By Maia Brown, President of the Beltane Guild
In 2018, I was in between lectures at paramedic school when I got my lab results back. My Anti-Mullerian Hormone (AMH) level was 0.28ng/mL. AMH is a reflection of ovarian reserve, or how many eggs you have left. I was 35 years old at the time, and this level put me on par with someone about to go through menopause.
Coupled with the stress and sleep deprivation from my intense paramedic program, I completely broke down. I had always wanted a family and now that possibility seemed bordering on impossible.
Before I go further, some may interject: “What about adoption?” Use caution with that sentiment. Consider that the person may already feel ashamed for the simple fact that their body is not doing what it’s meant to do and you’re just throwing gas on the fire. And from a practical standpoint, there are many factors that make adoption unavailable to many who want it.
After some time, I began to wonder if my career as a firefighter had affected my reproductive health. Part of me considered that, even if it had, what was the point of focusing on that when there was nothing I could do about it? Initially, I came to the resolution that I had chosen a career in the fire service, and this was a consequence of that choice. But I soon found myself scouring the internet for studies on firefighter reproductive health. It occurred to me that while my own fate may be sealed, there was still a chance to prevent other firefighters from learning the hard way.
After completing paramedic school, I spent several months focusing on my physical and emotional health to see if I could improve my hormone levels. My regimen included fitness, acupuncture, a therapist, travel with friends, and massage. It was an amazing turn of events to see that after several months of intentional effort, my AMH levels had improved to 1.28ng/mL.
While this wasn’t a guarantee that a family was a possibility for me, I at least felt I had a chance. If you consider that the causes of reproductive health issues are similar, if not identical, to those that cause cancer, you may not be surprised to learn that irregular sleep, stress, toxins, and heat are some of the leading exposures that we need to be mindful of.
My next decision was to pay about $10,000 to go through an egg retrieval cycle and freeze my eggs. I wanted to remove some of the anxiety that came with knowing each day my odds of conceiving were diminishing. Knowing the clock would be “frozen” was a great relief.
Incidentally, I met my husband right around this time, and our second date at the Woodland Park Zoo in Seattle ended with me injecting myself with the follicle-stimulating hormones that were necessary for egg retrieval. His ability to respect what I was doing and show complete acceptance was definitely a factor in how quickly I fell in love with him (we were engaged three months later).
My friends would say the more entertaining story was the night I had to do my trigger shot, which has to happen at a very specific time prior to egg retrieval. While waiting to see Brothers Osbourne at a country musical festival, I couldn’t find my friends in the masses of people in the pit. So, I used crowd-surfing in my daisy dukes and cowboy boots to quickly and efficiently locate and reach my friends. Once reunited, while my friends created a human shield, I gave myself my final injection in the glute just as the lights went low and the music began.
In 2019, we made preparations to try an IVF cycle. My department was exceptionally supportive by allowing me to transition to modified duty a month prior to the IVF. This allowed my body to return to some version of homeostasis and gave us the best possible chance of success.
We were successful on our first attempt and welcomed twins into the world in February 2020. Seven months later, we were overjoyed to learn that we were pregnant again, this time without fertility treatment. Our third child was born in July 2021, and today, we are a family of five with three kids, three and under, elbow-deep in potty training, pasta, and paw patrol.
The final chapter of my journey through infertility, two pregnancies, returning to work, and expressing breastmilk at the firehouse concludes with the fact that three months postpartum, after my second cesarean section delivery, was likely too soon to return to work. I sustained an L5-S1 disc herniation in my spine that resulted in excruciating sciatica down to my ankle that was only relieved with a discectomy surgery.
The body goes through so many changes with pregnancy, and major abdominal surgery to pull out babies only further complicates the matter. It’s important we restore our core and pelvic strength before returning to the heavy, awkward lifting required of a career in the fire service.
Personal story aside, here is what you need to know: firefighters are at higher risk for infertility, miscarriage, birth defects, low birth weight and pre-term birth, and more. Guys — according to a study of male Danish firefighters, you have a 46% to 53% increased risk of infertility compared with general workers. Given that one in 10 of the general population is experiencing infertility, how many of us firefighters are affected? We can and should be doing so much more to protect, support, and educate our firefighters.
One way to educate firefighters is to provide a brief overview of firefighter reproductive health to recruits as well as all current personnel about the effects of firefighting on reproductive health. The all-star move would be to offer a simple, preliminary assessment of a new firefighter’s reproductive health. You don’t want to scare the crap out of them, but based on their results, they may choose to freeze their eggs or sperm before they start getting tampered with. This is all about allowing firefighters to have families and is just as important as the awareness training we do for cancer, mental health, etc.
Having a solid policy not only guides the firefighters trying to have a family, but it also provides guidance to officers and those in positions of leadership. If your firefighter is pregnant or coming to you with reproductive health concerns, it’s too late. Do the pre-plan now and get your policy updated.
It is also important that firefighters understand the laws surrounding pregnant firefighters. It is unlawful to require a pregnant firefighter to notify the department of their condition. It’s entirely up to the firefighter and their OBGYN to decide when to transition from shift work to a modified duty assignment.
The recent adoption of the Pregnant Worker’s Fairness Act means that employers with more than 15 employees must make reasonable accommodations for pregnancy and pregnancy-related conditions unless an employer can justify an undue hardship. Employers must provide a private, secure space that is not a bathroom for firefighters to express breastmilk at work.
Some things I wish I’d known
If there is a stigma in your department about becoming pregnant early in your career, don’t let it stop you from doing what’s right for you and your family. You don’t have forever and your job may make it harder to conceive.
While it is entirely circumstantial and up to the individual pregnant firefighter, please be aware of the risks of staying on shift work and make an educated decision with your OBGYN. Many firefighters I have spoken with say the moment they decided to transition to modified duty was the moment they realized they were endangering their fetus on a call.
It is also important to note that a recent study’s preliminary results indicate that firefighters responding to EMS calls have just as much exposure risk as those responding to structure fires, so a pregnant firefighter and their fetus are not necessarily safe just because they’re not going interior on a structure fire.
Additionally, Women in Fire now has a reproductive health toolkit that can be mailed out to individual firefighters who are pregnant or facing reproductive health challenges. There is also a mentorship program where firefighters can find support and leadership by networking with other firefighters.
