What to Say (and NOT Say) When Someone Miscarries

A few years ago I miscarried while attempting to conceive my second child. My firstborn was conceived through IUI on our first attempt, programming me to believe that although it probably won't happen naturally, we won't have much difficulty providing our child with a sibling once we decided we were ready. Instead, my second-born was finally conceived after one year of fertility treatments and five failed IUI attempts, the last one ending in a miscarriage.

Over the years I've watched friends and acquaintances struggle through early pregnancy losses. My understanding of what they've gone through and how to support them dramatically changed after experiencing my own miscarriage. This week is National Infertility Awareness Week and I thought it a good opportunity to offer some tips. Please feel free to add your own suggestions in the comments.

First, don't assume that since miscarriages happen early in the pregnancy they are easier on the parents to be. We do not live our life on a scale or "in comparison" to other people. Our tragedies don't become more palatable simply because somebody else we know may have had a more traumatic experience.

In addition, an early pregnancy loss may seem like a "beginning of the road" to us, the outside onlookers, but we never know when exactly did the parents to be start this journey. As I've mentioned ours included four previous rounds of IUI.

Don't assume that the sentences: "At least you know you can get pregnant" or "at least you already have one healthy child" are helpful. I don't mean to sound harsh or dismissive. I've actually used the first sentence myself. It is SO hard to find something comforting to say in this situation and these choices seem like no-brainers. Being on the receiving end of these words of comfort, I realized something important. When you're hurting and grieving the interactions you seek are not about getting an "instant remedy" they're about being around those people who allow you to be you, when being you means broken and shattered, those people who allow you to express what you're feeling and are willing to listen.

Do let your friend know that you acknowledge their loss, by saying something as simple as "I know it's a really difficult time for you."

Don't get offended if your friend seems to be avoiding you. It's possible that they are, but it's not because they're not happy for you and your growing family, it's because of how they feel about themselves. At this point in their life they feel betrayed by their body, inadequate, and maybe even like a failure. Spending time with other young families may trigger that. Give them time and let them know that you're patiently awaiting a sign from them, when they're ready to resume the relationship. Don't be blunt or too direct about it, remember they're very sensitive right now. Express the understanding that they're hurting and that they need time to heal. Promise that you'll be there once they do.

Don't assume that it's okay to express your fears of miscarrying around someone whose personal history you're not too familiar with. I was once involved in a work situation where this topic was brought up by people who didn't realize I had gone through this. I wasn't hurt since they clearly had no way of knowing my story and since I could very much relate to their fear – I was them a few years ago -- but I didn't know what to do in case I'd be brought into the conversation not wanting to lie or embarrass my counterparts.

Don't assume that if you do know that a person's been through this the most tactful thing to do is to behave like nothing happened.

Do mention that you realize they've recently gone through some hardship and let them know that you are open to listening and supporting them in any way they find appropriate.

And finally, a note to medical staff:

I realize that you've had to develop thick skin. It's probably not easy conducting an ultrasound and knowing that the hopeful parent in front of you is about to receive devastating news. I also know that you have perspective. You've seen some of those shattered parents come back and proceed to have healthy children. Your perspective, experience, and ability to see the end result may diminish your empathy for the parents as the situation unfolds. I've seen and experienced this with at least three different medical professionals. Please DON'T trivialize our losses.