You Can't Fix Everything: Miscarriage and Pregnancy Loss in First Responder Families
First responders spend much of their careers being called when something has gone wrong. They arrive, assess the situation, determine what needs to happen next, and get to work.
There is usually something to do.
Pregnancy loss can be especially difficult because sometimes there is nothing we can do to change what has happened.
There may be no intervention that changes the outcome. No amount of training, determination, physical strength, problem-solving, prayer, or wanting the baby can make the situation different. For people accustomed to taking action in the middle of someone else's crisis, that helplessness can be incredibly difficult.
And then, eventually, you are expected to go back to work.
"It Was Early" Doesn't Necessarily Mean It Was a Small Loss
People sometimes minimize miscarriage because of how early it occurred.
"You can try again."
"At least you know you can get pregnant."
"Everything happens for a reason."
"It was only six weeks."
Most people saying these things are trying to help. But grief does not necessarily correspond with the number of weeks a pregnancy lasted.
For many parents, attachment begins long before a baby is born. Sometimes it begins before conception. By the time a pregnancy test is positive, parents may already have imagined a due date, holidays, maternity or paternity leave, names, bedrooms, siblings, grandparents, and what life will look like with another person in the family.
The loss, therefore, may involve more than the pregnancy itself. It can also include the loss of an anticipated future.
That is grief.
And grief does not require anyone else's permission.
The First Responder Problem: "What Do I Do?"
One of the strengths of many first responders is their ability to move toward problems. Something happens, you assess it.
Someone is hurt, you help. Something is unsafe, you make it safer.
That problem-solving ability is valuable on the street, at the station, and at home. But pregnancy loss can put a responder in a situation where the usual tools don't work.
This can be particularly difficult for the partner who was not pregnant.
You may find yourself thinking:
What am I supposed to do?
How do I make this better?
What does she need from me?
Am I allowed to be upset when she is the one physically going through this?
Do I need to hold it together for her?
Research involving men following miscarriage has repeatedly identified this problem. Men often describe feeling that their partner's needs appropriately come first while simultaneously struggling to understand where their own grief belongs.
That can leave someone functioning as the caregiver while quietly grieving the same baby.
Two People Can Lose the Same Pregnancy Differently
Different people regulate emotion differently. None of these reactions, by themselves, tell us who loved the baby more or who is grieving more deeply:
This becomes important in first responder relationships because compartmentalization is often a well-developed skill. A responder may go back to the station, run calls, joke with the crew, complete reports, and appear completely normal.That does not necessarily mean the loss was insignificant.
Sometimes staying busy is how people get through the first few days or weeks. The problem comes when staying busy becomes the only way they know how to deal with what happened.
Going Back to Work Can Be Complicated
Returning to work following a miscarriage may seem like returning to normal.
Sometimes it helps.
Work provides structure, familiarity, coworkers, and something else to think about.
But first responder work can also create unexpected reminders:
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None of these situations means the first responder is incapable of doing the job. But an emotional reaction to them should not be interpreted as weakness either. The brain is very good at making associations.
After a significant loss, sights, sounds, dates, places, medical environments, and situations connected to what happened can trigger memories and emotions.Sometimes the reaction catches people completely off guard.
The Next Pregnancy May Not Feel the Same
One of the less discussed consequences of pregnancy loss is what can happen when another pregnancy begins.
This is one reason telling someone who has miscarried, "You can try again," misses something important.Another pregnancy does not erase the previous loss. In fact, pregnancy after loss can bring the previous experience back into focus.
The Responder Who Wasn't Pregnant Matters Too
Most medical attention following miscarriage understandably focuses on the person experiencing the physical loss.
Psychologically, however, the other parent can disappear.
This is particularly relevant in first responder culture.
A male firefighter, police officer, EMT, or dispatcher may be asked repeatedly:
"How is your wife?"
Far fewer people may ask:
"How are you doing?"
Research on men's experiences following miscarriage has identified this pattern. Men may feel secondary to the loss, uncertain about whether their own grief is legitimate, and responsible for protecting or supporting their partner while receiving little support themselves.
That creates a difficult position: Be strong for the person you love while you are hurting too.
Strength does not require pretending the loss did not affect you.
You can support your partner and still need support yourself.
Both things can be true.
What Actually Helps?
There is no perfect way to grieve a pregnancy loss, but several things can make the process healthier.
 Talking with a trusted friend, counselor, faith leader, or pregnancy-loss support group can help you feel less alone. You do not have to carry the grief privately. |  Pregnancy loss can affect the body as well as the heart. Rest, attend follow-upappointments, and give yourself permission to recover without rushing back to“normal.” |  If this baby mattered to you, you do not have to minimize the loss because someone else considers the pregnancy "early." |
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 Do not use identical emotional responses as the measure of whether your spouse cares. |  Instead of assuming, ask: "Do you want me to listen, help you figure something out, distract you for a while, or just stay with you?" |  Returning to work can be healthy. Using work indefinitely to avoid thinking or feeling may not be. |
 Pregnancy announcements, due dates, Mother's Day, Father's Day, pediatric calls, medical appointments, or the anniversary of the loss may hit harder than expected. |  Some families name the baby. Some keep ultrasound pictures. Some mark the due date privately. Some want none of those things. There is no requirement. |  You can be grateful, excited, scared, and grieving at the same time. |
None of these situations means the responder is incapable of doing the job. But an emotional reaction to them should not be interpreted as weakness either.The brain is very good at making associations.
After a significant loss, sights, sounds, dates, places, medical environments, and situations connected to what happened can trigger memories and emotions.Sometimes the reaction catches people completely off guard.
When It May Be Time to Talk to Someone
Grief itself is not a disorder, and having difficult days after a miscarriage does not mean something is wrong.
But additional support may be helpful when distress is not improving, functioning is becoming increasingly difficult, or you notice significant changes such as persistent withdrawal, severe anxiety, escalating alcohol use, uncontrolled anger, recurring intrusive memories, significant relationship problems, inability to sleep even when there is an opportunity, or thoughts that life is no longer worth living.
You also do not have to wait until things are that bad.
Sometimes the best time to talk to someone is simply when you realize: "I'm carrying this harder than I thought I would."
First responders spend their careers walking into other people's worst days. Sometimes the worst day happens in your own family.
There may not be a call to run, a problem to solve, or a way to change what happened.
But there are ways to carry it without carrying it alone.
Research Behind This Section
Williams, H. M., Topping, A., Coomarasamy, A., & Jones, L. L. (2020). Men and miscarriage: A systematic review and thematic synthesis. Qualitative Health Research, 30(1), 133–145.
Obst, K. L., Due, C., Oxlad, M., & Middleton, P. (2020). Men's grief following pregnancy loss and neonatal loss: A systematic review and emerging theoretical model. BMC Pregnancy and Childbirth, 20, 11.