Ask an expert: How do you talk sensitively to a woman who’s had a miscarriage

Q: MY friend has just had a miscarriage after trying for a baby for years, and I don’t know what to say to her. What advice do you have for talking to women who’ve lost a baby?

A: Psychotherapist and counsellor Julia Bueno, author of The Brink Of Being: Talking About Miscarriage (Virago), says: “A miscarriage refers to a pregnancy spontaneously ending in the first 24 weeks, and it’s possible it’s described as something other than the loss of a ‘baby’. It may be a ‘lost pregnancy’ or a ‘bump in the reproductive road’ to a woman. Whenever you talk to a woman about her miscarriage, it’s important to tune into the language and meanings she uses.

“But hearing your friend had been trying to conceive for years suggests how much she wanted to be a mother, and it’s highly likely her miscarriage involved a significant loss, causing significant grief.

“Her baby may have never breathed life, but it would have nestled in her mind for the years she tried to conceive, along with myriad hopes and dreams for her future family.

“Bear in mind the enormity of this potential lost future, which has no correlation to the gestation of the pregnancy.

“If your friend is willing to talk — she may want to grieve privately — ask about her feelings of loss, and be curious about what her baby meant to her: Maybe he or she had a name, or an earmarked school. Know that miscarriage can also hit a woman’s self-worth hard, and guilt and anger are common responses too.

“Miscarriage is also an inescapably physical experience, and women often need to talk through the frightening, and sometimes traumatic, process their bodies went through.

“An early miscarriage (during the first trimester) doesn’t necessarily mean it was pain-free or quick — far from it. It may have needed medical intervention, via drugs to promote the process, or surgery. Hospitals are often overstretched and under-resourced and miscarriage care is patchy — so it may be that her medical experience compounded her upset.

“A late miscarriage is more likely to have happened in hospital. If so, a woman may have washed, dressed and held her tiny baby. And at whatever stage of gestation, she may well be considering a funeral or other ritual to say goodbye.

“Talking about these little-known aspects of loss are important too: They underscore the truth for many that a child-to-be has died.”