The ultrasound tech turned to us and quietly affirmed what we already knew:

the struggling, tiny heartbeat that had been blinking on her screen last week, was no longer there. That day, I came to grips with the news of what would be my fourth miscarriage. I scheduled another D&C for later in the week and tried to fight the feeling that I was becoming hollow inside — that this was finally the day I'd have nothing left to give.

My husband and I hoped a birthday gathering of friends and family at a restaurant later that evening would give us a short reprieve from our grief. We hadn't told them about this latest loss, but they knew what we'd already endured. On this night, as I was sinking into the delight of stories and jokes, I was stopped short by a surprise announcement from one of the couples. Lisa pulled from her purse what looked like a small greeting card. A shy grin spread across the face of her husband, Eric, and he put his arm around her shoulder.

A blurring, buzzing sound filled my ears as she opened the card to reveal a gray photo with a murky white image of a tiny, peanut-shaped being and I caught splotches of words like "April or May." I willed a smile to appear on my face and "congratulations" passed from my lips. Underneath the table, my knuckles turned white grasping my husband's knee. I gave thought to abruptly leaping from my seat and bursting through the restaurant to take off in our car.

But I also knew this wasn't a pivotal movie scene to act out and that I wasn't going to take the leap into becoming the "troubled, overly-sensitive, infertile woman" to this group. I simply sat through it, made some sort of conversation, and sang "Happy Birthday" with the rest of them. No one took me aside to ask if I was okay or if I needed to go to the ladies' room with them where I could collapse into an embrace. We drove home in silence.

— By Laura, age 37