Through loss, a book of hope is born

Newton resident Darci Klein has written a book about her desperate quest to have a family, a six-year odyssey that was harrowing, painful - and joyous.

She recounts in journal form the premature birth of her daughter Maddie, who spent seven weeks in a neonatal intensive-care unit. She writes about her three lost pregnancies, including twins at five months, and the full-term birth of her son, Sam.

Released in June by Penguin Books, "To Full Term" is a memoir that also supplies medical research and a guide to dealing with pregnancy loss. It discusses available tests and has support group listings.

The information comes from Klein's unrelenting attempts to figure things out on her own as she suffered though the miscarriages.

Klein spent two years sifting through medical studies to find an answer. A career market researcher with a concentration in statistics, Klein asked her doctor to administer a thorough set of tests. From the findings, she was eventually diagnosed with factor V Leiden, a common hereditary blood coagulation disorder, and a condition known as cervical incompetence.

With treatment, Klein gave birth to Sam in 2004; her fifth pregnancy, it was the only one carried to term.

One of the most revealing studies that Klein unearthed came from Dr. Mary Stephenson, a University of Chicago professor and director of the school's program focused on recurrent pregnancy loss. Stephenson's research concluded that when a pregnancy is lost after 10 weeks gestation, the likelihood that chromosomal abnormalities are the cause is less than 5 percent, meaning 95 percent of losses after 10 weeks are caused by medical disorders.

"Shouldn't miscarriage be viewed as a legitimate medical symptom that warrants investigation?" asked Klein, 41, during an interview at her Newton home.

Klein has also launched a website, Prevent Pregnancy Loss (preventpregnancyloss.org), as an educational resource for women and to advocate for testing. She hopes that the information she disseminates will prevent others from enduring the physical and emotional pain she and her husband suffered.

Wearing black-rimmed glasses, her straight blond hair pulled back in a ponytail, Klein talked about the day her daughter was born in San Francisco in 1997.

"I was looking at a 3-pound baby with tubes running everywhere," said Klein. "She was on a ventilator, and for the first 48 hours the doctors gave us no odds on her survival."

Maddie survived with no long-term effects.

Over the next few years came three miscarriages. In her book, Klein recounts the details of labor in which she was forced to deliver her twins "into a world that offered them only death."

The repeated losses created a difficult relationship between Klein and her husband, Jon, which she openly shares with readers:

"Every tragedy has wedged a slightly wider gap between us," Klein recounts in her book. "The first happened when our daughter Maddie was born 12 weeks premature. We watched her through different eyes as she fought in a neonatal intensive-care unit for nearly two months before coming home. And then the losses came, when pieces of me shattered and he struggled to understand why. I've spent the last six years stumbling from pregnancy to pregnancy, filling the gaps with work as my grief mounted, grappling to reconnect the strands of marriage frayed after repeated loss was borne so differently."

Jon Klein, who runs a management-consulting firm, agrees that the long road was not easy.

"The first miscarriage didn't hit me as strongly, but when we lost the twins at 20 weeks and both expected the babies, it hit me very, very hard," he said.

Stephenson said Klein's book has been inspirational for her patients in the pregnancy-loss program.

"We need to evaluate couples sooner," she said in a phone interview. "Patients need to know why they had a miscarriage - and how do we know why? By sending the miscarriage tissue for chromosomal testing."

The Kleins moved to Massachusetts in 2003, with San Francisco holding too many painful memories. "It's a beautiful city but I felt like that's where I lost my babies; we needed a change . . . a big one," she said.

There was no job or family waiting to greet them here. What they did get was a fresh start. Two weeks after the move, Klein learned she was pregnant. Nine months later she gave birth to Sam.

In her book, Klein recounts the feelings that she and her husband experienced at the time:

"Jon looks at me on the table and nods before shielding his eyes to hide his tears. My chin quivers. We actually made it, past the constant danger that threatened to preclude this moment, threatened to steal this wondrous child that will grow up and strive to somehow make the world better. We now stare in near disbelief at the miracle that stretches and squirms and puckers before us, and today, we have both seen grace."

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