Isolated, misunderstood, guilty, desperately lonely...

The myriad emotions that surge through a woman after the loss of a fetus can leave her feeling totally spent. Oftentimes, however, the tragedy of miscarriage is needlessly compounded by the usually well-meaning but all-too-frequently pain-rendering reaction of friends and family. Rather than the comfortable security blanket that she needs, the grieving mother is too often confronted with a wall of silence, insensitivity and ignorance. The result? The emotional pain of her grieving is sometimes compounded to the point of serious depression.

"Emotional intolerance of loved ones can be a greater trauma than the actual event of the miscarriage," according to Jan Ramsey, Ph.D, a clinical psychologist at Tawa Medical Center in Wellington, New Zealand. Yet, it doesn't have to be that way. By showing a little empathy, a little wisdom and a whole lot of love, friends and family can assist the grieving parents in working through their pain. Here are some suggestions:

Realize that although you never saw this baby, the grieving mother lived with it for weeks, maybe even months -- she may have felt the gentle, loving nudges of its first kick, knew instinctively when it was sleeping, felt every movement. Show insight by knowing not only what to say, but also what not to say. Here are some common phrases to steer clear of:

• You can always try again
• I know how you feel
• Maybe it was for the best
• Time will make it all right
• It's not like it was a real baby

Be available. Don't stay away because you feel uncomfortable. "I felt terribly isolated after I got home from the hospital. The support network that I was counting on just wasn't there," says Martha, who suffered a miscarriage in the fourth month of her pregnancy. The presence of a caring person can make all the difference.

Think of practical things you can do to help out. Run errands, help out with the care of children and provide assistance in other daily activities. Grieving is an extremely exhausting process. Don't make the mistake of saying, "If you need anything let me know." Rarely will a grieving person actually call and say, "I've thought of something you can do." As Shelly, who suffered two miscarriages in the space of two years, relates, "I was so confused that I didn't even know what I needed to do, let alone what I needed someone else to do for me." Be proactive. Take the initiative by not only offering specific assistance, but by showing up with two bags of groceries or a casserole for dinner.

Listen and provide reassurance. By being a sympathetic listener, you can share some of the grieving mother's pain. Don't, however, make her feel uncomfortable. Simply ask, "Would you care to talk about it?" Reassure her that whatever emotion she is feeling -- sadness, anger, guilt -- is normal and valid. "What I learned in a most painful way was that before this happened to me, I really had no idea of what my friends had to bear. I had been as insensitive and ignorant toward them as I now feel people are to me," says Moana, who felt stung by her friends' lack of recognition of her loss. Don't minimize the validity of the grieving process. All grieving people must work through certain essential steps: shock/denial, anger, guilt, depression and, ultimately, acceptance -- be a pillar of support as your friend passes through these stages.

Be hospitable to the grieving parents. Rather than offering a "come over anytime" invitation, set a specific date and time. If they refuse, you may discern that a little gentle encouragement is in order. According to Dr. Ramsey, "They may decline an invitation because they are afraid of losing control of their emotions in front of others. Or they may feel guilty about enjoying a meal and fellowship at such a time."

Consider writing a card or letter. "One friend wrote me a lovely note. I really appreciated it because I could read it over and over," says Shelley, a mother who suffered two miscarriages. Don't feel that you need to be extravagantly clever with your words. A simple, loving message of support from your heart to theirs can be a wonderful gift.

A situation that friends should be aware of is the grieving mother who complains bitterly to a friend about her partner's apparent insensitivity to the loss of their unborn child. Martha recalls her husband's seemingly uncaring attitude: "I was totally disappointed in my husband at the time. As far as he was concerned, there really was no pregnancy. He couldn't experience the grief I was going through." As a caring confidant, you may find yourself in a rather uncomfortable position if your friend starts revealing such feelings to you. So, rather than discussing the specific perceived failings of her partner, let her know that the reactions for a father are necessarily going to be different than those of the mother. They are, however, no less valid. He, too, has suffered a loss. Hiding it may be his way of dealing with it. Whatever you do, don't encourage her in her negative attitude towards her partner. Rather, suggest that she talk through her fears with him.

The wounds caused by miscarriage are deep and lasting. By being a friend in time of distress, however, you can provide a vital ingredient in the healing process. So, rather than shying away from a couple who are grieving over the spontaneous abortion of their child, view the situation as an opportunity to let your loving concern for them blossom.

About the Author: Steve Theunissen is a freelance writer based in Wellington, New Zealand. He is married and has a 12-year-old daughter whom he currently home schools.