Who ever invented the term ‘pregnancy glow’ has obviously never been pregnant.  Unless by ‘glow’ they mean oily skin, acne and stretch marks. While pregnancy can be a wonderful and joyful experience, it does tend to reek havoc on your skin. Here are a list of the top annoying skin changes of pregnancy, and what you can safely do to treat them.

5. You Get Hairy

Most women will develop coarse hair on their abdomen and inner thighs that progressively worsens throughout pregnancy. For some, this is minor and a little extra shaving is all that’s necessary. For others it becomes a little more Chewbacca-esque.  The extra hair usually decreases after pregnancy. It is OK to shave during pregnancy. Laser hair removal, chemical hair removal and waxing are not harmful to the baby, but they may cause increased irritation because your skin is much more sensitive during pregnancy.

4. Acne

Though you would never know it by looking at all the porcelain skinned models on the cover of those pregnancy magazines, acne is extremely common during pregnancy. The hormonal changes of gestating can really do a number on your face and back.  Your skin usually goes back to normal shortly after delivery. Microdermabrasion and facials are safe, however your skin is more sensitive in pregnancy so notify your aesthetician as she may need to use milder settings.

Safe: benzoyl peroxide, salicylic acid, resorcinol, adapalene, topical antibiotics (clindamycin and erythromycin), Vaniqa

Not recommended: RetinA, tazarotene, Avita, Oral antibiotics (especially tetracycline), Isotretinoin

3. Stretch Marks

The dreaded stretch marks. The amount of stretch marks you get are merely a function of your skin’s elasticity and how much weight you gain. Your elasticity is genetic, so that’s out of your control. All women are encouraged to stay active and maintain a healthy weight during pregnancy. There is no ‘magic cream’ that prevents stretch marks, so don’t waste your money on expensive anti-stretch mark creams. Use a good lotion and stay hydrated, but in most women stretch marks are a fact of life.

2. Increased Pigment

What’s this weird line on my belly? I often get asked by women as they begin to notice a brown stripe running down the middle of their belly. In addition to the belly stripe, which is technically called the linea alba, women of darker skin tones may notice darkening of the skin of their nipples, arm pits, groin and neck. This darkening is thought to be estrogen related and begins to fade slowly postpartum.

Melasma {see image above}, some times called ‘the pregnancy mask’ refers to the darkening skin on the face. It can occur in up to 70% of pregnancies. Reduce sun exposure and wear sunscreen to reduce its effects. Up to 30% of women will experience persistent melasma after delivery. It can be treated by a dermatologist with lightening creams and laser therapy.

1. Veins

Both spider veins and varicose veins can make their appearance during pregnancy. The text book I consulted for writing this article recommended to “avoid prolonged standing” to relieve discomfort. For those of us with jobs and kids, that’s not very practical advice. Support stocking and lower salt intake can reduce swelling and symptoms of varicose veins, but only delivery will reduce their size.

Hemorrhoids are varicose veins of the rectum. Stool softeners, high fiber diet and adequate hydration can help relieve the discomfort of hemorrhoids.

Varicose veins can also be present on the vulva during pregnancy. While they can cause significant pain and swelling, they does not interfere with delivery and resolve quickly postpartum. Support garments are available on for vulvar varicose veins (try saying that 5 times), but in general my patients have not found them helpful.

What skin issues are you struggling with during pregnancy?

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Isaiah 50:4 “The Sovereign Lord has given me an instructed tongue, to know the word that sustains the weary.”

I have this scripture written on a post-it in my most legible handwriting, hanging on my work station. It’s the first thing I see each morning at work. Many of my patients need more than just a pap smear or an ultrasound. The circumstances of life have left them weary. Nothing that I can write on a prescription pad is going to help them. Each day I pray for wisdom and guidance, both in my medical decision making and for the encouraging words my weary patients need.

Weary. I can think of no better word to describe the last few weeks of pregnancy. Yes their weariness is temporary, but often it feels endless.

• Swollen ankles
• Back aches
• Sleepless nights
• Constipation
• Nausea
• Heart burn
• Endless contractions

Sometimes when I see women in the last days of gestating, as I ask them how they are doing, they take a deep breath and attempt to smile, then lie through their teeth “OH, Just fine”. {I understand that some really do breeze through their entire pregnancy, I am not talking about those 3 women.} It’s OK to be miserable, I reassure them. Often there comes a point in pregnancy where the kicks no longer fill you with the joy, but rather stabbing pains of wakefulness shooting through your liver. Admitting you are uncomfortable doesn’t mean you don’t love your baby. The last month’s miseries often leave you too uncomfortable to worry about labor. You just want to serve an eviction notice to the squatter in your womb.

I cannot cure their discomforts, but can hopefully give a simple word of encouragement or listen patiently to their concerns. Perhaps I can tell a joke or anecdote to lighten their load, or reassure them that they are not alone in their misery.

Here are some great scriptures to encourage the weary moms who struggle with the miseries of pregnancy. {These would make great labor scriptures as well.}

1 Chronicles 16:11 Look to the Lord and seek His strength; seek His face always.

John 16:33 I tell you these things so you might have peace. In this world you will have trouble, but take heart! I have overcome the world.

Phil 4:13 I can do everything through Him who gives me strength.

Isaiah 40:29 He gives strength to the weary and increases the power of the weak.

Isaiah 40:31 but those who hope in the Lord will renew their strength. They will soar on wings of eagles, they will run and not grow weary, they will walk and not be faint.

Isaiah 12:2 …I will trust in the Lord and not be afraid. The Lord, the Lord is my strength and my song.

1 Peter 5:10 And the God of all grace, who called you to his eternal glory in Christ, after you suffered a little while, will himself restore you and make you strong, firm and steadfast.

Matthew 11:28 Come to me all who labor and are heavy laden, I will give rest.

Galatians 6:9 Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up.

Colossians 1:29 To this end I labor, struggling with all His energy, which so powerfully works in me.

Did you find the last few weeks of pregnancy miserable? Was there anything that helped you feel better and rest?

Download a FREE printable of these scriptures! –> 10 Scriptures for the Weary Pregnant Mom

Me holding Baby Eia, one of my favorite surprise deliveries

“When do we get to find out what we’re having?” is often the first questions my new pregnant patients ask. With the frequency and accuracy of ultrasound, most couples are finding out their baby’s gender as soon as possible. This is followed by the ever complex ways to announce the news. Pintrest is full of reveal party ideas. What’s better than a box of pink balloons opened to thematic music with your facial expression captured by a professional photographer? Nine months of anticipation, followed by the doctor placing a pink crying baby in your arms and announcing to everyone’s surprise, “It’s a girl!’ Or at least I think so.

Rarely is there a medical indication to know the gender of the baby, but my personal opinion is that waiting until delivery is still the best way to go. I will admit selfish motives on this one (announcing the gender at birth is one the favorite parts of my job), but  hear me out on why you should buck the trend and wait until delivery for the big announcement.

5. It’s All Natural

A lot of my patients choose natural childbirth and I am extremely supportive of this. Most are very health conscious, avoid medication if they can, and desire their pregnancy to go as naturally as possible. Well, except for finding out the gender as soon as is humanly possible in order to make pink or blue cupcakes to cut into. But what is more natural than finding out as nature intended: at delivery?

4. It’s More Fun

It’s more fun to wait until delivery. I promise. Having the entire 9 months to build up anticipation, while listening to everyone’s guesses and wagers is awesome. Hearing the news in the delivery room is so much more exciting then the anti-climatic ultrasound appointment.

3. It Drives Everyone Crazy

“What do mean you are not finding out? You’re a doctor, you OWN an ultrasound machine, you could look at any moment!” These were the comments I got during my pregnancy (where we didn’t find out). For some reason it really annoyed people that we were keeping it a surprise, which I found exponentially amusing.

2. There’s No Doubt

As soon as a couple finds out the gender on ultrasound, the next question is, “How accurate are these things?”  Truthfully ultrasounds are extremely accurate, but never 100%. There can always be an element of doubt. You will always have someone tell you a story of their cousin’s, sister’s best friend from college who painted her nursery bright pink only to have the ultrasound be wrong.

Full disclosure: I have had a few dads over the years who wanted to announce the gender at birth, and being unfamiliar with the swollen appearance of newborn genitalia, got it wrong. So, technically it can initially be wrong at delivery as well.

1. You Get Better Presents

I am a huge proponent for not finding out the gender with your first baby for one very practical reason: you get better presents. What do you NEED when you have a baby? You need gear: highchairs, bedding, bouncy seats, boppies, etc. It makes the most sense to have these essentials gender neutral, so you can use them for your next baby. What happens when people know you are have a girl? They buy you cute dresses and bows. Makes for a fun and adorable baby shower, but you won’t use half of those outfits. If you don’t find out the gender, people tend to buy you more practical gifts at your shower AND then when the baby is born they get you additional presents that are gender specific.

I know I will never convince the majority of you to wait. Most of you are planners or simply can’t resist the temptation to discover if your little one will be a Jack or a Jill. Jessica is likely shaking her head as she edits this, already formulating her own post in her head on why you SHOULD find out {I couldn’t convince her to be surprised either}.  There are so few genuine surprises in life, I’m of the opinion that finding out the magical news of boy versus girl should be teased out as long as possible.

Any other fans out there of keeping your baby’s gender a surprise?

Platelets are the components of blood that are the first on the scene when you cut your finger, lodging themselves in the microscopic openings of blood vessels giving the other clotting proteins a place to attach and stop your bleeding. A normal platelet count is between 150,000-450,000.  Platelet counts are routinely checked 3 times during pregnancy: with your initial blood work, glucose test, and at delivery.

Low platelets can occur in up to 7% of pregnancies, but rarely are the platelets low enough to result in bleeding (<20,000). The three most common causes of low platelets in pregnancy are ITP, Pre-eclampsia and Gestational Thrombocytopenia.

ITP

ITP (Immune Thrombocytopenia) is a chronic medical condition (one that the patient has before pregnancy) characterized by the immune system attacking the body’s platelets. A woman would likely already be diagnosed with ITP before pregnancy, but if not it would be discovered with her initial pregnancy blood work. ITP usually occurs after a viral infection in childhood and continues into adulthood. It is treated with steroids if the platelet count drops below 50,000. Platelet transfusions do not work well with ITP, because the body will attack the foreign platelets as well. There is a 10% chance of the baby having low platelets, so a cesarean section is often recommended in cases of ITP.

Pre-eclampsia

If associated with high blood pressure and protein in the urine, low platelets can be a sign of a severe form of pre-eclampsia known as HELLP syndrome and is usually seen in the third trimester. HELLP syndrome is usually an indication for immediate delivery of the baby, but it does not have to be by cesarean section. The baby’s platelets are normal with HELLP syndrome. After delivery, mom’s platelets return to the normal range within a couple weeks.

Gestational Thrombocytopenia

By far the most common cause of low platelets in pregnancy is Gestational Thrombocytopenia, which occurs in 5% of normal pregnancies in the third trimester. These women will have normal platelets on their first blood count in early pregnancy. Sometimes the low platelet count is picked up on a routine blood draw in the third trimester, and other times it is not noted until the patient arrives for delivery. The platelets return to normal shortly after delivery and do not cause any issues with the baby, so a vaginal delivery is recommended.

The main concern with Gestational Thrombocytopenia is that if the platelets drop too low (usually below 100,000) then it is not considered safe to administer an epidural. The overall risk associated with epidurals is extremely low, but the most serious complication that can occur is bleeding in the epidural space which can lead to permanent paralysis and injury. Since platelets are involved in stopping bleeding at the earliest stage, most anesthesiologists do not feel it’s safe to administer an epidural if the platelets are too low (the exact platelet count cut off varies by hospital). Also if you require a cesarean section, general anesthesia will be used instead of spinal anesthesia.

When a  woman arrives in labor anxiously awaiting her epidural, only to discover that no relief is in sight due to an unforeseen issue of low platelets, drama can ensue. This does not happen very commonly, but when it does, it can be a quite unpleasant conversation.

Low platelets are a common complication of pregnancy that rarely causes any permanent issues. However, it is always good to be mentally prepared for the possibility than an epidural might not be an option if your platelets are too low.

Have you had a natural childbirth even though you were planning on epidural? 

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It’s the third week of January and I feel like my entire world is covered in a fine layer of snot. My kiddos are sick, my friends are sneezing on me and half my staff is home with the flu. Luckily, so far I have managed to stay healthy, but I realize many of my pregnant patients are not so fortunate. The flu is miserable. Pregnancy can be miserable. Together they can be truly awful. This post is intended to give you solid advice on avoiding the flu and how to safely treat it if you do get it.

How do I stay healthy?

In addition to stretch marks, pregnancy also brings with it a lowered immune system. This makes you more susceptible to viruses. If you do get sick, your body also has a harder time fighting off disease, placing you at an increased risk for more serious complications including pneumonia, preterm labor and even death. While we can never fully prevent the flu, there are some steps that can help reduce your odds of transmission.

Get your flu shot. The flu shot is safe in all trimesters and is your best defense against the flu. It does not cause the flu, hurt your baby or cause autism. The preservatives in the flu shot are not harmful, but if you have lingering concerns, preservative free shots are available. The flu shot consists of the top three strains of the flu that the epidemiologists predict will be the most active, so some years the vaccine works better than other years.

Getting the flu shot can protect your baby, as a portion of your immunity can pass through the placenta in the third trimester, helping to protect your precious newborn from the virus. It is also recommend that all household contacts and close family get the flu shot to hopefully provide a cocoon effect for the baby, since the baby can’t get the flu shot until 6 months of age (his immune system is not strong enough for the vaccine to work properly).

Wash your hands. The flu virus travels through the air when an infected person sneezes and coughs. The infected droplets can travel up to 6 feet away and primarily infect your body as you inhale them through your mouth and nose. Less commonly, when you touch something with the virus on it, you can infect yourself by touching your mouth, eyes or nose. Make Lysol your friend, often wiping down commonly touched surfaces like doorknobs and telephones.

Take care of yourself. Attempt to get 8 hours of sleep, take your prenatal vitamin, and eat your fruits and veggies. Make sure to consume lots of fluids and protein (i.e. chicken soup). Avoid sick contacts if at all possible. If it is unavoidable to be near the sickies, then consider wearing a mask.

What should I do when I start feeling sick ?

Rest. If you are experiencing minor cold symptoms such as dry cough and runny nose, reduce your activity by about 50% if possible.

Treat symptoms. There are many cold medications that are considered safe in pregnancy. I’ve listed some at the bottom of this post.

Extended fever (>101) in pregnancy can lead to serious complications, especially in first trimester. If you do have fever, take acetaminophen (Tylenol) to help bring it down. It is safe to take the maximum dose (1000 mg every 6 hours, not to exceed 4000 mg in 24 hours) if needed. Aspirin and ibuprofen are not recommended in pregnancy.

When should I call the doctor?

Known exposure to the flu. If one of your kids or someone you have close contact with tests positive for the flu, you should notify your doctor. The CDC recommends to consider giving antiviral medication to pregnant women who are exposed to flu in order to help prevent them from getting sick. The sooner you can start the better, so call right away.

You have the flu. If you test positive for the flu or have classic flu symptoms (acute onset of fever >101, body aches, headaches or weakness) then notify your provider immediately. There are antiviral medications that can help you feel better more quickly when you have the flu, but they work best if taken within the first 48 hours of symptoms. The medications also can reduce your risk of pneumonia and other more severe complications.

You are not getting better.

• If you have been treated for the flu but continue to have severe symptoms or develop a productive (chunky) cough then you could be developing an additional infection such as pneumonia.
• If you tested negative for the flu, but have a fever (>101) despite Tylenol.
• If you have a sore throat and fever it could be strep throat, so a visit to the doctor is recommended.
• If you have nausea and vomiting lasting greater than 12 hours, dehydration could be eminent and you should call your doctor.

How do I know if I have the flu and not just a cold?

Flu season in the US usually runs from October to April. Most often, flu symptoms come on very suddenly. A woman may feel fine in the morning, but by the afternoon feels like she was hit with a load of bricks. Body aches, shaking chills and fever are usually the initial symptoms. Additional symptoms may include headache, nausea, vomiting and sore throat.

Cold symptoms are usually milder, with a more gradual onset. The common cold is characterized by runny nose and cough, rarely accompanied by high fevers.

If you are unsure, then talk to your provider to see if you need to get a flu test.

Medications I recommend to my patients for use in pregnancy :

• Acetaminophen (Tylenol)
• Zinc lozenges
• Chloraseptic spray
• Vitamin C
• Calcium (Tums)
• Dextromethorphan (Delsym & Robitussin)
• Claritin
• Allegra
• Zyrtec
• Guaifenesin (Mucinex)
• Benadryl
• Cough drops and throat lozenges
• Oseltamivir (Tamiflu)
• loperamide (Imodium)

Medications NOT recommended in pregnancy:

• Aspirin (full strength)
• Ibuprofen
• Pseudoephedrine

Have you had the flu during pregnancy? What was your best method for feeling better?

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While 75% percent of pregnant women will have nausea and vomiting in pregnancy, luckily only 1.5% are diagnosed with the more serious hyperemesis gravidarum. HG occurs when the nausea and vomiting is relentless despite all conservative measures, resulting in severe dehydration and weight loss. If untreated a state of partial starvation occurs that can cause electrolyte imbalances and even death.

Luckily, with modern medicine, severe complications rarely occur. The initial step when treating HG  is hospital admission with intravenous hydration and nausea medication. After getting their dehydration fixed, some women will then be able to go home with oral anti nausea medications.  Ondansetron works well and is available as a tablet that dissolves under the tongue. Its most common side effect is constipation. At other times they may need a continuous infusion pump of mediation under their skin, or in rare cases being sent home with IV fluids and IV vitamins may be necessary. Another common medication is Promethazine. It can be given as a pill, cream or rectal suppository, and may make you feel sleepy.

Nausea and vomiting in pregnancy and its more serious cousin, HG are thought to be caused by rising levels of the hormones HCG (Human Chorionic Gonadotropin) and estrogen during the first trimester.  Most women’s symptoms will resolve around 16 weeks as these levels begin to drop.  Also HG is more common in female fetuses, hence the estrogen association.

Women can have HG with one pregnancy and not the next.  Often if they do get recurrent HG the severity can vary between pregnancies, even when carrying the same gender.  We are unsure why such variance occurs, other than the old adage ”every pregnancy is different.”

When nausea first rears its ugly head, some initial approaches to calm it would be:

Bland diet: Avoid spicy food, coffee, sugary and fried food. Stick to breads, nuts, bananas, applesauce and rice.

Eating often: Eat small amounts every couple hours. Try to never get hungry or full. Keep crackers by your bed so you can eat before you even get up in the morning.

Avoiding triggers: If certain smells (i.e. gas, meat, a dog) trigger nausea, do everything you can to avoid these smells.

B6: Vitamin B6 25 mg every 6 hours taken alone or in combination with doxylamine (unisom) is one of the safest, best studied medication for nausea. Both are available over the counter.

If you continue to have symptoms of severe nausea and are unable to hold down food for 24 hours; or are losing weight, you may be developing HG and should contact your provider.

For those of you that have struggled with HG, what did you find most helpful to ease your nausea?

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Dear wide-eyed and hopeful mama-to-be,

I see you standing there, hands gently resting on your growing belly. . .full of life and hope and wonder. You carry beauty within and without, part of an incredible miracle. I know it’s hard and uncomfortable at times. But mostly it’s wonderful.

The awe you hold within your heart for the tiny life blooming inside you is the fertile soil and rain that allows it to grow. Your body is a home for your child where he or she will forever remain, close to your heart.

Treasure each day mama – even those marked by severe discomfort. Allow those moments to draw you closer to the Maker so you can be filled with grace and strength. For this is a practice that gives way to the dependance you’ll forever need as a mom. Utter dependance on the One who placed the soul of your child within yours.

There will be hard days as you enter your role as mom. Days when you wonder how He saw fit to entrust you with this life. Days where you can’t breathe, the pressures fall so heavy. But at the end of yourself, there He is.

When those days come, reflect back to this time when awe eclipsed your inconvenience. There will always be wonder in the life of your child as they grow into a little person with personality, hopes and dreams. But with that growth comes challenges at every turn. So remember. Remember what a gift they are to you. . .what a privilege it is to guide them and love them.

Sweet hopeful mama-to-be, I see you. . . I am jealous of you as you should be of me. For I hold in my arms the hope you only now hold in your heart. Be good to our baby. I promise you the same.

Love,

Me

FREE printable of A Letter To My Pregnant Self

{Photo taken by me. The beautiful model is my sister-in-law, Monica. Her little miracle, Jason was born September, 2012.}

One of the biggest challenges I face as an Obstetrician is determining how to handle big babies. Currently 10% of women deliver babies that weigh more than 4000 g (8lbs 13oz), which is the medical definition of ‘big’ (macrosomia).  For first time moms especially, this can be a dilemma. If you await labor, the baby continues to grow even bigger during that interval. The bigger the baby, the more likely the need for cesarean section. Alternately, induction can often subject the patient to a prolonged labor that may end in cesarean section regardless. Despite delivering babies for over 10 years, I can’t always accurately predict whether the baby will fit through the mom’s pelvis. Until I can invent the Magic 8 Ball of labor, I will have to rely on studies and clinical judgement.

Some situations are straightforward, if the baby is actually a toddler (>11lbs), then the recommendation is to perform a cesarean section. Period. The big debate lies in how to manage those pregnancies with babies between 9-11 pounds. The current recommendation is to wait for these women to go into labor on their own. Statistically, induction increases the risk of cesarean, so the thought has always been to let nature take its course.

The current recommendations are based on studies looking at induction versus spontaneous labor. But that is not really a fair comparison. When I see a woman at 39 week who has a suspected 9 pound baby, my choices aren’t really induction versus spontaneous labor. If they were, I would obviously choose spontaneously labor. But I can’t just wave my magic wand and make contractions appear out of thin air. In first time moms spontaneous labor is almost always better than induction. My actual choice is between induction or waiting for labor to occur. Labor can be elusive, it might not occur for several more weeks.

A recent large study has finally looked at this issue. Cheng et al (BJOG 2012;1119:402-409) looked at 130,000 labors of first time moms with big babies. They found that induction at 39 weeks actually lowered the cesarean section rate. The rate for women who were induced was 35% versus 41% for those who awaited labor to occur.  One of the key statistics was that in the wait and see group, 30% did not go into labor by 41 weeks. I told you labor can be elusive.

This study is not perfect. It does not take into account the patient’s BMI or cervical dilation, which we know to effect the success of induction. Additionally, the best tool we have for estimating baby size is ultrasound which can often overestimate the size of the baby by up to 10%.

Honestly I was surprised by this study. I have always been more of the wait and see type. Is induction the right choice for all women with big babies?  Of course not.  Each woman’s pregnancy and labor is unique. Therefore, I do not think this study should cause women to decide if induction is right for them. As always, we encourage you to discuss your options and your unique case with your provider.

Did you give birth to a big baby? If so, were you induced or did you wait to go into labor?

Photo credit www.jenniepyfferoen.com

Each woman’s response to pregnancy is as different as her unborn child. While we could never fully understand all that is within your heart and mind throughout 9 months of baby-growth, there are a few truths I believe apply to all moms-t0-be. I hope you will pour over this list. Commit these truths to memory. Print out this post and keep it nearby as you journey through pregnancy.

Most of all we pray your pregnancy will be full of peace and joy as you soak up the beauty of the miracle growing inside you.

9 Truths to Carry Your Through Pregnancy

1. God is holding your little one together in your womb. {Colossians 1:16-17}

2. God cares about your apprehension and fears. Cast your cares upon him. {1 Peter 5:7}

3. This too shall pass. But all too quickly. Remember pregnancy doesn’t last forever which is a reality that is both good news and sad.

4. Your child’s life is destined for such a time as this. {Esther 4}

5. There is very little you can do that would hurt your baby in the womb. Relax.

6. People will say stupid things to you. Ignore them. Like, “Wow, you look huge!” But the joy of the miracle growing inside your belly should trump any idiotic comment someone makes.

7. You are called and therefore equipped to be a mother. {2 Corinthians 9:8}

8. Every woman’s body responds differently to pregnancy. Do not compare. Keep your eyes focused on your journey.

9. Relish every kick and movement that reminds you your baby will never be this close to you again, receiving life from your body.

For you shall go out with joy, and be led forth with peace. . . {Isaiah 55:12}

It’s fall and somehow the leaves that abandon their source to make way for new life once winter rest has passed gives me hope. I see evidence of this cycle of life all around. What looks as though it’s been lost is giving way to something new.

But we must wait. Wait until the time has come for the newness to flourish in sun and rain.

I notice the color of loss is vibrant yet deceiving. So full yet so empty. Sad but hopeful.

I allow myself to feel every emotion that waves through me as I process this process. But I am determined to land on hope.

There is a sweetness in the sorrow as it draws us closer to our Maker and His divine purposes. As He comforts our pain and silences our questions with His love.

There are many different colors and shapes to our grief and they mirror the variation I see through the seasons.  There is no good or bad. Our variety reveals who we are.

We beg the Maker to remove loss and replace it with abundance because we are desperate for joy. . .we are desperate for peace.

But there is peace in the process. . .that passes understanding.

My dear friend, I grieve with you in your process. I weep as you weep and I question as you question but I pray you find hope. I implore you to find the beauty that is hidden within the buds of growth and life as you journey through the seasons.

He will not leave you barren. He will not leave you bare.

“May the God of Hope fill you with all joy and peace in believing.” Romans 15:13

This post was written in honor of Pregnancy and Infant Loss Awareness Day. I am part of this community having experienced 3 miscarriages and 1 ectopic pregnancy. Today I stand with the brave women who have endured loss and I remember the life we once carried in our wombs. I also stand in hope that the desires of their hearts will be fulfilled in His perfect timing. He is faithful.