This post is in response to a question from reader “O.” If you have a question you’d like one of our contributors to address, you can send it to contact(at)

The loss of a much wanted pregnancy through miscarriage or stillbirth is one of the most painful experiences someone can go through.  Friends and family of the loved one suffering the loss often desperately want to help, but are unsure of what to do or say.  We were approached several weeks ago by a reader, “O” who found herself in this position.  Her close friend was in the second trimester of her pregnancy and discovered that her baby had profound genetic abnormalities and could not survive outside the womb.  Her friend decided to terminate the pregnancy, but “O” wrote that she didn’t know how to support her friend through such incredible grief.

To answer her question we reached out to Dr. Jessica Zucker, a clinical psychologist specializing in women’s reproductive and maternal mental health.  Dr. Zucker created the #IHadAMiscarriage campaign to give voice to the grief that is all too often suffered alone and to normalize an experience that many women feel is abnormal (20% of known pregnancies end in loss, making the experience all too common).  Dr. Zucker has advice for “O” and others that want to support a loved one through a miscarriage or stillbirth.

This is something I think a lot of people have gone through: watching your friend suffer a miscarriage, stillbirth or a planned pregnancy loss without having experienced that kind of a loss yourself.  Every situation is different, but are there standards for what to say or not to say to someone going through this?
It’s probably easier to start with what not to say. Some of the go-to lines like “everything happens for a reason,” “god has a plan,” “you’ll have another baby,” “at least you know you can get pregnant,” “be grateful for what you do have,” or “aren’t you glad you knew this in advance – the baby probably wasn’t healthy anyway” are some of the most unhelpful well-meaning loved ones might say to someone going through this kind of loss. It’s best to keep things simple when someone you love is grieving.

It can be tempting to try to make the griever feel better through platitudes, but when someone has just lost a wanted pregnancy, they need to feel their way through it. Everyone has a different experience.  Trying to make them feel something they’re not feeling, like that there’s a silver lining, isn’t helpful in the midst of mourning. Support can come through simple sentiments like: “I am deeply sorry for your loss”, “I am here for you”, “Feel free to reach out anytime. I am here to listen.”

Why do you think we default to trying to make the person feel better as opposed to supporting them through their grief?
I think that as a society we’re poised to focus on positive outcomes and eschewing difficult circumstances. All too often we go straight into “fix-it” mode, but the griever does not need fixing. Her feelings are normal and expectable.

Try to sit with the pain of the griever and maybe even try to imagine what you would want to hear if you were in her shoes. Sometimes we have difficulty tolerating the various feelings that can come along with this kind of grief, because out-of-order grief is not something we are conversant in as a culture.

So how would you support a friend that’s going through a miscarriage, stillbirth or pregnancy loss?
Let them know that you’re here for them, that you’re there to support them, whatever that means to your friend. You can do little things that show your support, such as: sending flowers, making a meal, or sending a care package.  I created grief cards after I suffered a loss because, after my loss, I realized there was a gaping hole in the marketplace surrounding this topic.

If you haven’t been through a similar loss, acknowledge that. Say, “I’m not going to pretend I know how you feel,” and then follow through on supporting her by letting her know that you’d like to listen to anything she would like to share, at anytime. Let her know that you care, that you are committed to being a dear friend through it all and maybe even acknowledge that you might say the “wrong” thing, you might mess up, but that you are there nevertheless.

We say things like, “you must feel so relieved it’s over now” or “if this happened to me I would …” well what if the person doesn’t feel that way and it makes them feel bad or wrong for not feeling that way? Leave room to hear what they are experiencing. Sometimes we might be tempted to tell people what we think they’re feeling instead of letting them tell us.  Be an active listener and be open to not knowing. Learn from them. Be there. Be empathic. If your friend isn’t ready to talk that’s OK too, just reassure them that whenever they’re ready, you are there for them. Make sure you’re there when they’re ready.

Most importantly, know that grief is circuitous. There is no timeline for grief, so we can’t rush it or expect someone to be back to normal or to “get over it” in a specific amount of time.  Support feels best when it is shown consistently. Grief ebbs and flows.  Be available now and down the road.

In our reader’s case, the friend learned that her baby can’t survive outside the womb due to catastrophic genetic abnormalities and has chosen to terminate the pregnancy.  Would she have different needs than someone whose loss occurred spontaneously?
Electing to terminate can be incredibly complicated from an emotional standpoint.  In many situations, terminating for medical reasons is not a choice. In other words, the baby might die later in the pregnancy or within a number of hours or days after birth. What part of this is a choice on her part?  If she had a choice, she would give birth to a healthy baby.

Because the friend has actively made a choice to end the pregnancy before the pregnancy ends itself, it can lead to a very different feeling in people’s minds.  It’s important to remind her that her feelings make sense, but that she seemed to make the most compassionate choice available to her.

If her friend becomes pregnant again, is there anything that she should keep in mind when supporting her friend through the next pregnancy?
It’s a different type of support this time around.  Until she says otherwise, expect her to not necessarily be comfortable or celebratory until the baby is born crying in her arms. She might be terrified. She might still be grieving. She may have conflicting emotions of happiness, relief, excitement and be scared all at the same time.  She may or may not want to talk about the loss during the next pregnancy, but let her know that you’re there for her if she does want to talk about it.  Just because she is pregnant, his doesn’t mean her grief has vanished or that she wished that the prior pregnancy had worked out. It can be complicated to trust one’s body and the process of pregnancy after loss, depending on the circumstances.  Be open to talking with her about the past, the present, and the future.

Categories: Mental, Emotional, + Behavioral Health, Pregnancy, Birth + Family Planning