SAN ANTONIO—Badly wounded and woozy from medication in a chopper speeding over Baghdad, Iraq, Staff Sgt. Sophia Mitchell softly sang the “I Love You” song she and her daughter had made up.

“They must have thought I was high on the morphine,” Mitchell said.

In those fragile hours, clinging to life after a mortar attack, she kept thinking of her 5-year-old girl, Jurnee. Mitchell is one of 599 women wounded in the Middle East and part of the first wave of female combat amputees in U.S. history.

Most people see patriotism and the sacrifices of war as masculine values. A vast majority of the nearly 2.6 million Americans killed or wounded in major conflicts since the Revolutionary War have been men.

But in today’s war, women play a larger role and even are at risk “inside the wire” of a secured base. Of the 4,650 U.S. troops whose deaths the Defense Department counts relating to the fighting in Iraq and Afghanistan, 110 were women, and 61 of them were killed in combat.

Jorge Torres, clinical nurse specialist at Fort Sam Houston’s Center for the Intrepid, said he’s seen some of the problems faced by women wounded in war, the challenges with body image and the guilt some feel, unable to play the role of mother as they rehabilitate.

Torres, who works in behavioral health, said he supports a bill in Congress to launch a study of physical and mental health issues among female veterans as a means to improve treatment and conditions for women in the battlefield.

“It may be the wave of the future,” Torres said. “There is a difference between female and male casualties. Can I give you all the specifics? No. If we could better delineate the differences, we could better help these women and their families.”

Staff Sgt. Ireshekia Hilliard was standing next to one of those 61 women killed in action. She has the scars to prove it.

Hilliard was right by Staff Sgt. Lillian Clamens, going into the chow hall in the Camp Victory complex, when they were attacked Oct. 10. Mitchell was about 10 feet away, on her way out, as 107 mm rockets hammered the heavily fortified Baghdad base.

Mitchell and Hilliard survived the assault, which wounded about 40 coalition troops, mostly Americans. Clamens, an administrative clerk set to return home to Florida the next day, was one of two soldiers killed.

After what she’s been through, just seeing a U.S. flag waving in the breeze sometimes forces Hilliard to take a deep breath. Hearing the national anthem gives her a lump in her throat.

Hilliard lost her lower left leg in the mortar attack, and has a special prosthesis on order from England. It’s brown to match her skin and shaped like a woman’s leg.

Male amputees typically prefer a titanium leg. But she wants to look pretty in skirts, dresses and panty hose.

One of the guys’

Females constitute 11 percent of the force in Iraq and Afghanistan. Women are legally barred from front-line service, but often are exposed to danger as gunners, military police, helicopter pilots, explosives handlers and security personnel assigned to search Iraqi women at checkpoints.

Women have excelled when they have found themselves in battle, often with bullets whizzing past. A Texan, Spc. Monica Brown of Lake Jackson, recently became the second woman awarded the Silver Star since World War II, for helping save two badly wounded troops during an ambush in Afghanistan. Under heavy gunfire and mortars, she directed action and helped carry the men to safety.

Women also have faced indignities not directly related to war, as in the case of a Texas soldier killed by an out-of-control ex-boyfriend.

The death last Aug. 16 of Spc. Kamisha Block of Vidor initially was reported as a “non-combat-related incident” in Iraq. Her family was told she’d been hit by “friendly fire.”

The Beaumont Enterprise reported June 19 that Block had been fatally shot on a military base by another soldier, who then committed suicide. Army reports indicated Staff Sgt. Paul Brandon Norris had assaulted Block at Fort Hood, and was disciplined and sent to counseling before they deployed.

Staff Sgt. Audrey Ramos, a San Antonian now on a third tour in Iraq, said she’ll never be a “lamb amongst the wolves.”

“Yes, this is a male-dominated profession ... yes, the men are the stronger sex. But I’ll never show weakness. I’ll never be that helpless little lamb,” Ramos wrote in an e-mail.

That’s the resolve it takes for women to serve in a male-dominated war, and to adjust afterward. Sgt. Lilina Benning grew up more than 7,000 miles from the U.S. mainland, and worked in Army human resources. But she bears the wounds of a war that has no clear battle lines.

On Sept. 11, 2007, two rockets hit the SUV she was driving on base in Iraq. She lost most of her left foot, and can’t bend her left arm, which is held together with two blade implants and about 20 screws.

Benning, one of 12 children in a family growing up on the Pacific islands of Micronesia, spoke Kosraean until she began learning English in first grade. The thought of a girl joining the military wasn’t accepted.

“Females were supposed to stay in the house,” said Benning, 37.

Now, she’s trying to stay on active duty. When Benning arrived at Brooke Army Medical Center, she was the only female amputee. Hilliard, Mitchell and Mary Dague, a sergeant from Montana who lost both arms trying to deactivate a bomb in Iraq, soon joined her. The four have bonded at BAMC and the Intrepid Center.

Of 803 U.S. troops who’ve had major amputations—not fingers or toes—20 have been women. Seven female amputees have been treated at BAMC.

Dague, 23, is witty and buoyant, coming from the male-dominant field of ordnance disposal. She fits in as “one of the guys,” Hilliard said. Benning has a small frame but a big smile, and athletic drive that inspires others.

Hilliard’s friendship with Mitchell has been more intimate. They were wounded together, have similar injuries and both are mothers. They shared tears, reliving the Oct. 10 attack when a female medic who had treated them visited BAMC. The medic “actually told me she didn’t think I would make it,” Hilliard said.

When she needs inspiration to keep going, images of her three kids flash through her mind. But Hilliard, 32, hasn’t forgotten about Clamens, who died in the blast.

She and Clamens, who spent most of her yearlong tour in southern Iraq, worked in human resources. They sparked a friendship over the phone. They stayed together for about a week when Hilliard went to Tallil on business.

“We knew all about each other’s children,” she said.

They met again when Clamens got to Baghdad. She had called her husband to tell him she was in the Green Zone and would be home soon. He and their three children had planned a Halloween-themed party for her homecoming.

A few weeks after the attack, Hilliard was at BAMC, recovering from her amputation. She learned in a phone call from Clamens’ first sergeant that her friend had died.

Her children, all in their early teens, have accepted that soldiers, even the ones who are moms, get hurt in the war.

“They know it was just part of my job,” Hilliard said.