Learning to support friends and family who are experiencing miscarriage

Going through pregnancy loss is incredibly difficult. It is of course difficult for the woman going through it, but it is also difficult for her partner and for their friends and families. In different ways, a miscarriage is also a loss for each of our friends and family members who care for us.

Everyone has their own way of processing the information and loss. Despite the best intentions though, some responses to pregnancy loss can be very hurtful. This adds to the difficulty of the situation for the woman or couple going through pregnancy loss because they have to not only process their own loss; they also have to process how the people around them are responding to the pregnancy loss.

I am 100% confident that everyone has the best intentions in trying to support women and couples who experience pregnancy loss. Every person is only saying or doing these things to be supportive, after all. But good intentions do not always score a perfect landing. This is why I want to share how some of the different comments and actions impacted me. I don’t want to give advice because you know the people in your life and the specific situation best. I do want to share some ideas though, and let you take away from them what you need.

I am not writing this to scold anyone. In fact, I am so grateful for all of the ways I have been supported by friends and family. I, myself, wouldn’t have realized many of these things could be hurtful until being on the receiving end of these comments.

We can all do better and we can all learn out of these experiences. That’s why I want to explain what it is like to be on the receiving end of these responses, and offer alternatives that may help you better support the people you love and care for during this difficult experience.

Well-intentioned responses that were not helpful:

• People asking over and over how I am doing. I know the intention is good and that they are thinking of me and want to check in. But the answer is and (for some time) will be that I am not doing well. Asking how I am repeatedly either serves as a reminder that I am not well or it puts pressure on me to answer in a different way and pretend that I am well. It’s okay to ask this now and then (say once a week), but asking too frequently made me feel like I was cornered. How should I respond to this? Even if I do have a moment of feeling better, getting this question over and over again makes me start to feel guilty for having a ‘good’ moment in which I feel okay.
• Trying to come up with reasons for why it could have happened. It’s natural to grasp for answers and reasons after a miscarriage. Sadly though, in most cases there are no clear cut answers. The lack of answers is one of the aspects that make this experience so difficult. Being close to someone, you might be struggling to understand the reasons behind the miscarriage as well. This is not a time to share your theories. You can bet that the woman who had experienced pregnancy loss has already thought of all of the things she might have done wrong and the 101 ways that this experience could be her fault. Do not add your concerns to hers. Listen when she chooses to share her own concerns. Ask questions once she has brought up a topic she wants to discuss. Reassure her when she has the courage to express guilt or shame but do not add reasons for her to feel guilty. I know we’re all grasping for answers, myself included. But your theories really don’t help me, especially when most of them have to do with things I might have done wrongly or things I could have done differently. All this does is put the blame on me and make me feel worse. And honestly, I was super alert and sensitive to reasons related to things I could have done wrong so I paid extra attention to anything that might imply that, even if that is not the intent behind the way it was communicated.
• Saying something along the lines of ‘At least you can get pregnant.’ Yes, I can get pregnant but what is the point if I can’t carry a healthy pregnancy to term? You might see it as a silver lining but most women who experience loss do not, at least not right away. Some women might find comfort in this thought but let them be the ones to bring it up.
• Telling me that next time will be fine. Or ‘I know someone who had a miscarriage and went on to have a healthy pregnancy.’ Maybe this is helpful for some other women but honestly, I am not worried about the future. I am just sad and grieving about the current moment. While this response is not per se hurtful, it does not meet me where I am and does not address my concerns and pain. It is a response to a concern I do not have and a lack of showing up for the grief of the current moment.
• ‘This happens to so many women.’ I know it does and that’s horrible. My heart breaks for every woman who has to go through pregnancy loss. I heard this one a lot from medical professionals who wanted to send me along. What they said between the lines is: ‘It happens a lot. Get over it. Move on.’ But why should the amount of people to whom it happens be relevant to my grief? I know it happens frequently but that doesn’t take away the pain of this very personal experience.
• Maybe you’re feeling this so strongly because of all of the hormones. Yes, the remaining pregnancy hormones definitely make the situation more raw and emotionally overwhelming. But saying that undermines the validity of what I am feeling.
• Trying to push me to focus on the positive when I am not yet ready. When I am in deep sadness, I don’t need someone to tell me to focus on the future and be hopeful. I need someone to meet me in this sadness and support me where I am at until I am ready to shift perspectives.
• Telling me to give myself time to recover. I didn’t want time. I wanted to move forward again as soon as possible. Saying this made me feel guilty for not wanting to wait before trying again. Instead, I had one friend who told me ‘Do whatever you need to take care of yourself.’ This was so much better because it made me feel that whatever I felt was best for me was the right thing to do.
• Not saying anything at all. Instead of saying something painful, it was also hurtful when some people close to us completely ignored the topic. I understand it’s an uncomfortable topic for everyone, but not acknowledging it or making space to speak about it makes the woman or couple going through it feel even more alone.

We have two main tendencies in difficult situations that we need to keep in check. One is to offer solutions and the other is to point the person towards hope. Both of these responses, though well-intentioned, can be hurtful. Try to avoid offering solutions unless specifically asked. Even though it might be your instinct to try to make this better, that is not your job in this situation. Your job is to acknowledge what the woman or couple you want to support is going through, confirm that the pain is real and the experience difficult, and to sit with her or them in that pain. Only when someone concretely asks for solutions, are you to go into a problem-solving approach.

The tendency to point towards hope before someone is ready is a form of toxic positivity that only makes the situation more difficult to process. Discuss and encourage hope only if the person in pain is ready for it and seeking it out themselves. Pushing the person towards positivity before they are ready undermines their pain and feelings in the moment — pain and feelings that are important to feel fully when they come up.

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Often these lists end at what not to do. But I want to celebrate all of the ways that my friends and family were there for me. I have been overwhelmed by support in so many unexpected ways the past few months and I am very grateful for it. At times, my friends and family knew what I needed when I myself did not have this clarity. Yes, some things people have said were well intentioned but hurtful. But most of all I was blown away by our support system. It made me feel like there was a net there to catch me.

I want to share all the ways I felt supported in case it gives you some ideas for how you can be there for those you are trying to support.

Responses that have been helpful:

• Statements of support and acknowledging the difficulty of the situation. Instead of asking how I am, I also had many friends and family writing regularly to tell me they are thinking of me. Friends just wrote acknowledging how difficult experience must be and letting me know that they are thinking of me. I found this way of letting me know they are there for me so much easier than asking how I am. Acknowledging the difficulty of the situation and telling me you are thinking of me takes the pressure off from responding if I don’t feel up to it and it also acknowledges my pain instead of pushing me to say that I am okay. Depending on how I am feeling, I might engage with these messages or not, but at least they don’t put pressure on me to do so.
• Asking factual questions until guided otherwise. One thing that was oddly comforting was when people asked more ‘factual’ questions that I could engage with. Questions less to do with how I am emotionally, and maybe more to do with physical aspects. These questions were much easier to engage with and it took my mind away from some of the more emotionally laden aspects. They pulled me out of deep dark emotional places and helped give me a lifeline to interact with the world. These are questions with black and white answers. A friend did this over text and my midwife did this during an appointment. I felt the overwhelm quickly dissipate and my breath stabilize as I started engaging with these questions.
• Unexpected care packages and notes. I got a lot of flowers, care packages and notes from friends and family. Unexpected care packages showed up at my door with all sorts of treats, a stay at home spa as well as a remote wine tasting. All of this is not necessary or expected but it did make me feel loved and supported. It doesn’t have to be a gift per se — even a note is a gesture to show that you are thinking of the person.
• Hearing out irrational guilt and combating it with reason. I have one very rational friend who encouraged me to voice the things I felt guilty about or things I thought I might have done wrong during the pregnancy. Most of the time I knew that there was nothing I could have done differently but sometimes this guilt does enter your mind. In those situations I would tell her my thoughts and she would, one by one, find evidence against these wild ideas. I found it really helpful to share these thoughts. At first I felt a lot of shame around all of the ways I might be responsible for the miscarriage. What if I say them outloud and they happen to be true? But as soon as I started talking about them, it helped disarm them, especially when a rational friend found evidence against them.
• Sharing your own experience with pregnancy loss. I had a lot of friends and family open up about their own experience of pregnancy loss. I had told a neighbor about our loss in the stairwell and came back home to flowers and a note waiting for me. The note mentioned how they themselves went through a loss and it hit all of the right notes about how I was feeling. It was always helpful to hear about the experiences of others who had been through something similar. There was a deep connection there and it made me feel understood and connected.
• Providing distraction when needed. I think it is important to sit with the pain and work through it but it is also important to give yourself a break when you need it. I had one friend reach out with some film and show recommendations. This was a nice way to show she was thinking of me and wanting to help, again without putting expectations on me to respond or say that I am doing okay. Other friends came over to play a board game one evening to take my mind off things. It was nice to be around people at some point without feeling the pressure to talk about how I was feeling all the time.
• Taking time off to be with me. My partner more or less took the week off to be with me after the miscarriage and even though we didn’t do much, it was just such a sign of love for him to be there with me that it made me feel much closer to him and I think our relationship grew stronger because of it.
• Being there for me, even when I do not ask. My partner took the time off work to be with me even though I did not ask him to. I am so grateful because in that moment I would not have known to ask him for that but it was exactly what I needed. A friend stopped by to drop off some chocolates for me. Even though I would not have sought out seeing friends, it was comforting to have her come over and to have an afternoon together.
• Encouraging me to do what I need to do in order to take care of myself. We tend to be so prescriptive with our suggestions. ‘Take time. Take it easy. Wait before starting to try again. Change doctors.’ Why do we assume we know what is best for other women? Instead of offering suggestions, I felt most supported when I was encouraged to do whatever I need to do, whenever I get clarity on what that is for me. Each person knows themselves best and all we can do is to encourage them to listen to that inner voice that guides them towards what they need.
• Checking in, even after a lot of time has passed. We tend to think of miscarriage as an event in time, that you then get over. Instead, miscarriage a process that you’re in the middle of for months or years. There are unexpected triggers and recovery is not a straight line towards feeling better. The grief comes in waves and a really difficult day or week can come out of nowhere. Instead of shoving the experience under a rug, I appreciate when friends checked in about how I am feeling even months after my physical miscarriage. It doesn’t have to be with a specific question, but you can indirectly make space in conversations for people to talk about it if they need to.

Our society has not prepared us for how to be there for one another during pregnancy loss (and other difficult, painful situations). We are poorly prepared to be there for one another and often don’t have the tools or skill set needed in these situations. This is why it’s important to admit we may not always know what to do and say, and to seek to learn and improve. We need to talk about these topics more openly so that we get better at being there for one another and reacting and supporting each other in these situations.

I probably would have done most if not all of the things that I found difficult when I was on the receiving end. And I will probably still say and do the ‘wrong’ things when trying to be there for people in the future. Our instincts to offer solutions and positivity are strong and sometimes dominate, even in situations when they do more harm than good. Each of us will continue to slip and do or say the wrong thing when trying to help a loved one. But my intention in sharing these thoughts is that we are all more aware of the ways we can truly be there for each other in a conscious and aware way, even if that feels awkward and clumsy at first.

I hope these reflections give you some ideas, or at the very least make you reflect on how to more thoughtfully offer your support. Each experience, person and situation is different and I don’t want to imply that this is what will work for everyone or that this is what everyone needs. These ideas are here for inspiration. You know the situation and person you are trying to support best so it’s up to you to take away the ideas that are best suited for that individual experience.

Once you start talking about it people start opening up and you realize miscarriage is all around you. We just have not made space for people to talk about it openly. But we can collectively change this. It’s difficult and uncomfortable but if we want to be there for the people we care about we have to be willing to learn how to be there for them.

Miscarriage no longer has to be a taboo and stigmatized experience. It takes practice and effort but we can change this culture towards openness. We can educate and inform each other. We can make an effort to learn how to be there for one another, even if it feels clumsy at first. We can share our experiences. We can change the culture one story at a time.

For ideas on how to take care of yourself going through miscarriage, read my reflections here. www.carriedtogether.com