HARRISBURG -- Charity and Kathleen Lincoln spent their early years in the national spotlight.

Conjoined at birth, intertwined through their abdomens and pelvises, the identical twins with curly, strawberry blond locks from Lacey, Washington, were just 7 months old in fall 2000 when they underwent a complicated, nearly 30-hour separation surgery at Children's Hospital in Seattle.

Many more surgeries would follow.

"We've kind of lost track," their mother, Vaneice Lincoln, 45, said of the number of surgeries. "A lot."

The family left Washington state in 2012 so that Greg Lincoln, 47, could lead the Church of God (Seventh Day) in Harrisburg, a rural farm town about 20 miles north of Eugene.

One Saturday in February, before beginning his sermon, the senior pastor took a deep breath and announced that Charity and Kathleen were turning 16 the following day. The news was followed with applause and a chorus of "Amens."

"God is good," he told the 115-person congregation. "God -- he's covered us during surgery after surgery, event after event."

Extraordinary beginnings

Conjoined twins are genetically identical and develop when a woman produces a single egg that begins to split, but does not fully separate after fertilization. They occur in about 5 of every 1 million births.

Most sets do not survive because their organs cannot support them; about 40 percent are delivered stillborn, and about 35 percent die within a day of birth.

Charity and Kathleen were "ischiopagus tripus" conjoined twins, one of the rarest types. At the time of their births, only 18 sets of such twins had been recorded in medical literature, according to media reports.

Vaneice Lincoln said they learned about the girls' condition early in her pregnancy through an ultrasound. At about 8 weeks, she began seeing a doctor who specialized in conjoined twin pregnancies.

They also turned to family, friends, their church family and God for support. Church of God (Seventh Day) denominations from around the region fasted and prayed for the girls, said Karen Lebitty, 61, of Harrisburg.

"When you get that kind of news, when they were still in the womb and there wasn't something right, we just all cried for them because we love that family so much," she said. "We just really went to prayer that God would protect them while they were in the womb and growing."

The girls were born by Caesarian section at the University of Washington Medical Center in Seattle. Plans began right away for their separation surgery. Four teams of specialists -- including pediatric surgeons, urologists, orthopedists and plastic surgeons -- employed surgical techniques and imaging technology that were relatively new at the time.

Charity and Kathleen were the 19th or 20th set of twins conjoined through the abdomen to be separated, according to lead surgeon Dr. John Waldhausen.

"This is a real team effort," he said for an Oct. 1, 2000, story in The Olympian. "This couldn't be done by one physician, or without the support of the hospital."

To date, there have been about 250 successful separations in which one or more twins survived over a long period. Most of those surgeries have occurred in the past 15 to 20 years, according to the American Pediatric Surgical Association.

Charity and Kathleen's surgery is considered one of the pioneering surgeries and occurred about the same time as a highly publicized case in England, in which a court ruled that doctors could legally separate girls, known as Jodie and Mary, against their parents' wishes. In that case, one of the twins died.

With Charity and Kathleen, it wasn't until about five hours into the procedure that doctors would be able to tell whether the girls could be separated.

"We told them both had to live, if they did the surgery," their mother said.

The girls were joined from the sternum through the pelvis and shared several internal organs, including a liver, bowel and bladder, which the surgeons divided. Each had a leg, and they shared a third. The third leg was not a functional limb, so its muscle, skin and soft tissue were used to reconstruct the abdominal wall of one of the girls, according to the UW Medical Center.

Twenty-two days later, they were wheeled out of the hospital, greeted by a media frenzy. The family's story went around the world and was picked up by major publications and television shows, including People magazine and Dateline NBC.

Their father said he doesn't remember much of that time, other than that it was filled with stress, prayers and hope.

"It was a blur," he said. "One day at a time."

Vaneice Lincoln said she tries not to think about the separation surgery or the dozens of others that would follow.

"You can't live there," she said. "Life goes on."

It's no surprise that the girls say their earliest memories involve hospitals. Charity said she never wants to eat Jell-O again. Kathleen is not fond of vanilla pudding.

"I think I would call it amazing and kind of scary at times," recalled their big sister Annelise Lincoln, 18. "I never got used to them being in the hospital."

Becoming independent

Charity and Kathleen celebrated their 16th birthday with dinner at a Mexican restaurant and laser tag with friends.

Their once bright ginger hair is now more the color of dark honey, and they've traded glasses for contact lenses.

Their last surgery -- a final fusion of their spines -- was in 2013, and, if all goes well, they won't need any more surgeries, their mom said.

Kathleen is 4-foot-11. Charity, the baby who worried doctors because she drank the most formula when they were conjoined but grew thinner before the surgery, is an inch taller.

"They're their own persons," Lebitty said. "They have grown into very talented, loving girls."

They had prosthetic legs when they were little -- they called them "helper legs." But these days, both girls say they prefer using forearm crutches.

"It was bulky and I wasn't as fast as I'd be on crutches, so it's kind of like, 'Why?'" Kathleen said of the prosthetics.

The girls say they love kicking a ball around the soccer field with their friends, riding bikes -- each has a pedal strap that makes one-legged bike riding possible -- and spending time with their friends.

Until this year, they were homeschooled. They've adjusted well to attending Harrisburg High School, their parents said.

Kathleen's favorite class is Advanced Placement Literature; Charity likes anatomy and physiology.

They haven't shared a room in years.

"They're teenagers," their mother said with a chuckle. "They like their own space."

Both girls plan to attend college. Charity said she might study to be a nurse; she fondly remembers a nurse who brought her Froot Loops and chocolate milk in the middle of the night.

"They were always super nice, and that had a big impact," Charity said.

Kathleen enjoys writing and is thinking about studying to become a high school teacher.

From early on, the girls showed strong differences in personality. Now that they're older, they can demonstrate it through their style and personal choices.

Kathleen wore a dress and a high-heeled shoe to church, and Charity donned leggings and a flat shoe.

Charity listens to rap music. Kathleen likes country.

"They say I'm more independent in that I'm more outgoing," Kathleen said. "We're both independent."

"We'll have the same thoughts sometimes," Charity added. "And we'll finish each other's sentences."

Originally, Greg Lincoln said the family chose to share their story to help other parents of conjoined twins. They also wanted to support the hospital, doctors and staff who helped the girls through the surgeries.

But eventually Charity and Kathleen became "a living testament to the pro-life message," he said.

For them personally, he said there was no choice: Their babies were a gift. Sometimes, they are asked to talk with families who are facing a similar situation.

It's scary and hard work, but it's worthwhile, they say.

"Every life is precious and unique, and the blessing you get going through this is so much better than any of the trials you go through," Vaneice Lincoln said.

Doctors say Charity and Kathleen should be able to have their own babies someday. But that could be a long time away, especially since their dad isn't too keen on the idea of them dating.

"When I said 16, I meant 16 years from the day I said that," Greg said.

That was followed by "Dad, don't you dare" looks from the girls.

Vaneice Lincoln said she's more worried about another rite of passage: driver's education.

The girls have been practicing driving with their permits for months, and are antsy to sign up for an after-school driver's education program and get their licenses.

"I think that whole driving thing is hard on moms," Vaneice Lincoln said.

And talk about independence.

"They're doing well, and they have a bright future ahead of them, physically speaking," their father said.

"They can do whatever they set their minds to," their mother said. "(They) have a lot of talents and gifts, and use them."

-- The Associated Press