After a Loss, She Won’t Remember Your Words. She’ll Remember Your Presence.
What to say — and what not to say — when someone loses a pregnancy
It was New Year’s Eve. The phone rang. A woman in her 35th week, a patient of a colleague for whom I covered that night — she hadn’t felt her baby move.
I told her to come in.
When she arrived, I placed the ultrasound probe on her belly and saw what I was afraid I would see. No heartbeat. Her baby had died.
I put the probe down. I looked at her. And I told her what she already feared — her baby’s heart had stopped. There was no heartbeat.
Then I said: “I am so sorry this happened.”
That was over twenty years ago. I don’t remember what she was wearing. I don’t remember the exact time. But I remember her face. I remember the silence in that room. And I remember that in that moment, there was nothing to fix, nothing to explain — only a woman who needed someone to be present with her in the worst moment of her life.
I have thought about that night many times since.
And what I’ve come to understand is something Maya Angelou said better than anyone: people forget what you said, people forget what you did, but they never forget how you made them feel.
In obstetrics, that truth is carved into every loss I’ve witnessed.
What people say (and why it hurts)
“Everything happens for a reason.”
“At least it was early.”
“You can always try again.”
“It wasn’t really a baby yet.”
“It was meant to happen.”
“At least you know you can get pregnant.”
Every one of these sentences is meant to comfort. Every one of them lands like a door being closed. What the grieving person hears is: Your pain is not that serious. Move on.
Here’s what I’ve learned after decades in obstetrics: there is no ranking system for grief. A loss at six weeks can shatter someone just as completely as a loss at twenty-six weeks. The depth of grief doesn’t scale with gestational age. It scales with love. And love starts whenever it starts.
When we minimize that — even with the best intentions — we tell someone that what they’re feeling is wrong. That’s a wound on top of a wound.
What silence can do
Sometimes the most powerful thing you can say is nothing.
Not an awkward, avoidant nothing. Not the kind of silence that comes from pretending it didn’t happen. I mean the kind of silence that says: I’m here. I see you. I’m not going anywhere.
Sit with them. Let the room be quiet. Let them cry or not cry. Let them talk or not talk. Your presence is the message.
This is incredibly hard for doctors. We are trained to fix. We are trained to have answers. When someone is hemorrhaging, we act. When someone is grieving, the instinct is the same — do something, say something, make it better.
But grief is not a hemorrhage. You cannot stop it with pressure. You can only be there while it flows.
What actually helps
If you need words — and sometimes you do — here are a few that tend to land gently:
“I’m so sorry.” Simple. Honest. It doesn’t try to explain or fix.
“This is not your fault.” Many people who lose a pregnancy blame themselves. They wonder if they exercised too much, ate the wrong thing, didn’t rest enough. They carry guilt that has no basis in reality. Hearing a doctor say clearly that this was not their fault can be one of the most important things they ever hear.
“I’m here for whatever you need.” And then follow through.
“Would you like to see the baby?” For later losses, this question — asked gently, without pressure in either direction — gives back a measure of control in a moment where everything feels out of control. Some families find deep comfort in holding their baby. Others don’t. Both are okay.
“Can I call someone for you?” Practical help. A partner, a parent, a friend. Sometimes the person in the room can’t think clearly enough to make a phone call.
Use the baby’s name, if they’ve chosen one. This is a small thing that carries enormous weight. It says: Your baby was real. Your baby mattered.
A word to clinicians
We set the tone.
When a patient loses a pregnancy, they are watching us. They are reading our faces, our body language, the speed of our words. They are storing every detail in a kind of emotional amber that will preserve this moment for the rest of their lives.
I have had patients come back to me years later and quote, word for word, something I said after their loss. Not the medical explanation. Not the plan for follow-up. The human part. The sentence that made them feel seen — or the sentence that made them feel dismissed.
This means we carry a responsibility that goes beyond the clinical. When we walk into that room, we are not just delivering information. We are shaping a memory that this person will carry forever.
We don’t need perfect words. We need to be fully present. To slow down. To let go of the reflex to reassure, and instead just be there with someone in their pain.
The takeaway
Pregnancy loss is one of the most common and most isolating experiences in medicine. Roughly one in four known pregnancies ends in loss. That’s millions of people every year walking through grief that our culture still struggles to talk about.
You don’t need a script. You don’t need to fix it. You need to show up with honesty and stay.
“I’m sorry” is almost always enough to start.
And if you’re not sure what to say? Say that. “I don’t know the right words, but I want you to know I care.” That sentence, said with sincerity, does more than any platitude ever could.
Because in the end, they won’t remember the exact words. They’ll remember that you stayed. They’ll remember that you didn’t look away. They’ll remember that in the worst moment of their life, someone made them feel like they weren’t alone.