6 Tips for Talking Supportively About Miscarriage

Now that Mark Zuckerberg and Priscilla Chan have a healthy baby girl, it may be tempting to dismiss the tragedy of their prior miscarriages.

Yet nothing about any couple’s miscarriage is easily dismissed, as Zuckerberg expressed himself – on Facebook, of course: “Most people don’t discuss miscarriages because you worry your problems will distance you or reflect on you – as if you’re defective or did something to cause this. So you struggle on your own.”

Although the miscarriage conversation is now on the public’s radar screen, for many couples simply revealing that a miscarriage has occurred is much easier said than done. Going a step further to openly discuss the thoughts and feelings it triggered can be utterly daunting.

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This is because of the sensitivities involved, which are deeply connected to an individual’s identity and self-esteem. In addition to the common feeling of being somehow damaged and defected that Zuckerberg bravely expressed, miscarriage can cause profound anxiety, despair and grief–which are especially poignant when it occurs during the course of infertility treatment, including failures of in vitro fertilization to take hold. When a couple’s mourning about such losses are piled on top of grief over their perplexing inability to conceive, the despair about a miscarriage can lead to depression, often severe.

In my decades as a psychiatrist specialized in mind-body interactions, I have encountered women whose stress and despair were so acute that they actually developed the symptoms of pregnancy despite not having conceived: missed periods, distended abdomen, the sensations of fetal movement, and even breast secretions. These ‘false pregnancies’ – a phenomenon known as pseudocyesis – are the result of psychological mechanisms to protect people from the unbearable pain of their loss. They allow women and their partners to once again be able to feel hopeful, albeit only temporarily until the truth is revealed. The hero of my novel The End of Miracles experiences a false pregnancy after the sorrow of years of infertility and a late-term miscarriage.

With such intense and difficult feelings involved, what can be said and done to support friends or loved ones who have miscarried? Here are 6 pointers.

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Acknowledge the loss

The simple act of acknowledging that miscarriage is indeed a painful loss can be tremendously supportive. Often, less is more. Simply saying: “I’ve heard, and I’m sorry for your loss” shows you understand that the person is grieving and are willing to engage with her on that level.

Show compassion and support

It’s not as important to find the “right thing to say” – and there isn’t necessarily one right thing – as it is to convey compassion and support. This can be done by giving your friend a hug, for example. Leave space for her to respond.

Listen

Asking, “Would you like to talk about it?” demonstrates that you’re willing to listen– and this fact is in itself a source of support. However, it’s not helpful to pressure your friend to talk. Instead, if she doesn’t say much in response, you can indicate understanding by saying, “I’m always ready to listen whenever you’d like to talk about it.”

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Let her lead the conversation

If your friend has indicated she’s open to talking, this is not a carte blanche to dive with comments you assume might be helpful. Rather, let her steer the conversation where she needs it to go. Then, often, a simple acknowledgment of the feelings she’s expressing, such as: “I can understand why you feel so devastated” is best. Feeling heard and understood is priceless.

Keep the success stories to yourself

While it’s tempting to try to cheer up your friend or loved one by sharing stories of others who have succeeded in having a child after miscarriage, it’s better not to do this. It may only make her partner and her feel even less competent in comparison and all the more frustrated.

Respect her autonomy

Ask if she’d prefer you to continue the conversation by asking questions in the future, such as “How are things coming along?” or if she’d rather be the one to initiate updates. Then stick with it.

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Finally, bear in mind throughout that as a loss, miscarriage must be mourned and this process varies from day to day. If your friend was open to talking one day, she might not be open to it the next. Take her lead about whether to talk or not while continuing, for as long as necessary, to indicate that you care and are available to listen whenever she needs that.

 


{Image credit: Maria Victoria Heredia Reyes}

 

About the Author

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Monica Starkman, M.D., is associate professor of psychiatry emerita and scientific researcher at the University of Michigan Medical School’s Department of Psychiatry. She’s author of the novel The End of Miracles (She Writes Press, 2016), whose themes stem from her extensive professional research into women’s experiences with infertility, pregnancy and labor. As a recognized expert on the effects of stress hormones on mood and brain structure, Monica has been published by dozens of academic journals and several news outlets includingThe New Republic and Vogue magazine. She has also served on the board of the Journal of Psychosomatic Obstetrics and Gynecology. She lives in Ann Arbor, Michigan.

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