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In a remarkably candid essay published Wednesday, Meghan, Duchess of Sussex, revealed that she experienced a miscarriage in July.

Writing in the New York Times, the duchess described an otherwise normal summer morning — until she felt a “sharp cramp.”

“I dropped to the floor with [18-month old Archie] in my arms, humming a lullaby to keep us both calm, the cheerful tune a stark contrast to my sense that something was not right,” the 39-year-old wrote. “I knew, as I clutched my firstborn child, that I was losing my second.”

It was previously unknown to the public that Meghan and her husband, Prince Harry, had been expecting a second child.

In the essay, Meghan broaches a subject that, despite its frequency, still remains taboo: miscarriage. She said that in opening up about her experience, she hopes to change that dynamic.

Ten to 20 percent of known pregnancies end in miscarriage, according to the Mayo Clinic.

“Losing a child means carrying an almost unbearable grief, experienced by many but talked about by few,” she wrote. “Yet despite the staggering commonality of this pain, the conversation remains taboo, riddled with (unwarranted) shame, and perpetuating a cycle of solitary mourning.”

“Some have bravely shared their stories; they have opened the door, knowing that when one person speaks truth, it gives license for all of us to do the same. We have learned that when people ask how any of us are doing, and when they really listen to the answer, with an open heart and mind, the load of grief often becomes lighter — for all of us. In being invited to share our pain, together we take the first steps toward healing,” Meghan continued.

And yet, so many people still feel unsure of what to say when listening to people share accounts of pregnancy loss. What — as friends, family members, partners, colleagues, strangers — do we say to the many people who have experienced this?

Meghan suggested asking “Are you OK?” as a starting point, to check in with anyone during this time of collective loss, grief and “siloed living.”

Lisa Gray, a licensed marriage and family therapist in Livermore, Calif., has also experienced a miscarriage, as have many of her clients.

“I think it is one of the most difficult grieving processes there is because there is no formal way to grieve, and no one talks about it. But it is a death and loss just like anything else,” she said.

She suggests asking, “Do you want to tell me what happened?” Or simply, “What do you need?”

The latter is particularly freeing, she said.

“The grieving person knows what they need and there is no harm in asking ‘How can I be there for you?’ because everyone is an individual,” Gray said. “Women might want to be distracted by something else, and some women might really want to just talk about the story until they don’t need to talk about it anymore.”

Even right now, there are ways to connect, Gray said. “The decision to call it social distancing rather than physical distancing has done harm — even if you get the distinction, it’s hard to get past the message. In cases like miscarriage, you can’t get a hug, you can’t have any kind of memorial. I think we underestimate how much something like just coffee with a friend can boost mental health.”

The key is really focusing on what each person needs, added Andrea Syrtash, a dating and relationship expert who also hosts the podcast, “Pregnantish.”

“The best thing to say when someone shares that she had a miscarriage is ‘I’m sorry.’ You can add, ‘I’m here for you, this must be so hard,’” Syrtash said.

She warns against sharing advice, your own personal experience or dismissing the experience by saying something like, “At least you got pregnant.”

Sarah Slack, who founded the Tears Foundation, recommends giving grieving women “permission to not be okay right now.”

Something helpful to say would be, “I’m thinking about you and your baby. I’m here for you,” and ask about what could be useful, be it in the form of errands, meals or simply listening.

“Don’t be afraid to ask about our baby or our experience of loss,” Slack said, since women are already aware of that loss. “Listen without judgment. And most importantly, give us permission to take all the time we need to mourn our loss.”

Meghan also notes that during this time of collective grief, we have lost touch with checking in on each other and connecting with other humans.

“So this Thanksgiving, as we plan for a holiday unlike any before — many of us separated from our loved ones, alone, sick, scared, divided and perhaps struggling to find something, anything, to be grateful for — let us commit to asking others, ‘Are you OK?’” she wrote. “As much as we may disagree, as physically distanced as we may be, the truth is that we are more connected than ever because of all we have individually and collectively endured this year.”

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