Dr. Himanshu Singhal, Senior Fertility Specialist, Cloudnine Group of Hospitals, Bengaluru (Bellandur &Whitefield)
Since one in eight couples experiences infertility, awareness of infertility has grown but we have a long way to go in infertility etiquette. Culturally, there is a large taboo about infertility and pregnancy loss. Infertility, like weight, religion, and political beliefs should be considered personal and off-limits for discussion but, unfortunately, it seems like fertility is an open topic. Unfortunately, the grief that couples experience is not really validated as an actual ‘loss’ on a societal level. Many people simply don’t understand what it’s like to go through challenges trying to conceive.
Unintentional remarks can feel dismissive, leaving the couple feeling sad & anxious.
Because often we don’t really talk about pregnancy loss or infertility in our society, most people don’t know what to say in these situations.
The holiday/marriage/baby showers/festival season can be especially hard to navigate, with friends and family asking tons of invasive questions which may be invasive or belittling. Even when they are well-meaning, it can be gutting to be asked again and again at the family holiday party. In India some women even might have faced being banned from certain ceremonies acting like you have a contagious virus.
Questions bombarded to you could be anything from
“When are you going to have a baby?”
“Hey, don’t you want to give lovely daughter a brother?”
“Are you crazy for wanting three?”
So the twins are your husband’s but not yours, right?”
“What a shame, you’re a woman and can’t have children.”
“If you just lost a few pounds it would probably happen.”
“Just get a dog!”
“You can have my children if you want.”
Sometimes it feels like you just can’t win! Here are some tips to deal with specific comments.
So here are a few tips for the couple how to deal with such situations as well as for family/friends whose dear ones are going through this & they don’t know how to comfort them.
For the couple– Think about the words which hurt you badly, you don’t know how to deal with situation prepare some comeback lines so that when someone drops a bombshell on you next time, you are ready.
There are three ways to deal with: 1. Polite- you respond with dignity, 2. Educate- you inform the person about your situation in a kind but informative way, 3. Zing- you literally zing them right back. If you think they deserve it of course.
If you are the couple
Focus on self-care during this time
May be they are feeling helpless and trying to make you feel better. Keep in mind those comments are coming from others who probably don’t understand pregnancy loss or infertility.”
Sometimes such situations can be avoided by avoiding social media for a bit if you don’t want to see birth announcements or not attending baby showers/functions for a while. It may not be realistic to be able to entirely avoid uncomfortable situations.
Seeking out healthy social support is always a good idea. It is incredibly helpful to connect with at least one or two other persons who have gone through this situation.
How to handle insensitive comments or questions about fertility.
Most insensitive comments may not be meant to be hurtful. May be they are not bad people & don’t want to hurt you.
The key is to resist the urge to fire back. You don’t need added stress of trying to navigate insensitive comments. Dealing with negativity gracefully—or not at all—can help you skip the fuming phase and get back to your day.
There is nothing wrong to be straight forward & say it’s private. You can either choose to openly discuss about your fertility treatment or can tell bluntly that it’s personal & talking about it makes you uncomfortable. It can feel releasing and will give you control of the situation.
Change the subject. If someone asks a question you don’t want to answer, change the subject.
Let your partner handle the conversation. After privately deciding what is off-limits to share, let your partner handle snarky comments or the nosey aunt, in laws.
Walk away. If you’re just not able to make any kind of response, it’s perfectly ok to excuse yourself and walk away.
Respond with humor. Some days this is easier than others, but responding with humor can ease frustration and nicely remind the commenter to choose their words more wisely.
Let it go. Sometimes people say awkward things because they don’t know what to say as they feel helpless. And sometimes people are just rude. If you can, let it go.
Few examples for handling negative comments
Example 1 Comment– Pados waali aunty will say “hamari Rinki ki aur aapke bete ki shadi saath saath hi hui thi aur hamari Rinki ko dusra hone wala hai. Aapki bahu kab khush khabari degi?
How to answer –
Polite: “I am so happy for your daughter. We are hoping to join her soon” .
Educate: “Getting pregnant is easier for some people than for others. We are trying our very best to conceive a healthy baby”
If still she doesn’t get it or it was very hurtful aunty bluntly
Zing: “I think your daughter is very brave to have a second child in her situation. I feel so lucky that my life is going so much better than her”
I am sure auntie will never trouble you again
Example 2 Comment You will very often get this comment when you go to any functions “ Aaj kal ladkiyan zaroorat se zyada padi likhi hai. Pehle to naukari mein lagi rehtee hai baad mein bacha nahi hota varna hamare zamane mein to choote hi bache ho jata tha”. Conveying ” it was easy for her” & as if you need to stop focusing so much on your career.
How to answer
Polite: “I so appreciate your concern for my health and wellbeing.” It may not be easy for everyone.
Educate: “Actually, infertility is a disease and is not caused by stress or travel. We are getting the best medical care available to treat this medical condition”
Zing: “If you would concentrate a bit more on your own job and financial situation, you wouldn’t be in so much debt. I feel proud at how much I have accomplished and saved”
If you are the Family/Friend
Keep in mind, it’s often helpful to do more listening than speaking.
Lend a caring, patient ear. Listen, give them a hug and let them share what is on their mind. Don’t ask questions or offer advice. By listening, telling them you care and letting them know you are always there for them, you can show your support.
Talk about things that are not centered around children or babies.
While you are out to dinner/holiday keep conversation something other than kids such as hobbies, work, current events so that they can laugh and share with you.
Be understanding if they opt out of social obligations. They aren’t skipping the party because they don’t care about you; they are opting out because some events can be so painful that their heart aches. Sometimes people need a little space and privacy to grieve as they deal with infertility.
Think about what it is like in their shoes.
An infertility diagnosis can cause feelings of shame, inadequacy, depression and isolation. People with infertility often blame themselves for their diagnosis. Be aware and sensitive to what their needs may be, and choose your words wisely.
Act interested. Some people don’t want to talk about infertility, but some do. Let them know you’re available if they want to talk.
Ask them what they need. They may also appreciate if you ask them what the most helpful things to say are.
Provide extra outreach to your male friends. Infertility is not a woman’s-centric issue; your male friends are most likely grieving silently. Don’t push, but let them know you’re available.
When appropriate, encourage therapy. If you feel your friend could benefit from talking to a professional to handle his or her grief, suggest therapy gently. If you go to therapy regularly, or ever have, share your personal story.
Support their decision to stop treatment. No couple can endure infertility treatments forever. At some point, they will stop. This is an agonizing decision to make, and it involves even more grief.
Attend difficult appointments with them. You can offer to stay in the waiting room or come into the appointment with them. But the offer lets them know how committed you are to supporting them.
Watch their older kids. Attending appointments may be difficult if they have older kids at home.
Offer to be an exercise buddy. Sometimes losing weight is necessary to make treatments more effective. If you know they are trying to lose weight, you could offer to join them.
Let them know about your pregnancy. But deliver the news in a way that lets them handle their initial reaction privately – email is best.
Already said one of them? Don’t be afraid to go back to your friend and apologize. It can become a healing moment for you both.
“You Can Always Do IVF”
It’s not so simple, very expensive treatment, rarely covered by insurance, multiple cycles may be needed to achieve success. Even if you have the cash, IVF may not be successful. Success rate vary depending on the cause. Couples may also need donor eggs, sperm, or embryos, or even a surrogate, which is significantly more expensive. Everyone doesn’t wants to go through the IVF process due to invasiveness, emotionally intense, sometimes due to religious objections to IVF.
Adoption can be a wonderful option which couple is already aware of. Adoption doesn’t take away the pain of being unable to have a biological child. There is an application and approval process which may take forever.
Don’t complain about your pregnancy/kids
We all know babies cry and puke. Who hasn’t been seated at a restaurant next to a loud, messy family or endured a long plane ride next to a screaming baby? We know our lives will change drastically when we have kids. Don’t downplay a couple’s situation by making your blessing sound more like a curse. Comments like, “Just enjoy being able to sleep late . . . .travel . . etc.,” do not offer comfort.
Don’t gossip about your friend’s condition.
Don’t be crude Comments like, “I’ll donate the sperm” or “Make sure the doctor uses your sperm for the insemination” are not funny, and they only irritate your friends.” You Need to Relax. All these comments doesn’t help relax.
“Maybe You’re Not Meant to Be Parents”
This one really hurts. Being qualified for the job is clearly not required. No one knows why bad things happen to good people. Please don’t play God by commenting so.
“But You’re so Young! You Have Plenty of Time to Get Pregnant”
Not always so. Being young doesn’t make you immune to infertility, and time is not always on your side eg. woman with premature ovarian failure or endometriosis. The longer she waits, the more likely she will need an egg donor.
“You Put Your Career in Front of Having a Family? ”
Suggesting that infertility is someone’s fault is insensitive. Don’t assume someone didn’t have a child at a younger age because of career.
“What’s the Big Deal? You Already Have a Child”
Having a child or children doesn’t take away the pain of being unable to have more. Before you tell someone to “be grateful” for what they have, don’t assume they’re not. It is possible to feel grateful for what you have and sad over what you don’t at the same time.
“So, Whose Fault Is It? His or Hers?”
Don’t assume that since someone confided in you that they’re infertile that they’re now ready or willing to share all the details. Please respect people’s privacy.
“It Could Be Worse. It Could Be Cancer”
Interestingly enough, research has found that the emotional distress experienced by women with infertility is similar to the distress experienced by cancer, HIV, and chronic pain patients.
My intention in writing this entry was to enlighten all of us. Infertility is a subject that leaves many battle scars. Let’s try to support each other, as best we can, while we are waiting to celebrate the birth of your future children.