working conditions—including night shifts, long hours, and physically strenuous tasks such as lifting patients—may contribute to the higher miscarriage rates. She also pointed to chronic staff shortages, saying they make it difficult for employers to reduce workloads for pregnant employees.
One 31-year-old nurse from Tochigi Prefecture recalled miscarrying at 10 weeks four years ago while working at a general hospital. She said she was not exempted from night shifts or overtime after becoming pregnant.
Shortly before the miscarriage, she experienced abnormal bleeding and asked to leave work early but was reprimanded by her supervisor because the ward was busy.
“I loved my job,” she said. “But I reached the point where I couldn’t keep sacrificing my own health and my baby’s.”
(Read the article in Japanese.)
Author: Yoshino Nakai, The Sankei Shimbun
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