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As anyone who has ever struggled with infertility will tell you, the experience can be incredibly isolating. Silent losses, quiet moments of grieving, and precious, hushed celebrations. The stress can make even the most social of people feel like cocooning themselves away to cope with it all. And yet, despite the feelings of loneliness that it can bring, fertility struggles are surprisingly common. With 1 in 8 couples and close to 16% of women facing challenges related to fertility as well as roughly 15-20% of pregnancies ending in loss or miscarriage, there’s a good chance you know someone who is or has been affected by infertility. There also seems to be a larger discussion and community growing. A momentum building.
However, this increased awareness does not always bring with it a clearer understanding of how to actually support a loved one who is struggling to conceive, experiencing a miscarriage, or going through fertility treatments. Often times, the most helpful support involves just showing up, being open to your friend’s experience, and recognizing the power of your presence, no matter how silent conversations may be.
1. Recognize the uniqueness of your friend’s experience.
With a multitude of treatment options (not to mention acronyms: IUI, IVF, ICSI, etc.) and an even greater number of reasons why individuals and couples face challenges related to fertility, no two struggles are alike. Above and beyond the specific treatments and outcomes, it’s important to recognize the uniqueness of a friend’s experience. What one person finds most difficult can be very different from another. For some, it is the physical discomfort that comes from medications, daily injections, or invasive ultrasounds and procedures. For others, the financial commitment can be a significant stress and even a barrier to treatment. It’s also not uncommon to mourn the loss of a “natural” conception or to experience the very real sense of emptiness that a miscarriage brings with it. That’s why one of the most helpful approaches is to remain open to your friend’s experience. Sit with them in the lows, celebrate the highs, and just be present when things feel stagnant. Hear them out. Hear their story. In doing so, you’ll likely gain a better appreciation for what your friend is going through and a clearer idea of what you can do to show your support.
2. Know it’s not your place to problem solve.
When a loved one is struggling, it’s only natural to want to jump in and problem solve— To take away their pain, help them overcome road blocks, and support them in reaching their goals. More often than not, this approach does more to minimize our own discomfort or feelings of helplessness than it does to improve the actual situation or problem. This is especially true when it comes to fertility treatments and family planning where there is very little control to begin with. What’s more, the decisions that need to be made and obstacles that need to be managed are deeply personal.
Instead of chiming in with possible solutions to a friend’s dilemma, let your friend guide the conversation and support your friend’s plans, whatever they may be. It’s unlikely that you’ll suggest a route that hasn’t already been thought of and some options might not be realistic; we’re not always aware of our friend’s personal, medical, or financial situation or history, nor their personal beliefs or values. Instead of working overtime to “fix” situations that are beyond anyone’s control, focus on making smaller decisions and stressors more manageable— Drop off groceries or home cooked meals or offer to drive a friend to one of their many appointments. These daily hassles tend to feel even bigger in the face of major life challenges like infertility.
3. Watch out for triggering language
“Just relax, it’ll happen when you’re less stressed”, “What’s meant to be will be”, “At least you can get pregnant”. As good as your intentions might be, these kinds of statements can actually be quite triggering. At best, they might not reflect your friend’s experience and can minimize the intensity of what a friend is going through. At worst, they can come across as blaming (and it turns out research on the link between stress and fertility outcomes is fairly inconsistent). Even simple questions like asking a friend if they are pregnant (when you know they recently had a procedure) can be delicate. Of course, it shows you’re thinking of them, but it can also create extra pressure and make a friend feel like they are letting others down because of their struggles.
That said, it’s a delicate balance between monitoring your language, and not getting too caught up in saying the “right” thing. If uncertainty of what to say is holding you back, focus on showing up (and keep showing up) and let them guide the conversation : “I’m here for you whenever you want to talk”, “I am thinking of you”, “How are you feeling today?”.
4. Balance optimism with realism
Hope is very real and immensely powerful. But it also has its place. The truth is, no one knows when, how, or if they will be able to conceive or build a family. And there needs to be space to talk about the very real barriers and profound, unexplained losses or struggles.
Instead of encouraging a friend to remain optimistic by saying things like: “Where there’s a will there’s a way”, “Don’t worry your time will come”, or “It will happen when the timing is right”, support them in the areas where they can build a sense of control or resolve, whether it’s the strength to cope with fertility struggles or a commitment to building a family in whatever form it takes. If you feel like a friend is in need of a boost, it can help to check in and ask: “Is this one of those times you’re in need a pep talk? Or would you rather I just listen?”.
5. Understand their need for space.
As isolating as fertility struggles can be, sometimes space is exactly what’s needed. Recognize that your friend might find social gatherings or events difficult, especially those that involve family or children. The last thing you want to do is to make a friend feel like they aren’t welcome or add to their experience of isolation, so be sure to invite them regardless of their ability to be there. Show your sensitivity by letting them know that you wholeheartedly accept their decision, whatever it may be.
6. Be sensitive when sharing your own news
There may come a time when you find out the wonderfully exciting news that you are expecting. As momentous as this may be, it can be clouded by feelings of anxiety or even guilt when a close friend happens to be struggling with fertility. While it might be tempting to avoid having a frank discussion, it’s often exactly what’s needed to preserve or even strengthen your friendship. Here are a few tips for having that difficult and delicate conversation:
- Give fair warning: Let your friend know you’re expecting before they find out from someone else or through social media. Give them this courtesy and have the discussion in a quiet, safe space.
- Focus on feelings: Share your own feelings, including your ambivalence about sharing your news, and validate theirs by letting them know you appreciate that they might have conflictual feelings of their own (be it envy, anger, sadness, or anxiety). Just be careful to avoid getting stuck in a cycle of co-rumination.
- Recognize and respect their need for time: Understand that your friend might need to take some space for themselves and reiterate that you will be there if or when they are ready to chat.
- Take care of yourself: Know that a friend’s need for space or conflictual feelings have little to do with you or your friendship. Reach out to others so you can get the support you need to cope with all of the emotions and experiences that pregnancy brings with it.
- Continue your thoughtfulness: Try to avoid complaining about those uncomfortable pregnancy symptoms around your friend and make sure you find other topics and activities to share together. Keep in mind that a friend also might struggle with seeing you build new relationships with other parents and families. Be sure to express your commitment to preserving your friendship, no matter what life throws your way. If you’re unsure of what might be helpful – it never hurts to ask. You might be surprised to learn that a friend actually wants to hear more about your pregnancy or new arrival. Notice when you’re drawing conclusions about what a friend is experiencing and challenge your assumptions by creating the space for honest discussions and moments for connection.
Ultimately, showing your friend this kind of thoughtfulness and support can be an important way to preserve your friendship during what might be the most exciting time in your life and the most difficult in theirs.
Miriam Kirmayer is a therapist and Ph.D. Candidate in clinical psychology specializing in young adult and adult friendships. She is a regular contributor to Psychology Today and works with the media to make information about well-being, mental health, and relationships available and relatable. Connect with Miriam on Facebook, Twitter, and Instagram.