When someone experiences pregnancy loss, it is hard to know what to say or how to help. Here are some thoughts based on my experience with two miscarriages and a stillbirth.
1. Don't minimize the precious child she has lost by saying she can always have another child, she was "only" at 10 weeks, or at least she has another child. She is grieving a life that lived inside of her -- for however short a time -- and that life and loss deserves honor and respect.
2. Recognize that her loss affects her ability to experience the innocent excitement and anticipation of future pregnancies -- whether her own or others'. Events like baby showers, creating or purchasing from a registry, or setting up a room may feel daunting or even frightening, as they raise the specter of further loss and disappointment.
3. Let her talk about her baby by name and share stories from her pregnancy, if she wishes. Like most parents, those who have lost a baby may wish to talk about their child. Unfortunately, others are often uncomfortable listening. After our son was stillborn, I found that whenever I mentioned him, the tone of the conversation shifted from casual to intense. I wanted to be able to speak about my baby, but felt inhibited by others' discomfort. I was grateful for those people who allowed me to speak about him with whatever tone felt right to me at the moment.
4. Follow her lead. Grieving involves many complex and often shifting emotions. Some days she may want to talk about what happened to her. Other days (or moments) she may prefer to be distracted, and avoid the subject of her loss. Let her mood and cues guide your response. Stay with what she is feeling in the moment, rather than imposing what you think she should be feeling.
5. Don't judge her feelings, even if they may seem irrational at times. She is trying to make sense of the nonsensical -- the death of an innocent baby and the dream of the life and family she imagined. Her many mixed emotions are confusing and exhausting enough without concern about being judged by others for grieving or feeling "wrong."
Several months after our son was stillborn, I told my husband that I was feeling intensely angry at a friend who wrote a Facebook post congratulating herself on reaching a milestone in her pregnancy. He tried to tell me that I wasn't "really" angry at her (which only served to raise my anger at my husband in addition). While I could recognize that my anger wasn't entirely fair or rational, allowing myself to feel it was a part of my grief. Later I was able to process that I was angry at her for feeling the same excitement and anticipation that I had allowed myself to feel, and for not protecting herself from the horrible disappointment that I had experienced when our son was stillborn (thankfully for all, her daughter arrived healthy a few weeks later).
6. Recognize that certain people, places and events may trigger her grief. Seeing someone who was pregnant along with her or going to the hospital or medical office where her loss occurred may bring up strong emotions. Holidays, due dates, or anniversaries of the loss are other common triggers. Try to give her some extra TLC around these challenging times.
7. Realize that it may be hard for her to fully share in your happiness. Her difficulty sharing in your joy does not mean that she doesn't wish the very best for you -- just that your happiness may be a painful reminder of her own loss.
8. Don't assume that another pregnancy will make things all better. When we see someone we care about hurting, it is common to want things to be better for them. Since the person has lost a pregnancy, many people think that reclaiming what was lost -- having another pregnancy -- will make things better. Keep in mind that it may not be as simple as it first appears. Children are not replaceable, and parents may continue to feel a longing for the child who was lost, even if they go on to have future children. Moreover, having another pregnancy may not be easy for all women. Some have difficulty conceiving. Others may have conditions that make them vulnerable to complications or losses in future pregnancies. In any case, subsequent pregnancies carry with them the fear of further loss. While couples may decide it is worth the risk, this is not always an easy decision.
9. If she becomes pregnant again, don't minimize or mock her fears of another loss in an attempt to alleviate her anxiety (or your own discomfort with her anxiety). I'll never forget the doctor who -- after my first miscarriage -- mocked my fears in my next pregnancy, pointing to my engorged breasts and saying, "They don't stand up on their own like that if you're not pregnant." Far from being comforting, his behavior was off-putting and invalidating of my fears. Just moments later, he had the unfortunate task of diagnosing my second miscarriage. Rather than trying to talk her out of how she is feeling, recognize that fear of loss is part of her reality, and support her as she tries to live with it.
10. Don't forget Dad. While I've written from the woman's perspective because that is my experience, it is important to remember that pregnancy loss affects the entire family. Dad, surviving siblings, grandparents and other family members are all affected. Consider ways in which you can support the entire family through this challenging time.