Support Normal Birth

thanka2

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I am all for a natural birth.

That being said, in my case had I not been in the hospital for my first daughters birth they would not have discovered through blood tests that I had developed a life threatening condition that was otherwise asymptomatic and had I opted for a home delivery I would've died without post delivery treatment.

Let's not forget that child birth was the leading cause of death for woman in the days of yore...
 
I think that if you read the above statements clearly there is nothing said about home birth whatsoever. I've given birth twice--both in a hospital. In my case, I am glad I was in a hospital as I hemorrhaged so much the first time that I passed out form blood loss and the second time to prevent that, after I had given birth to my child, I was given synthetic oxytocin (in a continuous intravenous drip for several hours) to force my uterus to contract--I still had an unusually large amount of bleeding but it wasn't as dangerous.

I think there is a misconception that the above elements of normal labor must take place in a person's home. Totally not true.

So, for miran and erina320, I just want to point out that the above poster never once mentions home birth. I think the choice to give birth at home in HK is long overdue but given the choice, considering my own medical history, I would still choose to give birth in a hospital. Of course home birth is and always will be controversial--as are many other things.

Also, the above elements on the poster are generally healthier for mother and baby in the long-run. To attribute the sole reason why women would die in childbirth to having homebirths is a bit of a stretch. You have to also take into account things like nutrition, sanitation and general medical knowledge. The maternal death rate in countries like the US has gone up significantly as c-sections became more common place starting in the early to mid-1990s. Anyway, the poster above isn't about home birth at all so...

In order to facilitate a normal birth in whatever setting (hospital, birthing center, home) the following can help (verbatim from above):

-hiring a doula (Allowed to hire a doula in HK but not allowed inside of the labor rooms in the hospitals here--but most hospitals elsewhere in the world allow this. I did not have a doula at either of my births but my mother and husband
served in this capacity. They both took classes and we prepared extensively and especially for this role.)
-vocalizing in labor (Being allowed to cry out, speak, moan or otherwise use your vocals to get through labor--I was reprimanded for this in the labor room and heard others being reprimanded for it as well in HK--it's a basic right to speak or cry in labor and no woman should be chastised for it--it is part of the process and a useful tool. Thankfully, I just told them to leave me alone and they did.)
-no routine episiotomy (I refused an episiotomy during both births because I would rather tear if I'm going to tear than have a clean cut start the process and tear even longer and deeper).
-mother-led pushing (In the hospital here in HK the staff tried to get in there and "coach" and tell me when and how to push but it was a pretty pointless exercise for them--I didn't need their help--my body and mind are quite capable on their own. Eventually they figured it out and left me alone.)
-breech vaginal birth (With the right relaxation and support this is possible--I've seen videos of women giving birth breech in hospital settings using waterbirth. Thankfully I didn't encounter this situation with my own births.)
-unrestricted movement (Not being told to lie flat on your back in a bed--or any other position-- and go through contractions that way. I found that walking and standing during contractions lessened my own pain by half. Also a basic right to not be restricted in labor. I had to buck the system and refuse to be continual fetal monitoring and thus being tethered to the bed)
-listening to mom's instincts (They've served me well.)
-pitocin only as a last resort (Usually it's the first resort here and that messes up labor from the start--makes contracts more painful and harsh which puts the baby's health at risk and easily escalates leading to the need for a c-section to rescue the baby. In my case, pitocin--or its equivalent--was administered after the baby came out for my own safety.)
-eating and drinking in labor (With my most recent birth I took a lesson from my first birth and as soon as I knew I was in labor, I had a hearty bowl of soup--it was still early enough in labor that I felt comfortable eating but I knew that I would need the energy that food would provide later on. I stayed at home for 8 of my 12 hours of labor this last time so I made use of that time to stock up on food--it made a world of difference in the ability of my body to perform in labor).
-natural methods for pain relief (There are a lot of them. For me, personally, walking, rotating my hips, counter pressure applied to my hips and lower back, warm water, vocalizing, breathing and some herbal pain relief got me through.)
-no unnecessary vaginal exams (The reason for this is simple. Vaginal exams during labor don't tell much because a woman can be dilated and then "close up" after a vaginal exam--the cervix is like a sphincter muscle that closes due to tension--vaginal exams can give unnecessary tension to the area. On top of that, they can introduce bacteria to the area and can cause the membranes to rupture. As soon as the membranes rupture then labor becomes a race against the clock as the baby needs to come out sooner to prevent infection. During my first labor I had one vaginal exam and during my second one as well--upon admittance to the ward.)
-perineal massage and support (This is the one step I really didn't get around to during labor although I used it to prepare for labor--maybe I wouldn't have torn either time if I had.)
-no separation of mother and baby (Common sense--for bonding, breastfeeding, comfort, safety etc.)
-spontaneous rupture of membranes (see above concerning vaginal exams)
-allowing labor to start on its own (see above pitocin use)
-pushing in whatever position feels best (see above freedom to move in labor and pain relief)
-intermittent monitoring or none at all (see above regarding freedom to move in labor. My OBGYN told me at one of my checkups this past pregnancy that fetal heart monitoring is wrong 50% of the time. Those are pretty bad odds. Anyway, I refused to be strapped to a bed in both of my labors. In my first the hospital policy was 15 minutes of fetal heart monitoring every 45 minutes. In HK they carry a portable wand and do intermittent monitoring with that. However, they never really got around to doing it with me because it was too inconvenient for them to wait for me to go through a contraction before shoving the sharp thing against my belly.)
-informed consent and informed refusal without persecution (I think it will be a great day when women are not persecuted for their choices in the labor room and when they really are given a chance to give informed consent/refusal. I consented to some things and refused others while I was in labor in HK and got to listen to the staff bad-mouth me for the rest of my labor. Good thing that it didn't matter much to me. Yes, the hospitals here definitely like the compliant and quiet types.)
 
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... and baby in the long-run. To attribute the sole reason why women would die in childbirth to having homebirths is a bit of a stretch. You have to also take into account things like nutrition, sanitation and general medical knowledge. The maternal death rate in countries like the US has gone up significantly as c-sections became more common place starting in the early to mid-1990s. Anyway, the poster above isn't about home birth at all so...

I never attributed death solely to homebirth. I simply stated that preganacy and labor were a leading cause of death before current medical practices and methods.

Similarly, It is a stretch to attribute the higher death rate in America solely to an increase in c-sections, while the average age and weight of Mothers in America have also increased, both of which increase the chance for complications/death.
 
thanka2: have you read the article i posited ? am pro-normal labour. i am pro-choice. i am pro - consent. i am anti - the assumption that women are being foced into c-secs. and baffled by the idea that every woman who has information, education and good sense would somehow choose a natural delivery.
 
thanka2: have you read the article i posited ? am pro-normal labour. i am pro-choice. i am pro - consent. i am anti - the assumption that women are being foced into c-secs. and baffled by the idea that every woman who has information, education and good sense would somehow choose a natural delivery.

Yes, I did read the article. Still, I don't understand why an article which is talking about what statistics are reliable for reporting of infant deaths/miscarriages worldwide and which statistic is used for gauging the safety of maternal health worldwide and how these numbers relate to home births really relates at all to a set of guidelines that promote natural birth. Especially as home birth is not mentioned at all the those set of guidelines. I guess it could be argued that all home births more or less rely on these guidelines but not all births that rely on these guidelines are or must be home births. Just good guidelines for birth in general.

I want to point out that, at least on my part, there is no assumption that "women are being forced into c-secs." But, there exists in hospitals a standard procedure which many times involves the use of induction as a routine procedure in labor--whether it is medically indicated or not. Induction often times leads down paths that do lead to c-sections and once you're that far there's no turning back. And at the same time, by not offering women just as many, varied and reliable options in labor medical care providers are doing women a disservice--by literally only presenting one way of doing things as their standard practice. Therefore, often times women do have to go through the stress and pressure of "bucking the system" in order to have a birth that physiologically is the most natural.

Again, I want to state that I really don't think that "every woman who has information, education and good sense [will] somehow choose a [intervention-free, med-free labor]." I am saying that for women like me who did choose that route there weren't many options available to me and I did have to "buck the system" to lobby for my right to not be strapped to a bed, pumped full of drugs, tampered with, cut and injected just because having a baby the way that the poster above advocates is not part of how things are routinely done. It's more routine to have a medicalized labor even when it's not medically indicated. So, for those who are truly "pro-choice" in this area, I think there would be a stronger lobby coming from them for more true "choices" in labor. If you want an intervention-filled, med-filled labor you certainly can get that anywhere with a smile both here and in the States. If you want something different you are considered abnormal and are not catered for in the hospital or if you are it's only with harassment. That's my experience.
 
I never attributed death solely to homebirth. I simply stated that preganacy and labor were a leading cause of death before current medical practices and methods.

Similarly, It is a stretch to attribute the higher death rate in America solely to an increase in c-sections, while the average age and weight of Mothers in America have also increased, both of which increase the chance for complications/death.


Again, why are we talking about home birth here? Not really the subject at hand.

Interventions and c-sections that are not medically indicated (aka done for convenience etc.) do have impacts on mother and child--including slower reflexes in infants up to three months after birth (when they just stopped studying it) which also leads to more difficulties with breastfeeding which then leads to more formula use which can in turn affect obesity rates in children....that's just one path that is affected.

So, interventions can and do have a negative impact on our health. But, to only point out that "well, women were dying in childbirth all the time back when..." and not to also point out that "but that could have been also due to the fact that they were malnourished, unsanitary and didn't have access to modern medicine and devices" shows just as much hyperbole as to say, "Interventions and c-sections have led to more maternal deaths..." and "also obesity and women having babies at older ages has contributed." So, let's just be fair and look at both sides.

I get really tired of the sensationalism (i.e. "remember when our great grandmothers were all dying in childbirth...thank God we have all these wonderful interventions to save us from that!") that comes mostly through media that portrays birth as this wretched, awful, catastrophic event that women are in no way capable of handling save for the fact that there are teams of "professionals" there to get them through it. No doubt that many women believe this about childbirth from before they're even pregnant--so with a belief system like one's chances of a natural labor (if they would be "crazy enough" to even wish for one) are pretty slim.

I'd like birth presented as what it is--a natural thing that the body is naturally designed to do and with a little belief in yourself and a little preparation and knowledge and a little support from professionals who also treat birth like what it is--you can go through it with little or no intervention--if you want to.

Anyway, if you've experienced it, you may understand. All I came here to do was to share something that I really believe in because I've experienced it. If it helps you or helps any other mother to have a little bit of belief or just maybe to see things differently or consider other options, then that's great. I know what I will choose and why I will choose it and the health of my children and myself is enough evidence for me--not to mention the deep, touching, spiritual experience birth was for me--that I was 100% lucid in order to experience--one of the hardest-worked-for and most valuable gifts I ever gave myself was a natural birth.
 
thanka2 : ok. agreed. i guess the difference is in the worlds we are coming from. i am from a third world country where i wish daily medical facilities were available more widely and more lives could be saved. so i am mostly agape when i read these vehment arguments for normal delivery without interventions or likewise.

btw - people are talking about home birth and interventions (or the lack of them) because Judith Roocks beleives in these
 
thanka2 : ok. agreed. i guess the difference is in the worlds we are coming from. i am from a third world country where i wish daily medical facilities were available more widely and more lives could be saved. so i am mostly agape when i read these vehment arguments for normal delivery without interventions or likewise.

btw - people are talking about home birth and interventions (or the lack of them) because Judith Roocks beleives in these

Yes, it does have a lot to do with worldview and personal experience. Thanks for clarifying why home birth was brought up. Actually, that quote by Rooks is pretty much the only thing she "coined" so it features as probably less than 10% of the poster. The other elements aren't anything new and the quote is added on to those principles. It might be confusing for those who haven't read much about what goes into preparing for a natural childbirth. But there are plenty of other sources...much older sources that share the same information--for example the doctor and author mentioned in my signature, Grantly Dick Reed. As far as Judith Rooks' voice in the debate--honestly, I've never read anything by her and she's just that...one voice of many, many, many women and midwives. I have found Grantly Dick Reed, Robert A. Bradley and Ina May Gaskin to be far better sources personally for me. I think that's because they didn't politicize birth as much as other people have tried to. It's interesting to me that the two people that have posted to this section have mentioned nothing else about the other 90% of the poster. Makes me wonder if they read it? But, anyway, sorry for the confusion. The poster's entirety is not coined by or written by Rooks. Don't know much about her and honestly don't care much. I think it's always possible to pick out a few people in any movement to label as "fanatic" or "crazy" in an attempt to discredit the legitimate parts (and there are a lot in the natural or gentle birth movement). The "squeaky wheel" gets the grease in this instance. Meanwhile most midwives and natural birth mothers just keep at what they think is best with a quiet, passionate determination and they and their work goes unnoticed.

And as you mentioned third-world countries I would like to point you to acceptance speech of 2011 CNN Hero of the Year, Robin Lim and her work with poor Indonesian women. She says that the very best way that she knows to reduce maternal deaths in childbirth is to "support your midwifery to mother care so that the midwives can help lower the risks in motherhood and we can save lives together." Here is more about her work.

Again, my point is that medicalized birth systems (most of the developed world) offer it basically one way for women. Then they say, "Yes, if you want to have a med-free, intervention-free birth...go for it...but don't expect any support from us." How do I know they don't support it? Because they don't provide the training, staff, environment or tools to aid in the process. It's like telling a woman, "If you want an elective c-section, we're all for that....but you'll have to figure out how to cut yourself open and administer the pain killers because we don't provide surgeons or tools etc." It's supporting something in word but not in deed. Obviously, the second example seems ridiculous but it's just to point out that med-free, intervention-free birth is not the going option in most hospitals today.
 
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I think it's important to recognize that when Robin Lim talks about the 981 mothers that die daily in childbirth she doesn't distinguish between the ones in developed countries and the ones outside. Mothers are mothers and if they're dying in childbirth, something needs to change. It is inaccurate to picture the women dying in childbirth as living in squalor without medical care because out of those 981 there are plenty of women who are dying in high-tech hospitals. Over-medicalization of birth can kill and maim women and children just as total lack of medical care does the same. There must be a balance.
 
I subscribe to the Pulitzer Center on Crisis Reporting YouTube channel and just watched this story (which is horrific, in my opinion...especially since I experienced the exact same situation as this woman did but I had proper prenatal care and a midwife who anticipated this problem and acted quickly and correctly to save my life). It makes me think that people may think that a homebirth with a midwife in a developed country would be like this. Thankfully that's far from the truth (for any trained, registered nurse midwife in good standing professionally).
 
It makes me think that people may think that a homebirth with a midwife in a developed country would be like this.

I also get the opposite sense. That advocates of home births in developed countries think all home births are like the ones they are familiar with. I wish they would qualify that they are only referring to home births with good medical support systems in developed countries. So that people from developing countries who read the same articles would also have a clear picture of exactly what scenarios home birth advocates in developed countries are talking about.
 
I also get the opposite sense. That advocates of home births in developed countries think all home births are like the ones they are familiar with. I wish they would qualify that they are only referring to home births with good medical support systems in developed countries. So that people from developing countries who read the same articles would also have a clear picture of exactly what scenarios home birth advocates in developed countries are talking about.

I think it's pretty easy (if you have access to a computer as both of us obviously do) to research what midwifery in "the west" vs. midwifery elsewhere entails. The audience I'm addressing is pretty obvious by the fact that I'm posting to a forum that is frequented by mostly expatriate women in Hong Kong.

Just like we know that there is a general standard for medical practice in "the west" so when we say, "I went to see my doctor in the States..." it doesn't seem necessary to point out that, "and he isn't the shaman-type that burns incense and sacrifices animals to heal people." In most places in "the west", midwives are licensed nurses who have had years of practice before they become a midwife. In some cases they are apprenticed but still have years of experience and practice--often employing more variety of techniques with better success than most doctors are trained to do.

And women in the developing world can gain a lot from are properly trained midwives handling home births--especially where medical facilities (or in Mae's case, roads) are scarce.

I think that the people who are advocates of home birth in "the west" are generally comparing hospitalized birth in those countries against home birth in those countries. They have no interest in comparing "first world" midwifery (built on sound medical/scientific practice) to "third world" traditional midwifery (possibly based on superstition and shamanism--as we see in Mae's case) .

In the case of Robin Lim, she is training midwives in "first world" practices (hygiene, medical equipment, medical procedure etc.) not in "third world" practices (i.e. shamanism). It's the same way that in some countries in sub-Saharan Africa women are trained as medics and then serve dispatches to rural areas. Do they have a degree in medicine? No. But, they are trained and know how to help in many cases which in turn saves lives.

If we're just going to wait for the modernization of these countries (i.e. they have good infrastructure and abundant medical facilities) so that women can "properly birth in a hospital setting" (and "properly birth" is up for debate here) then we're just going to lose more lives. Why not properly train medics and midwives in sound medical practice?

"First world" sound medical practices can benefit "third world" world countries--whether it's in a clinic or with a midwife--it's a practical improvement on the system already in place.

So, in short, if the audience I was addressing was composed of women (and men) living in third-world conditions (similar to Mae's case) of course my explanations would be different. I just assume that women on this forum have the tools to educate themselves on the difference between third-world traditional midwifery practices and first-world midwifery practices. We have a lot of resources available to us, I think.
 
Thanka2, my comment was not simply about what you are saying and who you are addressing or about Robin Lim in particular. It is about articles I read about home births emanating from the West in general. In between "the west"/developed word/expatriate women in Hong Kong and poor women in some village in sub-Saharan Africa, there is a huge number of women in between in urban areas in developing/third world countries with access to good nutrition and medical care, including qualified mid-wives. These are the women with the tools to educate themselves and they go online and read about home births - most of what comes up is from the West, including the statistics. They probably identify more with women in the West because, as you say, they technically tick all the boxes you mention that make it 'safe' to have a home birth. And yet, I wonder if having a home birth is safe for them because the conditions, while superficially the same, are different.

Yes, I would like people writing about home births in the West - not necessarily posters on forums such as these where the audience is specific - to qualify the narrow circumstances (relative to the whole world, not just poor rural women) under which they are advocating home birth. Some of these articles will quote WHO statistics which are global, but then everything else they are saying pertains only to the specific conditions in their own country... why not say so so that in this globalised world, women everywhere who are reading what they post on the Internet, get that?
 
Thanka2, my comment was not simply about what you are saying and who you are addressing or about Robin Lim in particular. It is about articles I read about home births emanating from the West in general. In between "the west"/developed word/expatriate women in Hong Kong and poor women in some village in sub-Saharan Africa, there is a huge number of women in between in urban areas in developing/third world countries with access to good nutrition and medical care, including qualified mid-wives. These are the women with the tools to educate themselves and they go online and read about home births - most of what comes up is from the West, including the statistics. They probably identify more with women in the West because, as you say, they technically tick all the boxes you mention that make it 'safe' to have a home birth. And yet, I wonder if having a home birth is safe for them because the conditions, while superficially the same, are different.

Yes, I would like people writing about home births in the West - not necessarily posters on forums such as these where the audience is specific - to qualify the narrow circumstances (relative to the whole world, not just poor rural women) under which they are advocating home birth. Some of these articles will quote WHO statistics which are global, but then everything else they are saying pertains only to the specific conditions in their own country... why not say so so that in this globalised world, women everywhere who are reading what they post on the Internet, get that?

But doesn't that come back to your original premise (was it yours?....correct me if I'm wrong) that women are responsible and capable of making their own choices and if they choose a home birth or a c-section or anything in between we can't assume that 1) it's necessarily unsafe for them 2) they are "uneducated" and not aware of what they're doing or being "tricked" or "forced" into it. Is it plausible that highly educated women, in their right state of mind may choose home birth and that it is a legitimate option (even a healthier option) for some some women? Isn't it also possibly true that it is that many educated and informed women are also choosing home birth for maybe similar reasons that drive some women to choose elective c-sections--in that they've looked at the facts for themselves and have chosen that path. There is a lot of information out there, afterall.

The percentage of women who choose home birth is still something low like 1% or under in the United States so my view is that most women who choose (not mentioning those who have no choice--unlikely that exists in the States) home birth are in a special group. Women who I know who choose home birth (I know a lot of them) don't just casually make that choice...like "Oh, yeah...whatever...that sounds good...sign me up." (Showing my own bias...seems to me that many more women sign up for interventions with this attitude, though). Of course, there may be those that choose it like that but I've never met anyone. I think it must be similar to my own choice to do a med-free birth after giving birth already. I had no delusions that it was going to be easy and I had to overcome a lot of things in order to sign up for that type of experience. I would say that home birth moms are some of the most educated women on the topic. There is a lot of care given before baby's arrival and they really have to be "on their game" at the time of birth as well. They have to be a very active participant in the planning and execution of a birth plan--in a hospital often women can be passive patients as the doctors call the big shots for them. Again, that's my opinion.

Again, the people advocating home birth in the States are advocating it for women living in the States--who have the choice of hospital birth or home birth. Most people in developed countries aren't speaking to women in the third world who live in drastically different circumstances (nutrition, sanitation, infrastructure, support, position of women in society etc.). Most of the people writing about home birth are writing from the viewpoint of a western developed nation--to people in those types of nations under those circumstances. Maybe there is not enough writing being addressed to women of other backgrounds--that might be an area you can fill?

But, if they're quoting WHO global statistics, my thoughts are that this would (considering the plight of some women in developing countries) actually make the statistics look less in favor of home birth (if you throw in all the births that were like Mae's--where the woman lost her life or the child died)--so if it's an issue of thinking that statistics are skewed to make home birth look safer than it is--it doesn't seem to me that that would be the case. I wSo,ould think that if you throw in all the world statistics for home birth (i.e. Mae's case coupled with cases like the ones my friends have experienced) it would look less and less in favor of home birth due to lumping traditional midwifery practices (shamanism) into the same category with modern midwifery practices (medically-based). So, except that maybe the statistics aren't as clear as they could be, I don't see what the contention is--as if women are being tricked into giving birth at home (in the developed world). But, you know what they say about statistics. "There are three types of lies. Lies, damn lies and statistics." So...
 
thanka: irrespective of wether i agree with you or not, you seem to be very passionate about birthing wthout intervetions. but what is the way forward ? surely posting on this forum couldnt help beyond a point ?
 
thanka: irrespective of wether i agree with you or not, you seem to be very passionate about birthing wthout intervetions. but what is the way forward ? surely posting on this forum couldnt help beyond a point ?

I'm just having a conversation here--it's only a small reflection of what goes on in real life for me. :) I enjoy interesting conversations and this has been and continues to be one. It is very interesting for me to be exposed to the various mindsets that are out there when it comes to this and related topics.

I'm from the "each one, reach one" camp. I think most people who share a similar mindset with me on this topic also advocate for it on a more individual level--for us it's an intimate topic that we're passionate about because it's close to our heart and we've experienced a lot of great benefits from it. It's easy to write off if you haven't been around it, experienced it or know others who have, I think.

So, as I said, this little forum here only gives a glimpse of my real life involvement. :) If the only thing I do here is challenge womens' perceptions, that is already a great thing. I think the women I've met here mostly stick to one mindset and easily write off others without really examining all sides in-depth. Hopefully, I'm going against that trend myself and hope that others will as well. I think it's really important to engage deeply with this topic. The more people engage, the more they think and then the more likely they are to dig deeper and discover more for themselves. That's how I started on my personal journey and am really thankful for those people who challenged my thinking. But, I tend to be a fairly "fluid" thinker--meaning I don't compartmentalize things so easily--I see that all of life--all aspects of it are connected--so I'm not just a body divided from a mind divided from a spirit--I'm a whole person so that's how I see birth (and many other aspects of life)--it must be approached as a system. That's why I have a problem with the lack of bedside care in the medical system here in HK. Anyway....

As far as what can be done? Depends on what your perspective and agenda are. If you think that the system as-is in the developed world is great for maternity care then there doesn't seem to be any reason to deviate from that. If you think that medicalized birth has gone too far (as I do) then there are women (mostly midwives) slowly but steadily working to give more women options. But...they are met with red tape as the medicalized system is the majority and holds the keys to the gate, so to speak.
 
sure :) am still not fully convinced about the topic but atleast i understand where you are coming from.

nb: birthing was a very neutral expereince for me. i dont remember much nor did i care about pregnancy / delivery. my single agenda the whole of those nine months was that my baby be safe and as healthy as God wills him to be. so we chose and still would whatever was the safest option presented to us and advised by a doctor we trusted. am not saying this is the ideal way to be. change comes because people question existing mindsets. am just putting accross another mindset to you on why women like me are not buying into birthing without interventions.
 
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