The Toledo woman was continuing to mourn her other daughter, Megan Marie, who lived just six hours after the Miller twins were born premature. And it was acknowledgement that Mrs. Miller was mother to two girls - including a card from her mother, Sharon Spencer of Toledo, written in Megan's voice - that helped console her that first Mother's Day.
"Mommy, you and Daddy made the right choice to let me be free," the card said, referring to the removal of Megan's life support after there was no hope for survival.
"There was a lot of tears," Mrs. Miller recalled. "But it was very thoughtful."
The approach of Mother's Day and the typically cheerful holiday can be a time of particular sorrow for mothers who have lost infants.
But family and friends of grieving mothers should not overlook their loss, even though talking about deceased children has long been taboo, said Paula Samples, clinical nurses manager of the neonatal intensive care unit at Mercy Children's Hospital.
"They're still mothers," Ms. Samples said. "What you find with a lot of parents is they don't want to make you feel uncomfortable, and they're really suffering inside."
For Colleen Kwiatkowski, a nurse practitioner in the neonatal intensive care unit at Toledo Children's Hospital, her anticipation of the first Mother's Day after losing her only child 13 years ago was worse than the actual holiday.
She does remember she was angered on one of those first Mother's Days after overhearing another mother complain about the gift from her husband because it was such a trivial concern. Ms. Kwiatkowski's son Patrick, who had a blood clot in his umbilical cord, died shortly before birth.
People should be sensitive to grieving mothers, said Ms. Kwiat-kowski, who belongs both to the hospital's perinatal bereavement committee and support group for bereaved parents.
"Don't expect too much from them," she said. "All you want on Mother's Day is to spend it with your child, and that's not going to be."
This Sunday will be Valerie Fogle's first Mother's Day since the Defiance woman lost her son, Ethan Edward, who lived for 21 days. His twin, Maddie Hope will be 1 next Friday.
"I hold Maddie, and there's times my arms don't feel full because I'm supposed to be holding two," said Mrs. Fogle, who also has an 8-year-old son, Chase.
Mrs. Fogle became emotional when talking about her Mother's Day plans, which includes a visit to Ethan's grave with her family.
"I'll always hug two children, and I'll always just talk to one," she said.
Mrs. Fogle had Ethan's name tattooed with angel's wings on her wrist so she could see it while gesturing.
A Mother's Day card or, if the grieving mother is a close friend or relative, a call will help those who have lost infants, Mrs. Fogle advised. Be simple, and avoid saying a child is in a "better place" or "God has another angel," she said.
"The reality is, the card doesn't have to be poetic," Mrs. Fogle said.
Two of Mrs. Miller's friends sent her and her husband, Ron Miller, two sets of Mother's Day and Father's Day cards that first year. One celebrated their new status as parents, while the other let them know they were thinking of them, she said.
Both Mrs. Miller and Mrs. Fogle, who had their twins at Mercy St. Vincent Medical Center, talk fondly of their surviving daughters and their advances.
Sarah, who turned 2 in January, is so small she looks like she is 1, Mrs. Miller said. The girl, who was born nearly four months premature, needs physical, occupational, and speech therapy, but her development is catching up, she said.
"We protect her - we have to protect her," Mrs. Miller said. "She's so tiny."
Maddie and Ethan, meanwhile, were born eight weeks premature to Mrs. Fogle and her husband, Ben Fogle.
While Maddie weighed 4 pounds 1 ounce, Ethan was an ounce shy of 3 pounds.
The extent of Ethan's medical problems were not clear early on, and his death at the University of Michigan Health System where he was transferred was a shock.
Maddie, though, is doing fine, Mrs. Fogle said.
"You would never, ever know that she was a preemie," she said.
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