When Missions Affects Family Planning

by Krista Horn

When we moved overseas we knew certain things would be laid on the altar.  Things like consistent electricity and wifi.  The freedom for me to wear pants outside the home.  Having someone else teach our kids.  Trips to the library.  Cherry Coke.  The list goes on, big and small.

We also knew there’d be unforetold sacrifices.  Expect the unexpected, right?  What we didn’t know was that one of our unforetold sacrifices would be much greater than others like bathing in dirty water or conforming to community living.  When we moved overseas to live out this calling as missionaries, we didn’t know that our family planning was being laid on the altar.

By the time we moved to Kenya, our youngest son was six months old.  If you had asked me before he was born, I would have said that I hoped to have one more baby after him.  One more baby…in Africa.

I liked the idea of having four kids.  So did my husband.  But the practical side of ourselves said to take family planning one kid at a time, so we had our third child – our third son – and were content.  Besides, our life was a blur.  We’d just had three babies in as many years and were in the final stages of preparation for moving to Kenya.  Debating what the final and complete size of our family should be was not exactly a priority at that time.  We did, however, begin regularly praying for God’s guidance in the matter.

So we moved to Kenya with our three boys, ages 3, 2, and 6 months.  After a couple weeks of settling in and figuring out the basics like where to get groceries and how to use our phones, my doctor husband began working at the hospital and we hit TRANSITION.  The next few months felt like utter chaos.  My husband was gone almost all of the time, learning how to do medicine in a completely different context than he was used to.  And I was home almost all of the time, learning how to make chicken nuggets from scratch in between changing diapers and rescuing our toddler from pincher ant attacks.

Thoughts of family planning were as far from our minds as they had ever been.

Eventually we settled into a rhythm of sorts and could entertain the thought of having another child.  We still liked the idea of having a fourth baby, but as we prayed we discovered we had doubts for the first time.  We asked ourselves difficult questions like, “Do we have the capacity for another child anymore?  Do we even feel called to this?”

There seemed to be a thousand factors to consider, all of which stemmed from our life overseas.  This life means homeschooling.  It means more effort with cooking and cleaning.  It means having a husband who’s on-call and running to the hospital at all hours of the night.  It means limited babysitting options and fewer opportunities for self-care.  It means finding new ways to connect in our marriage.  It means putting desires and dreams on hold all the while creating new desires and dreams.  Adding another child to the mix would affect all of this, one way or the other.

We prayed and debated for well over a year.  In the end, we decided against having a fourth child.  The mission field had changed enough in our life that we knew growing our family would make us head in a different direction than what God had in mind.

This was one of the unforetold sacrifices for us.  It was also the greatest sacrifice we’ve made as missionaries.

Our decision was made with confidence and led to both relief and grief.  There were days when I rejoiced that we could move forward and not be mired in toddler tantrums and potty-training forever.  There were also days when I cried as I folded a onesie for the last time, knowing we’d never have another baby to wear it.  But in the midst of our back-and-forth emotions of relief and grief, one thing remained abundantly clear: we are called to medical missions no matter the size of our family.

When we moved overseas we didn’t know we had closed the chapter in our lives for having babies.  We had to wrestle with that realization when it hit.  But we don’t regret our choice because God was faithful to guide us through this major decision as we laid it before Him.  At times we still grieve the idea of having another child. When those moments come, we remember that God has given us three beautiful boys, along with confidence in our calling as medical missionaries, and we know that we have been blessed beyond measure.


Krista Horn met and married the man who once took her on a date to go tree climbing, which just about sealed the deal then and there. After her husband slogged through seven years of medical school and residency (with Krista doing quite a bit of slogging herself between work, grad school, and becoming a mom), they left for the mission field with three boys 3 and under. Now they live and work at a mission hospital in Kenya. While her husband is busy on the wards, she stays busy with all the details of motherhood on the mission field.  When she’s not making meals from scratch or singing lullabies or chasing skinks out of the house, Krista loves to curl up with a book, bake chocolate chip cookies, and go to bed early.  Krista blogs at www.storiesinmission.blogspot.com.

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Krista Horn

Krista has roots in the Midwest but moved to Kenya in 2016 with her doctor husband and three boys ages 3 and under. After exchanging life in the far north for life on the equator, they have lived and served at a mission hospital ever since. While her husband stays busy teaching and training on the wards, Krista stays busy with all the details of motherhood on the mission field. When she’s not homeschooling, cooking from scratch, or helping her boys look for chameleons, she loves to curl up with a book and eat chocolate from her secret stash. She is known for packing chocolate chips before anything else goes into the suitcase. Krista blogs at Stories in Mission.

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