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example, that people think it is not deserving of the same type of compassion we offer those who have lost a relative, or a friend. “Aren’t you over it by now?” or “at least it happened early in the pregnancy. You’ll move forward quickly” are two salient and all-too commonly spoken examples I hear about in my office from patients and in online conversations. Bombarded by crushing disappointment and disillusioned despair, women express how dumbfounded they are—having thought their loved ones were more capable of nuanced empathy than they showed themselves to be. It’s as if the perceived severity of a loss situation somehow determines a grief time frame and its course, one that is delineated by others—others often being people who are not in the throes of it themselves.

But grief needn’t be monitored or surveilled. Though one woman’s loss might seemingly be “easier” or “harder” than somebody else’s, we can’t really know what her emotional experiences leading up to this point have been. One woman’s six-week loss might be felt as a normative, expectable, and unemotional event, while another woman’s six-week loss might yield complex ongoing grief. We can’t know unless we inquire. We all bring our individual histories of loss, community, and support to current losses.

Next time you hear about a loss, try to remember that one person’s interpretation might be altogether different than the person’s standing beside them. One woman might get pregnant “easily,” another through IVF; another has suffered multiple losses, another already has many children but wants more, and another thought she never wanted to be a mother—the list goes on. No matter the specific details of what any one person is going through, we all benefit from loving support and the suspension of judgment.

• • •

Still, it is not easy to know what to say, a fact I understand. Scrambling to show compassion or to avoid putting our feet in our mouths can surely prove onerous. The following bit of guidance on what to say—and what not to say—after a loved one experiences pregnancy loss can hopefully change all of that.

Don’t say: I haven’t reached out because you seem fine. I thought it was better not to bring it up.

Do say: You can turn to me—to vent, weep, reflect. I’m here to listen.

Some people prefer privacy, others long for support, or a little bit of both. Find out what she wants. Do not disappear. Challenge yourself to show up even if it makes you uncomfortable.

Don’t say: At least you know you can get pregnant. Things will be different next time.

Do say: I’m sorry for your loss.

Resist predicting the health of future pregnancies. Attempting to foresee like this minimizes what just happened, how she’s feeling in this moment, and assumes she will try again.

Don’t say: My miscarriage wasn’t as difficult as yours, mine happened early, in the first trimester.

Do say: This is a significant loss.

People start picturing their future families at different stages. Resist comparing trauma. Swapping stories might provide support—but it could just as likely create anxiety, envy, or resentment.

Don’t say: At least you have a healthy child. You were ambivalent about having another baby anyway.

Do say: …

Say nothing about her future babies or current children. Now is not the time. Shame, guilt, and self-blame are common among women who miscarry. Bringing up her ambivalence could compound confusion.

Don’t say: The baby wasn’t healthy. Aren’t you relieved things ended early? It wasn’t really even a baby yet.

Do say: How have you been feeling since receiving the test results—since learning the baby wasn’t healthy?

Millions of pregnant women miscarry every year. Despite the fact that miscarriage is common, many women who miscarry feel alone. Often, they’re scared of what this loss might mean about their reproductive futures. This is not the time to debate what constitutes an embryo, a fetus, or a baby. Loss is real, no matter the time frame.

Don’t say: You can always adopt.

Do say: I will not focus on “fixing” your future. I can be present with you in your pain.

Unless asked, do not give advice on family-building options. Let her lead the discussion about how she envisions her reproductive future.

Don’t say: It wasn’t meant to be. Everything happens for a reason.

Do say: Some people try to pinpoint a reason why their miscarriage occurred. You did nothing wrong. This is not your fault.

Support her in shying away from searching for things she might believe she’s done to deserve or create this loss. A majority of miscarriages are a result of genetic issues.

Don’t say: You look great! You don’t even look like you were pregnant.

Do say: It’s wonderful to see you. How are you feeling?

Commenting on her body, even if you are delivering what you think is a compliment, erases her recent pregnancy. This comment could also incite anger or disappointment that she’s no longer pregnant.

Don’t say: As soon as you get pregnant again, your grief will wane.

Do say: Time eventually eases sadness.

Some women grieve, others don’t. We shouldn’t assume miscarriage affects people in the same way or for the same amount of time. There is no benefit to rushing heartache.

I implore each of us to speak up—to talk about the very things that make us uncomfortable. To examine our fears, our superstitions, and our premonitions, if only as a way to understand what it feels like to engage rather than shut down when we find ourselves reckoning with an untimely death. Be present in no uncertain manner, and engage. If conversation about the vicissitudes of miscarriage became contagious, then the shame and isolation that often accompany this type of loss could, perhaps, be contained.

6

“I don’t know what I expected her to say, but it wasn’t that.”

I was born in the dry heat of August in New Mexico. My father was working on the Laguna-Acoma Reservation about fifty miles west of Albuquerque as a form of government service following his medical training. His days were full of caring for patients, and my mother spent most hours of the day looking after a toddler (my sister)

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