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Chris Knight

Jill, Derick & the Kids: Moving On!!

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The midwife legally can't treat her after 42 weeks in Arkansas

The midwife actually can continue to treat her after 42 weeks.  The regulation is that the patient must be seen by a licensed physician or a CNM.  If that medical professional clears her for a home birth, they could continue.  I would say the odds are against getting that clearance, but it is allowed.  

 

I'm sure there is one out there, but I've never yet encountered an OB who would try to do a c-section just for going post term.  If ultrasound shows a fetus that is likely to get stuck they would encourage scheduling a section.  Routinely though they would highly suggest trying to induce labor.  

Edited by Absolom

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No reason not to try an induction. All she might need is a little prostaglandin gel to get things going at this point.

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I've known some real OB horror stories. They cut both ways - some like Michelle's miscarriage "doctor" and other's who have left women in Appalachia not only with unnecessary C-sections, but with hysterectomies and ovary removals that were completely unnecessary.

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The midwife actually can continue to treat her after 42 weeks.  The regulation is that the patient must be seen by a licensed physician or a CNM.  If that medical professional clears her for a home birth, they could continue.  I would say the odds are against getting that clearance, but it is allowed.  

 

I'm sure there is one out there, but I've never yet encountered an OB who would try to do a c-section just for going post term.  If ultrasound shows a fetus that is likely to get stuck they would encourage scheduling a section.  Routinely though they would highly suggest trying to induce labor.  

As I understand it, the lay midwife cannot deliver at home post-42 weeks. AR does not allow the practice of CNMs, to my knowledge, so Jill would be referred straight to an OB, and must deliver in a hospital. 

 

As for induction, I don't remember any stipulation that they would induce immediately, unless they saw an urgent need to. Obviously, the same would hold true if a c-section was necessary. I doubt that they will take Jill to the hospital today or tomorrow and just induce her because the calendar says that she's 13/14 days overdue. If someone can dig up the AR midwife rules and regs and can confirm automatic induction or planned c-sections that aren't medically necessary at the time, please correct those of us who find that to be a bit ridiculous (but could be in place to avoid those pesky lawsuits). 

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I'm in the camp of "That baby has been born but they are keeping it under wraps for maximum exposure".

 

I think so too. I really hope so. It's way better than thinking they're having medical issues.

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I am not too worried that Jill will have a successful hospital birth either vaginally or by c-section in the next day two. I've known several friends and acquaintances deliver at 42 weeks without any problems. Jill and the baby should be fine. She isn't going to take any unnecessary risks and has done her homework. She has a hospital plan in place which is probably being enacted upon as we speak or within a matter of hours. Jill and baby should be fine.

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If any of the following PRENATAL conditions are identified, the client must be

examined by a Physician or CNM currently practicing obstetrics. Division clinicians

may accept referrals per Division of Health protocol. A plan of care for the

condition must be established, and execution of the plan must be documented.

Midwives caring for these clients will submit additional required reports. If a

referral is not made or if the clinician advises against home delivery the client must

be transferred.

Odd how the regulation references CNM if they aren't allowed in AR.  :)   It says if the clinician advises against home delivery the client must be transferred.  The clinician could agree to let the home delivery proceed or to allow the patient to go another few days.  

 

I'm not saying how likely it is the CNM or OB would agree to a birth outside the hospital or to letting the pregnancy continue at that point.  It is a legal

possibility though.

 

My current guess is that we'll hear something by Wednesday.  

Edited by Absolom

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Ok, that doesn't sound very definitive at all. Basically says she needs a CNM, not a lay midwife, probably because of likely access for monitoring. But I'd guess she's been having that, and I'm assuming, baby here or not, both are just fine.

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This is the first I've learned that CNMs could be registered in AR. Maybe that's because Jill went the lay midwife path, but *someone* should have been identified as a CNM in Jill's studies, given how long she'd been apprenticing. 

 

At any rate, GEML is right: clear as mud. But we know that there is a hospital plan in place, so I'm confident that Jill is under good care. I hope that if she was induced, it was because she was ready, not because of some law. The same sentiment goes for a c-section...but I hope that wasn't medically necessary.

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I know people keep saying AR doesn't allow CNM, but then I found this website below:

 

http://bcnwa.com/our-approach/


I'm glad she has to be seen by someone else besides a lay midwife at this point.  Apparently that is the only real requirement and her lay midwife would be in trouble if she doesn't follow the guidance given.  Jill, of course, can do as she wishes, but it all has to be documented.  I fully expect Jill will follow or is following reasonable medical advice.  

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Arkansas definitely permits CNMs. All 50 states do. CNMs have significantly more training, experience and education. It's a graduate program. The legal availability of direct-entry/lay midwives varies by state because of their lesser training. But all states allow the practice of a CNM. Not all CNMs have hospital privileges but that would be by choice if they focus on home and birth center births. They all have the training to get hospital privileges. No lay midwife would have hospital privileges. 

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Hello, my name is Nancy aka bigskygirl, and I am becoming too obsess about Jill Duggar Dillard having Dilly Baby. Is there a 12 step program for this?

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I know someone who just last fall was 10 days late and gave birth in a hospital and her baby came out with respiratory issues and could not be revived from aspirating meconium. It happened right before my baby was born and scared the bejesus out of me. I can't imagine the devastation of losing a full term baby during delivery and my heart still hurts for her and her husband.

Also when I was pregnant last fall, my doctor asked if I wanted to be in a research study about inducing at 39 weeks as there have already been studies that it is safer for mom and baby to be induced a week early rather than a week late at 41 weeks. Luckily I went into labor on my own at 39 weeks but I would have gladly induced at 40w 1 day ( even though I was scared) because I could barely walk or sit at the end because her head was already down in the birth canal. If Jill is still pregnant -and I seriously think she is because it will be announced by People or US and not the family or the show- then I hope it all goes smoothly there are a lot of dangers to giving birth at any time but I wouldn't take any unnecessary risks.

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Hello, my name is Nancy aka bigskygirl, and I am becoming too obsess about Jill Duggar Dillard having Dilly Baby. Is there a 12 step program for this?

Why yes each night there is a support group meeting the Holy Warehouse Church with linoleum floors at 6 pm. All are welcome bring food! (Just in case Boob decides to pop in)

Edited by Fuzzysox
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Is that casserole chickenetti or tater tot crap? I could use a few crispy tater tots about now.

Edited by Chicklet
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I was induced with my daughter at 39 weeks. I was labeled high risk due to having gestational diabetes, and my doctor advised inducing before my due date as I wasn't dilated, had no contractions...basically my daughter wasn't coming out on her own anytime soon. When they broke my water, there was a lot of meconium which made them worry even more. She was born with the cord wrapped around her neck twice, thankfully did not aspirate any meconium, and was (and is) perfectly healthy. Still, I realize just how quickly and easily things could have gone another way.

I wish Jill the best, but I really hope she's thinking logically and really evaluating what's best for her and the baby at this point, and not being unreasonably attached to her original plan.

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I really doubt that Jill has given birth. 1) The Duggars have no ability to keep secrets, and there is nothing that they are more vocal about than their fertility. 2) *We* are interested in this baby, most people -- even fans of the show -- are not. For most people, I think it's either a "That nice Christian family had another baby," or "Those weirdos had ANOTHER baby!" but not much more than that.

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I also doubt that Baby Dilly has arrived yet.  Labor can be long for a first time mom - 36 hours or more.  Maybe the social media silence is because she's in labor, but no news yet. 

 

Jill was the topic today on Dr. Amy's blog, which also has some explanation for the different kinds of midwives.

http://www.skepticalob.com/2015/04/jill-duggar-dillard-risks-her-babys-life-at-homebirth.html

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Why yes each night there is a support group meeting the Holy Warehouse Church with linoleum floors at 6 pm. All are welcome bring food! (Just in case Boob decides to pop in)

Bring food?  Damned if I'm feeding that cheap asshole.

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Its starting to look like I'll be sharing a birthday with a Duggar- I mean Dillard.

to think, there's a chance baby Jesus Isreal Immanuel Duggar Dillard might make his way here tomorrow is just, wow. I'm so blessed and honoured to even think that this could happen.

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Well, I can come back with horror stories of babies born at 38 and 39 weeks that had to go to the NICU because the mother induced and they weren't ready to be born. (I actually wrote a novel on midwifery in Appalachia and am somewhat recognized as a regional scholar on the history of maternal women's health history within the region, so I'm not just pulling stuff out of thin air.)

But anecdotes still don't mean anything against the bell curve of healthy births, and there is ZERO reason to think that Jill and her baby are any less healthy than they were two or four weeks ago.

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Word. My stepdaughter whined and cried until her OB finally agreed to induce her at 39 weeks; she was uncomfortable and was SURE the baby was "too big." Result: Baby (7 lbs) was NOT ready and spent two weeks in the NICU as his little lungs developed enough for him to go home. For that reason, I appreciate the fact that Jill hasn't been in a hurry.

I was 42 weeks, two days with baby #2. She was over 10 pounds and posterior, and my amniotic fluid was low. She aspirated meconium and had transitional low glucose; we spent two days in the NICU. She's 23, healthy, and getting married next month, but her entrance into the world was a little too dramatic for my taste. I hope Jill delivers soon, and easily.

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I also doubt that Baby Dilly has arrived yet.  Labor can be long for a first time mom - 36 hours or more.  Maybe the social media silence is because she's in labor, but no news yet. 

 

Jill was the topic today on Dr. Amy's blog, which also has some explanation for the different kinds of midwives.

http://www.skepticalob.com/2015/04/jill-duggar-dillard-risks-her-babys-life-at-homebirth.html

 

Very interesting/informative post. I had no idea there was such a major difference in the educational requirements for CPMs vs CNMs - as well as how they are viewed around the world. It's evident why Jill did not opt for the CNM though - I'm sure after she looked into it she realized she couldn't hack it educationally. I doubt Boob was eager to shell out for her tuition either.

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Here is the applicable rule regarding CNM/OB care after 42 weeks: 

 

 

 

If any of the following PRENATAL conditions are identified [including 42+ weeks gestation], the client must be examined by a Physician or CNM currently practicing obstetrics. Division clinicians may accept referrals per Division of Health protocol. A plan of care for the condition must be established, and execution of the plan must be documented. Midwives caring for these clients will submit additional required reports. If a referral is not made or if the clinician advises against home delivery the client must be transferred.

 

So, transfer is the call of the CNM/OB of record. 

 

Source: http://www.healthy.arkansas.gov/aboutadh/rulesregs/laymidwifery.pdf (p.23)

Edited by Sew Sumi

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It also wouldn't have allowed her to raise her siblings and travel with the family, as she would have been tied to an academic schedule. I'm convinced that this, more than anything else, is the real reason they wouldn't let their children pursue actual higher educations.

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Very interesting/informative post. I had no idea there was such a major difference in the educational requirements for CPMs vs CNMs - as well as how they are viewed around the world. It's evident why Jill did not opt for the CNM though - I'm sure after she looked into it she realized she couldn't hack it educationally. I doubt Boob was eager to shell out for her tuition either.

 

Yes there is a significant difference in their training. CNM's have graduate degrees. But the rest of this post is offensive and clearly written by someone who has blinding bias to anything but her medically invasive approach to birth. 

Edited by 3girlsforus
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Yes, Sew Sumi, I've quoted that one several times now on this thread.  :)  

Edited by Absolom
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Yes, that post is quite ridiculous. Let's just remember that it was an OB/GYN that convinced Jim Bob and Michelle that using birth control had led to their miscarriage and likely was a turning point in Michelle's mental health which put them down this path. You can be an idiot and uncaring and still have an MD after your name.

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Yes, that post is quite ridiculous. Let's just remember that it was an OB/GYN that convinced Jim Bob and Michelle that using birth control had led to their miscarriage and likely was a turning point in Michelle's mental health which put them down this path. You can be an idiot and uncaring and still have an MD after your name.

 

Even worse, the MD was a Gohardite, and actively recruiting for the cult. In my book, that both malpractice, and criminal.

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Personally I don't think Jill conceived on her honeymoon, so I'm not reading too much into her being past her due date. I think a honeymoon baby is the utlimate badge of honor for these people and Jill may truly believe she got pregnant on her wedding night even if it isn't the case.

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eta: According to Jill's own data, she would have been at the tail end of her period on her wedding night. Date of conception was on or about July 1st, 10 days after the wedding, and a few days after they'd come back from the honeymoon. :D 

 

Regarding the midwife thing, I read that as the OP meant that JILL would require more education than Boob would have been willing to give her, not that there is anything inherently wrong with CPMs. Just that the path to become one doesn't require multiple degrees and maybe not something Jill could hack. I don't know Jill well enough to make that judgment, but I do think that the fact that CNMs require non-Gothard approved methods of study factored heavily into her decision to pursue the CPM. 

Edited by Sew Sumi

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I think the OP meant that JILL would require more education than Boob would have been willing to give her, not that there is anything inherently wrong with CPMs. Just that the path to become one doesn't require multiple degrees. 

 

I'm not sure if you are referring to my response but I didn't mean there was anything wrong with the OP's post, CNMs or CPMs. It was the linked blog post written by an OB that was arrogant and obnoxious. 

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Oh, my bad! 

 

That blogger is known to have a very strong position against CPMs. But since she hasn't practiced medicine herself for what seems to be at least a couple of decades, I think her opinion should be taken with a huge grain of salt. :) I am personally quite live and let live on this issue. There is no reason a healthy woman with no risk factors can't deliver at home with a CPM. Jill certainly falls in that category. If she hasn't delivered yet, I'm sure she's getting assessed by an OB. Heck, maybe Dr. Sarver will make an appearance! LOL

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But anecdotes still don't mean anything against the bell curve of healthy births, and there is ZERO reason to think that Jill and her baby are any less healthy than they were two or four weeks ago.

 

There absolutely is. We see post dates babies in the NICU all the time. The only 37/38-weekers we see have other issues (idiomatic sepsis, infection, hydrocephalus, etc.). The placenta cannot meet the needs of a 42-week baby. A mother risks her life, her baby's life, and her baby's brain function when she chooses to go postterm, and further when she chooses a postterm home delivery. The ACOG and AAP specifically exclude pregnancies ≥41 weeks from their home birth eligibility. Here's a mom whose 42wk3d baby didn't make it: http://www.thedestinymanifest.com/2012/08/she-was-still-born/

 

From the AJOG: Postterm pregnancies are associated with multiple, well-known complications, such as labor dystocia, increased perinatal mortality rate, low umbilical artery pH levels at delivery, low 5-minute Apgar scores, postmaturity syndrome, fetal distress, cephalo-pelvic disproportion, postpartum hemorrhage, and increased risk of neonatal death within the first year of life.

 

BTW, the midwife Jill Dillard trained with was found negligent by the AR Board of Health regarding the birth of a baby with GBS (group B strep) and lost 2 babies in one week in July of 2014. This is all from her public FB page. Lay midwives are dangerous to mothers and babies.

 

I do truly hope this baby is born safely and healthy.

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My bad too... I should have been more clear. I was definitely referring to Dr. Sarver rather than anyone on this board. I suspect that Dr. Sarver doesn't approve of home births with any type of midwife.  She reminds me of the OB who when she found out I was having a home birth (with a CNM) told me she hoped I didn't care if my baby died. I wasn't even seeing this person medically. She was a mom in my daughter's play group. 

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Personally I don't think Jill conceived on her honeymoon, so I'm not reading too much into her being past her due date. I think a honeymoon baby is the utlimate badge of honor for these people and Jill may truly believe she got pregnant on her wedding night even if it isn't the case.

I wonder if MEchelle in hindsight wishes she had had a honeymoon pregnancy. Look at how much higher her baby count would have been if she had started earlier!

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 You can be an idiot and uncaring and still have an MD after your name.

 

100% yes! When I was a kid my mom took me to a dietitian, who looked at me, 12, heavy, dark hair, more olive skin, all the paternal Italian/German genes, and my sister, 11, super skinny, very blond, all the maternal English/Polish genes, and asked my mom "do they have the same father?" My mom shot right back, "yeah, why? Don't your kids?". That doctor was lucky my mom didn't take a swing at her. Ask me about the time my mom almost got arrested at Chuck E Cheese when I was a kid…. that did involve taking a swing. 

 

As much as Jill likes to stay sweet and be the perfect little Gotherd wife, she's got to be more than ready for the baby to be born. I can't even imagine how uncomfortable she's had to have been for the last month. Just looking at her make ME feel uncomfortable for her. 

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I wonder if MEchelle in hindsight wishes she had had a honeymoon pregnancy. Look at how much higher her baby count would have been if she had started earlier!

I'm sure she has done the math and calculated how many blessings she could have had before Josh if only she had not been a pants wearing fool! I'm sure she weeps over the 2-3 she could have had, and thinks that if only she hadn't broken up that married couple with her hot bikini body, she could have been the mother of 24 by now!

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There absolutely is. We see post dates babies in the NICU all the time. The only 37/38-weekers we see have other issues (idiomatic sepsis, infection, hydrocephalus, etc.). The placenta cannot meet the needs of a 42-week baby. A mother risks her life, her baby's life, and her baby's brain function when she chooses to go postterm, and further when she chooses a postterm home delivery. The ACOG and AAP specifically exclude pregnancies ≥41 weeks from their home birth eligibility. Here's a mom whose 42wk3d baby didn't make it: http://www.thedestinymanifest.com/2012/08/she-was-still-born/

 

From the AJOG: Postterm pregnancies are associated with multiple, well-known complications, such as labor dystocia, increased perinatal mortality rate, low umbilical artery pH levels at delivery, low 5-minute Apgar scores, postmaturity syndrome, fetal distress, cephalo-pelvic disproportion, postpartum hemorrhage, and increased risk of neonatal death within the first year of life.

 

BTW, the midwife Jill Dillard trained with was found negligent by the AR Board of Health regarding the birth of a baby with GBS (group B strep) and lost 2 babies in one week in July of 2014. This is all from her public FB page. Lay midwives are dangerous to mothers and babies.

 

I do truly hope this baby is born safely and healthy.

I agree. I have been watching infants come and go through this NICU and all the term babies have congenital issues. The post 41 weekers have things like sepsis, meconium aspiration, diabetic issues, and even one that died when the placenta detached at 41 weeks because placental aren't meant to last ten months. I am a proponent of women having choices and midwives being used in healthy pregnancies. But, by virtue of her non progression, it's fair to wonder if all is well. I would hope her midwife was smart enough to do a NST and kick counts.
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Wow, so much can go wrong at this stage that I'm starting to worry about Jill now. I really do hope that my original guess is correct, in that the baby was born sometime this weekend but the Duggars for once are keeping quiet about it because of the upcoming tv show which will be the gender reveal. I am guessing a lot of people who watch the show don't follow them on social media and have no idea that it's a boy, so if People broadcasts it tomorrow morning, the Duggars are afraid that no one will watch tomorrow's show and ratings will drop. That's my optimistic viewpoint, anyway. I still can't remember if we found out the birth of Michelle or Anna's babies the very day that it happened but I do remember a birth special for Jordyn that was shown about 4-5 days after she was born. 

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I was so fortunate to have an OB/GYN who practiced with midwives. I couldn't have a midwife, as I was too high risk, but I could see then for my care. Best of both worlds. My second was a high risk OB, as even care under a midwife was too risky. But I had, by then, the advantage of many midwives as friends. Felt doubly cared for.

Hoping this is what Jill is finding out should this be necessary in her case.

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In the UK all care is midwife led first unless high risk. NHS guidelines are to start induction 12 days after due date (scan date) unless obviously needed earlier or the mother refuses induction (as is her right) in which case they monitor daily & scan until either baby arrives or the mother changes mind about induction, I was induced at 12 days past with my first and was more than happy to be so but no one involved in my care would have done it sooner as the risks are just not there with a low risk healthy pregnancy. And they positively encourage you to have home births here! Am sure Jill is aware of all risks & she sounds like she's happy to be guided by health professionals.

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My bad too... I should have been more clear. I was definitely referring to Dr. Sarver rather than anyone on this board. I suspect that Dr. Sarver doesn't approve of home births with any type of midwife.  She reminds me of the OB who when she found out I was having a home birth (with a CNM) told me she hoped I didn't care if my baby died. I wasn't even seeing this person medically. She was a mom in my daughter's play group. 

3 girls for us too, 3girls!  2 born at home with CNM and a dr. in attendance.  Still, I heard comments like that.  I don't even tell my co-workers I had home births.  They'd have a field day dissing me.  They don't approve of breastfeeding either.  I have two sisters who had post-term stillbirths (different causes) in the hospital.  It was tragic and heart-breaking.  I hold my breath when any woman goes past her due date, but usually everything works out.  My own daughter went 11 days past with her first and I was terrified.  It was a difficult birth with a big baby for my small daughter, but we had a healthy outcome, thank goodness. 

 

Every day I check to see if it's happened yet for Jill and Derrick.  This must be one time when they don't enjoy being in the spotlight.  I hope it all goes well for them.

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