*sigh*

[rivka]

Someone just came onto a message board I read, seeking guidance for a friend. Her friend, who is in her early 40s, just had a miscarriage when she was four weeks (i.e., just barely) pregnant and wants to try again. The poster is looking for a list of recommendations she can give her friend about ways to change her diet and do healthier things so she can prevent future miscarriages.

Here's my Public Service Announcement:

Don't ever do this.

No matter how well-meaning you are - and this woman seems to be very well-meaning - there is no loving way to say, "I figure that you probably killed your last baby. Please straighten up so you don't kill the next one, too."

Especially when you are probably wrong. The vast majority of miscarriages, especially early ones, are caused by profound chromosomal or genetic abnormalities in the embryo. That's even more likely for miscarriages in women over 40. Unless your friend is a crack addict, or something, the odds are overwhelmingly high that she didn't do anything to cause her miscarriage and won't be able to do anything to prevent another. Conception and embryo formation are high-error activities.

I know this woman doesn't mean to imply that the previous miscarriage was her friend's fault. But she's skating reeeeeal close to that, and vulnerable grieving people are awfully susceptible to guilt. It's just... yikes. Just don't.

Comments

[wcg.livejournal.com]

Yeah. What is it that's paved with good intentions?

[kalmn.livejournal.com]

aaagh! she what?

i had not processed through all the implications of offering that sort of advice, but you're right, that is what it's implying. ugh.

i am usually comfortable offering some combination of a stiff drink, a dinner, and an ear to listen, depending on how close geographically and physically we are. and then i say "oh honey, that's awful. i'm so sorry." a lot.

it is not the perfect response that makes everything better that i wish i had, but it's what i've come up with.

[redbird]

Oh, dear. Even if someone were to come along and say that she had miscarried herself and wanted health advice, it would be important to tell her what you've said here.

[fiction-theory.livejournal.com]

Wow, just wow. Insensitivity much? Even without the guilt-factor, since when is it your friend's place to give you medical/dietary advice unsolicited? Especially about something like this.

I'm one of the childfree type folks, and I even *I* went "Oh for cryin' out loud!" when I read this. I may never plan on having children, but I know that for those who are, this kind of thing is just absolutely devastating and heartbreaking. And even I know better than to say something like that.

Whenever I have friends who have something traumatic happen to them, I tend to follow a four step procedure because otherwise I know I'll do/say something bubble-headed.

Step 1: Listen to what your friend/loved one has to say, sans platitudes, opinions, or stupid questions. Questions should be limited to: "What happened (if you feel like talking about it) and Is there anything I can do for you?". Dole out plenty of hugs where appropriate and needed. Don't try to be a hero, just be a friend.

Step 2: Be willing to stay if they need that, be willing to go away if they need that. Make sure they understand that you don't resent doing either. And don't expect them to be over it in a certain time frame or pull away when they seem to go back to "acting normal". Just because someone isn't crying and screaming doesn't mean they're not grieving. Don't assume that they don't need you anymore just because they're not wailing uncontrollably.

Step 3: If you feel like making any comments that aren't: "I love you, I'll be here for you when you need me, is there anything I can do?", refrain. Such jems as "it's not as bad as (insert other bad thing)" or "there's a reason for everything" or "this, too, shall pass" or "maybe it's a blessing in disguise" should never ever be said. EVER. This is not the time to play "Confucius says". If words could fix what they're going through, then someone would've already said the magic damn words and gotten it over with.

Step 4: And finally, acknowledge that you are about as powerless as they are in this, use your common sense, and come to terms with the fact that all you can do is love them, support them, and try not to do anything to make it worse.

[roadnotes.livejournal.com]

I think I do this most of the time, but this is an excellently -laid-out and explicit explanation.

[fiction-theory.livejournal.com]

Thanks. Trust me, I've made enough mistakes in this area to have learned from them.

[wild-irises.livejournal.com]

Like roadnotes, I think this is an awesome list, and very applicable to my current state as listener.

The one thing I would add is that if you do resent staying or going away, admit that resentment to yourself but not to them and talk to other people about it so that it doesn't leak through to them.

[fiction-theory.livejournal.com]

The one thing I would add is that if you do resent staying or going away, admit that resentment to yourself but not to them and talk to other people about it so that it doesn't leak through to them.

So very correct. And like I said, use common sense. You're going to have your own feelings on the matter, but like you said, go vent those feelings in the opposite direction.

[rivka.livejournal.com]

Yes.

And really? There's no need to come up with something original and insightful to say. It's usually better not to. "Oh, how awful, I'm so sorry" does not wear out.

[fiction-theory.livejournal.com]

Exactly!

[micheinnz.livejournal.com]

You are very wise.

[tendyl.livejournal.com]

That is a great, well laid out explanation for anyone whose friends/family are grieving. Having been the grieving person, I wish I'd had this to hand to a few people.

[wild-irises.livejournal.com]

Awful, yes.

Also part of the basic American psyche/value system, which has a lot of the "bad things that happen to you are because you weren't perfect" mentality in it. This kind of behavior is on a par with how we use "good attitudes help cure cancer" (which may be true, but is still used as a club to beat people who are scared and/or angry), the Kubler-Ross phases of dying ("Why haven't you gotten to acceptance yet?") and much more.

Thanks for calling it out; discussing these things matters.

[rivka.livejournal.com]

Yes. Psychologists call it the "just world" hypothesis. A lot of people are unconsciously driven by it, probably as a protective thing. If bad things happen because of something the victim did, then I don't need to worry that bad things will happen to me.

From other things this woman said in her post, it looks as though she's trying to conceive. So she probably has a lot invested in the idea that miscarriages are preventable.

[wild-irises.livejournal.com]

Exactly! Thanks for giving me a name for it.

Privately, I call it the "Linda McCartney phenomenon" because of the level of "she did everything right!" outrage when she died of breast cancer.

[jonquil.livejournal.com]

YES. Americans are particularly bad about this. Britons will say "Oh, bad luck" when an American is trying to say "You could have prevented this." Note that when an obituary says "She died of lung cancer", they are always careful to say "even though she was a lifelong non-smoker", if it's true. "LUNG CANCER WAS NOT MY FAULT. REALLY." Ditto heart attacks and exercise.

[hobbitbabe.livejournal.com]

I can't count the number of times we had the conversation of "My father had another heart attack." "Why? Did he start smoking again / did your mother drag him around to too many meetings?/ Did he go off that diet?"

And when my sister-in-law was dying far too young of lung cancer, people who didn't even know her wanted to know about her risk factors before they even said it was awful.

[mjlayman.livejournal.com]

People in our church kept telling Mother that she got cancer because she didn't have enough faith in god. So I was prepared when I got sick, and got similar. Fortunately, I don't believe in gods, but it's still pretty annoying to be told you made yourself sick when you didn't.

[roadnotes.livejournal.com]

That's... awesomely thoughtless.

And from another angle, how does she think her friend is going to take it? "Oh, you got all this information for me NOW, and let me suffer the first time? Thank you so much!"

I'm incoherent, perhaps because I can't even verbalize how perturbed this makes me.

[kightp.livejournal.com]

Good lord. If ever there were a time to shut up and *not* offer advice, surely this is it?

(Don't get me started about people who profess to think they/we can prevent all evils by eating the right stuff/not eating the wrong stuff. I'm related to one of those, and it's all I can do to sit down to a meal with him...)

[jonquil.livejournal.com]

There is a time for advice and a time for sympathy.

Great tragedies are not a time for advice. Chronic illness is not a time for advice. Trust me, your friend has ALREADY CONSIDERED acupuncture, herbalists, homeopathy, ... It's irritating to have somebody tell you about Googlable wisdom; it's as if you can't Google for yourself.

But no, do not tell her what to do to avoid a miscarriage.

[ricevermicelli.livejournal.com]

I looked at the thread. It gets worse.

I agree that everyone on it is well-meaning, but uh, yeah, bad direction.

[rivka.livejournal.com]

What on earth do you mean? What could possibly be offensive or crazy-making about the suggestion that working full-time can cause miscarriage?

...Yeah. That was when I decided that I needed to leave the thread or there was going to be blood on the screen.

[kcobweb.livejournal.com]

I can't read those boards at all, because pretty much every single thread makes me want to hurt people in bad bad ways.

But I thought everyone knew that women are delicate flowers, and if you read or work too much, then the blood will be redirected away from your reproductive organs. Lo, the wandering womb!!

[hobbitbabe.livejournal.com]

Read too much? Gosh, think of all the time and money I've wasted on birth control over the years!

[lerryn.livejournal.com]

That does sound bad. When people are that thoughtless, maybe there needs to be blood onthe screen.

[ricevermicelli.livejournal.com]

Perhaps, but the blood shouldn't be *mine*. And I lack access to more appropriate targets.

[ailbhe]

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Wow.