October. The air grows chill, and the leaves begin to fall. Pink ribbons decorate the stores reminding us that it is Breast Cancer Awareness month. Much less known is the fact that October is also Pregnancy and Infant Loss Awareness month. Statistics say that among women who know they are pregnant, 8-20 percent will lose their child to miscarriage by the 12th week. That’s as high as 1 in 5 pregnancies ending in loss. There are countless women who bury the grief of miscarriage in their hearts, rarely if ever speaking about it.

Having gone through several miscarriages in a row since the birth of my youngest, I know a little about the shroud of silence surrounding pregnancy loss. Sometimes I have been silent because I wasn’t ready for my children to know about them, just yet. (Kids have an uncanny way of blurting out information at the most inopportune moments.) Sometimes I was silent because I was afraid of losing my composure. And sometimes I have been silent because what people say about miscarriage can more hurtful than helpful.

What are the words that hurt and the words that heal? What should you say and not say to a friend who just miscarried?

Don’t say: It’s nature’s way of cleaning, or, The baby probably had a genetic disease so it’s better you miscarried. No one wants to hear that their baby died because of a genetic defect, even if it is true. Yes, the sad trend nowadays is to abort babies who have been diagnosed with Down syndrome or other genetic abnormalities. But there are those of us who would have lovingly carried our babies to full term and cared for them irregardless of the test results.

Instead, acknowledge the preciousness of the lost one. Your friend may have very little to remember her baby by, maybe not even an ultrasound picture. So, a small keepsake such as a prayer card or journal is far more helpful than undermining the value of the baby lost to miscarriage.

Don’t say: At least it was early. True, an early miscarriage resembling a hellish period is probably not as heart wrenching as losing a child at birth or during infancy. Nonetheless, an unborn child of six weeks is no less human than a child at birth. Your friend is not grieving over a blob of tissue, but over a beloved child and whom he/she could have been.

In all honesty, with my really early miscarriages I have told myself those very words. At least it was early. At least, this time, I did not have to endure all the discomforts of the first trimester, all the while wondering in agonizing suspense whether this baby would live or die, only to suffer the pangs of labor and the loss of death. But, even though I’ve thought this, they’re hard words to hear from anyone else. Phrases that begin with at least seem to undermine the value of the baby’s life and our need to grieve.

So don’t say: At least you have another child/other children. Of course, children who are living are a great consolation and blessing. But having other children does not diminish her need to grieve the one she’s lost. Each child is a pearl of great price; each child lost is a shaft to the heart.

Instead, acknowledge the depth of her suffering and her right to grieve. If you’ve had a miscarriage before, the simple words, “I know how it is,” can be so consoling. The silence surrounding miscarriage can make your friend feel isolated, so knowing that others understand her sorrow takes away a little of the loneliness. If you’ve never been through a miscarriage, words like, “I can’t even imagine how hard this is for you. I am really so sorry,” tells your friend you genuinely want to be sympathetic.

Remember that during a miscarriage, the fluctuating hormones alone often cause strong feelings of depression and emotional fragility. Even if the miscarriage started a day after the pregnancy test, your friend might really be hurting.

Don’t say: You can always have another baby. After the first miscarriage, those words might offer consolation. After repeated miscarriages, they sound cheap. In either case, you don’t really know. Leave those words for the doctor to say.

Instead, gently help her to see beyond her sorrow. After my third miscarriage, I had to face the hard fact that I probably wouldn’t have any more kids. I felt as if I were closing the door to a chapter in my life which I had loved and relished. My sister reminded me that every stage in a child’s life is wonderful and that there were still so many things to look forward to in the lives of my other children: birthdays, sports, reading books together, game nights, family dinners, summer vacations… the list is endless. I was so grateful for that conversation with her.

Whether your friend has no other children or whether she has ten, there are always plenty of things to look forward to and be grateful for.

Mary Cooney is a home-schooling mother of five who lives in Maryland. This is an excerpt from a longer article that can be found on her blog, Mercy For Marthas.

Mary Cooney is a home-schooling mother of six who lives in Maryland. She blogs at Mercy For Marthas