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Pregnancy

Miscarriage Support in 7 Steps

Written By
Jessalyn Ballerano
Certified Childbirth Educator & Doula

If you or a loved one are experiencing pregnancy loss, it may be that support comes in unexpected ways. Families navigating miscarriage, grief and health concerns can benefit from a broader conversation about support and some of the things that are most - and least - helpful in navigating a difficult experience.

Any unexpected loss can be impactful on our emotional health, and pregnant people navigating miscarriage may require time and care to recovery physically. Being supportive about miscarriage may sound difficult, and it can be, but a with a little education and perspective, we can all share compassionately caring for individuals who have experienced pregnancy loss. Start here to learn some of the facts and realities of miscarriage, or read on for seven suggestions for getting or giving support during this sensitive process.

1. Physical assistance during and after...

Depending on the timing and nature of someone’s miscarriage they may go through the process at home, in a clinical setting, with or without medication, and with or without knowledge beforehand of what to expect. The nature and duration of healing and recovery will also vary.

Offering physical support is one way to help ensure their safety, as well as help them focus on what they need to do at that moment for their body, mind and spirit. Providing this kind of support might include:

  • Driving them to and from appointments
  • Waiting with them after any procedures or medications are used
  • Preparing food/meals beforehand or cooking for them at home
  • Helping them get settled and comfortable in recovery
  • Offering to run errands, pick up groceries, or drop off their other child at school
  • Assistance arranging for any funerary or ceremonial events

2. Calm companionship

Some people will be very grateful to have someone with them, others might have complex feelings about being witnessed in what can be a vulnerable and scary situation. Most people will appreciate the company of a trusted, calm support person. Not only does this help them to feel (and be) safe, as described above, but being witnessed in a difficult moment can be emotionally validating. Companionship validates the reality of what is happening, and creates a shared memory that can support healing. A companion can also be a source of strength and comfort during uncomfortable moments, or serve as a sounding board if an important decision has to be made. If you are accompanying someone experiencing loss, whether they are the pregnant parent or not, consider it an honor to be included in their process, and use the tips below to inform your support along the way.

3. Listening language

A person experiencing pregnancy loss may or may not want to discuss their pregnancy, the experience of loss, or how they or their partner are feeling. Without forcing them to, offering a listening ear without expectation is one of the most supportive things you can do for someone. They may want to talk about their dreams of parenthood, or they may need to process what happened physically during their miscarriage. Equally valid, they may not want to discuss any of it and want to hear a story about something else, listen to music or poetry, or be in silence. 

First, meet them where they are at and respect their wishes. While listening, pay attention to the words they use (such as “my pregnancy, or “the baby”) and make an effort to use the same language when you do speak. If they use a name for their child, say it out loud. Words are powerful, and there is a benefit to “speaking the same language” as the person you are supporting, as well as fully honoring the existence of the child. Circle back at other times to make the same offer in a low-pressure way.

Examples:

  • “I imagine you might be feeling a lot, so if you want to share anything, I am available to simply listen.”
  • “It’s okay if you need to vent or cry, we are here for you.”
  • “Do you want to talk about what happened?”
  • “If you feel like talking later, know you can call me, anytime.”  
  • “Thank you for sharing with me about Baby ____; I can hear how much you love them.”
  • “How are things going with you? Last time we spoke you were processing a lot, just want you to know I’m here.”

4. Making space for difficult emotions

When faced with difficult feelings like grief, anger, confusion or even emotions we don’t fully understand, it can be tempting to avoid, distract or even replace the feeling. Yet the more we understand about psychology, the brain, and the ways humans process stress and emotion, the more we understand the value of letting these emotions be expressed, either physically, verbally or in some other form of expression.

People experiencing pregnancy loss might have a full spectrum of emotions, including ones that are conflicting or might not make sense to their support people. If someone you are supporting needs to cry, let them cry, with a tissue on hand. If they need to shake, or say how angry they feel, or they get snot on their face alternating between tears and laughter - that is fully okay and 100% human. Whether a pregnancy was planned or unplanned, known or unknown, and the circumstances of the loss might all impact the way someone does, or does not feel. 

Simple tips for holding space without manipulating the person’s experience include:

  • Simply listen as in the step above
  • Use basic phrases of acknowledgement and acceptance, such as... 
  • “I’m so sorry this happened.” 
  • “It’s okay to feel whatever you are feeling right now.”
  • “It does suck, you’re right, and we love you.”
  • “Whatever you need, we support you.”
  • “I know it hurts, and you’re safe to feel it. I’m here.”
  • Offer to share your own experience of pregnancy loss or fertility challenges (and only share if they want to hear it in that moment)
  • When safe to do so in their recovery, offer to walk, swim, dance or stretch with them
  • Offer to join them in prayer, ritual or ceremony

5. Don’t try to fix it or explain it away

Along with trying to “fix” hard emotions, many of us also have tendencies to try to explain, understand or solve every problem that comes our way. The truth is, most miscarriages happen randomly, and are not preventable. Some people may put a high value on understanding the medical factors that might have contributed to a pregnancy loss, while others would rather engage their faith or spirituality in processing the miscarriage. Physiological explanations in general should only be offered if requested, and by skilled or knowledgeable people, such as healthcare providers, who have specific, relevant and accurate information to share.

Attempts to assign specific cause, meaning or level of acceptance to the experience is usually not as helpful as intended. Saying things like, “Everything happens for a reason, God works in mysterious ways” or, “Weren’t you using contraceptives?” is very dismissive of the person’s experience, and may actually shut them down or create tension. On the other hand, if someone has a deep desire to understand more about their loss or miscarriage in general, that is an appropriate time to share more facts about miscarriage or help them identify next steps or resources to do so.

6. Release judgements and comparisons

When it comes to pregnancy, parenting and babies, everyone has an opinion. Because the nature of reproduction is so personal, so complex, and yet universally human (in the big picture), many pregnant and birthing people - including those experiencing pregnancy loss - run into commentary and attitudes that are judgmental, comparative and even competitive.

The timing of someone’s miscarriage, the nature of their pregnancy, whether or not they had planned to have a child, the status of their current family dynamic…..all of these are, of course, factors in one’s experience, but there is not one correct way a person “should feel” or act based on these factors. Someone who never even knew they were pregnant might feel the same grief as someone trying to conceive, and a loss at 8 weeks might feel just as significant as a loss in the second trimester. 

While we all have gut reactions to the experiences of our friends and loved ones - especially over matters of health, life and death. It is best to let go of judgment in the moment of someone’s need. If you are feeling unable to interact with someone supportively, it may be best to disengage or acknowledge that, saying something like, “I want to support you and I’m having a hard time managing my own emotions right now - is there someone else you can talk to right now while I gather my thoughts?”

7. Practice patience

Incredibly important to supporting someone’s loss is giving them the time to process how they need to. Grief is complex, and so is family planning. When a pregnancy loss occurs, it may take weeks or even years for the person to feel more ease and a sense of resolution in their body, lifestyle or in a future pregnancy. If they do have other pregnancies or children, certain events or sensations, such as the common experience of postpartum lactation after loss - can be triggering.

While it is tempting to say, “Time heals all wounds,”  - it isn’t always true. Time may make a devastating loss less painful, but just as important are camaraderie, community acknowledgement, and simple acceptance of the full range of human emotions. Avoid phrases like, “You will have other children,” or, “Isn’t it time to move on?”. Usually, these things are said more for the speaker’s benefit than anyone else, and most people report feeling isolated, misunderstood or dismissed by such comments. Recognize that their grief may last or resurface longer than you might anticipate, and your acceptance and loving follow-up - with a hug, or even a card a year later - is far more helpful to their healing.

Pregnancy after loss is a part of this practice in patience, as two partners or a family may have certain expectations around the possibility and timing of children. For the pregnant person’s physical health and everyone’s mental ease and emotional well-being, prioritize healthy activities, continued availability for emotional support, and a mutual acknowledgement of if, or when, it may be comfortable to discuss future planning. 

Additional Resources for Pregnancy Loss & Miscarriage Support

Jessalyn Ballerano
Certified Childbirth Educator & Doula
Jessalyn (she/her) is a Childbirth Educator and Doula serving families in the San Francisco Bay Area, nationwide, and in her new home of Eugene, Oregon. She started studying birth in 2010 as an anthropologist, and often brings a systemic approach to helping birthing people to understand their options, experiences and possibilities. She integrates evidence-based training and research with a holistic mindset and an activist’s passion for reproductive empowerment. Jessalyn serves on the board for the Oakland Better Birth Foundation, where birthworkers, birthing people, and care providers work together to end preventable maternal and infant mortality and address racial disparities in health care. Jessalyn is a CAPPA-Certified Childbirth Educator, SMC Full-Circle Doula.
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