How to talk about pregnancy loss

Whether it’s your own or someone else’s.

After Erica Freeman lost two pregnancies, a stillbirth at 39 weeks and a miscarriage in her second trimester, she hoped to connect with other Black women on social media discussing their experiences. “I didn’t find any out there that were sharing their story,” she says.

In 2017, Freeman became that voice she longed to hear. She launched a podcast, Sisters In Loss, to encourage freer discussion of pregnancy loss, infertility, paths to parenthood, and Black maternal health and infant mortality. “When something bad happens, it’s typically held close to our chest because we think we’re alone, like we’re the only person who’s gone through this terrible traumatic experience,” Freeman says, “when in many cases, it’s not true.”

Pregnancy loss is common. About 10 percent of “clinically recognized” pregnancies end in miscarriage — the loss of a pregnancy before 20 weeks gestation. There are many causes for miscarriage: chromosomal abnormalities causing the embryo not to develop properly, hormonal imbalances, unmanaged diabetes, malnutrition. Exercise, sex, and going to work does not cause miscarriage. Stillbirth, when a fetus dies after the 20th week of pregnancy, accounts for one out of every 167 pregnancies in the US. Black women have greater risk of miscarriage and stillbirth compared to white women, according to research.

Still, discussing pregnancy loss can be difficult. Well-meaning loved ones fear saying the wrong thing and those who have lost a pregnancy often don’t have a good road map for sharing this news due to a cultural tendency not to talk about miscarriage and stillbirth. “We don’t have the language for this,” says Loree Johnson, a licensed marriage and family therapist. “We have language to communicate the loss of a spouse: you become a widow or a widower. You become an orphan if you’ve lost your parents. There’s not really a language in the US culture for someone who’s lost a pregnancy.”

How each person discusses their pregnancy loss is entirely dependent on what they’re open to talking about and their experience. They may be sharing news of the loss with loved ones because they need tangible support, like help cooking dinner while they heal. Others may hope to fend off insensitive questions about their bodies from coworkers. Freeman was motivated by transparency, to show others they aren’t alone. But as more people talk about miscarriage or stillbirth, these conversations are normalized, Johnson says, and society can better understand both the physical and emotional realities of pregnancy loss.

There are ways to compassionately talk about pregnancy loss, whether you’re looking for support from loved ones after your own miscarriage or you want to lend a sympathetic ear. Here’s some guidance.

How to talk about your pregnancy loss with friends and family

When and how to tell loved ones about your pregnancy loss will depend on your needs and comfort level. “You get to decide when the right time to tell others might be,” says Landon Zaki, a licensed psychologist and owner of Bloom Therapy. “For some, this might be immediately as they seek needed support. For others, this might be after some time having processed the loss.”

It may be helpful to share the news incrementally, Freeman says, where you first inform your partner and family about the loss — and coordinate logistics, like who will pick up your other children from school — and then slowly open up about the experience as you’re ready. You can say something along the lines of “I just wanted to let you know I had a miscarriage. I would love for you to support me by ...” Freeman says “sometimes it’s very hard for people to ask exactly how [they] can support you.” It’s okay if you don’t know what kind of support you need — it can often change from minute to minute, day to day. Johnson says it can be helpful to get tips and strategies from pregnancy loss or infertility communities for guidance on what they found useful to request from family and friends. Both Freeman and reproductive health psychologist Jessica Zucker provide resources on their websites and social media.

How you share news of the loss can differ based on your relationship to the person, your emotional capacity, and whether that mode of communication best facilitates how you want to be supported, Johnson says. Some questions to consider: Who is the easiest person to tell? What communication method is easiest for you? Will you get the support you need through a text message? Do you have the energy for a phone call? Some of Johnson’s clients have found mass emails the easiest way to inform many people at one time. You can also tell your loved ones how you would like to be contacted, she says. Texts or emails give you the opportunity to reply when you’re in the right headspace, Johnson notes, in a way that a face-to-face conversation can’t.

In her book I Had A Miscarriage: A Memoir, A Movement, Zucker wrote of her experience informing a few close friends and family members of her miscarriage by simply texting, “I had a miscarriage.” “I found myself reaching for some semblance of community, of comfort, of a way to tether myself to the living as I remained in the presence of death,” she wrote.

You may also want to enlist the help of a trusted friend to help inform your network of your loss on your behalf. They can be the point person for providing details about what’s going on with you and how others can support you. This gives you the space to grieve and process without fielding multiple calls and texts.

Even if you did not share your pregnancy with your network in the first place, Zucker still finds value in discussing the loss. You could say, “I was pregnant, and we recently learned I’m not” or “I was waiting to share good news with you, but unfortunately, I got some not-so-great news.”

Conversations with your other children, if you have them, should be age-appropriate but honest, says Patti Budnik, the bereavement care manager at Share Pregnancy and Infant Loss Support. Say something like, “The baby stopped growing” or “The baby passed away and we don’t know why.” Avoid language that might unintentionally frighten your children. “If you tell them that baby was sleeping, then they may be scared to go to sleep themselves,” Budnik says. “If you say the baby’s sick and then every time mom gets a cold or dad gets a cold or they get a cold, they might think that, ‘Oh my gosh, I’m gonna die also.’”

When taking off time from work, you may need to provide your manager or HR with basic information in order to take advantage of bereavement leave or other time off policies if you have them. There is no federal bereavement leave policy, but five states — California, Illinois, Maryland, Oregon, and Washington — currently have statewide bereavement guidelines. Employees may take time off to recover from stillbirth under the Family and Medical Leave Act, but that time may be unpaid. It’s up to you to determine how much you want to disclose to your employer. Freeman suggests saying, “I’ve experienced pregnancy loss. My doctors are recommending two weeks off. How do I make sure that I get paid for those two weeks?”

Some people may, in their effort to comfort you, ask for more information you aren’t yet comfortable sharing. While it may be difficult in the midst of your grief to set a boundary, you need to speak up for yourself and what you’re comfortable discussing, Budnik says. Tell loved ones what you’re willing to speak about or point out comments that hurt you. Zaki suggests saying, “I know you want to help, but what you are saying isn’t helping me right now. Here’s what I need instead.”

You may be confronting a whirlwind of emotions, from anger, guilt, shame, grief, and even relief. Give yourself grace for any emotion you’re experiencing. To help process your grief, Refuge in Grief offers self-guided courses for engaging with your pain. Share Pregnancy and Infant Loss Support also hosts online chats and Facebook groups for bereaved parents. “Attributing a miscarriage — and any response to it — to a personal character flaw or individual choice, rather than the basic comingling of chromosomes during fertilization,” Zucker writes, “keeps us suspended in the past.” Understand there are many pregnancy experiences, including loss and responses to such loss. “But the best way to make room for all those experiences,” Zucker writes, “is by speaking them aloud.”

What to say to a loved one who has lost a pregnancy

Hearing the news of someone’s pregnancy loss can be painful, but remember your role is to be supportive; the griever should not have to manage your emotions on top of their own. The best thing you can tell someone who shares their loss with you is, “I wish there was something that I could say that can make this better. I’m here for you,” Budnik says. Your loved one might just need you to listen, to babysit, to tell other friends. Consider whether your loved one shared their plans for their pregnancy and their baby. It may be helpful for them to hear, “Tell me about your pregnancy” or “Tell me what you were planning for this baby,” according to Budnik.

Tangible support is often appreciated, Freeman says. “Always think about things you can remove from their plate that are basic life functions,” she says. “How can we make sure that they have food and groceries in their house?” Think about their life and needs when making offers of assistance. Do they need someone to walk their dog? A ride to a doctor’s appointment?

Acknowledge the loss and don’t minimize the grieving parents’ pain. Budnik says it can be helpful to ask if they named the baby and if they plan on holding a funeral or other remembrance ritual. Always try to refer to the baby’s name if the parents told you, Budnik continues.

When looking for words of comfort, well-meaning supporters often turn to platitudes that do more harm than good. Avoid these statements:

• “At least it happened early.”
• “At least you have other children.”
• “You can always get pregnant again.”
• “God wouldn’t give you more than you could handle.”
• “Everything happens for a reason.”
• “You don’t even look like you’re pregnant.”
• “Have you considered IVF?”
• “Once you get pregnant again, you’ll feel better.”

Keep showing up and checking in with your loved one beyond the first few weeks following the loss. Tell them you’re thinking of them, ask them how they are and if they’d like to talk. Don’t assume that just because the parents seem “okay” or “fine” that they’re not hurting and in need of a friend, Zucker says.

If your loved one told you their due date, Budnik suggests reaching out on or around that date. Say, “I know your due date is coming up. I’m thinking about you.” Zucker suggests sending a thoughtful message or phone call on the anniversary of the loss. “And if they’re like, ‘You know what, actually I’m so tired of talking over it. I can’t deal with it anymore,’” Zucker says, “Then you don’t need to, of course, bring it up anymore.”

Discussing grief in any capacity is difficult — especially so for those who lost a pregnancy. Tread lightly, lead with compassion, and listen. “People will always remember who was there for them,” Freeman says. “They may not even remember any of the events of exactly what happened during their pregnancy loss, but they will always remember who showed up for them at the end of the day.”