We would like to talk a little bit today about our experiences with perinatal loss and infertility and how we have been coping with them. My husband Chris and I have had a lot of trouble over the past few years trying to start a family. Both of us have undergone a lot of testing, fertility treatments, and scheduled ... "intimate interludes." It has been a very long and sometimes frustrating process that we are still going through.

This past February, after going through an ovulation induction cycle, we learned I was pregnant with triplets. We were a little surprised, and a little worried, but overall very happy. As my husband Chris said when he saw the first sonogram at six weeks, we had conceived "an instant family." If everything went as we hoped, I would never have to go through injections or other fertility treatments again. If things worked out, I would only have to go through pregnancy once, since we didn't want any more than three kids, and I might not even have to go through labor, since the triplets would require a C-section that could be scheduled. After all we had gone through to conceive one child, a multiple pregnancy seemed like a blessing.

After they got over the shock of learning I was carrying three babies, our friends and family members were very supportive, and at times pretty humorous. When the father of our three godsons heard the news, he said, "You know, you didn't have to have three kids all at once to catch up with us!" My supervisor started referring to me in the plural, saying things like, "Why don't you four come sit over here?" And my mother told me I was "very efficient" when it came to starting a family. We began to think of names for the babies, to make arrangements for child care, to shop for clothes and other baby-related items, to clean out the room that we intended would become the nursery.

Sadly, our little family was not to be. The evening of May 23rd, the day before my 31st birthday, I started to bleed. I was by then in my second trimester, at about 16 1/2 weeks of pregnancy, or 14 1/2 weeks fetal age. The blood worried us, but since I had experienced bleeding on and off during the first trimester without any apparent effect on the triplets, we decided not to go to the hospital. I called my obstetrician's emergency number and described the situation to the doctor on call. He told me that unless I began to hemorrhage, I should simply stay in bed and call my regular doctor in the morning. So, I went to bed and hoped that things would get better.

In the morning I called my obstetrician's office again, and learned that he was away on vacation. The office staff said they would contact the doctor who was covering for my obstetrician and call us back. By then I had begun to experience some mild cramps and was becoming more and more worried. The cramps were not very strong, but the pain was in the same area as the cramps I had experienced the previous summer when I had lost a pregnancy at four weeks. I called my supervisor and told him I would not be available that day. I also asked my husband to stay home from work, even though he had a big presentation scheduled for that morning. And he did; he called his office and told them that someone else would have to take care of the presentation because I needed him.

My obstetrician's office called us back, and after relaying some questions from Dr. Doppelheuer, the doctor covering for my obstetrician, told us to go to Dr. Doppelheuer's office for an exam. There we learned that my cervix was dilated, so much so that my membranes were visible. I knew that was bad, though I'm not sure whether or not Chris did. The day got worse from there.

Dr. Doppelheuer sent us to the hospital to see if there was anything the perinatal unit here could do. We met with Dr. Khoury, who examined me then told us that even if he could close the cervix again with a cerclage, the stitches probably would not hold long enough for the triplets to develop until they could survive being born or to avoid major health problems if they did live. He said that he was very sorry, but that there was nothing anyone could do. It was only a matter of time before my waters would break and the triplets would have to be delivered. He warned us that if my waters broke and we did nothing, I could develop an infection that would threaten my ability to have children in the future.

I asked Chris to call my father at work to tell him what was happening and to ask him to come to the hospital. I then asked him to call my supervisor to explain the situation and to tell him I wouldn't be back to work for a while. Lastly, I asked Dr. Khoury to call Dr. Asmar, my fertility specialist. In the absence of my obstetrician, I wanted other people who were familiar with our medical history to hear the news, to give us emotional support, and to help us decide what to do.

About an hour or two later my father arrived at the hospital. Chris, my father, and I discussed whether or not to induce labor, but ultimately decided to let nature take its course. We had not done anything to cause the situation, and I at least did not want to take any action that would hasten the triplets' demise unless my health was at risk. Even though we knew it was only a matter of time before my waters would break, I wanted to keep the triplets inside of me for as long as I could; I wanted to stay pregnant for as long as I could. I kept telling everyone that it was my birthday, and that I didn't want to lose the babies on my birthday.

About an hour after deciding we didn't want to induce labor, nature decided to act. I began to have contractions that progressively grew stronger and stronger. The hospital staff moved me to a labor and delivery room and put in an IV. I endured contractions for about five hours, then agreed to an epidural and a pelvic exam from Dr. Doppelheuer, who had come to the hospital to see how I was doing.

During the exam, my waters finally broke. Dr. Doppelheuer coached me on how to breathe and push, and finished delivering all three babies about an hour later.

Chris and I debated whether or not to see the triplets. The idea of looking at the dead bodies of our babies seemed pretty morbid at first, but finally one of the nurses, Mary Ruth, persuaded us to do so, and we in turn persuaded my father to do the same. Though the experience was probably the most painful we have ever gone through, ultimately we were very glad we took Mary Ruth's advice, as it was the only chance we had to see the triplets and to bid them farewell.

Throughout the pregnancy, I constantly worried that something would happen to one or two of the triplets -- a genetic defect, a problem with a placenta, a problem with a cord. Perhaps the babies would be premature, and one or two of them wouldn't make it. But I never thought I would lose all three of them at once so early in the pregnancy. I didn't know I would never get to feel them move inside of me, or hear them cry when they were born. I feel sometimes as though I have been cheated, and I don't really know how to describe the experience to people. Because I was only 17 weeks along, the loss of the triplets is considered a miscarriage. Even though I went through labor and delivery like other women and produced breast milk for weeks afterward, even though my husband and I held the babies and the hospital performed autopsies on their bodies, technically the triplets did not qualify as "stillbirths." In our medical records, this loss is listed as a miscarriage. And yet, to me and my husband, the triplets were our firstborn children and will always live on in our memory.

My original due date was November 2nd. If I had carried the triplets to full term, they would have been born next week. Right now we should be packing our bags for a hospital stay and putting together lists of people to call after the delivery. Instead, we are here, speaking at a perinatal memorial service.

Since the miscarriage, I have tried many things to cope with the loss. I have written a lot of journal entries and letters and have listened to a lot of music. I have learned to play Eric Clapton's "Tears in Heaven" on the piano, and I have written poetry. I have read books on dealing with grief, I have attended a support group comprised of parents who have lost children, and I have gone through therapy. Recently my husband and I took a long vacation, and both of us returned to work full time months ago. The world goes on even though the triplets are gone.

I have had many good days emotionally and a few very bad days since the miscarriage. Some days I laugh and socialize with friends and feel as lively as I did in the days before the miscarriage. Other days I feel as though I am coated in a thick film of depression that I can't get rid of, no matter what I do. Most of the time I am somewhere in between.

Although most days I feel normal, it seems as if my life now will always be divided into two parts -- the part that came before the miscarriage and the part that came after. I am not the same person I was before the miscarriage. I know if I ever manage to get pregnant again, I will be a nervous wreck the entire 9 1/2 months, or however long the pregnancy lasts. I don't ask people anymore whether or not they have kids, and I often react badly when people ask me that question. When I hear about friends who have just had a baby, I share their joy, but I also feel a spike of jealousy, then guilt for feeling jealous. When I hear of friends or co-workers who are pregnant, I don't ask for progress reports -- even though I want them -- because I am afraid to learn that they, too, have suffered a miscarriage or stillbirth, and if things are going well with them, it hurts to compare their joyous experiences with mine.

On the positive side, I am much more sensitive to other people's feelings nowadays. I am much more patient at work when people want to talk about things that seem irrelevant, and I am not afraid to reach out when I see people going through hard times. I no longer get frustrated when people don't respond to my letters or calls as quickly as I think they should because I know what it is like when the mere thought of communicating with someone is too hard. As news of the miscarriage has spread throughout our network of friends and family members, I have also reconnected with a lot of people I had lost touch with over the years, and have become much closer to some I had stayed in touch with only on a casual basis. I have also made some new friends in real life and online by sharing the experience of our miscarriage and learning about other people's hardships.

I am eternally grateful for the support of our families, friends, and co-workers and all the health care professionals who saw us through this experience and are caring for us still -- Dr. Pierre Asmar and the staff of the Fertility and Reproductive Health Center; Dr. Paul Weisshaar, my ob/gyn; Dr. John Doppelheuer, who delivered the triplets; Connie and Dr. Khoury of the antenatal testing unit; Mary Ruth, JoLynn, and Sandy of the labor and delivery section; my nurses Becca and Carole from the high risk pregnancy unit; and counselors Beryl Ash and Paula Weisshaar. Were it not for the miscarriage, I would never have met most of these people, nor have learned how wonderful they are.

So in some ways, a lot of good has come out of this tragedy. And perhaps one day we will encounter many of you again on a happier occasion.

Now I would like to read you a poem I wrote about the triplets this past Memorial Day. A copy of the poem, "Three Little Angels," is toward the front of your poetry handouts, so please feel free to read along if you like.