Like all grief, pregnancy loss isn’t linear and people deal with it in different ways. Once some women get their rainbow baby (that babe who comes after the loss, or after the “storm”), the heartache and the pain of the journey can feel a distant memory. That’s a wonderful and reasonable way to handle it. 

For others, they live with the heaviness of the loss every day. Or they feel guilt at the prospect of joy or happiness when maybe they “should” still be wallowing in all of the pain and loss and trauma. These are also completely normal and reasonable ways to handle it.

My husband and I tried to become parents for six years, three of those with the help of science, medical professionals, drugs, and a lot of therapy. What I’ve come to learn is that while infertility — and the pregnancy loss that often comes alongside — is an issue so many couples of our generation face, most of us are not made aware of the struggles until it’s time to face them ourselves, at which point it can feel foreign and unrelatable. Reproductive information, miscarriage, and fertility complications are still often shrouded in shame and secrecy.

The irony is, of course, that recent statistics in the United States say “among married women aged 15 to 49 years with no prior births, about 1 in 5 (19%) are unable to get pregnant after one year of trying (infertility). Also, about 1 in 4 (26%) women in this group have difficulty getting pregnant or carrying a pregnancy to term (impaired fecundity).” And globally, that number is 1 in 6. 

My first miscarriage came three years into waiting, two years into treatment, and three rounds into IVF. And despite what we knew rationally, statistically, and how long we’d waited, I was completely shocked. It never occurred to me that after all I’d been through, I could also have a loss. I felt that I’d put in my time and deserved the win, and therefore was sure I wouldn’t be a part of the one in four who also lost a pregnancy. I was wrong.

I also was clueless when it came to what the miscarriage experience was. I thought that you feel a cramp, you gush blood, you go to a doctor, there’s a painless procedure, and it’s over. WRONG. Like on all counts - wrong. 

I didn’t take into account the longer-term emotional toll or the way a miscarriage would change my relationships. I didn’t think about it alongside infertility - wondering if, when, it would ever happen for me. That was the scariest part. 

Pregnancy loss was the hardest obstacle in my marriage, by far. And in some ways that didn’t surprise me. We don’t flirt, date, court, and ask each other hypothetically how we’d handle the shared loss of a life we created together….maybe we should. 

I was surprised by the friendships I lost. I was deeply disappointed with the way some people showed up for me, but miscarriage - and infertility moreso - was a line-in-the-sand moment for me in many relationships. And you know what? That’s ok. My husband taught me the cliche: “a reason, a season, or a lifetime.” I have since heard it a million times, but never had until we went through our losses. Friends who I thought were a ‘lifetime’ friend turned out to be a ‘season,’ or a ‘reason’ friend. When I was able to view the relationships through that lens, it helped clarify a lot for me.

I learned from my own losses that I wasn’t a great friend to others when they went through it either. I didn’t have the right words in their time of need, and I said all of the wrong things, or worse, nothing at all., But I only realized it when I went through it myself and felt so alone. It was important for me to acknowledge this with several close friends. I went back and apologized, told them that I wish we talked about it more as a society so I’d have known what to say and been a better support to them.

And to that end, I believe in talking extensively about what to say, and what not to say.

To make it simple, the single most important ground rule is less talking, more listening. 

Please don’t say:

1. Nothing.

Think of it this way: If I were grieving a different kind of loss (death of a loved one, for example), I’m sure you’d bring it up. Living with infertility is a daily dose of loss and grief, and you can be there for me by simply letting me know we can talk about it together.

What IS great to say:

Last time we spoke you had a loss and were going through IVF. I realize you may not want to talk about it at all right now, but if you do I am here to listen.

2. “At least you know you can get pregnant.”

After four IUI treatments (intrauterine insemination) and three IVFs (in vitro fertilization), we finally got pregnant – only to eventually miscarry. A lot of people thought they were comforting me by saying such a statement. Of course, there is no guarantee that getting pregnant once, or even more than once, means you’ll carry a healthy baby to term in the future, EVER. 

What IS great to say:

I’m so sorry. I can’t even imagine what you’re feeling. If you want to try to explain it to me, I am here – I see you. And if you don’t and you want to go eat ice cream and drink a bottle of wine, I’m here for that too.

3. “OMG my cousin’s best friend had like five IVFs and they now have two perfect kids!”

I think that people assume this offers me hope, but, the truth is, I don’t care, because when I’m going through my own treatment and pain, no one else’s story matters. 

What IS great to say:

Last time we spoke you had a loss and were going through IVF. I realize you may not want to talk about it at all right now, but if you do, I am here to listen. (Are you seeing a pattern here?)

4. “Keep me posted.”

Instead of saying “keep me posted” or “let me know if you need anything,” just send me a text saying “thinking of you.” This stuff means the world.

What IS great to say:

Last time we spoke you had a loss and were going through IVF. I realize you may not want to talk about it at all right now, but if you do I am here to listen.

5. “Just relax.”

People undergoing infertility treatment or mourning the loss of a pregnancy are not going to relax, and they’re definitely not going to do so because you told them to.

What IS great to say:

Just listen. That’s enough. Truly.

More than anything, your efforts to go the extra mile to understand further this chapter in your loved ones' lives are rare and deeply meaningful. True empathy and compassion are the greatest gifts you can offer.

My first due date ever from my initial miscarriage was December 1st. And I do think about it every year on that date. I did get to my happy ending after more loss, and an ectopic pregnancy. I eventually welcomed twins and to this day I marvel at them in disbelief that they finally made it earthside. I am acutely aware of how lucky I am - and I know it doesn’t happen that way for everyone.