It’s Mother’s Day. Women of the congregation are everywhere spruced up and a smidge giddier than usual. Hymn singing rises to match the levity in the room. At the first break in the service, a few deacons bring parcels of flowers to the front for distribution and the worship pastor smiles broadly as he launches into the annual Honoring Mothers tradition of recognizing the oldest mother, newest mother, and the mother with the most children. With everyone smiling and another successful Honoring Mothers ceremony in the books, the worship minister gathers attention and again launches into song.

On the third row from the back, a young woman sobs uncontrollably. She is not a mother. She longs with all her heart to be a mother, but she and her husband have not been able to conceive a child of their own. They are infertile. For her and her husband, Mother’s Day brings inexpressible sadness. A few weeks later, a similar ceremony is repeated for Father’s Day. They attend church on Mother’s and Father’s days only because they know in their spirit they must. Gathering for worship is what Christians do, irrespective of the holiday.

I tell this story to stimulate some initial reflection on the question of how pastors can help couples struggling with infertility. For a variety of complicated reasons, that question of how to help isn’t an easy one to answer. We tend for good reason to keep our procreative lives private, for one thing. Its nobody else’s business. That privacy naturally extends to the experience of infertility. Couples feel wounded or vulnerable or fearful and are fiercely reluctant to vocalize their struggle. Some might even resist voicing their struggle because doing so affirms that it is real.

Whatever the particular circumstances and disinclinations of couples, there are a few things pastors should bear in mind as they come alongside infertile couples:

1. You may not be aware of just how many families in your church have or do experience infertility.

The World Health Organization defines infertility medically as the inability of sexually active, non-contracepting couples achieve pregnancy after twelve months. And according to the CDC, approximately 10% of couples experience some form of infertility. To put that number in perspective, if your church has, say, 100 families, then at least ten of those families have experienced infertility. A considerable number. Add to this the likelihood that another 15-20% have experienced miscarriage, it quickly becomes clear that nearly a quarter of your church has suffered the pain of infertility and/or miscarriage.

2. Handling infertility with pastoral care will mean handling the Bible with care.

Offering pastoral care for those experiencing infertility is a delicate matter. It is important to resist the impulse to “fix” the situation, especially that involves offering a platitude and prayer. In my extensive conversations with infertile couples, one particular wound is recurring: people, particularly pastors, failing to meet them in their pain and resorting instead to some modified wives tale to relieve anxiety. Pastoring couples experiencing infertility requires bearing with them in their suffering, in what ways are possible. I’m reminded of some pastoral wisdom from Henri Nouwen on this point: “The friend who can be silent with us in a moment of despair or confusion, who can stay with us in our hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality our powerlessness, that is a friend who cares” (Out of Solitude: Three Meditations on the Christian Life). Listen, listen, and listen some more.

When the time comes for counsel, please bear in mind that the infertility narratives in the Bible—Abraham and Sarah, Jacob and Rachel, Elkannah and Hannah, Elizabeth and Zechariah—have a specific purpose within the wider scriptural narrative. Each of the narratives has a happy ending, as it were, but it is a mistake to see them as proof that God always prevails over infertility to provide a longed-for child. The stories can’t be named and claimed, for there are scores of faithful couples who, like Hannah, have wept before the Lord for children and who have never conceived a child. Life is a gift. The purpose of the infertility narratives is to illustrate God’s special care for the childless and his faithfulness to the covenant. So much of pastoring infertile couples is helping them glimpse the dazzling hope extended to them in Jesus, that their lives are defined first by discipleship to him and only in this relationship do we then understand who we are as spouse or friend or even parent. The purpose of the infertility narratives is to illustrate God’s special care for the childless and his faithfulness to the covenant. Click To Tweet

3. Become better informed about modern fertility treatments, especially artificial reproductive technologies.

If families in your church are experiencing infertility and have perhaps sought medical advice or treatment from a specialist, then it is important on a pastoral level to be aware of what specifically they may be going through or asked to undergo. Like other forms of medical intervention, fertility treatments begin with the least invasive measures and escalate up only as needed. Sometimes couples simply need lifestyle or dietary changes. Other times they need more, like hormonal therapy or some minor outpatient surgery. The less invasive or involved a treatment, the less likely it is to raise moral concerns.

At some point, however, when minor treatment options have been exhausted, a couple may become eligible for more advanced—and also more invasive—forms of fertility treatment. Proceeding to this phase nearly always involves the use of Artificial Reproductive Technologies (ARTs). The most prominent of these technologies is Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF). I cannot go into full overview here, but I would encourage pastors to appraise themselves of these forms of reproductive technology. IVF, in particular, involves some definite moral risks and it is, I think, important for pastors to understand the basic process of IVF and get a clearer idea of what couples are committing themselves (and their embryos) to. While reading up, get familiar with surrogacy, too, which is now mainstream both inside and outside the church. Pastoring couples in this area will only get more complicated in coming years.

I do not wish to over-prescribe a pastoral strategy for ministering to couples struggling with infertility. I suspect your pastoral instincts are probably pretty keen. If you’re a good shepherd of your flock, you know the needs of your sheep and you protect them from circling wolves. You want your people to flourish. The difficulty here is that many infertile couples feel so deeply wounded and afraid they become overwhelmed by the totalizing force of the experience. Infertility feels life-defining for them, like the story they imagined their lives taking has been thrown into question. It is deeply important for pastors to grasp the gravity of this experience because grasping it goes a long way to companying with them sensitively and persistently.

God may not give children, but by his grace, he has made us his children. The God who gives life is the same God who heals the sick, mends wounds, and raises the dead. He is near the broken-hearted. Good shepherds bring the wounded and hurting sheep to the one who has bore our griefs and carried our sorrows, to the one who heals and makes all things new—the Lord Jesus Christ.