According to the American College of Obstetricians and Gynecologists, about 15-20% of pregnancies end in miscarriage, usually within the first 13 weeks of pregnancy. For the woman who has miscarried, this can be a difficult time emotionally, both in coping with the loss and thinking about its impact on her marriage and her ability to conceive in the future. Even among the best of friends, it's hard for a friend to know what to say or how best to provide support to someone who is grieving the loss.

In 1981, Robbie Miller Kaplan gave birth to two children: a son Aaron, in January and a daughter Amy, in December. Both babies died in infancy from the same heart defect. It is her own experiences with loss as well as a passion to make a difference with others that motivated her to write a book on effective communication during difficult times.

Robbie is a writer, speaker, and founder of The Comforting Words website. She is the author of nine books, including How to Say It When You Don't Know What to Say: The Right Words for Difficult Times, available in volumes on Miscarriage, Illness & Death, and e-books on Death of a Newborn and Stillborn Baby, and Death of a Child. I recently interviewed Robbie on the topic of miscarriage.


What makes miscarriages so painful emotionally?


A miscarriage is a death in the family and just like any death, the bereaved must grieve for the loved one they've lost. Miscarriages are extremely painful because the mom and dad loved their baby and yet the parents will never have the chance to have this beloved child as a part of their lives. All their hopes and dreams will never come to fruition. If they have other children, those children will never take the place of the precious baby they've lost.


How is this compounded when a woman has had more than one miscarriage?


Not only is the mom grieving for her loss, but the physical aspects of pregnancy have taken a toll on her health. Her body has gone through physical and hormonal changes and she has had to repeatedly recover. If she has no children, she might also fear that she will never have children. Once she recovers from the miscarriage, if she wants to try again, she has to get healthy and strong enough to sustain another pregnancy.


What can a friend say or do to comfort someone who has recently miscarried?


It's important to acknowledge the loss. You should treat your friend just like you would treat any loved one who has had a family member die. Send a bouquet of flowers, write a heartfelt note, or bring a meal. One of the most caring things you can do is offer to visit and listen. Let your friend share their feelings and allow them to do the talking. One mom said the nicest thing her friend did was to repeat some of what she said back to her; that way, she knew her friend was really listening.


How can you handle being pregnant when your best friend just miscarried?


This is a tough one. Loss is very isolating so it's important that you keep in touch; if you stay away, you'll isolate your friend even more. Have a conversation with your friend and be honest; share that you understand this is a difficult situation. Let your friend set the parameters; ask her to let you know what's comfortable for her and what's not. As much as your friend might love you, there are aspects of your pregnancy and your excitement that will bring her pain. It's important to be sensitive to her feelings.


How can a good friend ease the anxiety of pregnancy after miscarriage?


Communication is so important. Let your friend know you are available to listen and when she wants to share or vent, give her your undivided attention. Everyone needs an outlet, so be her outlet. What doesn't help is making unrealistic comments, such as, "This time it's going to be okay" or, "I'm sure this time it will work."


If you are the one who has miscarried, what can you say to make it more comfortable for your friends?


When you're feeling so bad, it's a lot of pressure to try to pull yourself together to make things more comfortable for your friends. And yet most of us downplay how we really feel so we don't make our friends and loved ones feel uncomfortable. If you have just miscarried, you might say to your friends, "There are a few things that would make me feel better if you'd like to help." And then share those things, whether it's a cup of coffee and companionship, company to your next obstetrical appointment, or a home cooked meal. If you want your friends to support you, sometimes you need to take the initiative and let know just how they can help you.

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