In Japanese, there is a word — “mizuko,” or “water child” — for babies lost to miscarriage, abortion or stillbirth. According traditional Buddhist beliefs in the country, the souls of unborn children haven’t had the opportunity to earn karma and therefore don’t go to heaven, but they are protected by a bodhisattva — a being on the path to enlightenment — named Jizo, who in this case functions like a patron saint.
At Buddhist temples, you may find rows of Jizo statuettes, each representing an unborn child. Grieving families dress them in red bibs and caps, and they place offerings of flowers, food and toys at their feet.
By contrast, in American culture, the primary tradition surrounding pregnancy loss is often silence.
“We are so used to focusing on the positive sides of fertility, pregnancy and having babies,” Anna Sane, a co-founder of the infertility support platform Tilly, told HuffPost. “There are celebrations and rituals that emphasize how wonderful it all is, while the negative and difficult aspects are left out of the narrative.”
According to survey results issued last year by Tilly and Sands, a U.K. organization that supports families affected by the death of a baby, 96% of respondents said they considered pregnancy loss a taboo subject.
In the U.S., many people seem to have tacitly agreed not to reveal a pregnancy before 12 weeks, or the end of the first trimester, by which time the chance of miscarriage is much lower. Although these losses are usually kept quiet, they are very common, with an estimated 10% to 20% of known pregnancies ending in miscarriage.
When a friend or loved one loses a pregnancy, it can be hard to figure out an appropriate way to support them. You may wonder if you will make them feel worse by speaking about the loss, and it can be challenging to find words that feel right.
HuffPost spoke with a number of therapists about ways for you to acknowledge this loss and let a loved one know that you are thinking about them.
Gently check in with them.
“Friends and family may avoid bringing up the miscarriage out of fear that this will remind the person of their loss,” Britta Dinsmore, a psychologist who specializes in fertility and pregnancy loss, told HuffPost. “However, it is likely that the subject is already on their mind, and it is often a relief to be asked about it.”
You will want to “consider the situation,” said Dinsmore — and not bring up the topic in the middle of the workday or in front of a group of people, for example. But you won’t do any harm by letting the person know that whenever they want to talk, you will be there to listen.
You might start with one of the following phrases:
- “I’m so sorry for your loss.”
- “Do you want to talk about it?”
- “I’m here to listen anytime.”
Even if they don’t want to talk the first time you offer, continue to give them opportunities to do so. Grief doesn’t follow a predictable schedule, and they may need your support weeks, months or even years after the loss occurs.
It can be especially meaningful for you to check in with them on what would have been the baby’s due date.
“You’re not reminding them. They know. They remember,” Katelin Buchanan, a therapist who endured multiple pregnancy losses herself, told HuffPost.
Make specific offers of support.
Don’t task the grieving person with finding ways for you to be helpful. Instead of saying, “Let me know what I can do,” give them a couple of specific options to consider. You might say, “I’m bringing bagels or donuts — which do you prefer?” or “Do you want to go for a walk or watch some TV together?”
Buchanan said that “the most standout moments” after her own losses were when people just showed up, whether face to face or by phone, text message or email.
“Sometimes it’s just a handwritten card,” she said. “Little touches here and there.”
After her most recent loss, Buchanan said, a friend called to tell her: “I don’t know what I’m doing. I have no idea what I’m supposed to do. But I’m going to be in your driveway tomorrow around 4 o’clock, and I’m going to have your favorite cookies. I’m just going to be there. If you don’t want to come out, that’s fine.”
It’s OK if you feel uncertain or are afraid you might not say the right thing. “It doesn’t need to be some fancy script,” said Buchanan.
If you travel in the same circles, you might also volunteer to inform others about the loss. This can be helpful in certain situations, perhaps among a group of friends or family members. You could ask, “Is there anyone you’d like my help sharing this news with?” suggested Dinsmore.
Avoid saying anything that minimizes their loss.
Silence can be uncomfortable. But in the rush to fill the space with words, people sometimes say things that aren’t helpful or may even cause hurt.
Phrases that you mean to be reassuring can inadvertently diminish the impact of the loss. Buchanan and Dinsmore listed these as some of the more common ones:
- “At least you weren’t that far along.” There isn’t necessarily a connection between the length of the pregnancy and the intensity of the grief. Every situation is unique. (Buchanan noted that any sentence starting with “at least” is probably a bad choice. “At least you already have one child” is another example.)
- “You can get pregnant again.” This makes it sounds like one pregnancy or baby is interchangeable with another. The person is mourning this particular loss right now.
- “Maybe you were too stressed.” Anything that suggests the loss was somehow the person’s fault can be deeply hurtful and is almost certainly untrue. The vast majority of miscarriages are caused by chromosomal abnormalities in the fetus or placenta, which cannot be prevented or treated.
- “It’s all part of God’s plan.” This implies that the loss was meant to be, or even that the person deserved it.
“Sometimes there’s just no silver lining and there’s no positive, and people work too hard,” said Shara Brofman, a psychologist who practices in New York.
“You don’t have to say all that stuff,” she continued. “People just want to hear: ‘I’m so sorry. That sounds really difficult.’”
Anything that diminishes the impact of a loss can contribute to what’s known as disenfranchised grief, which occurs when a loss may not be a “societally recognized” or have a “ritual process” acknowledging it, said Brofman. The idea that the person doesn’t have the right to grieve can be isolating and hurtful.
Respect their boundaries.
“It can be hard for someone who has recently experienced a miscarriage to be around others who are pregnant or have children, especially infants or young children,” said Dinsmore.
In the Tilly and Sands survey, 79% of respondents who experienced pregnancy loss felt the need to distance themselves from people with babies and children.
Baby showers and children’s birthday parties may simply be too much to bear, and you should respect the boundaries of your friend or loved one if they don’t feel able to attend such events yet.
But that doesn’t mean they’ll want to stay away from children forever. “This is what they feel they need to do in the present moment to take care of themselves and give themselves time and space to grieve and heal,” said Dinsmore.