In three days families all around the country will gather together to celebrate Thanksgiving, marking the start of the holiday season. While this can be a joyous time of year for so many, it can be painful one. In my clinical practice, I work with many women who have experienced pregnancy loss or who are coping with infertility. For them, this is often a time of year marked by unacknowledged grief, insensitive comments, and various emotional landmines.

For example, how many times have you heard a well-meaning relative ask, “when are you having kids” or “isn’t it time to start thinking about your second child?” While this may seem like an innocuous comment, imagine how heartbreakingly painful this feels if you are coping with infertility or have experienced pregnancy loss? Or what about the woman who is told to not “make anyone uncomfortable at dinner” by referencing her loss, and that “she will have other babies.”

Sometimes these comments are made without knowledge of the loss or fertility concerns. However; for many of my clients, family and friends who know about their history still make these remarks. To me, this speaks to a greater problem of how we talk (or rather how we don’t talk) about pregnancy loss and infertility. When we shroud these issues in silence, we are communicating a larger message about the acceptability and space for this type grief and sadness. We are telling women not to feel or talk about what they are feeling and that their grief doesn’t count.

For those who have lost or who are struggling to conceive, please take extra care of yourself this holiday season. In my practice, I work with clients to anticipate around possible triggers and prioritize their own self-care over the urge to manage other people’s discomfort with their grief. For example, if you anticipate that Thanksgiving dinner may come with a side of intrusive and insensitive comments, have an exit strategy, enlist a few supportive people who will be there, or rehearse a stock phrase or response. In short, do whatever you need to take care of yourself.

Remember this is not about making someone else feel comfortable so if it feels better to respond honestly and talk about infertility when asked why you haven’t had a baby then do it. If it feels safer to quickly dismiss the comment that is fine too. If you want to reference a pregnancy loss in your holiday card or acknowledge a child who should have been here to celebrate their first thanksgiving then do it, but know its ok to bow out of the whole exercise. Bottom line, it’s about your emotional safety.

And to friends and family, we can and must do better. We need to support the 1 in 8 couples experiencing infertility, the 10-30% of women whose pregnancies end in miscarriages, the 1% that end in stillbirth, and the families that have made the difficult decision to terminate a pregnancy for medical reasons. They need to be seen and heard, this holiday season and always.