"And I was a workaholic," said Carmen, 44, who does personnel work for the government.

When she was 35, they decided to start trying for a baby. But creating a family wasn't as easy as they had thought.

Carmen suffered two miscarriages. Their marriage was strained. And Andy didn't understand his wife's profound grief.

"We had some problems, and it was like we failed at this, too," Andy said. "It looked like another failure, another mistake."

Their communication broke down in between moves, the death of Andy's mother, his retirement from the military and numerous trips to infertility doctors. "It was like one thing after another," he said.

At a time when they could just as easily have decided to divorce, they kept trying to start a family.

They say persistence and a determination not to give up on each other led them eventually to have two daughters. But the miscarriages aren't forgotten.

"I'm hoping it provides some level of closure, although it can't complete the loop," said Cindy Nachtigall, a Tripler pediatric social worker and coordinator of the event.

Professionals from other hospitals, including Kaiser Permanente Moanalua Medical Center and The Queen's Medical Center, are helping to bring together families who have suffered losses for the service.

"It's so nice to remember that baby," Nachtigall said. "As parents, we bond to the pregnancy. A loss is a loss. Along with the loss of that baby is all of our hopes and dreams."

Each year in the United States, more than six of every 1,000 births result in a stillbirth or newborn death, and many more women miscarry before the 20th week of pregnancy. At Tripler, the hospital of choice for many younger military families in Hawai'i, there's an average of one miscarriage or infant loss a day. That's a higher number than the number in the community at large because the hospital caters to so many women of reproductive age, Nachtigall said.

The grief that goes along with these losses is profound but often misunderstood and ignored.

"It can be more devastating than a divorce or losing a grandparent," said Lynn Kalaiwaa, a nurse who runs a support group at Kaiser's Moanalua Medical Center called HOPING (Helping Other Parents In Normal Grieving). "You're not supposed to lose a baby."

Carmen remembers suffering in silence, feeling as if she were mourning a death in the family that her husband didn't acknowledge.

She had held the remains of her would-be children after the miscarriages. Her husband never did.

"I felt I was less inclined to view this as a child," he said. "Deep down, I was disappointed. She was depressed, and I was angry. I think that was my way of hiding my disappointment."

He remembers after the first miscarriage, his boss, a father of four, told him not to worry. "You can always adopt," he had said.

After the second miscarriage, Andy said, "I remember saying when we buried the remains of that child-to-be, I said, 'For whatever reason, you just weren't meant to be.' "

They got marriage counseling. Carmen was active in Resolve, a support group for couples dealing with infertility. Then she became pregnant naturally after ending fertility treatments, and she remembers not being able to enjoy her pregnancies.

She didn't buy a stroller until she was 7 1/2 months pregnant, and even then, she still didn't feel comfortable that everything would go smoothly.

Kaela was born four years ago, and then Ciana came along almost a year ago — both healthy, happy babies.

Sometimes, Carmen's mind drifts back to the could-have-beens for her two lost babies.

"I still think of them as if they were real kids," she said. "Keeping busy helps keep the pain back."

Andy held his oldest daughter when they attended a memorial service for lost babies a few years ago.

"I was almost embarrassed to go to the first one with a live child, knowing others there were dealing with loss," he said. But the candlelight vigil helped him realize he was not the only one still dealing with loss. And like the others, he discovered it was natural to feel like he was part of a family and still feel as if something was missing.

"It's likely to bring up the pain again," Carmen said of this year's service. "I guess like any memorial service, it's good. It brings you closer in a way, and it brings you together with people who can share it."

Nachtigall, the social worker who is organizing the event, invites whole families to come, to have a place to grieve and remember with a group of people who have gone through the same thing.

"We find it takes another parent who has gone through a loss to understand it," she said. "There's built-in support."