One of my friend has just had a baby and her prerequisites were: a bible passage she'd picked, Mary, Jesus, a shepherd and lambs.
I youtubed how to make an altered book and gradually got some inspiration. It took a couple of months to make as I had to wait for layers of glue to dry and cutting the niches also took a while. I also had to wait until I was feeling the love as I am not religious and just wasn't feeling inspired some days. There were a number of times I though God was going to strike me down for damaging a Bible but I was assured that I was celebrating his work and not abusing it so it was ok. It sounds cheesy but when I make an artwork I like to know who I am making it for, and as I make it, I pour my love and happy thoughts into it.
I really enjoyed the process and I think I did pretty well for a 1st go!
Here are a couple of pictures of the process: