Two weeks after losing her baby during pregnancy, Jami Crist sat down in her first therapy session. The therapist asked her questions no one else had: “Was it a boy or a girl? What was her name?”

When she was about 14 weeks pregnant, Crist and her husband learned their daughter had a serious condition and they would need to terminate for medical reasons. It would be the first of four pregnancy losses they'd endure in two years. In the days and weeks that followed, the casseroles came. So did the automated registry emails, cheerfully tracking a pregnancy that no longer existed: You're 18 weeks along, here's what to expect! Friends and family said things like “everything happens for a reason” and “at least you know you can get pregnant.” No one used her daughter’s name. No one, until that therapist, treated what had happened as an actual loss instead of a medical event.

Pregnancy loss—including miscarriage, stillbirth, and termination for medical reasons—is common, which means someone in your group chat, office, or family has likely experienced it. Someday, you may be the person trying to figure out what to say. Here's what experts, and women who have endured it, want you to know.

Why these conversations are so hard

Part of what makes pregnancy loss so hard to talk about is that it doesn’t fit neatly into the categories we already have for grief. “It’s a form of quiet trauma,” says Amelia Kelley, a trauma-informed therapist in Cary, N.C., who has had three miscarriages. With most losses, there’s a finality that points us toward a script—we know we’re supposed to pay our respects, send flowers, write condolence cards, show up at the funeral. Miscarriage is different. “It’s often happening within the ebb and flow of potentiality still,” Kelley says. Because the future is theoretically open, the people around the griever instinctively grab for it as the fix: Try again. You’ll have another.

Even people trained to handle grief can get blindsided. Jessica Zucker, a psychologist who specializes in reproductive and maternal mental health—and who miscarried alone at home 16 weeks into her second pregnancy, an experience that turned years of theoretical training “corporeal,” as she puts it—launched the #IHadAMiscarriage campaign in 2014 to push back against societal silence surrounding pregnancy loss. She frames what most loved ones get wrong as a “cultural hiccup,” not a personal failing.

“People are just saying whatever they think they should say to make things less uncomfortable,” she says. The trouble is, much of the language they turn to is meant to ease their own discomfort—not the griever’s. “The person who loves you doesn’t want to feel that pain either,” says Zucker, author of I Had a Miscarriage and Normalize It. So they reach for silver linings and “toxic positivity,” trying to “grab the griever and fling them into a state of sort of happiness or gratitude for what they do have, rather than allowing them to sit in the sh-t and really be with the impact of what’s just happened.”

What people often don’t realize is that the griever is already locked in a loop of self-blame. Research suggests that the majority of miscarriages are chromosomal and outside a person’s control, Zucker says, but many women still feel guilt and shame in the aftermath—running through their own private list of if onlys. “If I hadn’t had a sip of wine, if I hadn’t had sex, if I didn’t want this so badly,” Zucker says. Phrases like “maybe it wasn’t the right time” or “maybe your body wasn’t ready” only exacerbate those thoughts. 

The other thing most people miss is the sheer scale of what’s actually being grieved. It isn’t only the pregnancy. It’s the daycare spot you waited months for, the nursery half-imagined. A close friend of Crist’s, after three years of secondary infertility and multiple losses, finally had to let go of the nanny she’d kept on payroll in the hope of a second child. “It’s all the planning, it’s all the thinking around it, your life together,” Crist says. “Kids change your life—so when you plan for all these things, and then it doesn’t happen, all of that changes.”

What not to say 

The reflex that comes out fastest when someone loses a pregnancy is also one of the most painful: “Just try again.” It assumes a readiness—clinical, financial, emotional—that you almost certainly don’t have visibility into. “We don’t know; they might be done trying,” Kelley says. “Maybe they’re doing IVF and don’t have any eggs left. Maybe they need time.” Some losses also require a waiting period for medical reasons: After a molar pregnancy, for instance, doctors may recommend waiting at least six months before trying to conceive again.

Any sentence that starts with “at least” should be reconsidered before it’s uttered, Zucker says—at least you weren’t far along, at least you can get pregnant, at least you already have a healthy kid. They’re attempts to point the griever toward a silver lining, and they all minimize what just happened. Crist, who practices a healthy lifestyle, found “at least you can get pregnant” especially infuriating. “I can get pregnant, but I cannot have a healthy pregnancy,” she says. “Do you understand the connection here?” 

Kelley calls “at least you already have another child” one of the most devaluing things a person can say. “It doesn’t give the respect to the life that was,” she says. “It’s almost like saying to a person, if they lose their mother, ‘Well, at least you have another parent left.’” The same logic applies to people experiencing secondary infertility: the loss of a hoped-for second or third child. Crist watched a close friend go through five rounds of IVF and three miscarriages while trying for a second baby. Her friend’s father told her: You have a perfect son. Why are you doing this to yourself?

Others try to make sense of the loss for the griever. But meaning-making, Kelley says, is deeply personal and usually unfolds slowly—it isn't something a friend or relative can hand to a griever on day three. Zucker adds a specific warning about religious framings: Invoking God or a higher purpose with someone whose beliefs you don’t actually know can throw up a wall. “If you don’t believe everything happens for a reason, but you just had a stillbirth and somebody’s telling you, ‘Oh, God has a plan’—it’s so alienating,” she says. 

Meredith Eades, who is Christian and was working at a church when she had her first miscarriage in 2007, remembers being told: “God needed your baby more than you”—a comment that stung, rang false, and stayed with her.

People also often jump prematurely into problem-solving mode. Avoid brainstorming someone’s family-building plans unless they’ve invited you to, Zucker says. Have you considered adoption? What about surrogacy? Have you looked into IVF? All of those paths carry their own emotional, financial, and physical weight that the person you love is almost certainly already thinking about—or deliberately not thinking about, because they just lost a pregnancy.

Even well-intentioned encouragement can overlook how personal and layered pregnancy-loss grief can be. One common misstep: comparing the griever's loss to someone else's eventual happy ending. Zucker cautions against anecdotes like, “I know someone who had five miscarriages and now has three kids.” “We don’t need to talk about other people’s happy endings when this person isn’t currently in their own,” she says.

What to actually say—and do

Zucker’s favorite move, and the one that takes the most pressure off the speaker, is to name the awkwardness out loud: “I don’t know exactly what to say to you, because I haven’t been through this—but I love you, and I’m here.” Even if you’re terrified of saying the wrong thing, don’t default to saying nothing at all. “That’s incredibly cruel,” she says. “It feels better to be acknowledged for what you’ve been through than to have it be ignored.”

What helped Crist most after her losses, she says, were the friends who said the least clever thing: “I’m so sorry for your loss.” “As humans, we try to fix everything,” she says. The people who didn’t try—who just said the obvious “sorry” and then kept showing up—were the ones who got it right.

It can be powerful to acknowledge the bereaved person as a parent, too. After one of Crist’s losses, a friend texted her: I want you to know that you are a mother. “That was everything,” she says.

When it comes to offering help, skip unspecific offers like “let me know what I can do.” “That’s just giving me a job to do,” Eades says. The people who actually helped her were the ones who made the decision themselves—dropping off dinner, sending a gift card, showing up to organize the house, or putting away the baby gifts that had already arrived.

Perhaps the most underrated thing you can do is keep reaching out. “Everybody’s continuing on with life like everything’s fine,” Crist says, “and here you are, still working through it.” Put the follow-ups on your calendar, she suggests: a check-in after one month, three months, six months. A text on what would have been the due date. One friend Venmoed her a coffee with a simple note: “I was thinking of you this morning.” Crist still remembers it. 

A simple “I know today isn’t an easy day, but I’m thinking of you and your family” on what would have been a first Mother’s Day or Father’s Day also goes a long way. “It’s just those little touches you can do,” Crist says.

Don’t forget the partner, either

Partners are often treated like supporting characters in someone else’s loss. “It’s their child too,” Kelley says. Yet many partners feel pressure to stay strong or focus entirely on supporting the person who was physically pregnant.

Reach out to them directly, Kelley advises. After one of her losses, a friend asked if she could check in on Kelley’s husband too. “I felt comforted by people checking in with my partner,” she says, “because it made me feel like I didn't have to fully carry all that for him.”

Crist had a similar experience with her husband, who poured himself into his business after each of their losses. Most of his friends—particularly his male ones—didn’t know what to say to him. The few girlfriends of hers who did reach out to check on him stood out.

That kind of support is what tends to outlast everything else. It’s been almost 20 years since Eades' first miscarriage. She has a 12-year-old son now, who arrived after a decade of trying. But she still remembers the people who showed up for her after her losses and acknowledged the grief. "They're the ones who were meaningful to me," she says.