Maci has several other tattoos as well, like a pocket watch and the word "Bullet Proof," which is a reference to a book she wrote.
While she is almost fully covered, the main work of art is her "Notebook Paper" tattoo.
On her blog, Maci writes, "This began my back piece. It is a piece of notebook paper, literally covering my back. I love to write, so the notebook paper is fitting. Written on the paper is a little part of a poem that I wrote: 'When my heart hurts worse than my head, that is when i will get scared… and that is when i will know, that it is worth it all.'"
She goes on to add, "Close to bottom of the notebook paper is my last name 'Bookout'. The three O's are replaced with cupcakes representing my mom, dad, and brother.
Finally, Maci added a "Fun Fact," explaining, "In the top right corner of the notebook paper, there is a yellow rubber duck… Identical to the one used in the 'Teen Mom' logo. Being on MTV was a huge part of my life, this was my way of incorporating that in to my back piece."
Fans were perplexed as to why the network failed to intervene, and MTV responded to the situation by saying, "MTV does not condone driving under the influence. Ryan's erratic behavior was due to actions that he took without anyone's prior knowledge."
Shortly after the situation exploded, Edwards released a statement confirming that he had gone to rehab for substance abuse issues.
He wrote, "A little over 30 days ago, I made the decision to check myself into a rehabilitation facility. I am back home now doing well, and life could not be better. Without the support of my wife and parents I would not have been able to do this. Thank you all for your well wishes."