What (not to) say.

On one of the forums I'm on, for women coping with miscarriage, a woman wrote in to ask how she could help her friend, who had just told her she's miscarrying. This got me thinking about the things people said (or should have said, or should NOT have said) to me when I miscarried.

Hmm, maybe that's a little misleading. The truth is, I still think about it all the time - and cry about it, and sometimes just go quiet and space out, and feel wistful and sad and frustrated and angry... So thinking about this is not exactly out of character for me right now. It's still very present in my life.

Anyway, the point is, if your friend is having a miscarriage, there are a few things you should know if you want to support her.

The best thing you can do is listen.

She will need someone to talk to who won't judge, won't pretend it's not a big deal (it is a huge deal when you go through it) and won't make her feel bad for hurting or giving "too much information". She will need someone who will offer hugs, cry with her, and let her talk about the pain, the plans she had made for the baby, the emptiness and futility she may be feeling now.

Miscarriages happen before 20 weeks - after that it's considered a stillbirth - so being so early in the pregnancy she may not have yet told anyone she was pregnant. So she may want to talk about the way she felt being pregnant, to relive the joy a little and even the first trimester complaints.

Many women I know are having babies later in life. (I'm 33 and just had my first pregnancy which resulted in the miscarriage - and I have so many friends my age with their first pregnancies or newborns.) So she may be feeling the pressure of 35 looming, with its increase in probability of fertility problems and chromosomal problems or other birth defects. She may have been trying to conceive for a while - years, even - and gone through the frustration of different fertility treatments. She may have seen her friends having children and been feeling so left out and heartbroken. To go from that situation to that Big Fat Positive on the pregnancy test, only to have that joy and hope taken away is truly traumatic.

The worst thing you can do is not call, not ask about it, pretend it didn't happen or act like it's not a big deal.

So your friend needs you. She needs to borrow your strength and your shoulder to cry on. She needs someone to rage about the unfairness of it all with her. So, what can you say?

The best thing you can say is:

If you need something to say, "I'm so sorry" works! Or ask how she is feeling, what she is feeling, how her partner is handling it, what her doctor/midwife said, if she is going to take time off work, if she wants a project to keep her busy, anything - just ask about it. She may feel like she can't talk about it - because no-one does - and that's not right. Women should talk about this.

Before I had a miscarriage myself and learned more about it, I had no idea how common it was. None. Nobody talked to me about this. The pregnancy book I bought - nearly 500 pages - has one paragraph about miscarriage. Neither my family doctor nor my midwife talked to me about the possibility of miscarriage.

Now I know that the best estimate is that 20-25% of pregnancies end in miscarriage. One in four! And this is only an estimate, because it is believed that many miscarriages happen before a woman even knows she is pregnant, so those aren't counted in the stats. Think about that... for every three kids you know, one baby didn't make it, and one woman has gone through a miscarriage. Some women go through many miscarriages before carrying to term. I can't imagine how hard that must be. And nobody talks about it.

I had no idea what to expect physically. My doctor was actually cheerful when I went in, sobbing, knowing in my heart I was about to miscarry. My midwife was kinder and talked to me about it over the phone, giving me some information. But I learned the most from the forum on the internet - from other women.

And I really want to emphasize that we girls need to talk about this. If I hadn't read the words "gushing" and "contractions", I would never have expected these things during the miscarriage. I think I would have expected a heavy period. Ladies, it's not like that at all. I would have flipped at the amount of blood and the feeling of passing tissue. I know this may sound like Too Much Information, but a little TMI is so much better than none if you are about to go through it. Or if your friend is going through it - learn a little about this, help her know what to expect.

The worst thing you can say is:

* "it was (wasn't) meant to be"
* "it will happen again for you soon"
* "lots of women have miscarriages"
* "at least it happened now and not later"
* "just think of the miscarriage like a period, only a little late"

... anything that diminishes her loss in any way just ends up hurting. This was a baby to her, not a "pregnancy" or a "fetus". A baby. Her baby. Most likely much wanted and already loved. Hours or days ago she was a happy, pregnant, mother to be. And suddenly she is not any of those things.

The last thing I will say is, it's not the kind of thing that is 'better' after a week or two. She may still be physically going through it even 4-5 weeks from now, and will certainly be grieving emotionally for a long while. A quick hug or even a phone call and a "How are you feeling?" over the next few months will mean a lot and show you care.