How to Talk About Miscarriage, According to a Psychologist

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On an October afternoon in 2012, Jessica Zucker gave birth to a daughter while home alone in her bathroom. She was just 16 weeks pregnant; the baby did not survive.

If anyone’s equipped with the tools to handle such a horrific loss, it’s Dr. Zucker—a PhD-carrying psychologist who’s specialized in women’s reproductive and maternal mental health for over 10 years. But her story proves that no amount of experience and empathy can possibly prepare a woman for what it’s really like to suffer a miscarriage.

“All the books I had read, my half-a-decade of clinical training, my years prior working in public health: None of this knowledge could buffer the cataclysmic emotional toll my miscarriage took,” she says. “It was a stunted hello and a goodbye that continues still. I think about this trauma and the loss of my daughter almost daily.”

One of the things that did help Dr. Zucker was talking about her loss, although doing so wasn't easy. After all, Western society doesn't exactly embrace open discourse around death. “We live in a culture that struggles with addressing grief head-on, especially when it comes to out-of-order loss such as miscarriage,” says Dr. Zucker. “As a result, silence pervades.”

“We live in a culture that struggles with addressing grief head-on, especially when it comes to out-of-order loss such as miscarriage. As a result, silence pervades.”

Dr. Zucker also believes the medical community can contribute to this "don't ask, don't tell" attitude around miscarriage. Think about it: Doctors often advise women to keep quiet about pregnancy until they reach the second trimester, because the majority of miscarriages occur within the first 13 weeks. “That translates to, ‘Don't share your good news in case it becomes bad news, so that you don't have to share your bad news,’” says Dr. Zucker. “This age-old construct essentially sets us up for silence and isolation if things go awry. Though we would prefer bad news not exist, it does. And therefore, it's time to become conversant in talking about this difficult and often murky topic.”

"Miscarriage is not a disease," Dr. Zucker adds. "It's not something that can be cured. Therefore, the sooner we institute new ways of discussing these traumas, the sooner women will feel more connected and receive the support they deserve."

To bring the dialogue around pregnancy loss into the open, Dr. Zucker created the #IHadAMiscarriage campaign and Instagram account in 2014, giving women a safe space where they can share their experiences and find support. Through this platform, thousands have told stories of loss, fear, and redemption, offering comfort and encouragement to others walking the same path. “It’s become this hub of community and connection and that has blossomed into some real-time friendships,” Dr. Zucker says. And her passion project has helped her navigate her own grief, too. “Connecting with women around the world has affected my healing process exponentially,” she says.

That said, it’s obviously not easy to initiate a conversation about miscarriage, whether you’ve experienced it yourself or it’s happened to someone close to you. Here, Dr. Zucker shares the wisdom she’s gained through both clinical and personal experience, in hopes that it will help amplify the discussion around pregnancy loss and help more women move through their grief.

Here’s what a psychologist wants you to know when it comes to talking about miscarriage. 

How to talk about miscarriage
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How to support a friend through a miscarriage

If someone you know experiences a pregnancy loss, the worst thing you can do is say nothing at all, Dr. Zucker stresses. You don’t have to say anything profound—just start by showing concern for how she’s doing and telling her you’re there for her no matter how long her grieving process may be. (And repeat often.)

“It’s hard to talk about these things, but unfortunately, not talking about it doesn’t make it go away,” says the psychologist. “After my miscarriage, I wish people had been less afraid to be direct. I wish people had been more consistent in their care, that people would have followed up days, weeks, even months later. A lot of people say: ‘I don’t ask because maybe she’s not thinking about it right now and I don’t want to trigger her.’ But don’t worry. She’s always thinking about it, and it feels good to be asked.”

“After my miscarriage, I wish people had been less afraid to be direct. I wish people had been more consistent in their care, that people would have followed up days, weeks, even months later."

What if your friend says she wants her privacy? Reach out anyway. Dr. Zucker recommends sending food, a card, or even a loving text letting her know you’re available if she wants to talk. Just avoid empty platitudes. “These are more painful than they are helpful, and it's wise to shy away from comparing and contrasting losses, as this can potentially minimize people's experiences,” Dr. Zucker stresses. So nix all of the following phrases from your vocabulary: “At least you know you can get pregnant,” “At least you have another child,” “This is God’s plan,” or the spiritual set’s favorite: “Everything happens for a reason.”

And if you’re still not sure what to do, she says, think about what you would want to hear or receive in your darkest moments—because chances are, she needs those same things from you. “Be a friend who musters the courage to truly connect, rather than tiptoe around her mourning process,” says Dr. Zucker. “Your love can make an indelible, positive impact.”

How to talk about miscarriage
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How to talk about your own miscarriage

Talking about your own pregnancy loss may be difficult, but Dr. Zucker swears it's extremely powerful—it helps you realize you’re not alone and can mitigate some of the shame and guilt that commonly surrounds such an experience. “[Women often] blame themselves or feel like they may have done something to deserve this. Let's say someone had sex during pregnancy and went into pre-term labor—women do tend to look at their activity and think, ‘Maybe it was that,’” Dr. Zucker says. (Side note: Sex during pregnancy is totally fine, in most cases.) "In part, that's because we don’t really have any standardized rituals in our culture that acknowledge that this is a normative loss." Up to 20 percent of pregnancies end in miscarriage, she notes.

To prepare yourself to open up about your miscarriage, Dr. Zucker suggests taking time to reflect on and identify your feelings. Writing, meditation, movement, and being in nature can be especially useful tools for contemplation, she says.

Then, if you feel like you want to share, seek out a therapist, support group, or people in your tribe who you’re comfortable confiding in. “It could be your partner, friends, family; whoever you trust and believe will be able to provide comfort and understanding,” says Dr. Zucker. “There is no right or wrong way to discuss these things.” Just know that you’re in control of who you talk to and how—and you don’t even need to talk to anyone if it doesn’t feel aligned for you.

“Upon opening up about our nascent experiences of grief, we often find our tribe.”

Eventually, some women are empowered to share their miscarriage stories with their wider communities—something that Dr. Zucker says can be really healing. “I think it’s interesting to use social media in this way because there’s so much focus on striving for perfection with images on Instagram,” she says. “There’s something really powerful and real about showing other perspectives.” You can also share anonymously on platforms like I Had a Miscarriage.

Bottom line: When a woman talks about miscarriage, Dr. Zucker says, she's not just helping herself. She's also helping other women feel less alone. “It takes unabashed courage to walk the vulnerable line of publicly sharing the experience of pregnancy loss,” she proclaims. “Upon opening up about our nascent experiences of grief, we often find our tribe.” And if a grieving mother can help bring more women into the healing fold, all the better.

With reporting by Rachel Jacoby Zoldan

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