The Phrase That Sounds Supportive (But Actually Isn’t)

“We just want you to have a positive outcome.”

Have you ever heard your provider say that to you? Maybe it comes up when they’re suggesting an induction. Or recommending extra ultrasounds or non-stress tests (NSTs). Or discussing a scheduled cesarean. Sometimes it sounds exactly like that: “We just want you to have a positive outcome.” Other times it’s phrased a little differently: “The goal is a healthy baby, right?” “No one wants to think about the worst-case scenario, but that’s what we’re trying to avoid, right?”

On the surface, this all sounds kind and supportive. My doctor only wants the best for me and my baby! And you know what……they do. No normal human who is also a doctor hopes for a bad outcome for their patients. So when a recommendation is wrapped in language like that, it can feel almost impossible to question it. Because if they want a positive outcome…..and you want a positive outcome…..then agreeing must be the responsible thing to do.

But let’s pause for a moment and look at what’s actually happening in that conversation. Because the phrase “We want you to have a positive outcome” carries a powerful bit of subtext. And what’s more, we’ve all probably used this tactic ourselves at one time or another. Allow me to set the scene:

My husband only drinks decaf coffee (and yet I still married him despite these obviously sociopathic tendencies.) However, it’s become such an ingrained part of his morning routine that if he doesn’t have it he’s out of sorts all day, the same as someone who drinks normal people coffee if they skip that first life-giving cup. Occasionally, if we’re running late, he’ll say he’ll just skip his coffee so we can get out the door faster, to which I respond: “Well, I want you to be in a good mood today.”

Technically, that sounds supportive, right? I want my spouse to be in a good mood! I care about his mental and emotional well-being! However the implication is obvious – if he doesn’t drink the coffee I’ll have to put up with a grouchy nightmare all day.

Still not quite seeing it?

Imagine taking your car to a mechanic. You ask whether the repair they’re recommending is truly necessary right now, or if it could wait. Instead of explaining the risks, costs and options, the mechanic looks at you and says, “Well….we just want you to have a positive outcome.”

You’d probably blink as your brain tries to compute this non-answer, and say, “Ok but….what does that mean?”

Does the suggested repair prevent something serious?
Is the risk small or large if you wait?
Is this urgent, or just precautionary?

Most of us would expect the mechanic to give us specific information before handing over our hard-earned money, not a vague statement about wanting things to turn out well.

Now let’s return to the OB’s office, where they’ve just recommended scheduling an induction at 39 weeks, or 40 weeks, based solely on…….you being 39 or 40 weeks. They say “Well we want you to have a positive outcome.” Translation: following the recommendation = positive outcome, ergo, declining it MUST mean you’re risking a negative one. Suddenly, the conversation isn’t about evidence or risk levels or alternatives anymore. We’ve jumped straight to “are you willing to gamble with your baby.” That’s a heavy implication to put on a pregnant person who’s just trying to understand their options. It also completely shifts the way our brain processes the conversation.

When we’re calmly discussing options – weighing benefits, asking about probabilities, considering whether to wait or intervene – we’re primarily using our prefrontal cortex, the part of the brain responsible for analytical thinking and decision-making. The part of the brain that knows to use BRAIN, actually:
• What are the benefits of this intervention?
• What are the risks?
• Are there any alternatives?
• What is my intuition telling me?
• What happens if we wait (or do nothing right now)?

Now, when the possibility of something bad happening to your baby is introduced – even by inference – the brain shifts gears. The threat-detection system (the amygdala) wakes up and takes the wheel. You know what else the amygdala is used for? Full-on survival. The “I-was-taking-a-hike-in-the-woods-and-now-I’m-face-to-face-with-a-grizzly” kind of survival. Suddenly you’re no longer concerned about the blister forming on your heel or if you packed enough sunscreen, but returning home with all of your limbs and skin.

Or, back in your OB’s office, the conversation has quietly moved from: “Let’s examine the evidence and options” to “How do I avoid the scary thing that was just implied?” And when that shift happens, people are far less likely to remember the questions they have, request time to think or explore alternatives. The instinct becomes: do what seems safest now. In other words, true informed consent goes out the window.

Parents don’t need vague promises of a ‘positive outcome.’ They need honest information and the freedom to make decisions with their eyes open.

-Meryl