There are few things more uncomfortable than being pregnant around someone you know is struggling with infertility.  You know that your growing belly can be a painful reminder of what she doesn’t have.  You wonder if talking about it would make it worse; she wonders if you’re avoiding it because you think she’s fragile.  Tension builds on a framework of unspoken words.  Your relationship suffers.  What do you do?

First, understand that there isn’t really anything you can do to lessen the hurts of infertility

The hurts are there, and it’s unlikely that words will make them better.  Your big old pregnant belly is probably going to make her sad.

Ashley Johnson, a professional counselor who tried to get pregnant for two years before she and her husband decided to adopt,  says that coping with others’ fertility was something they had to figure out pretty quickly, since several of their family members got pregnant during the time they were trying to conceive.  “Really it was our own process that we had to go through,” she says.  “We had to decide not to be bitter, not to cut them off.  We didn’t want to ask them not to talk about their children or not to be excited about being pregnant.  So in a lot of ways, that was really our thing to go through.”  Her husband, Tyler, adds, “It was really a matter of preparing ourselves to deal with those questions and comments.”

…but you don’t need to be a jerk.

It’s not really a good plan to tell someone that they need to make better decisions so that God will trust them with a baby.  Or to ask them if they know how babies are made. Or tell them they’re doing it wrong. Or to joke about how all you have to do to get pregnant is wash your underwear with your husband’s.  That’s like taking an open wound, ripping it open some more, and dousing it with lemon juice.

So somewhere in between being overly careful of and overly callous to your loved one’s feelings, there is a happy medium.  Here are some pointers on how to find it:

1. Be direct.

Rachel Mailhot, who tried to get pregnant for almost six years before choosing adoption, says, “When people are pregnant it’s best if they don’t go out of their way not to talk about the baby or pregnancy.   If they did the opposite– acknowledged it– and said, ‘I know you’re struggling with fertility and I’m so sorry this is so difficult for you,’ that’s so much better.”

Tyler Johnson agrees:  Says Tyler, “The hardest thing for me was when [fertile friends and family members] would avoid talking about it.  If you just approach the topic– which is hard, I know– just say, ‘Hey, I know this is something you’re struggling with, and that this might be hard for you, but we just want you to know that we’re here for you and we love you’– that’s much better than making it awkward by avoiding it.”

And don’t make assumptions about how your infertile friend is feeling.  Maybe they are totally at peace with your pregnancy.  It can never hurt to talk about it and ask, rather than making assumptions.  And you can also simply ask, “What can I do to support you?”

2. Don’t give advice.  

“I sure am glad that you told me that if I just relaxed, I would get pregnant,” said no infertile person ever.

So don’t say that.

Some other things to avoid offering advice on: fertility treatments, when to begin considering adoption, and lifestyle or religious choices.

Really, the rule is simple (and this is a good rule in all situations): don’t offer advice unless it is solicited.

3. Don’t complain about your pregnancy.

Most infertile women would dig out their right eye with a spoon if it meant they would be able to get pregnant, so please don’t complain to them about your pregnancy.   Says Rachel, “I hate to hear people complain about their pregnancies.  My sister in particular would say to me, ‘Just be grateful you aren’t pregnant, because it’s miserable…because my ankles are swelling….because I can’t fit in my jeans…because I’m sick all the time.  Even though she was trying to be nice and to make me feel better, it was kind of like a slap in the face.  You know, I would give anything to be flat on my back, puking for nine months.”

I know what you’re thinking, Fertile People.  You’re thinking, “She says that because she has no idea how awful that would be.”  But you say that because you have no idea how excruciating it is to not be able to conceive.  So, as much as you would like to assure your infertile friends that they are really not missing out on much by not being pregnant, don’t.

4. Be supportive.  

If your friend is trying IVF, tell her you’ll be there for her even if the hormones turn her into a crazy person.  If she’s quitting fertility treatments, let her know that you’re backing her up.  If she’s decided to pursue adoption, support that, too.

Really, the big thing you need to do is let her know that you know that it sucks.  That she is hurting.  And that you love there and will be there for her when she needs you.  A text message or a card letting her know you’re thinking about her, especially on days you know might be difficult (Mother’s Day comes to mind) can also be a good way of letting her know that she’s not alone, that you know she’s hurting, that she’s loved, and that you’re available if she needs to talk.