Sue Lynn Downes never took off the charm necklace. Never.
When she was 16, her mother gave her the gold necklace with a heart-shaped charm bearing the word "Daughter." After her son was born, Downes added a tiny pair of baby shoes, and later her two children gave her a "Best Mom" charm. She wore the necklace through basic training. She wore it when she was deployed to Iraq. And the Army corporal wore it the day a land mine twisted her Humvee like a washcloth, killing two fellow soldiers and leaving her so badly injured that doctors had to amputate both her legs.
Downes, 28, who has lived in Silver Spring since 2006 while undergoing treatment at Walter Reed Army Medical Center, knows all too well that she stands out among war veterans as a woman and a double amputee. She is also part of a growing contingent of mothers who have been posted overseas in the Iraq and Afghanistan wars.
FOR THE RECORD - An article on Page 1A in Sunday's editions incorrectly reported the country where Army Cpl. Sue Lynn Downes was serving when she was injured in a land mine explosion. The country was Afghanistan.
The Sun regrets the error.
Nearly seven times as many women have been deployed since the Sept. 11 terrorist attacks as in the first Gulf War, and so far, 10 times as many have died.
Although women are not assigned to combat arms units, they, like male soldiers, have faced increased exposure to combat in the current conflict, which makes them vulnerable to the psychological effects of war. Conditions such as post-traumatic stress disorder and depression can haunt them long after they return.
Experts say that mothers might have to deal with burdens and sacrifices that are different from those faced by fathers who served.
"In this current generation of young people, men's roles at home are changing a lot," said Col. Denise Dailey, the military director of the Defense Advisory Committee on Women in the Services.
"With that said, women are still the primary caregivers for children. ... And I think it's difficult for them to turn those roles over to husbands and family members when they deploy."
Though Downes thinks society views men and women in war differently - and that many believe that a mother should not leave her children - she doesn't see it that way.
"I think men and women are equal, and we both feel the same way about being away from our kids and families," she said. "The men carried pictures of their kids, and I did, too."
Before she was deployed to Iraq for a year in 2004, Lt. Latisha Turner of Baltimore tried to ready her daughter, Kyshea, now 10.
She didn't want her child to think negatively about the military. She wanted her to know that her mother chose to join the Maryland National Guard as a college student because it helped her get her degree and equipped her for the work force.
Preparing herself for her deployment was harder. She prayed a lot, but she still worried. "Daddy and Grandma, they can all love the children. But there's something about a mother's love," said Turner, 28. "You need Mommy's nurturing. I just think it's totally different."
It was especially difficult initially, because phone and Internet service were inconsistent in western Iraq, where Turner was helping to manage the flow of water, food and equipment across the country.
Later, she and her daughter would talk more regularly. But hearing her voice sometimes made her longing worse.
"You don't want your soldiers to see you break. I had to stay strong. But I am a woman and a mother. I could only take so much," Turner said. "Sometimes I just had to go off to the side and get it out."
She missed two of her daughter's birthdays, and when she finally came home, even her daughter's facial features had changed. Weeks passed before she felt remotely settled.
"It felt different. It wasn't the same," Turner said. "I felt like I missed so much, and I wanted to make up for it."
She now works full time for the National Guard helping to train soldiers for combat and is earning a master's degree in rehabilitation counseling so she can work with service members returning from war. She knows there is always a chance she will be sent back overseas.
"I would never volunteer to go on a mission, but I will tell you this: I am a soldier, so I'm not going to run away from the mission. And I've explained that to my daughter, too," she said.
In focus groups with veterans, the issue that surfaces most frequently among mothers is that they missed having other women to talk to about their common experiences, Dailey said.
Others reported that when they returned from a war zone, they had to instantly pick up where they left off - overseeing schoolwork, cooking, attending sporting events.
"They are immediately being put back into those roles as a mother and care provider and source of all knowledge in the family," Dailey said. "They are worried that they're not getting decompression time."
When mothers are wounded, it can render that transition all the more challenging, said Col. Elspeth Cameron Ritchie, a psychiatrist with the Army surgeon general.