Chapter 1 Not Viable On a brilliant, warm San Diego saturday in the spring of 1996, my wife, Shannon, had her First miscarriage. Our bafing, heartbreaking journey into the world of what doctors call "spontaneous abortion" began with a phone call. We were having a lazy brunch with my parents on our front porch, pine trees shading us, the PaciFic Ocean visible in the distance. Our daughter, Erin, nearly six, was chattering with her dolls in the pine needles. Paging my way through the newspaper, I struggled to dodge conversation with my folks, who were visiting for the weekend and would rather talk than read. Then the phone rang, and Shannon excused herself to answer it. Shannon is close to my parents, but had grown weary, as had I, of my mother's well-meaning but insensitive probing about our reproductive status. Any luck? my mother would ask, month after month, noting that a cousin of mine recently had succeeded with in vitro fertilization.

You really shouldn't wait. You really should have started earlier. Maybe you should see a specialist. Maybe there's something wrong with your sperm. Maybe you should do IVF. I'll help you pay for it. You two should have another. It's a shame.

For Erin's sake. She shouldn't grow up alone. My kids always had each other to play with.There must be something you can do. So it was with great delight that a week earlier, we had Erin phone my mother and tell her that Shannon, then thirty-seven, was pregnant. She was only four weeks along, too early to see anything with an ultrasound scan, but a blood test already had conFirmed the positive urine test we had done at home. We even had a due date. My mother squealed, really squealed, with joy.

She advised us not to tell anyone else until the baby was three months along, but at every opportunity she exclaimed, "Finally!" A few days after sharing the news, we drove to Los Angeles for Passover dinner at my aunt and uncle's house. Erin had already leaked the news to her cousins, and because Shannon's pregnancy with Erin had gone so smoothly, we ignored my mother's warning, celebrating our good fortune with all Fifty of my relatives. Shannon also conFided to my uncle, a doctor, that she had been spotting blood, but that her obstetrician had said it was common and usually means nothing. My uncle agreed. "Everything is probably going to be Fine," he said. Shannon's spotting continued, and we read everything we could Find to help us understand First-trimester bleeding, which doctors often refer to by the frightening phrase "threatened abortion." Sometimes, when the embryo implants itself in the uterus it causes bright red bleeding for a few days. But this blood was brown and had continued staining Shannon's underwear for several days.

Sometimes, bleeding occurs after intercourse because hormonal changes make a pregnant woman's cervix more exposed and delicate. Some women spot throughout their pregnancies for no known reason and without any harm to the child or the mother. Depending on whom you believe, 15 percent or 25 percent or 35 percent of women spot during their pregnancies and 25 percent or 35 percent or 50 percent of these women miscarry. Obstetricians sometimes prescribe bed rest to prevent miscarriages, but most often they do nothing. In part, the reluctance to intervene comes from the diethylstilbestrol Fiasco that surfaced in the 1970s. More commonly known as DES, this synthetic form of the hormone estrogen was widely used as a miscarriage treatment in the 1940s and 1950s. Reports began to surface in the 1950s that quest.