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Infertility and Miscarriage

Truth in Love 433

How do we counsel those who are struggling with infertility and miscarriages?

Sep 25, 2023

Dale Johnson: This week on the podcast, I have with me a good friend, Jeremy Pray. He’s the Pastor of Biblical Counseling at North Creek Church in Walnut Creek, California. He’s an ACBC certified counselor and he’s in the Fellow candidacy process. So, in the future, he will be supervising, potentially, some of you who are our listeners. In addition to overseeing the Biblical Counseling Ministry, he also oversees various other Adult Ministries there at North Creek. He has a Master of Divinity from the Master’s Seminary. He and his wife Hayley have been married since 2005, and they have four children. I want to mention even before we get into this, part of the topic has come up. We asked you to write a booklet on this topic. I think this is an area where biblical counseling has not addressed some of these issues and so as a part of what was produced from that conversation is you contributed to our Biblical Solutions series. I want you to talk a little bit about even your story as we work through some of these questions. And, and as you talk about infertility and miscarriage. So let’s start here. Did you ever think you’d be writing and speaking on a topic like a tiller be in miscarriage?

Jeremy Pray: Well, thanks for having me, Dale. No, I didn’t think that I’d ever be speaking or writing on this nor did I want to. My wife and I, not long after trying to conceive, we learned from the doctors that it was not impossible for us to have children, but it was unlikely. That then launched us onto a path of building our family in a way that we never would have dreamed, ending up doing embryo adoption for several of our children that the Lord has given us now and then having several naturally. And then our fourth child is a daughter and we learned after she was born that she has Down syndrome. So there’s all kinds of different things we can talk about here, but when it comes to the topic of infertility and miscarriage, no, I didn’t want to have knowledge on that. However, now that the Lord has brought us through that, it’s given me the ability to minister as a pastor in ways I wouldn’t have been able to do otherwise. I think it’s important, when we think about this topic, because nobody wants to be an expert on this kind of stuff. Many biblical counselors want to do all kinds of things; this isn’t a topic that they think they want to jump into. Sometimes because it’s a fearful thing, they’ve never experienced it, they know it’s tender, they know it’s a difficult thing for people to walk through. They may not even know where to start. And so, how do we, as biblical counselors, faithful brothers and sisters in Christ, when we know someone who’s struggling with infertility and miscarriages, how do we help? How do we begin engaging? Where are the places that we start? I think one of the most helpful things to do is to do some thinking before you actually sit down with them. In other words, you’re just considering the various ways in which they might be suffering. For example, you’d want to think about things from the wife’s perspective and the husband’s perspective, especially if one of them is the reason why they’re infertile. How are they handling that within their marriage? But thinking about miscarriage in particular, think about how a man has the ability to move on quickly. He can put it behind him and he can act like everything’s fine. It doesn’t mean that he doesn’t care, but women don’t have that luxury because this type of struggle is happening within her body. If medical doctors are involved, it’s usually on her to make and go to the appointments and if he’s working full-time, it’s not easy to be able to make it to all those. The pain and the suffering have a physical component for the wife that the husband will never experience. And so, thinking through those types of things ahead of time is going to help us in numerous ways and just helps us to think deeply about what that they might be going through, which is then going to inform the tone and the questions you ask and just to care for them well. You’d want to consider how this might be causing their walk with the Lord to struggle perhaps. Put yourself in their shoes. If you couldn’t have children, where would you be most vulnerable? Would you be prone to worry? Would you be jealous of others? Which you have fear of man? Would you question God and His goodness. After all, He’s the one that said that we’re to be fruitful and multiply so why isn’t He giving me children? Is He punishing me for that sin that I committed? So the goal is not to narrow down like the top five areas where they might be struggling, but instead is just to do the opposite: to help us realize that their response could go in a number of different ways. So when we’re considering the various ways in which they struggle, you begin to cultivate a spirit of compassion before you even sit down with them. And then when you actually do sit down with them, we want to ask good questions and by that, I don’t mean interrogate them. Sometimes as counselors we hear that so often you got to ask good questions and we don’t even wait till their lips have stopped moving and we’re ready to ask the next question. Especially in a situation like this, which you mentioned is very tender, this is the time when you want to ask a question and you want to slow down, give them plenty of time to respond to elaborate. Just remember that not every silent moment needs to be filled with words, because they’re going to be much more likely to really open up if they know that you seek to understand, not to be understood.

Dale Johnson: I can’t emphasize the things that you just said enough. Sometimes this is the first moment that people have verbalized some of the pain, the hurt, the difficulty and the suffering that they’re experiencing. Just as you mentioned, it’s taking them a while to process it. They thought through this story in their mind, they found themselves asking the very pointed questions (why is this happening?) and now they’re verbalizing it. To take those first moments slowly to ask questions and to be patient, to let them sort out how they’re thinking, what they’re feeling, even processing that as a talk-out-loud to someone even for the first time. That brings up all the vulnerability. They tried to deal with the suffering, they try to deal with the pain, they tried different solutions to try and insulate themselves, and now they’re bringing all that stuff back up. We work through some questions, we get some data, we’re trying to listen to their story patiently and tenderly. Because suffering, in things like infertility and miscarriages, is the same experience but people don’t always experience it the same. So it’s important that we listen well on how they’re handling the suffering that they’re walking through. Now we move into the issue of having to give counsel. After we’ve listened and given them ample time to share their thoughts or struggles, it comes to actually provide counsel. Where do we start as we we open our mouth at that point?

Jeremy Pray: So to be clear, you’re not asking what do we cover throughout our entire time with them, but where do we start? A couple things come to mind. First, I think that we ought to strongly resist the temptation to tell our own story, if you have one. That’s usually where our mind goes: I want to share this to encourage them and I would say it may be appropriate to do, so but I would argue that that should come much later, if at all. I’m not saying they don’t want to hear your story, they may even ask for your story. I’m just saying that I think that there’s a wiser place to start right at the outset and that’s to point them to their Heavenly Father. Instead of first offering your own advice and before mentioning helpful resources like books or sermons, we ought to point them to the Good Shepherd who cares for His sheep. So, how do you do that? Two major categories come to mind. The first is to help them lament. Help them, before they gather all their thoughts, help them to bring their honest cries to God now, not waiting until they get all their thoughts in good order. By way of example, my wife and I still look back on the times that we read and we cried and we prayed through Psalm 13, during our struggle with infertility. It was some of the most memorable and pivotal phases in our trial, because we just pour out our hearts to God, along with David in that Psalm. Then after we’re doing that, asking “How long O Lord?” and at that point, you settle down and you’re able to gather your thoughts and your emotions and come to a place where we could sing with David, literally sing out-loud, “But I have trusted in your steadfast love, my heart shall rejoice in your salvation.” What that means for you, as a counselor, is to come prepared with some good Psalms in mind. I mentioned Psalm 13, you got Psalm 24, Psalm 77 is a great one where he counsels himself. There’s lots of other ones, but just find a Psalm that will usher their raw feelings straight into the presence of God through prayer. The second one is to fix their hope on God. You don’t want to fix their hope on anything else but Him at the outset and your entire time together. You can remind them of John 10 where Jesus talks about how he cares for his sheep. John 10 is the personal fulfillment of what we read in Psalm 23. Ephesians 1:11 and 2 Corinthians 4:17-18 talk about how God’s always at work, even when He seems idle, even while they’re waiting. You can remind them that God will never leave them or forsake them, even in this trial (Hebrews 12:2-13:5). You can remind them that God promises to work everything for good in the lives of believers to make them more like Christ. You can teach them to hope in God, because he alone is their refuge and strength. On that point, on hoping in God, I just want to remind us to exercise some caution here. We need to strongly resist the temptation to just blurt out false hope, because sometimes we don’t know what to say. Regardless of the statistics, we can never promise that they’re going to have a child someday, if they’re going to have a child if they just stopped trying. We can’t tell them that their trial’s almost over. We can’t tell them that the pain will soon be gone. Placing one’s hope in anything but Jesus Christ will only lead to disappointment. So to answer the question, “where do we start?” more simply we could just summarize by saying, “just be ready to preach the gospel. It’s the good news of Jesus Christ for sinners living in a fallen world. Everyone needs the gospel. It’s central for salvation and sanctification. So give them that kind of hope right at the outset, fix their hope on Christ and then from that point on in many ways, it’s really just counseling like normal. So you’re coming alongside the couple to help them grieve well, perhaps addressing heart issues that are revealed like fear and worry, anxiety, loneliness and control, etc.

Dale Johnson: I appreciate even the warnings that you’re giving there in our tendency, when things get silent, we don’t know what to say. We might start trying to put God on the hook for things He’s not promised. We have to be cautious about that because we don’t know what the Lord has for their life and we’re called to prepare them to lean into Christ, no matter what their experience may have. I want to move now to thinking about, we always want to know practically what to do. So, when we talk in practical terms, what are the kinds of things that, after we’ve done all the things you’ve mentioned up to this point, what do we encourage them to do as a couple?

Jeremy Pray: I’ll try to narrow it down to several things that are specific helps for infertility and miscarriages, in particular. The first would be to encourage them to be good stewards of all that God has given them. This would include her body, their finances, the time that they have devoted to researching this topic, and going to all the doctors appointments and so forth. So remind them to be good stewards of their body, ask them questions in that regard. You may need to exhort them to remain in fellowship. In fact, I could say you probably are going to need to exhort them to remain in fellowship and not pull back. The hard part, with this particular trial, the hard part about being in fellowship, is it seems like everyone’s having babies without issue. They’re saying things like “I just look at my wife and she gets pregnant” and those are hard to hear, but the commands of Scripture to exercise “the one another’s” still apply and if they’re not careful, they’re just going to curl in on themselves, like an ingrown toenail. So you’re probably gonna need to equip them to exercise the sermon, also with medical care, because it is awfully tempting to completely dismiss morality when all you want is a child. The doctors don’t have the same morals. I’m assuming they’re unbelievers. Many of them just want to boost their success rate, so oftentimes morality is just out the window. They’ll help you get a child at all costs. If you’re not thinking clearly, if they are not thinking clearly, then sometimes you have to look out the rear view mirror to figure out “How did I get here? What decisions did I make?” So just help them ahead of time to exercise discernment and that area I’d say you need to emphasize resources that they need. I can guarantee they’re already researching resources that they want, circumstantially. Regarding pregnancy, whether or not acupuncture is okay, whether or not, I should change my diet. How should I exercise? What do I do there? Your job is to emphasize what they need spiritually. Give them what they need in relationship to the Lord. If Jesus was sitting right next to them, would He recommend a website? Would He recommend a sermon series? I have a feeling he’s going to say, “haven’t you read?” Lastly, I’d say encourage them to sing. I think this is important with heavy trials like this. Remind the brothers and sisters in Christ to sing songs that feed their soul, preferably songs with lyrics that are based on or related to the Bible passages that you’re studying with them. So lodge them in the context of a particular passage of Scripture and find a song that takes those truths and brings them to the Lord. I don’t mean find their favorite artists or their favorite melody. I mean find a song that will help them to take their affections and their feelings to both the inner man and the outer man and bring them to the Lord with spiritual truths so that they can worship God, with the Bible being tethered to their heart. This is what Colossians 3:16 talks about to help them to dwell, to have the word of God dwell in them richly, both in the inner man and the outer man.

Dale Johnson: I love the way that you bring music into that. I think that’s a way that we can continue to foster putting the Word into their heart and then turning that Word into the worship, as we bring our sorrows and difficulties to the Lord. That’s the right posture, that the Bible is not afraid of our difficulties, is not afraid of our grief, not afraid of our sorrows. It’s what do we do with it. Do we bring it before the Lord? Now I want to bring this back around to you and your wife, Haley. You and I’ve had conversations, even about this very topic. Tell us some of the lessons that you guys have learned for you and your wife, since you’ve walked through this miscarriage and infertility.

Jeremy Pray: God really used this trial, for my wife and I, to help us recognize how we had a really tight grip on our plans. If I could show you my fist, just it imagine there’s a tight fist around our plans. I didn’t even know that I had this tight fist around my plans. We knew exactly when we were going to have kids. Two years into marriage, we’re going to have kids in this month and this is how we’re going to do it. We’re going to have this many kids, this is where we’re going to live. The Lord used this particular trial to help us, not only say that we believe that God is sovereign, but to show us that what that actually means practically. Are we really willing to yield our desires for our future plans to Him and His plan? It’s one thing to say that God has control, but when His plan is different than what we were expecting, that’s where the rubber meets the road, in terms of the depth of our faith. We’re still learning the lesson too. When things don’t go our way, we’re learning that it’s one thing to just be okay with it, that’s like the first step. But it’s another thing to actually embrace it as God’s good and sovereign plan. The latter takes great faith. My wife and I definitely have not arrived, so it’s a lesson that I’m continuing to learn as I get older, and especially as we started to go through the trial with having a special needs child. All of a sudden, you look at the other hand and that hand is closed, like “What happened here? I thought I learned this lesson!” It’s just a lifelong lesson of learning to yield our plans to God’s perfect plan and recognizing as such, and then embracing as such, and worshiping Him throughout the entire trial.

Dale Johnson: This has been a helpful conversation. I want to encourage our listeners to pick up Jeremy’s booklet on this topic, infertility and miscarriage. He shares, even in more detail, some about his own story and the things that the Lord has taught him through this process. I think it’ll be an encouragement to all of you as counselors. Jeremy, thank you for your time.

Helpful Resources:

Booklet: Infertility and Miscarriage: Helping Others Trust God in Every Season

Click here for more information about ACBC’s 2023 Annual Conference.