This Was NOT Our Birth Plan

Here is the birth story of my son that took me TWO years to write…

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Lincoln and Mommy in the NICU at 1 week old. June 30, 2016

Can you believe that it has taken me two years to get my son’s full birth story typed out?

If you know me at all, you know that I’m not a “put it off” kinda gal. I like my to do lists to be crossed out early in the day, I do laundry multiple times a week to prevent any sort of pile build up, and the kitchen is clean before I go to bed each night. Overall, I’m what many would call a “Type A Do-er”.

At the same time, I’m also E.M.O.T.I.O.N.A.L.

And in this case, my emotions totally have trumped my ability to “do” when it comes to getting this out there, acknowledging the facts behind the day and sharing it with the world.

I decided this past winter, that I owe it to myself, and to my husband and sweet little tot, to get this damn thing done. And now it’s June, Lincoln will be two in nine days, and I’m sitting here telling you all about WHY I keep holding myself back instead of actually telling you WHAT happened. But, no longer… I’ve delayed long enough. I’ve hidden behind my own fear. I’ve concealed the drama. I’ve ignored the truth.

Let’s rip off the bandaid and do this.

*** Warning: The contents of the following blog post are RAW, TRAUMATIC, and HONEST. This content may be a trigger for families who have dealt with unexpected birth plan outcomes. Please do not continue reading if you have anxiety about your own (past or upcoming) labor and delivery. I will be back on the blog to share my sleep tips on July 1st, and my feelings will not be hurt, one bit, if you close out of this window right now. ***


When I was admitted to the hospital, I wasn’t even with my husband

I started having fairly intense and regular contractions early, early morning on Thursday, June 23rd, 2016 and was taken to Labor and Delivery around 8 am. A gigantic shout-out to my dear friend, Olivia Hansen, for being my chauffeur and sticking around in Labor and Delivery during the intense beginning of this birth day adventure.

Is it weird that my friend took me to the hospital and not my husband? Well, no. Because I was in Salt Lake City (THANK GOD), and JJ was in Elko. For those of you not local, it takes just over 3.5 hours to get from our house to the University of Utah Medical Center, where we elected to received our prenatal care.

School had gotten out for the summer, so my friend Andrea and I decided to attend a breastfeeding class in Salt Lake City. She was staying in Salt Lake until her son was born (just 2 days later), and I was 39 weeks preggo, on summer break, hotter than a sizzlin’ fajita at La Fiesta and living in a double-wide trailer with no AC.

A trip to Salt Lake for a nice dinner, a prenatal lactation class, and a trip to the mall with air conditioning was just what the doctor (errrr midwife) ordered. Plus, I had my 39 week appointment on Thursday, so I would just hang out there and then head back to Elko for our last weekend as a couple, before baby.

I was due on June 30th, and our son would be born that day, so we were in the clear. Completely.

Okay, back to the room in L&D.

I was hooked up to a few monitors to check out the baby and keep an eye on my ever stronger contractions, and things were looking good. So, I chatted with JJ and we decided he should continue in to work, driving over an hour to the West (aka the opposite direction of me). We we sure that even if it were  “real” labor (which we KNEW it wasn’t), things would take time. He would head to work, save up his PTO, and head my way as soon as he got the call that things were really happening.

But then, things changed…

By 9 am, it was clear that baby was not happy with the way things were progressing, as his heartbeat would drop with every contraction and the recovery time between contractions was taking longer and longer.

With JJ (and our families) on the way, we needed to buy ourselves some time and allow the medical staff to make a plan, so I was instructed to try all sorts of different positions to try to make baby happier. Despite the creativity of the midwife and nursing staff, baby was still under stress and the talk of a cesarean section began. This was not our birth plan.

The way it was “supposed” to be

I should probably back up and tell you about some of the “pre baby” prep that we engaged in. We completed the entire Hypnobabies course from the comfort of our home. We attended multiple birthing classes at the University of Utah hospital. I went to the lactation class just the night before. I had signed the paperwork for a water birth through the midwife team at U of U.

I attended EVERY single prenatal appointment, with a 3.5 hour commute, each way. We had an 8 week ultrasound, the 20 week anatomy scan, a “check up” scan at 30 weeks to ensure baby’s kidneys were functioning properly after a slight red flag at the anatomy scan, and a growth scan at 34 weeks to confirm that all was well despite the small-ish size of my baby bump.

We were READY for an unmedicated, all natural birth. We would delay the clamping of baby’s umbilical cord. We would do instant skin-to-skin. We would let baby latch before giving him a bath. We would donate cord blood. We would breastfeed for a year, at least. We would be THE BEST DAMN PARENTS this baby could possibly have. But, wait.

Things took a turn from bad to worse

It didn’t take long after the decels in baby’s heart rate and his lack of response to the new positions for the care of both baby and myself to be transferred from the midwives to the OB team. There goes the water birth. Gone. 

At this point, I remember looking at Olivia with tears in my eyes, asking her to call my JJ and then my mom, again. I knew things were getting serious. I couldn’t believe they weren’t there with me. Again, this was not our birth plan.

By 12 pm, we had decided to prepare for surgery, medicate to stop the contractions, order an epidural to allow for a spinal block when the time came, and pray that baby would stay stable enough to wait for JJ’s arrival. There goes the unmedicated birth. Gone.

I did not know that the team had called JJ and notified him that they would wait as long as possible, but that they would deliver the baby when they needed to, even if he wasn’t there yet. I cannot imagine the way he felt, driving 4.5 hours from work to the hospital, not knowing what was going on, not being able to talk to me, and being fearful of the overall outcome. I was scared. And he was clueless. Still, this was not our birth plan.

At 12:45 pm, JJ left his car in the line for valet, literally ran to the second floor to find me in L&D, and gave me a big hug. With tears in our eyes and shaky words, we were able to share a few minutes of alone time before being wheeled into the OR at 1 pm. JJ told our families he had arrived and informed them that we were headed in to have this baby. Today was a good day for a birthday. It had to be.

When “your” birth plan would be better up burned than saved

I didn’t get to experience labor the full-ness of labor. I didn’t get to dilate past 5 cm. I didn’t get to breathe through the contractions. I didn’t get to hold my husband’s hands as I screamed in pain. I didn’t get to send myself to my happy place and use my positive energy to get through a birth. There goes the Hypnobabies course. Gone. 

Instead, I was taken to the white, cold, lifeless room where a baby would be welcomed into the world. I had JJ on one side, and Christine, my midwife, on the other. She did not have to stick around, since I was now under the care of the OBGYN team, but she did. She never told me this, but I suspect she stuck around because she knew she would have to step in for grief and bereavement support. The midwives wouldn’t leave us alone for that.

Surgery prep started at 1:15. They transferred me from the wheeled bed to the operating table. They checked to make sure I was numb. They warned me that I would feel tugging in pulling. JJ squeezed my hand. I was numb. Physically, emotionally, spiritually.

Baby was born at 1:32 pm.

But I didn’t hear him cry.

He needed immediate assistance with breathing as a result of having swallowed meconium at some point during the stressful morning. The stress he was experiencing (and exhibiting on the fetal monitor) was a result of the cord being wrapped tightly around his neck, twice.

In the OR, the pediatric and resuscitation teams performed very prompt and incredible interventions to get baby supported and breathing. There goes the skin-to-skin. Gone. 

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At 3 days old, we finally got our skin-to-skin. July 26, 2016

To make matters more challenging for the little man, he did not have adequate amniotic fluid levels. This was a result of some leaking that had been going on, and I didn’t even know was happening.

At some point in the days, leading up to delivery, my water broke. How did I not know this happened? Without the fluid, he was unable to “swim” around to get things sorted out. The positions  I was trying earlier in the day weren’t helping because they couldn’t.

How bad was it?

When babies are born, they are given an APGAR score to gauge their overall health. There are 5 categories, which can earn 2 points each. This means the total scores range from 0-10 with 10 being a completely healthy baby. The data is collected at 1 minute, 5 minutes and 10 minutes after delivery.

Baby Stefanic had scores of 0, 1 and 7.

At birth, he had no heart rate (0/2), no respiratory effort (0/2), limp muscle tone (0/2), no response to stimulation (0/2), and was blue in coloration (0/2).

And even after 5 minutes of resuscitation, he was only up to 1 total point.

Thank God I didn’t know that at the time. But I did know I didn’t hear my baby cry. And I didn’t get to hold him.

I was scared and emotional, yet numb and lifeless. And then the midwife says, “They are taking him through the window”. Whatever the HELL that means.

There goes my baby. Gone. 

I later learned that “through the window” meant that baby was sent from the OR straight into the Neonatal Intensive Care Unit (NICU). There is a window between the two areas, so babies can be quickly and easily transferred from point A to point B.

I know I kept asking “Where is my baby, why can’t I hear him cry. Someone tell me he is okay.”

JJ kept squeezing my hand. And Christine kept telling me that he was receiving the best care possible which was exactly what he needed. I didn’t know he was blue, I didn’t know he had an absent heart rate. I didn’t know how bad it was.

There were 13 doctors, nurses and resuscitation team members waiting for our baby to arrive via emergency surgery. They were prepared for the worst. We were not. The baby was here, but this was not our birth plan.

Either way, he needs a name.

As we waited behind the blue surgical curtain unsure of what was happening with baby, we knew that we needed to pick a name. Either way, no matter the outcome, our baby needed a name. We had said all along that we picking his name would be a game time decision, and now this game time. In fact, overtime had started.

We had 4 names on the table, and standing in the OR room with hands clenched and tears flowing, JJ narrowed it down to 3, I selected my favorite 2 of those and then JJ decided on Lincoln Michel Stefanic.

I know now that his name fits him perfectly, and we are certain that he was waiting to respond to the resuscitation interventions until he had named. Fair enough Linc, we get it, you like to plan ahead, too! I wonder which of us you get that from 🙂

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World, meet Lincoln Michel Stefanic. Born June 23, 2016 at 1:32 pm.

When I was being stitched back up, the doctor said to me that he was going to take his time on the suture and do a really good job so that the “next time” we did this, I could safely try for a vaginal birth after cesarean. He mentioned “next time” a few times, and I know suspect that he was saying that because he was worried that our LMS would not make it and we would later try this whole thing again to attempt to fill the hole in our heart.

But guess what? He made it! And guess what else? There is not going to be a “next time”. We used up EVERY ounce of good grace, EVERY prayer in the book, and EVERY good thought we had on this little dude and we are so glad we did.

Without the assistance of the skilled medical team, we would have lost our baby, right then and there.

I don’t have to tell you how thankful we are for their assistance, as I’m sure you can only imagine.

I don’t have to try to put into words how lucky we were that I was in Salt Lake City at a wonderful university hospital with full resuscitation capabilities and incredible care. If I would have delivered in our small, regional hospital, Lincoln would have been transported in a flight-for-life helicopter to the U, and who knows what the outcome would have been.

I also don’t have to explain to you why we are not willing to do this whole thing again. Lincoln’s life was at risk, and that is nothing we ever want to repeat. Sorry doc, but there will be no “next time”. But, thanks for the clean scar and still numb battle wound across my lower abdomen.

Once Lincoln was transferred into the NICU, he was placed on oxygen for breathing support, was given a glucose drip though his central line (umbilical vein) to stabilize his blood sugar, and was being monitored by lots of wires and cords.

JJ was the first to see him as I was getting taken care of by the nurses in my postpartum room. He took a few pictures for me, was able to touch his belly, and promises me that he gave him a little love-filled pep talk.

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JJ’s first picture with Lincoln. He had the nurse take this on his phone and then brought it to show me. This was the first time I got to see my baby boy.

Baby is here… Now what?

We thought we were through the thick of it, but turns out the challenges were only getting started.

I wish I could say that this was all a total “freak” thing and that my body had done no wrong, but we would later find out that was not the case.

It wasn’t until about 30 hours later, once Lincoln was off of the CPAP machine and oxygen support, that we were informed of his inability to maintain his blood glucose levels.

Upon admission, the NICU team was concerned with stabilizing his respiration and then started to monitor other functions of his tiny little body. We (and they) had NO idea what a struggle his blood glucose levels would be to maintain.

Everyone assumed that we would be out of the NICU in a matter of a day or two, especially since Linc was born at 39 weeks. But it actually took us 13 days. Obviously this problem was a bit more complex than anyone expected.

I know that to some NICU families, 13 days is nothing. Some families are in there for 13 weeks and some for 6 months. And even worse, some don’t ever get to take their baby home.

I am not writing this birth story to discount those stories.

I am writing this birth story because it is ours. Because it has taken me 2 years to process it. Because I need to write it out. I am writing this birth story because there was only 1 thing that went our way. We got to leave the hospital with our baby, and that is the ONLY thing that matters. This was not our birth plan, but HE was the outcome.

I need to write this to allow myself to say SCREW the birth plan and the pressures that came with it. SCREW the expectations that we set for ourselves because of the influence of social media. SCREW the obsessive nature of our society with “breast is best”. SCREW the plans and fears and anxieties.

Because when push comes to shove, I worried about a lot during my pregnancy, but I never worried about having an unhealthy baby. I never thought that I would be discharged and he would have to stay. I never thought we would be a family who would need (and be blessed by) Ronald McDonald House Charities.

I never in a million years, thought we would have a baby with dangerously low blood sugars or with oxygen depletion at birth. I never imaged that this would be what it felt like to be a new mom.

I was in the midst of recovering from his birth day and we got more bad news.

On Lincoln’s 5th day of life, we were contacted by Christine, the midwife that was in charge of my care when I was admitted to Labor and Delivery the day he was born, with some news from the lab.

Due to Lincoln’s small size at birth, oh yeah I guess I forgot to mention that he was 5 lbs flat despite being full term born at 39 weeks, the birth team (including us) decided that the placenta would be sent in to be examined and tested. When delivered, the placenta itself was tiny and “ill” looking.

A part of me remembers one of the residents in the OR that afternoon mentioning something about the placenta by saying “Wow, did you see that?” when it was delivered, but I cannot confirm nor deny if this is true.

I’ve had a LOT of flashbacks about that day, and this particular memory might have been falsified in my mind. Regardless of what was suspected about the placenta, from the lab, it was found that it had many infarctions, or dead spots of tissue.

As a result of the impacted tissues, the placenta was not providing Lincoln with adequate blood flow and was insufficient as a support for him. This resulted in Intrauterine Growth Restriction (IUGR) which explains Lincoln’s small size at birth. I delivered an IUGR baby at 39 weeks and had NO idea he was growth restricted.

How did this happen?

The cause of the infarcts is unknown, and both the midwife and OBGYN teams were stumped as to why this would have happened. Placental infarctions are a cause of gestational hypertension and/or pre-eclampsia. I never had high blood pressure throughout my pregnancy, not even the day we delivered.

Risks of IUGR increase with gestational diabetes, maternal anemia, maternal alcohol or drug use, maternal smoking or pulmonary disease or cardiovascular disease. NONE of these were a concern during my pregnancy.

It is (still) hard for me to express how sad this makes me, as I can’t help but feel like my body failed to support Lincoln for no reason at all. When we first heard about the placental failure, I was confident that my personal feelings/blame of failure with the pregnancy were an immediate phase of grief, but now I know that it will be something that I always carry with me.

That was not a stage. This is life as a mom. We rarely feel good enough. We constantly question ourselves and our actions. I actually wrote an entire blog post about Mom Guilt because of the prevalence of it in our society.

I failed my son.

As Lincoln’s mom, I am supposed to care for him. I am supposed to take care of him. And when first put up to the job, I failed. Big time. Remember that we did ALL those things. Remember that we made that 7 hour drive SO EFFING MANY TIMES. Yeah. Me too. And guess what. I failed him.

And medicine failed him. There is STILL a part of me that is angry because of the amount of care that I received during the pregnancy. We drove to Salt Lake City for 12 prenatal appoints and received 4 ultrasounds. And remember when I started off this whole story that I told you there was one at 34 weeks that was to check specifically for Lincoln’s growth.

How did THEY not find the abnormalities? How did MEDICINE not point in this direction? How did SCIENCE not detect this? The biologist in me is angry at this.

It is hard for me to accept that the stressors that Lincoln went through (namely inadequate placenta and insufficient fluid levels which lead to the blood sugar issues) were never recognized as alarming to my care providers.

I know that they were comprehensive in their care, and I trust them fully. Yet still, I can’t even tell you how many times in the last two years that I have laid in bed at night wondering how things would be different with his start if we would have known more about what my body was putting Lincoln through.

The next two weeks.

During our time in the NICU, we realized why it has the name that it does. That place was an emotional roller coaster, and “intensive” is an understatement. The care was fantastic, but we can’t help but think that Lincoln SHOULD have gotten to be home with us. We SHOULD have been able to pump/feed/snuggle from the comfort of our own home.

I know now that there is no sense in asking why any of this has happened… While in the thick of things, my friend Natalie put it best… “You will spend a lot of time wondering why and sadly that time and mental anguish is a total waste”. So, instead of asking why, we have instead asked how.

How did Lincoln manage to survive in utero when the placenta wasn’t providing him with what he needed? How did my body know to send me into intense contraction to signal that something was wrong and get me to the hopsital? How did I know to go in to Labor and Delivery when Lincoln was at the very very end of his reserves? How did JJ make it just in the nick of time? How was the resuscitation team able to bring Lincoln back from such trauma and stress? And the biggest question of all… How did we get so lucky to have the chance to love, raise and care for this little miracle?

What’s with his blood sugar?

It’s hard to imagine that life after Lincoln’s birthday could get much more challenging, but day 7 was the most emotional day for everyone. That was the day that Dr Yoder (his neonatologist), Lincoln’s nurses and our family were at a loss.

No matter what we tried to do, we couldn’t seem to get Linc able to wean off his dextrose. This “sugar water” injection was now being given through an IV in his head since the Central Line IV had to be removed after being in for 1 week due to risk of infection.

Seeing this little 4 pound something baby with a head IV was scary, but the fact that we couldn’t wean him down off the dextrose was even scarier. Every time we would drop his glucose intervention, his sugars would drop dangerously low. At that point, it seemed like we were stuck..

I remember asking one of the nurses about the impact of the low sugars that he was experiencing at night when they would change the amount of dextrose. She calmly and kindly told me that values below 50 can result in brain damage.

Each night, I would call the hospital to check in on his readings and there would, without fail, be at least one reading that was below 50. Some nights we would rush up there to see him, but other nights, I would pump in our room at the Ronald McDonald House and just PRAY that he would be okay.

We had no idea what the outcome would be, short term or long term, but we just wanted to get our baby healthy and knew we would deal with the rest as it came.

A glimmer of hope, finally!

Thankfully, the next day, the pediatric endocrinology team was called and we FINALLY got four answers!

1- On day 8 of life, Lincoln’s due date, we ran an insulin panel and just got the results. “Normal” levels would be at a 1 or 2. Linc’s level was a 12, so he was been diagnosed with congenial hyper-insulinism. This is the opposite of diabetes, with insulin levels WAY too high.

 2- That same day, we met with the Endocrinologist and the Endocrinologist Fellow (pediatrician who was in training for endocrinology) and they were GREAT. They gave us lots of meaningful explanations and a course of action. They appeased both of our biology and engineering brains.

3- We created a PLAN. THANK GOD. In attempt to control the excess insulin production, we would start Linc on a 3x/day insulin suppressor called diazoxide which would (hopefully) take effect in 2 or so days.

4- There were other options if the diazoxide didn’t work, but that included pancreas surgery and other scary things that can only be done at Children’s Hospital of Philadelphia or in Isreal, so we tried really hard not to think about those options.

PROGRESS!

Within 23 hours since Lincoln was given his first dose of diazoxide, the medication that had a chance as suppressing his over active insulin level, and it started to appear that things were working as they should!

His blood glucose levels finally started to remain within a normal range. As a result, within this quick timeframe, the medical plan was to wean him off his glucose IV injections (which would ultimately mean one less scary cord to contend with when we held him).

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Snug as a bug in a rug. No more glucose drip. No more head IV. Just a sleepy boy with a feeding tube and some monitors. July 4, 2016

LINC, GO!

I have never experienced such relief as I did that day. We had a plan, AND it was working. And thank goodness, it wasn’t our birth plan.

Over the coming weeks, we would get discharged from the NICU but still be under care of the endocrinology team and remain for another 4 days in Salt Lake City at the Ronald McDonald House with Lincoln with us. We knew he was still fragile, and we did not want to be too far from our medical team.

We would check his blood sugars every three hours, page the team his values and then dose the diazoxide and make bottles depending on their recommendations.

On July 8, we finally got to go home!

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Stopping for a break during our road trip home so we could do a blood sugar check and get this boy fed. He was SO tiny… That is a premie shirt! July 8, 2016

Bottle feeding Lincoln was so much easier than breastfeeding because we could confirm his intake, and could ensure that any drop in blood glucose was NOT because of a lack of milk.

But, this meant that our nursing relationship suffered. I had ONE part left of our birth plan, and it was about to fly out the window. There goes the breastfeeding. Gone. 

Fed is best.

I pumped and pumped and pumped. I wanted SO badly to keep up with Lincoln’s caloric needs. I wanted SO badly for his tongue tie and lip tie revisions at 8 weeks to solve our latch issues. I wanted SO badly to form a bond while feeding him. But we were met with more failed plans.

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JJ getting to bottle feed Linc! They loved getting feed time together while I pumped! July 4, 2016

At 12 weeks old, I had a conversation with the pediatrician and finally got the closure that I needed to wean from the pump. She asked me if I had more of a relationship with the pump or with Linc, and it didn’t even take a verbal answer as the tears streaming down my face told her the truth. She recommended that I safely and quickly wean off the pump and start to focus on building a bond with my son.

You can imagine that my already anxious (and emotional) self was in a pretty bad place by the end of our 4th trimester. I have posted on my Facebook page about the Postpartum Depression and Anxiety that I worked through, but I promise to blog about it some day (sooner than not) because that struggle is real and so important to discuss. Weaning off the pump was not what I wanted to do, but it was what I needed to do if I was going to be able to sustain myself as Lincoln’s mom.

I wanted a lot of things before I became a mom. I wanted to wear the badges of honor of an unmedicated birth, of a natural experience, of exclusively nursing, of bonding like crazy with my baby boy, of cuddles and snuggles and happy tears a plenty.

And I didn’t get any of that. I was robbed of my plan. I was robbed of my pre-motherhood dreams.

New mom standing with baby in NICU

Making up for summer 2016

But guess what? It’s not all doom and gloom because NOW I GET BACK WHAT I LOST in June and July and August of 2016.

Now I get to make up for it. For him and for me.

Now I get to snuggle him and cuddle him and cry happy tears a plenty.

Now I get to be the mom that I want to be for the warrior boy that I love more than I ever thought possible.

He is my light and my life and my entire world.

I don’t know what kind of mom I would have been if things had gone the way I originally planned or thought they could/would/should go. But, thank God, I know what kind of mom I GET TO BE because of the way we started.

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Our first family photo at home and happy 1 month to Lincoln. July 24, 2016

Linc, I’m sorry that we had to start out that way. I’m sorry that things didn’t go as planned. I’m sorry about the rough beginning.

But I will spend the REST OF MY LIFE making it up to you because you deserve it.

In the operating room on June 23rd, 2016 in front of 13 medical professionals, your dad and God, I told you before I ever saw you that I would do anything as long as you were okay. What I meant was… ANYTHING IN THE WHOLE WIDE WORLD.

Lincoln Michel Stefanic THIS WAS NOT OUR BIRTH PLAN, BUT IT IS YOUR BIRTH STORY. It is far from what we had planned, but you are the end result, so it is perfect to me.

I love you sweet boy, and happy 2nd birthday!

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Those slimy kisses melt me. Lincoln and Mommy, Mother’s Day 2018!

 

1 Comment

  1. Krystal Keen on January 25, 2019 at 6:24 am

    Laying here in my bed, with my little 19 month old sleeping beauty next to me, and I can’t stop thanking God that she is here safe and sound as tears stream down my face. I never knew the full details of your birthing experience. I never knew the true extent of fear and helplessness you must have felt. I DO know, that you are one of the smartest, kindest, most inspirational women I have the pleasure of knowing… and I DO know that Linc is one lucky little boy to have such a strong, beautiful soul for a mama. Much love and respect to you, beautiful.

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