Q: My best friend and I are about the same age and we were both pregnant and expecting babies within a few months of each other. However, she had a miscarriage. Our friendship seems to be strained. I want to offer her support now more than ever, but just feel very uncomfortable. She has been hurt very much by people telling her that it was for the best, or that she can try again because she is young. What can I say, and how can I help her? I feel like I can't share the joy of my child with her, my best friend.

A: It sounds like you are having an experience similar to "survivor guilt", and yet you want to share this very special time of enjoying your first baby with your best friend. Miscarriage is common, affecting at least one in every five pregnancies, yet the topic is still social taboo. A grieving couple may find themselves up against a wall of silence from friends and family. We tend to shy away from the topic, make inappropriate remarks or ignore it completely because we don't know what to do or say.

Here are some helpful things you can do and say to your friend and her husband:

• Tell them you are sorry for what happened and show your genuine concern
• Tell her you have been uncomfortable about what you should or shouldn't say, and that you don't want your friendship to be lost because of what she is going through
• · Allow her to express her grief, be prepared for tears, anger and possible jealousy about your baby
• · Don't change the topic if she brings up the pregnancy. Encourage her to continue expressing herself, even if you don't think you will be comfortable or feel threatened
• · Don't set a time limit on her grieving
• Don't say anything that will devalue this pregnancy, like hollow assurances that she will get pregnant again

Encourage your friend and her husband to:

• Talk about it. Telling one's story helps the healing process
• Attend a support group. Many hospitals offer them and they can share their experience with others who know what they are going through
• Perform a ritual or set up a memorial. Name the baby, even if the loss was very early. Save keepsakes, such as sonogram photos, or light a special candle during significant holidays

I hope you and your friend can work through this difficult time for the both of you. Please let me know how you and she are doing soon. And thanks for your question.

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