If you know someone who is going through a high-risk pregnancy, you want to be helpful. Really, you do. It’s just that, if you’ve never been there yourself, it can be tough to find the right thing to say. Offering assurance feels phony — offensive, even — yet saying nothing feels even worse.
Yes, it’s true the wrong words or gestures really can cause damage, as I experienced first-hand during my own two high-risk pregnancies. But the good news is that the right words can provide immense comfort and healing, so here’s a concise list of high-risk pregnancy dos and don’ts.
1. DON’T gush about how excited you are.
Avoid raving about your excitement for the upcoming baby. The anticipation of the bumbling bundle of joy may be the furthest things from the expectant parents’ minds right now — in fact, they may not be allowing themselves to feel excited about much at all, due to all the accompanying uncertainty. Your outpourings of enthusiasm, while well intended, have the potential to be experienced as salt dumped on their open wounds.
2. DO assume that the parents-to-be are in a tight spot.
Recognize that the expectant parents are probably stewing in some heavy concerns, like whether or not this pregnancy will make it to full term, what the state of mom and baby’s health will be after the birth, and so on. They may be considering abortion, or wishing they could. Your job as a friend, coworker, or family member, is to keep this in mind and approach every conversation — no matter how mundane — with utmost sensitivity. Because even an innocuous question like “how’s the mama-to-be doing today?” can open the floodgates.
3. DON’T be nosy.
A woman I know recently confided that she had to distance herself from most of her good friends during her high-risk pregnancy — she simply could not handle all their questions. So, while you might think you’re just showing you care when you ask what the latest fetal prognosis is, or how the ultrasound appointment went yesterday, bear in mind that there is a fine line between polite inquiry and nosiness. And, if you sense your attempts at polite inquiry are being shut down, promptly change the subject to that new kombucha recipe going around.
4. DO offer support.
I would venture to say that for most expectant women or couples caught up in the high-risk rumba, all sincere offers of help are appreciated. Who could be offended by your desire to help them take a load off? So, offer to give rides, to pick up prescriptions, to send meals, to babysit older children, to cover at work, to be present at challenging appointments, or to work your medical connections on their behalf. Offer to listen, to support, or to share the journey.
5. DON’T play down the risk.
Out of uncertainty of what can or should be said, some fall into the trap of saying things that downplay the expectant parents’ experience. Statements like, “Oh, lots of moms/babies have that” are more offensive than reassuring because of their none-too-subtle subtext of “what are you freaking out about?” A more helpful statement might be, “I can put you in touch with someone I know who experienced something similar, if you like.” Or better yet, just listen and empathize.
6. DO invite informed optimism.
When it comes to high-risk pregnancy, optimism isn’t usually in the picture. There’s a very practical explanation for this: no doctor wants to later be accused of (or sued for) having misled a patient. Nonetheless, this cover-your-butt approach to prenatal medical care takes its toll. While it’s responsible and advisable for parents-to-be to prepare for all possibilities, sometimes they need to be reminded that there is room for hope, too. When these reminders come from people who are in the know about everything that’s going on, including the grim stats and prognoses, finding a positive edge can offer a tremendous sense of relief.
For instance, I found it empowering when people who knew the whole story told me that I was allowed to go with my gut feeling that things would be good, even if it was contrary to the statistical probabilities. Or that it was okay for me to imagine the best possible outcomes rather than the worst. You can be the person who opens that door in your friend or family member’s life, so long as you remember that informed optimism’s evil twin — uninformed optimism, or optimism based on nothing but good faith — is best kept on lockdown during this period.
7. DON’T spiritualize it for them.
It’s true that some people like to be reminded of the spiritual angle when they’re going through something challenging. But, even as a highly religious person, I know that what I want to do the moment a friend starts spiritualizing my challenges is sock them in the face! Unless you’re a clergy person and I’m expressly coming to you for spiritual guidance, keep the conversation in the here and now: support, empathy, and a listening ear.
8. DO be on board with every potential outcome.
This pregnancy might not end the way most others do. There may be complications involving hospitalization, disability, special needs, long-term medical attention, risky surgery, and more. The parents-to-be are likely already preparing themselves for lifestyle changes and for the various potential outcomes, so why not get on board with them? It helps when they know that the people close to them can handle the curveballs too. In my own pregnancies, it was a major source of reassurance when I heard things like, “This child will be equally loved no matter what” or, “We’re here for you no matter how this ends.” It meant that my friends or family members could hold their own, and that I didn’t have to manage their emotions, in addition to my children’s and my own. The sense of safety and security that afforded was priceless.
If you forget all of these dos and don’ts, just remember that you can’t really go wrong if you stick to the golden rule of empathizing, which is this: attempt to genuinely feel what your friend is going through, and then mirror it back. Mirroring can take the form of anything from a heartfelt sigh to a thoughtful text or email later that day. Use your intuition and your knowledge of your friend as your guide.
Listening and empathizing will open the doors to healing well beyond the high-risk pregnancy period. While you don’t have the power to determine how the pregnancy will unfold, you certainly do have the power to provide a listening ear.