What to Say, and What Not to Say, to Someone Who Has Received Bad News

As you may have read in a previous entry, my husband and I have been under a lot of stress because we received some scary screening test results for our unborn child. See How to Drive a Pregnant Woman Crazy for all the details if you are interested. At this point, preliminary tests indicate that our baby will be OK, and a specialized sonogram on Monday should nearly eliminate our worries.

Because I talk (or write) in order to process my thoughts, I've talked about this problem with A LOT of people. Their reactions have been very different. Many of them have been comforting, and some have been downright irritating. I thought that I'd share a brief version of what to say and what not to say when you encounter someone who has been given potential bad news (like poor screening tests results in pregnancy, or a diagnosis of a potential disease, or the like). Of course, others may have a different outlook, and if you disagree with me, please feel free to comment.

What to say:

Several people asked me if I felt OK talking about the situation - what the test might mean, worst and best case scenarios, and so on. I thought that was really nice. I felt better talking about it, but if I hadn't, then I could have avoided those conversations smoothly because of those few caring words.

One person said, "I know this will be OK. Well, I guess I don't KNOW it, but I'm pretty sure it will." This was left on my voice mail and I thought it was honest and sweet without being hokey.

"I'm sorry this has happened to you," or "I'm sure this is stressful - let me know if I can help," are two really, really great things to say.

"Let's go out and do something fun!" For me, such distraction was great, especially when it involved food, and double especially when someone else paid for it!

What not to say:

"This will be fine - I'm sure of it." You know what, maybe it will -probably it will - but there are no guarantees. Some people DO have babies with birth defects. It happens. Don't tell me there is no chance that my baby is going to be one of those. It's just not true, and I'm not dumb enough to believe it.

"This test is stupid, that's why I didn't take it." I knew that there were lots of false positives on the test, and that it only determines risk rather than definitive outcome. But my doctor suggested that I take it, he had good reasons for me to take it, and I took it. Telling me now that I shouldn't have taken the test makes me feel like you think I'm stupid. I don't need to feel that way right now.

Many people told me about person X, Y, or Z who had positive results on the screening test whose babies were fine. That was great, except that their tests were all positive for something different from what my test was positive for. I did the research, and I knew that more false positives occurred for people whose screening results came out with a high risk for Down's Syndrome rather than for neural tube defects (which is what our test indicated). If you are going to comfort with stories of other people this has happened to, make sure your story actually applies to the situation.

"I met someone with that disease and they are just fine!" Again, I've done the research. Most people with neural tube defects who are just fine have such a minor case of this disorder that it doesn't even show up on the screening tests. The screening is much more likely to catch gross abnormalities than small ones. It's hard to comfort people with facts if you don't really have them.

I realize that people are trying to be helpful when they say these things, and ultimately, the fact that they are caring and trying to be kind overrides the fact that what they have said might be annoying. I did appreciate them all. However, I'm going to try to learn from this situation for when I want to offer comfort for people who are also in a similar situation. I always try to be positive and bring people's spirits up, but now I can see that too much of that can just be the wrong thing. I'm going to try to stick with commiserating - "That stinks! I'm sorry that this has happened," and helpfulness - "What can I do to help you?" And I'll throw in a dose of distraction too, although I probably can't afford to pay for it!

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