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People tend to express care in the ways that they would like to receive it.
Do you notice your friend giving gifts to other people? Maybe instead, she does small acts of kindness, or maybe she compliments people freely? Sometimes it's as simple as quality time.
When someone is going through a tough time, they might feel very alone. Offering to listen without trying to solve the problem (trust me, they've already thought of all the options) is such a generous act.
I kinda rambled.. hopefully that makes sense and good luck. You're a good friend.
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When it was my birthday she bought me a slice of cake which was nice though and gave me a little note.
Sounds like a small gift + a card/note might be a good idea then.
I would suggest something simple like a coffee card, but if you want to be mindful of caffeine intake for pregnant women then maybe an alternative like a box of caffeine-free tea that's soothing and calming? Or perhaps aromatherapy in the same vein if she's not allergic to scents?
Moms with small children are stressful enough on a good day let alone going through rough times, something soothing can hopefully make her day more endurable.
Plus a get well card(or something appropriate for the event) with a short hand-written note can go a long way.
You both sound like wonderful people.