What to say to a friend who has had a miscarriage

When a friend tells you she has had a miscarriage, the fear of saying the wrong thing is often what stops people saying anything at all. That silence is the thing she is most likely to remember. A clumsy sentence said with care is almost always better than none.

Miscarriage is common and still rarely talked about. A major review published in The Lancet in 2021 estimated that around 15 in every 100 recognised pregnancies end in miscarriage, and that about one woman in ten has had one miscarriage, with smaller numbers having had two or more. Common does not mean small. In a large study led by researchers at Imperial College London, nearly a third of women met the criteria for post-traumatic stress a month after an early pregnancy loss, and for some the symptoms were still there nine months later.

So this is worth getting right. Here is what tends to help, drawn from the guidance of specialist pregnancy-loss charities, and what tends to hurt.

What to say first

Keep it short and keep it about her. The Miscarriage Association, a UK charity, suggests simple words such as:

• “I’m so sorry. I’m here.”
• “This must be so hard. You don’t have to say anything.”
• “I’m thinking of you, and of your baby.”

Use the words she uses. If she says “baby”, say “baby”. If she says “the pregnancy”, follow her. Some people feel they lost a child; some feel they lost a possibility; some do not yet know what they feel. Your job is not to decide which.

If you are not near her, a message is fine. End it with something that asks nothing back, such as “No need to reply”, so it arrives as support rather than as one more thing to answer.

What to avoid

Most of the sentences that wound are meant kindly. They tend to share one habit: they hurry towards a silver lining.

• “At least it was early.” Grief does not follow the number of weeks.
• “At least you know you can get pregnant.” She has just learned how little that guarantees.
• “It wasn’t meant to be” or “Everything happens for a reason.” These ask her to find meaning in something she may experience as senseless.
• “You can try again.” Perhaps. Not this week.
• Questions about why. Most miscarriages happen without anything the woman did or did not do causing them, and a question about lifting, exercise or coffee can land as blame.
• Your own story, straight away. If you have been through it too, that can become a real comfort later. In the first conversation, it can take the space that should be hers.

If you realise you have said one of these, you can go back and say so. “I said something clumsy the other day. I’m sorry. I just meant I care about you.” That repair often matters more than the mistake.

Help that asks nothing of her

“Let me know if you need anything” is kindly meant, but it hands her a job: working out what she needs and asking for it. A specific offer is easier to accept.

• “I’m dropping round a lasagne on Thursday. I’ll leave it on the step.”
• “I can take the kids to the park on Saturday morning.”
• “Do you want me to tell the others, so you don’t have to keep saying it?”
• “I’m going to the supermarket. Send me a list, or don’t.”

Respect a no. She may not want visitors, and that is not a verdict on your friendship. Friends who can hear a no without taking it as rejection are often the ones she turns to later.

Remember the partner

Partners grieve too, and they are often asked only how she is doing. If you know her partner, a separate message saying “I’m so sorry, this is your loss as well” is rarely wasted.

The weeks after

The first few days are usually full of messages. The weeks after are quiet, and that is often when it is hardest. Put a reminder in your diary for two weeks and a month from now, and send a line then: “Still thinking of you.”

Some dates will matter more than others. The due date, if she tells you it, is one many people find painful. Other people’s pregnancy announcements and baby showers can be difficult for a long time. Letting her skip them, without needing an explanation, is a kindness.

Carry on inviting her to things, and let her decide whether to come. Being treated as the same person, rather than as someone fragile, helps many people feel less alone. Friendship is built in ordinary hours, as the research on making friends as an adult shows, and it is kept in them too.

If you are worried about her

Grief after a miscarriage can be heavy without being a sign that something is wrong. If she seems stuck, cannot sleep or function over weeks, or talks about feeling hopeless, it is fair to say gently that you are worried, and to suggest she speaks to her doctor or midwife. Many countries have pregnancy-loss charities with support lines for the person who has had the miscarriage, their partner and the people around them; in the UK, for example, the Miscarriage Association and Tommy’s both offer them. If she is in danger now, call your local emergency number or go to the nearest emergency department. If she needs urgent help that is not an emergency, contact her doctor or a local urgent mental health service.

You do not need the perfect words. You need to show up, keep showing up, and let her lead.

Sources

• Quenby S, Gallos ID, Dhillon-Smith RK, et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. The Lancet, 2021.
• Farren J, Jalmbrant M, Falconieri N, et al. Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. American Journal of Obstetrics and Gynecology, 2020.
• The Miscarriage Association (UK). Supporting someone through pregnancy loss.
• Tommy’s (UK). Supporting someone who has had a miscarriage.
• NHS (UK). Miscarriage.