Words That Help, and Words That Hurt, After Pregnancy Loss

New 2022 research published in the European Journal of Psychotraumatology confirms that women who had miscarriages or stillbirths experience pronounced grief. In a paper published by Stat Pearls and titled "Grief Reaction," the authors remind us that: "The grief experience is not a state but a process." Given all this, how do we talk about this pain with someone who is suffering? What is the best thing to say or do—and the things to avoid?

Kim Hooper and I thought about this while researching the topic for All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss. Here are the important themes that came up.

Taking the stance that people want to be helpful and supportive for their friend or loved one who is suffering the loss of a pregnancy, what are the unwittingly hurtful (and perhaps, frankly, dumb) things that they say?
Most people genuinely want to help and simply do not realize when they may say something hurtful. During Kim's own losses, she noticed that people were very uncomfortable with her grief and wanted to say something—anything!—to just make it go away (poof!). That meant she heard a lot of platitudes, “everything happens for a reason,” and “the next one will stick!” She didn't want to skip ahead; instead, she wanted others to sit with her in the icky present, to acknowledge and validate her sadness. They were trying to give encouragement, but for her, it felt like disregard for the gravity of her losses.

What would be more helpful to say, and what would be useful to avoid saying?
Acknowledgment and validation go a long way. Perhaps say, “This is such a painful thing. I’m so sorry you are going through this.” Ask how they are doing physically. Pregnancy losses are medical events and that aspect often gets glossed over, too. Assure them that you are there for them: “I’m going to text you every few days if that’s okay.” It’s also perfectly fine to say, “I have no idea what to say.” Kim really appreciated that vulnerability and honesty. We found that most of us don’t know what to say in these situations. We are just humans, fumbling along. Admitting where we fall short helps. This statement is huge: “I’m thinking of you and I want to understand.”

What do loved ones not realize about the emotional experience of pregnancy loss?
It’s very hard for people to grieve a person they never met or saw. In this way, pregnancy loss is an ambiguous loss. For the woman who lost the baby, it’s very real. She was carrying this child and had started making plans for a specific future. Likely, her partner was doing the same. There is grief for the baby and for the future. Loved ones are on the periphery of those plans. They might not “get it.” They might not have even known about the pregnancy before the loss occurred; it’s hard for them to understand the magnitude of the loss. To them, the woman may look the same so they assume she’ll “get over it” quickly. It’s not that simple.

Some people may not be able to express empathy or are unable to tolerate the feelings of fear and grief that your loss evokes in them. They may be dumbfounded that their “helpful” words are not helpful. How do we navigate these situations?
Some people really do not understand how their words could be seen as unhelpful. They may even be offended that their words were taken that way. Kim quickly figured out who the avoidant people were in her life, the people who didn’t want to look below the surface and really sit with her during her grief. She took space from those people to protect herself emotionally. Her losses helped her find her “safe people,” people who really wanted to understand the pain. She was then able to practice expressing her needs with those people. In the midst of her grief, she found she was really bitter and resentful of the more avoidant people in her life, but in time she was able to have compassion for them as well.

Many people simply cannot tolerate grief. It brings up too much for them. But there are plenty of people who want real intimacy and are honored to hold space for your pain.