In the four years between my older brother's birth and my own, our mother had two miscarriages. In those four years, she carried, loved and grieved the loss of our would-be siblings. She was eight weeks pregnant when she miscarried the first time. The second time, she was nearly 18 weeks along. She told me about it just once. What she most clearly recalled was not the doctor, or the hospital, but how completely alone she felt when it was over. No one ever said anything about grief — that it would come, that she should let it, or that it was normal. With each heartbreaking loss, she tucked her feelings away and went back to work, back to supporting my dad in grad school, back to raising a toddler.

Miscarriage is not uncommon. March of Dimes reports that about 10 to 20 percent of known pregnancies end this way. In the public arena, miscarriage has historically and primarily been discussed as a public health issue. In "The History of Talking About Miscarriage," a 2018 article from the Cut, author Daniela Blei cites numerous examples of the link between public health and higher rates of miscarriage.

Though the American Pregnancy Association lists depression, difficulty concentrating, and frequent crying among the things commonly experienced by women after a miscarriage, it's only in the last couple of decades that we've begun to openly acknowledge miscarriage not just as a matter of public health, but also as a personal tragedy. It's not surprising, then, that we're often unsure how to best support our friends in this situation.

An article from the website the Conversation entitled, "The Dos and Don'ts of Supporting Women After a Miscarriage," recommends that you don't offer your friend unsolicited advice or belittle the situation. Do listen. Do offer practical support like bringing a meal. And definitely do acknowledge the loss because, "while you may worry you will say the wrong thing and upset them further, saying nothing at all is worse." Just be clear and keep it simple. "I'm sorry about your miscarriage" is enough to let your friend know you care.

Grief can be overwhelming. For some, it may help to attend a support group. The University of Vermont Medical Center keeps an updated list of support groups across Vermont. Offer to drive your friend, or watch her kids while she attends. Support is also available online through organizations such as Through the Heart, a nonprofit focused on pregnancy loss support and education.

There's no perfect road map for supporting a friend navigating this raw and painful road. What's important is that we put aside our own discomfort and, to the best of our ability, be available — to cook a meal, to provide a ride or childcare, and, most importantly, to listen.

In this monthly column, comedian, writer and mom Autumn Spencer answers tricky parenting questions. Have a question for Autumn? Send it to [email protected].