* A healthy baby is all that matters (i.e. the mother is just a vessel)
* Pregnancy/baby loss is shameful (i.e. it’s probably your fault)
* Women should be able to continue “as normal” when pregnant AND they should be able to “bounce back” to “normal” as soon as they give birth.
Heard those ones? I bet you have. These are some of the fundamental assumptions that underpin our attitude towards women when they become mothers. Even if people are wise enough not to say them to me directly (anymore) I still hear them in the hushed tones of congratulatory or conciliatory conversations and I still deal with the fallout in my therapy room each week.
These assumptions harm women every day. They block them from getting the support they need from loved ones, at work, from the healthcare system and perhaps worst of all they cause women to turn on themselves with the harshest of criticism.
This week I wanted to give you something practical that you can share with the people who want to help but feel helpless themselves. It is not our fault that we feel clueless when we see someone struggling. Compassion takes wisdom as well as strength and commitment. In other words, if I want to help you I need to know how to do it and our society hasn’t equipped us well to support women through pregnancy, birth and parenting.
Yet compassion turns out to be pretty important. There’s plenty of evidence that giving and receiving true compassion promotes better mental health. We also know that better mental health in pregnancy and early parenthood leads to better life chances for children and better health, productivity and more fulfilling careers for parents. So it makes sense to me that learning how to give and receive compassion should be a priority for all of us. But it can be tricky when we are used to dismissing or avoiding struggles (our own and other peoples’).
In this post, I aim to give some simple advice you can follow if you want to show some compassion to someone who is struggling in pregnancy or parenthood. If you are struggling right now, take a moment to share it with the person/people you need to read it most.
Caring for them starts with you
When you care about someone who is pregnant or postnatal and you can see they are struggling it is natural to experience your own stress and anxiety response.
If they are your partner you might be frightened about what the future holds, you might be dealing with your own sadness or fear and you might be experiencing many of the same factors that are causing them to struggle such as lack of sleep, financial instability, an unwell child etc.
If they are a colleague or a friend you might find you also have strong feelings coming up for you that you didn’t necessarily expect. We have all been babies so we have memories and gut reactions to all things pregnancy, birth and parenting that we cannot control and may not always be aware of. On top of that you may have had experiences that you know are directly impacting on your feelings. For example, you might have had a similar experience, I know when I talk to someone struggling with HG a part of my own trauma is activated by it. Or you may have had a very different experience and struggle to relate as a result.
These emotional reactions are not wrong. You don’t get to control your emotions, the memories that come up for you or the first thoughts that come into your head. The problem is if you are not aware of them then you will most likely respond with your “default” behaviour. For most of us, that means we will try to avoid uncomfortable feelings. This is because most of us were taught to try to distract ourselves or remove ourselves every time we were faced with a difficult emotion (chocolate buttons to stop a child crying is the best example of this).
However, unfortunately, our default avoidance settings can make it hard for us to connect with and show real compassion for someone who is suffering. In these situations, avoidance often looks like:
* Trying to “fix” things by focusing on practical problems and refusing to stop for long enough to listen.
* Looking for a brightside even when there isn’t one - the words “at least” usually indicate we are doing this.
* Trying to “snap someone out of it” by distracting them with “fun.”
* Insisting on doing the “same things as always” even when they are obviously not working well.
* Spending less time with someone or not listening well when you are with them.
Again, if you have been doing these things you should not feel guilty about it. We have been trained to be expert avoiders and it is the default setting for almost all of us. But the brilliant thing about being human is we get to override our default settings when we want to and this is the perfect time to start re-writing our programming.
Take a moment for your feelings (before you engage with theirs)
When trying to support someone who is struggling it is important to take regular moments to check in with yourself, notice how you feel and show yourself some compassion. Make sure that you have adequate support yourself, a friend or family member to off load to or, in a work context, your own line manager. Recognise the additional energy providing support takes and make space for it in your life where at all possible.
This exercise helps you to get in touch with your body and mind and bring some acceptance and compassion to your own experience. Try something like this regularly and you will find it is a little easier to sit with the discomfort of someone suffering. If you are interested in thinking more about this check out the books by Michelle Cree and Paul Gilbert on Compassion Focused Therapy for fantastic self help guides to developing this skill.
The colour of compassion
Before we begin I want you to make sure you are on your own, in a comfortable setting when you try this for the first time. It is normal, natural and unavoidable that your mind will wander, and probably criticise what I am asking you to do. The first time I did this type of work my mind would not stop telling me how idiotic the whole thing was. I promise you there is a whole heap of science behind it (go here if you love the data) so please proceed with an open mind and just gently refocus yourself on my voice anytime the mind wanders.
Five Stepping Stones to Compassion:
* Adopt and alert and dignified posture, it may be helpful to imagine your body as a mountain, strong, stable and powerful. You may wish to close your eyes at this point.
* Now begin breathing using a soothing rhythm, this can be in for 7 and out for 7 or any other rhythm you find relaxing.
* Now spend a few moments mindfully becoming aware of what your mind is doing. Your mind is like the sky, thoughts pass through and you notice them but do not linger on them.
* Now adopt a warm facial expression, perhaps a soft smile. Signalling to your body that you want to activate your soothing system through kindness.
* Finally remember to talk to yourself in the same kind tone of voice you would use when talking to your child or a friend who needed your compassion. This will also tell your brain and body to activate your soothing system.
Compassionate Colour
Now imagine a colour that, to you, symbolises compassion and warmth. It could be a mist or a light.
The colour gradually begins to surround you and as it does you feel the warmth and safety of compassion begin to surround, hold and support your body.
Just spend a few moments here, breathing in your soothing rhythm and imagining being surrounded by that mist, the soothing, relaxing colour of compassion.
Now you watch as the soothing, relaxing mist of compassion begins to flow into your body. You notice it entering your body, first through your heart and then slowly filling your body as it moves outwards.
You notice the light of compassion flowing into your chest, abdomen, back, shoulders, arms, fingers. Your thighs, calves, feet, toes, your neck, head, face.
As each body part becomes filled with the warm light of compassion you become more aware of it filling you with the qualities of wisdom, strength, kindness and warmth.
If you feel any blocks or resistance. Just notice this with a kind smile to yourself.
As you bring your attention back to the kind, warm colour filling your body, remind yourself of its intention to support you, to help you develop the compassionate part of your mind.
Spend a few moments breathing and imagining the warm light of compassion totally filling your body, growing stronger with each breath.
Now that your body could not be more full of the light of compassion, you begin to notice that it is flowing from your body and into the room around you.
Imagine the people you care about are in the room with you. Notice the light of compassion flowing from your body, into the room and into their bodies.
You see the warm, mist slowly filling them and know that they are feeling its supporting, holding, soothing presence.
It is filling them with kindness, strength and wisdom
When you feel that you and those you care about are totally full of the light of compassion gently bring your attention back to your breathing. Notice the sensation of your feet on the floor or your body in contact with whatever surface you are resting on. Slowly open your eyes but try to hold on to the sense that the colour of compassion remains with you, supporting you in all that you do.
OK, so now you are feeling on good form to offer some support let’s dive in to how you can be helpful to someone who is pregnant or postnatal and feeling rough.
Open up the conversation (so they don’t have to)
During the first trimester of pregnancy, our culture expects us to remain silent even when we are suffering. Having to divulge our pregnancy, let alone ask for support, is seen as a terrible imposition on another adult. “Don’t tell me yet” or “I wish I didn’t know until after the 12-week scan” are all comments I’ve heard others make after the news of an early pregnancy and they fill me with a rage I don’t know how to give voice to. In a similar way women are supposed to cover up the signs that they are struggling throughout pregnancy and motherhood. We expect women to show up for work and seem “professional” even if they are in agony (emotional or physical) and/or having to milk themselves in a toilet cubicle. We expect women to look presentable, get “back into shape” and make us tea when we visit them even if they are dealing with crippling anxiety, no sleep and a dysfunctional pelvic floor. All of this means the person who is struggling is very unlikely to ask you for help unless they are at complete rock bottom. So take that pressure off them wherever possible. Try opening with sympathy and asking a question like:
I heard about XXXX that sounds very stressful, how are you feeling?
It looks like XXXX is quite painful right now, is it bothering you a lot?
I can tell it is really tough right now. Can you tell me about it?
We are so used to shutting down emotional experiences that it can feel really strange to ask questions like this and part of you will want to jump straight to practical help but please don’t do that. Just listen and show that you see their suffering.
Bring the practical resources to them
Many physical health problems in pregnancy and the postnatal period make engaging with the internet very challenging. I could not scroll or use WhatsApp for almost all of my first HG pregnancy. When our mental health starts to suffer we also often lose motivation or become overwhelmed easily. Once you have spent a good amount of time listening doing some research to find answers to the specific problems they mentioned and facilitating them to access support can be very useful.
This should begin with making sure they are accessing all the NHS services they are entitled to so checking they have spoken to their GP/midwife/health visitor and helping them to do that if not is important. It can be surprisingly complicated in some areas! If they have done this but are waiting or have exhausted the support available, here are some suggestions of places to go hunting for practical help:
If they are suffering with Hyperemesis Gravidarum take a look at the Pregnancy Sickness Support website. If they are not receiving good medical care the pages on diagnosis and medication are likely helpful. If they are feeling lonely or lost the peer support service is the place to go.
If they are struggling with birth trauma try The Birth Trauma Association
If they have had a baby in the NICU visit Miracle Moon.
If they have been through pregnancy or baby loss head to SANDS
If they are dealing with depression or anxiety take a look at PANDAS
The key is to go the extra mile. Rather than just telling them to “look up XYZ” do it for them and, if they are keen, do all the tricky bits like registering or writing emails on their behalf. Oh and obviously if you are suggesting something that requires childcare you should offer to provide it!
If you are in the workplace then the same rules apply. Find out what policies you have in place that may benefit them, don’t expect them to know or ask. If they need to apply for something then, if they agree, do as much of the form as you can on their behalf, draft emails for them, work out the details. I remember when I was pregnant and sick I was so often asked to do completely reasonable things that I simply could not achieve, like working out cover for my appointments. This adds hugely to the stress and guilt of the situation. Knowing that you have anticipated their needs and taken it off their plate will mean a lot.
Suggest boring socialising
There is nothing lonelier than struggling at a time you expected to be full of joy. Sadly, due to the default avoidance setting we talked about most of my clients tell me their friends, family and colleagues become distant while they are struggling. People also tend to feel embarrassed if they aren’t able to go out or be as entertaining as usual. Try suggesting low-effort ways to see each other. Maybe just watching a box-set, no conversation needed, or sitting on a park bench together. They are unlikely to suggest these things themselves due to all the social pressures and the overwhelm they are feeling so go ahead and suggest the least taxing way of being together you can think of. If you can add some nice touches then do. I remember when I was at my lowest I was watching a box set, like I did all day every day, when my husband brought me a glass of fizzy water in a wine glass, a fresh box of tissues and sat down to join me. Little things that make you feel human can make a big difference.
Remember their priorities
Finally, I don’t think I have ever seen an article on supporting someone that acknowledges they are a human with a distinct personality. Some people may love bubble baths when they are stressed. Others may want to punch you in the face for suggesting it. Think about what normally matters to this person and try to solve these problems for them as much as possible.
For example, if they are a clean/neat person but they aren’t able to keep on top of things do as much as you can to make their environment how they like it. If you know they are usually the family organiser but they are feeling overwhelmed by all the “school stuff” they aren’t able to manage ask if you can go through the school emails or Whatsapps for them and pick out key points/actions they need to take (or that you can take for them).
In the work context, this could involve working out how to make tasks, meetings or projects that you know they value easier for them to access rather than removing them completely. Is there a way in which they can play their role without having to do something that isn’t possible right now. For example, could a meeting that usually happens in person become virtual or could they brief a proxy to take part on their behalf.
Remember that the things that usually matter to them still do and connecting with their old/usual priorities can help them feel less isolated.
I hope this has given you some useful ideas and a bit more confidence to support someone who is pregnant or postnatal and struggling. There is so much more I wanted to say so I am planning posts specifically for romantic partners and line managers soon.
If you are struggling please share this post with someone who could help you.
Before I go, I just wanted to say thank you so much for reading and please let me know if this was helpful. I’m planning to write regularly and would love to know what you would like to hear more about so please use the comments to tell me!
Until next week, take care,
Rosie
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