I still have a vivid memory of my miscarriage, but there's an aura of unreality about it as well. I remember the cramps when there shouldn't have been any cramps, then all the blood and the trip to the hospital. I remember forms and doctors and hallways and exams, then the procedure to clean out my uterus, and the overnight stay.

In the morning I was back home--just as if nothing had ever happened. I wasn't pregnant. There was no baby. There was no sign that I'd ever been pregnant--except that I didn't feel very well.

I remember going to work the next day--I couldn't think of an reason not to--and being sent back home by a boss who was more perceptive than I . I couldn't get in touch with any emotions. It just felt as if time had moved back three months, as if being pregnant had been a dream or a fantasy, or, at best, a dusty fragment of old history.

Luckily my boss wasn't the only perceptive one. A friend came to visit me that afternoon as I was lying in bed feeling numb and not very well--and she laid down the law. "You just lost your baby, Pamela. This is BIG." "But I'm okay," I protested weakly. "Yes, you're okay. I'm glad you're okay. But you just lost your baby. This is something that would make a lot of people cry." "But there's nothing here to cry about." "You're right. That child is not here. You will never have that child. It's like somebody dying." "It is? You mean it would be okay to cry?" And then the tears.

I was glad for those tears. They put me back in touch with myself. And the struggle to find them gave me a picture of the hidden grief of miscarriage.

Over the next few weeks, as I shared my news, I heard dozens of stories of other women losing their babies this way. One in five was the number, I heard. How could so many women miscarry and so few hear about it?

I think we as a society haven't quite come to terms with miscarriage. When a child is born dead full-term, the loss is visible and heart-rending. Everyone expects the parents to be overwhelmed with grief. A miscarriage is so much more subtle, so much more invisible. Often it happens before many people know of the pregnancy. It's hard to tell others that you're grieving the loss of a life that they never knew existed. Or we may feel, after miscarrying, that we are no longer players in the great conception, pregnancy and birth drama. We have no part any more. We have nothing to say.

Yet we are players, and we need to speak--not only for ourselves, but for all the women who will miscarry after us. When we conceive and carry and hope for a child, losing that pregnancy can bring tremendous grief. Loss of a life that is loved is loss of a life that is loved, no matter when it happens.