I don’t consider myself an advocate for infertility per se. More of a silent contender for those whose stories read a lot like my own. I’m not storming the hill like other amazing women but I am storming the gates of heaven begging God {much like I did for myself} to have mercy on women who are simply longing for what He creates – life.

I navigated through my journey of infertility with my faith as my guide. And now, I help lead this community of women, hoping to encourage those who are in the waiting, those who are just setting out on their path or those who have traveled so long they’ve lost sight of the destination. One of my greatest life passions is to share my story so that others know they are not alone and so that those who can, will make provisions for the millions of women who struggle to conceive.

I truly believe that if we are open, we can grow through whatever we go through. But the truth is, the journey to “the other side” is often long and always hard. Knowing your body doesn’t do what it’s supposed to do – can’t create or hold or grow life as it was meant to  – is one of the most confusing, maddening, heart-breaking realizations. It’s just plan unfair.

We will never fully overcome the injustice of infertility because it will never go away. But together, we can rise up as a community of family fighters that will not rest until others begin to understand what it’s like to feel broken and incomplete. We must not rest until we find a way to communicate our stories in ways that others understand – enough to do something about it.

This is why, although I’m “on the other side” of infertility, I will reach back across the fence and grasp the hands of my sisters – to steady them, comfort them and fight with them – until they can join me in seeing their dream come true.

No matter what the other side looks like for you, you WILL be better for having crossed over. . .for having endured years of hoping, waiting, and fighting for your family. And when you find yourself standing within the fulfillment of your deepest longing, I pray you’ll also reach back for those who need you to continue to fight.

Infertility has given me strength.

Infertility has given me gratitude.

Infertility has given me compassion.

Infertility has given me perspective.

I am a better woman for having endured and overcome my battle of infertility. I fought for my family and I pray strength and grace and provision for others in the midst of their battle.

Will you join me in the movement to bring awareness to those fighting for family?

{Photo Credit}

Friends, it’s infertility awareness week. I have been reflecting my journey and praying for those that find themselves longing for a child. Will you join us in praying and believing for LIFE to come to the over 10% of women who are struggling to conceive? Please share this message with others in your sphere and let’s storm the gates of heaven with prayers of healing and miracle life.

If you are struggling to conceive, please get in touch with us so we can be praying for you specifically.

He sees and he hears your cry. Trust him as you journey. Your story is being written and it’s not finished yet.

{Photo Credit}

Statistically more babies are born in October than any other month of the year. Actually the entire fall is crazy busy throughout the maternity ward. That means a lot of you are likely considering getting pregnant right now. The internet is chock full of ‘hints’ on improving fertility, but it is loaded with an equal amount of anxiety-provoking misinformation as well.  So what really works and what’s merely an old wives tale? Here’s what the most recent studies say:

1. Have sex

Have sex everyday or every other day for 5 days before and 5 days after ovulation.  Ovulation usually occurs  2 weeks before your period starts. Do not have sex more than once a day {Ain’t Nobody got time for that!} as that can lead to diluted semen.

Things that do not effect chances of conception:

• Female orgasm
• Sexual position
• Female position after sex

NO, it will not help if you stand on your head afterward. Neither is there a top secret magic sexual position that improves your chances of getting pregnant.

What may effect conception: lubrication. The best lubricants for fertility are canola oil, mineral oil or Pre-Seed.

2. Don’t smoke

Smoking is the culprit for up to 13% of all cases of infertility. Either partner’s smoking can effect their ability to conceive. The effects of smoking on your reproductive system can take up to a year to be reversed. There are so many reasons to quit smoking, but here is another excellent one: it can help make you more fertile.

3. Maintain a healthy weight

A BMI between 17-27 is ideal for conception. Recent studies report >60% of the US population are overweight. In some instances, being overweight can lead to higher insulin level, which can inhibit ovulation. This is a condition know as PCOS. (I did an entire series on it in the fall). In other instances, overweight women will have regular cycles (meaning they are ovulating) but still be subfertile. The good news is that even a modest weight loss of 10% of body weight can improve fertility.

Being too thin can also lead to subfertility. Your body senses that you don’t have enough reserves to handle the added nutritional demands of a pregnancy, so your brain tells your ovaries to shut down, causing your periods and ovulation to cease. This is often seen in cases of eating disorders.

4. Exercise in moderation

For women with a BMI of >25, exercise was found to cause a slight improvement in fertility. However women with a BMI of <25, who exercised vigorously > 4 hours a week were found to have a slightly decreased fertility.

Much like being too thin can shut down ovulation, extreme athletes like marathon runners and dancers can go through times of no cycles (no ovulation) when training intensely.

A man’s level of exercise has not been shown to effect fertility, with the one exception.  Men who bicycle > 5 hours a week were found to have lower sperm counts.

5. Healthy diet

Is there a magic food that will make you pregnant? No. However there have been several large studies looking at the diets of women with a history of infertility who become pregnant.

The dietary recommendations based on this study:

• Get the majority of your protein from plants
• Eat high fat dairy food
• Take a multivitamin with iron
• Eat complex carbohydrates

Another smaller study has supported the Mediterranean Diet to improve fertility.

Celiac Disease (gluten sensitivity), if undiagnosed or untreated, can lead to infertility. The treatment for gluten sensitivity is to follow a gluten  free diet.

6. Limit caffeine

It is recommended to limit caffeine to less than 300 mg a day. Here’s a helpful chart to know how much Starbucks you can drink.

7. Alcohol in moderation

While a little wine might be helpful in conception (wink-wink); excess intake may inhibit fertility. Studies show that consuming >14 alcoholic drinks a week has an adverse effect on fertility in both women and men. Consuming 3-13 drinks per week had a a slight negative effect on the woman’s fertility in some studies; but none on the man’s. Three or fewer drinks a week had no effect on fertility. There is no safe amount of alcohol in pregnancy, so once the stick turns pink, then you should abstain completely.

8. Know when to see a physician

Most couples will conceive within 6 months of trying, with 85% becoming pregnant within one year. If you are less than 35 and have regular menstrual cycles (every 21-35 days), it is recommended to see a doctor if you haven’t conceived after one year of trying. If you are over 35, it’s recommended to see a doctor after 6 months of trying.  If you do not have regular cycles or if you experience severe pain with your period or intercourse, you should see a doctor right away.

There is not a magic formula for conceiving. No magic food or sexual position that guarantees quicker results. What does work best is being healthy and regular sexual activity.

Hopefully your journey to pregnancy will be a smooth. Check out this previous post on recommendations for the first trimester once you do conceive.

In the meantime, enjoy the process!

What is the craziest home remedy or fertility “cure” you have heard?

{Photo Credit}

For many of  you, its been years since you thought about the physiology of the birds and the bees. Before we launch into the discussions on how NOT to get pregnant, we are going to go back to basics to review the biology of reproduction.   

The first day of your period is also the first day of your menstrual cycle (day 1).  Spotting doesn’t count, we are looking for the first day of red bleeding. [And if we had any male readers, they just surfed onward.] The menstrual period occurs approximately 2 weeks after ovulation. If no embryo has implanted into the lining of the uterus, the brain immediately realizes you aren’t pregnant and begins sending signals to the ovary to try again this month. An egg is recruited within the ovary and begins to grow with the help of rising estrogen levels. Thus begins a complex fluctuation of hormones that cause the many changes in your body, helping it prepare for pregnancy. It is these hormonal shifts that help the brain trigger the ovary to ovulate each month.

For women with a 28 day menstrual cycle, ovulation occurs on approximately day 14. Ovulation is the act of the egg escaping from the ovary. After breaking through the ovarian surface, it will either sit on the outside of the ovary or fall into the abdomen. The fallopian tubes have finger like projections on their tips that literally pick up the egg and begin to shuffle it toward the inner uterus (endometrium). A small cyst forms on the ovary (the corpus luteum) where the egg escaped. This cyst begins producing high levels of progesterone that will help a pregnancy grow if implantation occurs.

Fertilization occurs within the fallopian tube and the fertilized embryo then begins to develop and works it way toward the uterus. ~30% of fertilized embryos dissolve spontaneously before implantation. Four to six days later the embryo completes its journey and implants into the the lining of the uterus. Another ~30% of embryos will dissolve after implantation, before a period is missed. Another ~10% will be lost as first trimester miscarriages. For every 100 fertilized embryos that form, only 30 will result in a healthy birth.¹

Based on the fact that 60% of fertilized embryo dissolve spontaneously before the first period is missed, it is my opinion that life begins some point after implantation. It is difficult for me to fathom that God would place a soul in each fertilized embryo and then immediately take 60% of them to heaven. The scripture “God knit me together in my mother’s womb” is often used to support the belief that life begins at conception, but the ‘womb’ is the uterus. By the time the embryo reaches the uterus 30% of the embryos have dissolved with another 30% following soon.

The sperm are deposited in the vagina and then must travel through the cervix and uterus to reach the fallopian tube. A few of the strongest swimmers make it all the way to the egg. Only one can break through and fertilize. The sperm take appropriately 72 hours to travel through the uterus to get to the fallopian tube. The average sperm will travel 8 inches to reach its prize egg, this is why women can get pregnant without having actual vaginal penetration. Even sperm released near the vaginal opening can swim into the uterus.

Each month a normal fertile couple has a 20-30% chance of conceiving. If implantation does occur, the progesterone levels begin to increase and HCG increases. The HCG hormone is what makes the pregnancy test positive.

If pregnancy does not occur, then a period will start 2 weeks after ovulation. To determine when you are ovulating, you can count backwards 2 weeks from the period, and then use those numbers to predict when you will ovulate the next month. For example: with a 32 day cycle, you should ovulate on day 18.

To get pregnant, have sex at least every other day for 5 days before ovulation and 5 days after. Do not have sex more than once a day. [And if any men were still reading, now they really just stormed off.]

This week as we discuss contraception, we will see that there are 3 basic ways to prevent pregnancy: preventing ovulation, killing sperm and blocking the sperm from getting to the egg.

1 Sperff et al, Clinical Gynecology Endocrinology and Infertility (Philadelphia: Lippincott Williams & Wilkins: 2005), 245-246.

{Fertilization and Implantation Photo Credit: © 2010 Wolters Kluwer Health |Lippincott Williams and Wilkins. Used by permission.}

I begged God for my children.

I petitioned. . .contended. . .and pleaded with him to let me be a mom.

I knew in my heart that my being a mom was part of his plan for my life and the asking and believing was as well.

Here they are. . .my two beautiful miracles. Well worth the work {of said begging and pleading} and the wait.

But just like every mom, I have hard days. Because let’s face it. . .no matter the process by which you came to be one, being a mom is just.plain.hard.

Having walked through a process of intently asking God to allow me the privilege of being a mom, I often feel guilty on the hard days. How could someone who wanted so badly to be a mother, dare complain when it gets uncomfortable? I feel ungrateful and undeserved of these beautiful blessings.

This week as we head into the Thanksgiving holiday, much like everyone else, my heart and mind are focused on ways I can express gratitude for all of the amazing blessings in my life. There are too many to count. Truly. Most of all, these children that I fought for.

The thing about gratitude is. . .it often lies beneath layers of life in our heart. I’m learning to purposefully peel back those layers to get to a heart of gratitude. It’s not that I am not thankful for my children. God knows that. It’s just that the reality of life often piles on top of my thankful heart, causing me to abandon my thanksgiving and embrace an attitude of overwhelming stress. It’s a shame really. But I don’t have to be ashamed.

Instead of allowing guilt to rob me this week, I am making an effort to peel back those layers. To stop and focus my mind on all of the things I have to be thankful for. My husband and I will involve the children in this process because their hearts too often get piled upon with life and wants and messages of selfishness. We will help them peel back those layers this week to uncover their heart of thanksgiving.

Whether we beg God for something or it comes to us in effortless provision, our gratitude should be the same. . .because “Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows.” {James 1:17 NIV}

What have you begged God for in your life? Do you sometimes feel ungrateful because you’ve allowed the stress of life to overshadow the miracle of his provision? How can you peel back those layers this week?

Happy Thanksgiving Friends! Dr. Rupe and I are so thankful for this community of moms and moms-to-be who desire to encourage and uplift one another. Blessings to you and your families this week!

Often one of the first things that women hear when they are given the diagnosis of PCOS is that they will be infertile or at least have a challenging time getting pregnant. Such news can be devastating. What I prefer to tell women is that we know there is a problem, BUT we also know how to treat it! Sometimes there is a journey to health and fertility, but not always. Many women with PCOS can have successful pregnancies with only simple interventions.

When couples go for infertility testing, about half the time all the tests come back with normal results. Patients often find this reassuring, but as their doctor if there is nothing wrong, I don’t have anything to fix. I love to see infertility patients with PCOS because at least I know what the issue is that I need to correct: they are not ovulating regularly due to insulin resistance.

Metformin

As I mentioned in my last post, diet and exercise are key to treating PCOS. Women with PCOS who loose just 10% of their body weight will often see a return to ovulation. Weight loss and Metformin will lead to ovulation 60% of the time. Metformin is safe to take at the time of conception. Continuing it during pregnancy has been the basis of debate and is provider dependent.

Pregnitude

Pregnitude is a dietary supplement recently available in the US that has been shown to help women improve their fertility, especially women with PCOS.  It contains folic acid and myo-inosol, which is derived from a B vitamin complex. Myo-inosol is a natural insulin sensitizer made by the human body. The product was the focus of an article in the August edition of The Female Patient that listed 2 small but significant scientific studies which found improved menstrual regularity and ovulation in those taking the supplement versus folic acid alone. 82% of women on the supplement ovulated within 3 months, while only 63% on folic acid alone ovulated. The supplement allowed women to ovulate much quicker as well,  24 days versus 40 days.  Women undergoing IVF who took the supplement had significantly more eggs retrieved (12) on the supplement than those on  placebo (8). The supplement is taken as a powder mixed in water twice a day and is available over the counter. The cost is ~$30 a month if ordered from their website or bought from Walgreens.

Almost daily, I get requests for a ‘more natural’ option for fertility and Pregnitude appears to be the perfect answer. It also appears ideal for women who don’t meet the definition of infertility (one year of trying without conceiving) but are frustrated that conception seems to be taking longer than they think it should.

Clomid

When diet, exercise and Metformin have not resulted in pregnancy, then it may be time to discuss Clomid.  Mention the words ‘fertility drugs’ and people see visions of women getting shots in the butt, seven babies and a reality show. Clomid is the mildest of the fertility medications. It has a risk of twins of 10% but triplets or higher is extremely rare. Clomid is taken for 5 days during the cycle and has an ovulation rate of 70%. Clomid is inexpensive at less than $50 a month. So if you can’t afford Clomid, you likely can’t afford a baby.

To monitor if Clomid is working, your doctor will either perform ultrasounds or check progesterone levels at different points of your cycle. Once you have found a dose of Clomid that produces ovulation, you will usually conceive within 3-6 months. If you haven’t conceived in 6 months, the likelihood that you will is extremely low, so additional therapies should be considered. This is the point where  I will refer my patients to a reproductive endocrinologist (infertility specialist).

Clomid is an estrogen receptor modulator. It acts to starve your body of estrogen for 5 days, tricking your ovaries into ovulating. A lot of women report significant hot flushes and mood swings during the 5 days they are on the medication. Like estrogen itself, it can increase your risk of blood clots, so it should not be taken if you have a history of DVT or stroke.

PCOS does not have to be synonymous with infertility. PCOS can present challenges for those wishing to conceive, but these challenges can often be overcome with minimal interventions. For more on the diagnosis of PCOS, see the first post in this series.

Sources for this series of posts include: Clinical Gynecologic Endocrinology and Infertility, Seventh Edition pages 465-498; Summary from Up to Date; ACOG technical bulletin #109, in addition to the article from The Female Patient that was linked to within the post.

 What fertility interventions have you taken in order to become pregnant with PCOS?

In my last post I tackled the complex diagnosis of PCOS, compacting a 60 page text book chapter into an 800 word blog post that, hopefully, the average woman could understand. Good thing our readers are above average, right? This post will discuss the common treatment strategies, and next time we will look at attempting pregnancy and addressing infertility.

The root cause of PCOS is insulin resistance. The best treatments are those that help your body process insulin better. Exercise, diet and the medication Metformin are key to accomplishing this goal.

Exercise

If you have PCOS, exercise is not a suggestion but a command. It is the single best thing you can do for your body. Exercise helps your body process insulin better, revs up your super sluggish metabolism and helps maintain your weight. Getting at least 30 minutes of aerobic exercise 5 times a week is a MINIMUM. Weight training is also key. Building muscle can help boost your metabolism. PCOS increases your risk of diabetes, but regular exercise reduces your risk by 50%.

If you have trouble finding the motivation to exercise, then find a buddy or accountability partner; join a class or consider personal training. If you live here in Franklin, I recommend Temple Fitness (not a paid advertisement, just my honest opinion) as several of my patients have had great results there, and this is where I go to get my butt in gear.

Diet

The metabolism of  PCOS is really just not fair. Your girlfriends can pig out on pizza on the weekend and still fit in their skinny jeans, meanwhile, you walk past a bag of Oreos and gain 5 pounds. Acceptance that this is how your metabolism works is a key first step. You must learn to treat yourself like a diabetic. A higher protein, lower carb diet is going to be your best bet.

The first step to losing weight is determining how many calories a day you need.  Dieticians recommend for PCOS patients to distribute these calories as : 40% carbohydrates/ 30% fat/ 30% protein.  The carbs should be complex, not simple.  Avoid eating carbs alone, instead pair them with a lean protein.  To track your daily intake, try an phone app like “My Fitness Pal“.  As you enter your food throughout the day, it gives you a pie chart graph of carbs, protein and fat so you can actually see how your percentages are tracking each day.  It also has a bar code reader so you can easily scan in your foods (on that rare occasion that you are eating packaged food).  If you are continuing to have difficulty determining what your diet should be, meet with a dietician.

Metformin

Metformin (Glucophage) is a diabetic medication that decreases the amount of sugar (glucose) excreted by the liver, which reduces the amount of insulin your body needs. While not a weight loss drug, it helps put PCOS women back on the level playing field with everyone else. When they are following a lower carb diet and exercising, it helps them lose and maintain their weight. In addition to weight loss effects, Metformin will help up to 60% of women return to regular periods and ovulation. It must be stressed the Metformin works well WITH diet and exercise, but cannot replace it.

Side effects of Metformin are mainly GI upset. When first starting the medication, you can have serious diarrhea. Usually, the symptoms will resolve within a couple of weeks. If the stomach discomforts last longer than that, notify you doctor.

Birth Control Pills

For those women not wishing to conceive, birth control pills are ideal to treat the symptoms of PCOS. They increase the protein in the blood that binds the male hormone, reducing acne and unwanted hair growth. They also induce monthly cycles, preventing the heavy, crampy, unruly periods that sometimes accompany PCOS.

It is important to have a period at least every 3 months to help prevent the build up of endometrial tissue and the possibility of endometrial cancer. If you don’t like taking birth control pills, then taking progesterone every 3 months to induce a period is also an option.

Healthy Weight Women with PCOS

For the 20% of women with PCOS who are not overweight, these same principles still apply. Change the composition of your diet to the recommended percentages, just set your overall calorie goal to maintain rather than to lose.  We do not have a great laboratory test for insulin resistance.  Only 50% of PCOS patients show elevated insulin levels.  Often patients with normal insulin levels will still respond to Metformin, so it continues to be recommended as the treatment of choice.

For those women attempting pregnancy, often instituting exercise, diet and Metformin will lead to ovulation and pregnancy.  My next post will consider what happens when this is not enough.

For those of you living with PCOS, which do you find more challenging: diet or exercise?  What strategies have you incorporated to help overcome your challenges?

I don’t fault patients for finding the diagnosis of PCOS perplexing. It took me nearly 4 years of medical school to fully grasp it.  September is PCOS Awareness Month and with 5 % of  reproductive age women affected, we plan to bring you several posts this month on this often confusing diagnosis.

Polycystic Ovarian Syndrome is a misnomer. It is not an ‘ovarian syndrome’ at all. The root cause of PCOS is a combined genetic and metabolic issue. Women with PCOS do not react normally to insulin. When sugars hit their blood stream, their body requires extra insulin to process the sugar. The higher levels of insulin have several effects in different areas of their body, including messing with their ovaries. The insulin molecule is very similar in shape to another molecule that has receptors on the ovary.  Insulin then falsely attaches to the ovary, causing it to release too much male hormone, leading to lovely features like acne, abnormal hair growth and even male pattern baldness in extreme cases. The extra male hormone gets converted to excess estrogen in the fat cells, which prevents ovulation. The excess insulin makes weight loss more difficult, which can lead to obesity.

Estrogen is the hormone responsible for creating the blood and nutrient rich lining of the uterus. A normal amount of estrogen makes a healthy lining for an embryo to implant. With PCOS, there is an elevated level of estrogen, creating excess tissue, leading to heavy, crampy periods. In extreme untreated cases, it can lead to precancer of the uterus.

It is much harder for women with PCOS to lose weight and keep it off, due to their body’s resistance to insulin. As they get heavier, the fat cells themselves secrete additional hormones that worsen the insulin resistance.  Essentially, the more weight a woman with PCOS gains, the harder it is to loose the weight. This helps explain why 80% of women with PCOS are obese.

Some of you extra smart ladies are already thinking, “Isn’t extra insulin just like diabetes?” Yes and no. PCOS is in many ways a pre-diabetic condition. However, there has to be a genetic predisposition to PCOS as well.  PCOS is caused by how a woman’s body reacts to the excess insulin. Not all diabetics have PCOS. Many diabetics will ovulate regularly and have no excess of male hormone, despite their elevated insulin. We also see that PCOS tends to run in the family.  In studies of identical twins, if one twin has it, there is a 70% chance the other twin will have it as well. This leads us to think that the abnormal insulin metabolism is caused by an inherited genetic defect…yet another thing that we get to blame our mothers for.

Despite the hormonal imbalances going on in the body with PCOS, the ovary tries its best to ovulate. Much like the “Little Engine That Could” the ovary desperately attempts to make its eggs grow each month, but rarely will it mange to get an egg mature enough to fully ovulate. This leads to a swollen ovary with multiple tiny cysts of immature eggs (follicles). The PCOS ovary stays enlarged and swollen, but the ‘cysts’ associated with PCOS are multiple tiny cysts; not the large painful kind that women often need to be surgically removed.

I often see women for second opinions for PCOS. One doctor told them they had it, then another said that they didn’t. They are frustrated and want answers. However, PCOS is a clinical diagnosis, making it subjective. When your throat hurts, you go to the doctor.  She thrusts a q-tip down your throat and runs a test. The test is straightforward: positive or negative. Alternately, PCOS  is based on a collection of findings that can be supported by blood work, but there isn’t a definitive test.

To further add to the confusion, there are currently 3 sets of diagnostic criteria for PCOS floating around. Also, in Europe physicians put a lot more emphasis on ultrasound finding, while in the US clinicians look more at symptoms.

The most common definition in the US is the NIH {National Institutes of Health} criteria:

1. Irregular periods

2. Evidence of elevated male hormone (either lab work or symptoms)

3. Exclusion of other causes of elevated male hormone.

The classic patient with PCOS is overweight, with most of their obesity in their abdomen. Weight loss is extremely challenging due to their body’s insulin resistance. Their cycles are sporadic, every 2 to 3 months. They struggle with fertility due to their ovary’s inability to ovulate despite its best efforts. They get the added bonus of often needing to wax their chin way more than their friends. PCOS is a challenging condition but the good news is, it’s manageable. In my next post I will look at the different ways to manage your symptoms and a new natural therapy to help fertility.

Have you been diagnosed with PCOS? What questions do you hope we’ll answer for you as we participate in PCOS Awareness Month?

{PCOS Image Source}

I have to admit, up until this evening I had nothing as far as a blog post for you my friends. Life with a toddler has proven to be crazier than I remember. I’d forgotten that moms do not get to sit down when their littles are between age 12-24 months ish. But the great thing about having “nothing” is it forces you to seek God desperately for something. His thing. Providentially, the “thing” I feel He’s given me to share has a lot to do with seeking Him in our nothingness.

Barrenness.

 A state of being unproductive. Unfruitful.

Having been physically barren at one point in my journey and realizing there are several women in our community continuing to believe for life within their bodies, I of course am speaking in the most literal sense here. But for those that have not struggled with physical barrenness, take a moment now and ask God to show you other areas in your life where you might be unfruitful, areas where you need life.

After my second miscarriage, I closed the door to our empty nursery. I couldn’t stand the sight of the room at the top of the stairs that had no sign of life to come. It was easier just not to look at it.

One day my mother came over and with tears in her eyes she said, “You need to open this door. You need to believe this room will be filled. Open this door in faith that life is coming.”

As I looked deeply into her firm gaze, I nodded and opened the door

Weeks passed, and I found myself drawn to sit in that room every once in a while and pray. One particular morning I was led to Isaiah 41:18-20 as I prayed.

“I will make rivers flow on barren heights, and springs within the valleys. I will turn the desert into pools of water, and the parched ground into springs. I will put in the desert the cedar and the acacia, the myrtle and the olive. I will set pines in the wasteland, the fir and cypress together, so that people may see and know, may consider and undertstand, the hand of the Lord has done this, that the Holy One of Israel has created it.” {NIV}

As I read those words, I began to feel faith rise up within me. I knew that this was a promise for all of God’s people and in this season, especially for me. I’ve never been one to name it and claim in, but I began to believe – truly believe that it was time for me to have a child. I knew at this point, any further waiting was not God’s plan.

A month later I became pregnant with my now, 4 year old daughter, Hope.

This promise is not just for me . . .for some. It’s for you. It’s for the child you long for. The finances you so desperately need. The freedom from a life-draining addiction. The reconciliation of a strained relationship.

Wherever you are barren in this season, He has promised to bring life. Wherever you are parched, He has promised to bring springs of provision.

My father-in-law took this photo last year on a visit to Colorado. I just love the visual of rows and rows of trees standing firms towards Heaven. I believe this is a picture of the provision that is coming for this community of faith. Countless testimonies of His faithfulness.

“…so that people may see and know, may consider and understand, that the hand of the Lord has done this, that the Holy One of Israel has created it.”

For our growth and His glory . . .our barrenness will give way to life.

Do you believe it? If so, I want you to boldly share what it is you are trusting God for right now. We can believe together that He will make rivers to flow on barren heights.

I consider myself one of those people who doesn’t always know what to say. This is why I love to write. Writing allows you time to think and formulate and perfect. Having words on the spot requires much more instinct. And guts. . .it takes lots of guts to open your mouth, let the words fly and hope you are saying the right thing. The good thing about me though, is when I don’t know what to say, I usually just say, “I’m so sorry” or I keep my mouth shut. I suppose this is a talent I gained after enduring several losses and cringing at the thought of some unknowing person thinking they know and in turn telling me what I should know to be true about my situation.

“God has other plans.”

“Maybe you should adopt.”

“If you will just relax. It will happen.”

The loved ones that truly brought healing were those who thought, beyond words, to reach out to my broken heart. Sitting by my side. Crying with me. Bringing a meal over so I didn’t have to cook. Holding my hand even though I clenched theirs so hard it hurt.

When someone is hurting, this is the outpouring they remember. Not the cliches and recited prayers. We need to go beyond words to meet the needs of grieving hearts. Because there is a holiness in tears and touch that can get lost in words that flow out of the human heart.

I have the great privilege to introduce our readers this week to an amazing artist and mother, Stephanie with Beyond Words Designs. You can read more about Stephanie’s story and the loss of her baby girl here. As a tribute to her daughter, Stephanie created Beyond Words Designs where she creates art that celebrates life. I met Stephanie at Blissdom this past February. We were sitting at a table together during one of the sessions. I overheard her sharing part of her story and I knew I was to meet her afterward. While many other attendees made their way to chat with the speaker, I knew I needed to and wanted to meet this woman who endured such loss (from what I could hear) yet emulated peace and joy.

I know there are several mothers in our community who have suffered loss through infant death, stillbirth, miscarriage and infertility. I know the pieces in the Beyond Words collection will speak to you. But this art is not only about loss. It’s about life. So no matter what your story, there is something beautiful for you in these pieces.

We have the great honor this week of giving away a $50 shop credit to Beyond Words Designs! Enter below for your chance to choose your favorite item in Stephanie’s store. You may choose something to honor a loss or if you are currently expecting there are beautiful images portraying life to celebrate your pregnancy.

We’d love to hear from you. . .what acts that went beyond words meant the most to you when you were walking through a difficult time?

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