Whether you’ve been open about your struggles with infertility or have only told a handful of close family members or friends, at some point you’ve likely received well-intentioned, but unsupportive comments or questions from others. It may have happened when you were at a party having an otherwise enjoyable conversation with someone you hadn’t met before and they suddenly ask the question, “So, when are you planning to start a family?” Perhaps you just confided in a friend about how long you’ve been trying to conceive and they responded, “Just relax and it will happen,” “Have you ever considered adoption,” or “At least you’re having fun trying.” Maybe there’s a parent, sibling, or friend who you’ve always counted on to be supportive during other health or life crises, and it’s clear they change the topic whenever you bring up your fertility journey and never ask, “How are you doing,” or tell you, “I just want to let you know I’m thinking of you.” These types of negative or unsupportive social interactions often result in feelings of anger, sadness, and isolation for those experiencing fertility problems. Research has found that a majority of individuals who are diagnosed with a fertility problem have received negative, uncomfortable, or embarrassing responses from others, and these unsupportive social interactions are associated with increased psychological distress and decreased self-esteem.
Types of Unsupportive Social Interactions
There are generally four types of unsupportive or upsetting responses an individual may receive about their fertility problem:
- bumbling, which represents comments that are awkward uncomfortable, intrusive, or inappropriately focused on trying to “fix” one’s fertility problem (e.g., “At least you’re having fun trying,” or “I have a friend who adopted and then was able to get pregnant on her own.”);
- minimizing, which represents attempts to downplay the importance of a fertility problem (e.g., “Think about all the places you can travel without kids,” “You’ll never have to worry about college tuition,” or “Things could be worse.”);
- distancing, which reflects behavioral or emotional disengagement (e.g., when you confide in someone about your infertility treatment and they seem uncomfortable, never want to talk with you about it, or don’t “check-in” to see how you’re feeling); and
- blaming, which reflects criticism or fault finding (e.g., “You’re too stressed out – you just need to relax and let it happen,” or “You just need to think positively.”).
Don’t They Realize What They’re Saying or Doing Is Inappropriate?
Unfortunately, the answer to this question is usually, “no.” It can be helpful to think of about these unsupportive and inappropriate responses as a type social ineptitude. Some individuals simply lack a filter. Others have poor boundaries – they disclose too much information about themselves and expect others to do the same. Most commonly, though, the statements, questions, and actions of family members and friends are made with good intentions, but don’t consider the needs of individuals dealing with a fertility problem. Although public awareness is increasing and infertility is a topic more frequently addressed in the media, as well as, in popular television shows, movies and books, a majority of people still don’t understand that infertility is a disease.
How Can I Cope With Others’ Comments, Questions, and Suggestions?
Next time someone asks, “When are you going to have kids,” or “Have you considered adoption,” or says, “Just relax,” there are a couple strategies you can try:
- Take a couple of deep breaths. When someone asks that dreaded question or makes an inappropriate comment, it often feels like you’ve been punched hard in the stomach; it knocks the wind right out of you. You don’t need reply immediately (or at all). Taking a deep breath or two helps you regain your composure, and can give you some time to collect your thoughts and determine if and how you want to respond.
- Silently acknowledge that the question, comment, or behavior is likely a reflection of the person’s social ineptitude. They may lack education and information, or don’t understand how to offer helpful support when someone is experiencing a fertility problem.
- Prepare your response. Strategize how you or you and your spouse want to reply and come up with a few snappy comeback lines for common inappropriate questions and comments. You may want to develop multiple responses to reflect the different situations in which the negative social interaction could occur, such as at a party, family event, or in the lunchroom at work. For example, when someone asks, “When are you planning to start a family,“ you could say: “We’re working on it;” “We are a family;” “We’re way past the planning stage and already working with medical professionals;” “Sometime before we send out the birth announcement;” or just “Someday.” You may also want to have a few general lines in mind for when you receive a question or comment you’ve never heard before. These may include: “If you forgive me for not answering that, I’ll forgive you for asking it;” “I think you need to educate yourself more about infertility before you make comments that are inaccurate;” or “I don’t think you meant to say what you just said because I know you wouldn’t intend to hurt me like that.”
- Provide sources of education and information. This may be appropriate for family and friends in your close social network. Providing education and accurate information can help them understand the scope of your fertility problem, as well as, the emotional experience of infertility. The American Society for Reproductive Medicine has a patient website, reproductivefacts.org, which offers numerous fact sheets that provide information on all aspects of infertility and are written in easily understandable terms. RESOLVE, the National Infertility Association, www.resolve.org, is also an excellent source for information.
- Clarify your needs. You may have to specify to friends and family the types of support that would be most helpful for you. For example: “I just need you to listen and let me say what’s on my mind. I don’t need reassurances or advice;” or “I feel very isolated. It would mean so much if you would just check-in with me every week and ask me how I’m feeling.”
You can’t stop the occurrence of all inappropriate comments, questions, and suggestions, but you can change how you respond to these negative social interactions. Ultimately, this may be enough to increase feelings of empowerment and regain a sense of control in your communications with others.
Dr. Erica Mindes is a Licensed Clinical Psychologist and an Associate with the psychotherapy practice of Covington & Hafkin, which specializes in reproductive health issues. She has an office in Richmond, Virginia where she provides counseling to individuals and couples struggling with infertility, pregnancy loss, and other areas of reproductive medical care. She has conducted research and written on the psychological responses to infertility and infertility treatment, and recently co-authored the chapter, “Counseling Known Participants in Third-Party Reproduction” for Fertility Counseling: Clinical Guide and Case Studies. Dr. Mindes is a member of the American Society for Reproductive Medicine Mental Health Professional Group (MHPG) and serves on the MHPG Executive Committee.
Akizuki, Y. & Ichiro, K. (2008). Infertile Japanese women’s perception of positive and negative social interactions within their social networks. Human Reproduction, 23, 2737-2742.
Ingram, K.M., Betz, N.E., Mindes, E.J., Schmitt, M.M., & Smith, N.G. (2001). Unsupportive responses form others concerning a stressful life event: Development of the Unsupportive Social Interactions Inventory. Journal of Social and Clinical Psychology, 20, 174-208.
Mindes, E.J., Ingram, K.M., Kliewer, W., & James, C.A. (2003). Longitudinal analyses of the relationship between unsupportive social interactions and psychological adjustment among women with fertility problems. Social Science & Medicine, 56, 2165-2180.