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Women's Bodies

Women’s History Month Superstars: Ina May Gaskin, Midwife, Revolutionary

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Ina May Gaskin

Given that it’s Women’s History Month, it’s only fitting to continue to honor women who have been our heroes.  One of those heroes – and too many feminists don’t know about her — is Ina May Gaskin, a self-trained midwife, who began delivering babies on The Farm back in the 60s, mentored other women who wanted to be midwives, became an activist for pregnant and birthing women, and led a revolution which was made in her own lifetime.   The work of the Farm midwives under Gaskin’s watch, in part, made it possible for me and thousands of other women in the United States to birth our babies safely at home with midwives.  The home birth movement is one example of revolutions which were made over the course of a few decades.  When Ina May Gaskin began delivering babies, it was illegal almost everywhere to have babies outside of hospitals, “delivered” by obstetricians.  Within the space of a couple of decades as the movement Gaskin helped to create spread, home birth was legal in most states.  

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Sadly, women’s birthing rights and freedoms must be continually guarded.  Those of us who do not want the interventions of patriarchal medicine or male-centered medicine in our pregnancies and births threaten the medical establishment and the establishment just in general.  There are ongoing efforts to punish and silence us and midwives and doctors who support us, and to convince women that procedures like “elective” c-sections and induction of labor are safe and convenient, when in fact they are dangerous to women and their babies.   Antagonism towards Gaskin and midwives — brilliant health care practitioners, just generally, so very, very few among them who are not — continues amongst patriarchal doctors, even though their own medical schools often teach the “Gaskin maneuver,” a technique used by Gaskin and midwives she has mentored in the event of shoulder dystocia, where there is difficulty delivering the baby’s shoulders.  Before knowledge of this technique became available to medical professionals in the U.S., any baby presenting with shoulder dystocia would be delivered via c-section.  Of course, that’s still too often the case.  Most doctors can’t be bothered to work with birthing women so that they can have the kind of birth experience they want to have.

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It is incredibly sad and disturbing to me that creating a film entitled “Orgasmic Birth” is the only way Gaskin and the Farm midwives can envision that might reach this generation of young women.   gaskininamay8552.jpggaskininamay8552.jpgI have owned Gaskin’s first book, Spiritual Midwifery, for decades, and some of my daughters found it incredibly inspiring and empowering, even when they were very small.

Rebecca Scott, a commenter, e-mailed this article to me and I loved it!  Thanks, Rebecca.

SUMMERTOWN, Tenn. – Despite living on a commune in rural Tennessee, Ina May Gaskin has had the kind of career success most people only dream about.A midwife who never formally studied nursing, Gaskin has helped bring home birth and lay midwifery back from the brink of extinction in the U.S.

An obstetrical maneuver she learned from the indigenous Mayans of Guatemala has made it into scientific journals and medical textbooks, and her insistence on the rights of a birthing mother empowered a generation of women to demand changes from doctors and hospitals.

With a lifetime of accomplishment, the 67-year-old Gaskin has earned the right to slow down. But that is the farthest thing from her mind.

”At the time we began, I couldn’t have dreamed that in 25 years’ time women would be actively seeking Caesareans,” she said.Gaskin largely blames the nation’s rising maternal death rate on the increase in Caesarean section births and the drugs sometimes used to induce labor.

The National Center for Health Statistics reported last month that the maternal death rate for 2005 has risen to about 15 women per 100,000 live births, more than double the 1998 rate of seven.  At least part of that increase is due to better reporting, but researchers say Caesareans also may be a factor.

Gaskin passionately believes natural childbirth is the answer. The number of women giving birth with a midwife has doubled over the last decade and accounts for about 8 percent of births today – the vast majority in hospitals.

Still, she says it’s a challenge to promote natural birth to a generation that favors comfort and convenience. Promoting home births is an even tougher sell. The American College of Obstetricians and Gynecologists has continuously warned against home births as too risky.

In 1975, Gaskin published “Spiritual Midwifery,” which included birth stories and a primer on delivering babies. Her book has sold around 750,000 copies, has been translated into four languages and has inspired a generation of women to become midwives.

She promoted the idea that a woman’s state of mind will influence how easy her birth is. At the same time, she kept detailed records of each birth, providing her commune, The Farm, with statistics that would prove important in the debate over the safety of out-of-hospital births.

She has tried to widen the reach of her message by airing natural birth videos from The Farm on television.TV stations rarely have run them, calling them too graphic.”  I started to think I should put them on YouTube,” Gaskin said.

But the high rate of Caesarean sections in the U.S. may help Gaskin’s message gain some traction. Former talk show host Ricki Lake produced and starred in a recent documentary that features Gaskin and is critical of hospital births and their high rate of C-sections.  The U.S. now has a Caesarean section rate of 31 percent, a figure the College of Obstetricians and Gynecologists agrees is troubling.

At the same time, this group of doctors who perform the C-sections also reiterates its “long-standing opposition to home births.” In a recent statement, the organization said childbirth decisions “should not be dictated by what’s fashionable, trendy or the latest cause celebre.”

Home births are not safe, the statement warns, because “a seemingly normal labor and delivery can quickly become life-threatening.” Over the years, studies on the safety of home births have conflicted. The doctors’ group says research comparing the safety of home and hospital births has been limited and is not scientifically rigorous.Their organization approves of the assistance of hospital midwives certified by the American College of Nurse Midwives.

These midwives have nursing degrees or comparable training. The college of obstetricians warns against lay midwives like Gaskin, who have no formal medical training and who aid in home births.Even so, the College of Nurse Midwives says home births can be safe and they are fans of Gaskin’s. “She’s quite a remarkable woman and an icon of midwifery,” said Mairi Breen Rothman, a nurse midwife and consultant to the midwives college. Rothman herself was inspired by Gaskin’s book.

Gaskin began her practice as one of about 250 hippies who pooled their money in 1971 to buy rural land south of Nashville to form a commune. Soon she and a few other women on The Farm were delivering 25 to 30 babies each month.

While training herself, Gaskin sought out doctors and other midwives and devoured medical texts. But she never sought a medical degree, instead helping create an alternative certification so lay midwives could prove their competency.Not all obstetricians think home births are inherently unsafe. New York obstetrician Heidi Rinehart spent a few weeks at The Farm while a medical student. Although her husband also is an obstetrician, when they were having a baby, they asked Gaskin to be their midwife.

But even doctors who’ve never heard of Gaskin have felt her influence because of patients who have read her books, seen her birth videos or heard her speak.” They request or demand or vote with their feet to have the kind of birth they want,” Rinehart said.

Now, Gaskin has a film in the works that is in keeping with her anti-establishment, freewheeling nature.”We’re doing a movie called ‘The Orgasmic Birth,’ ” she said.That’s not a metaphor.  Gaskin says that under the right circumstances women experience a sort of birth ecstasy.”I mean, it’s not a guarantee,” she said, shrugging her shoulders and smiling, “but it’s a possibility.”It’s the only way I can think to market it to (this) generation.”

  • Insurance Industry Kills Health Care Reform
  • An Untapped Resource
  • Shoulder Dystocia
  • Bibliography of Midwifery
  • Interview with Ina May Gaskin
  • Discussion

    15 thoughts on “Women’s History Month Superstars: Ina May Gaskin, Midwife, Revolutionary

    1. I only wish more midwives were being trained as “lay” midwives rather than through medical schools. The birth of my daughter, with shoulder dystocia was HORRIFIC! The midwife used a procedure that normally causes many problems for both baby and mother but we were very blessed to have no long term problems. I tried several times to put myself in the all fours position, as recommended by Ms. Gaskin, and was physically forced to lay on my back by my midwife and 3 nurses. Awful!

      My midwife was clearly trained by the institutional medical system and I later informed her she should be ashamed of herself as she was misleading women (such as myself) that wanted to avoid the ordeals of medical practices.

      Blessings on women like Ina May Gaskin. Thank you for the lovely post.

      Stacey

      Posted by Tia | March 11, 2008, 9:06 pm
    2. Yeah Ina May!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :)************ And all “The Farm” midwives, mothers and babies!!!!!!

      Posted by Jeyoani | March 11, 2008, 9:24 pm
    3. Thank you so much for this tribute!! My friends and I devoured our one copy of Spiritual Midwifery when I was having my earlier children and passed it around among us. I remember we used to laugh at how someone in it described labor pains as “psychedelic”.. and meanwhile we absorbed from every page ownership of our births. Midwifery is the norm in Australia, I have had my babies at home, at birth centers, in a hospital, in the car.. and never has there been a doctor there. Even my one experience with intervention, an induction, no doctor every showed up.. they leave it all to the midwives in my state. Yet still people YEARN for intervention, pay private insurance just so they can have an obstetrician rather than midwives. Every generation you have to start afresh.

      I was very interested to read that she learned a technique for delivering shoulder dystocia babies from the Mayans. It makes me wonder what other treasures of birthing techniques are out there, practiced by people who have never had the C-section option. Does anyone go and research these things?

      I feel like reading Ina May Gaskin again now. I’m looking fwd to her film, please keep us updated if you hear more!

      Posted by Arietty | March 11, 2008, 10:18 pm
    4. thank you so much for providing this tribute, heart. the farm sounds like an amazing place . . . i’m adding it to my list of places where i might try to do a rotation.🙂

      Posted by ladoctorita | March 12, 2008, 1:04 am
    5. This is very interesting. What do midwives do in the case of cephalopelvic disproportion?

      Posted by Branjor | March 12, 2008, 2:52 am
    6. I trained with Ina May and the mws at the Farm..and it was AWESOME… I am a midwife in alabama and have a lot of legal issues with the state being so anti woman.
      I want to be like Ina May when i grow up.

      Posted by moon goddess | March 12, 2008, 3:06 am
    7. Hey, Tia, I’m so sorry you got manhandled during your birth! By women, no less! You’re right, though– very often, midwives who work in hospitals or are answerable to doctors/hospitals are not much better than most ob-gyns. Of course, there are always a few enlightened ob-gyns who are great, the way la doctorita is going to be!

      moon goddess, how amazing that you trained at the Farm!

      Every generation you have to start afresh.

      So true, Arietty. I know I’ve said this probably one too many times, but Naomi Wolf’s book is a case in point. She is highly educated, a committed feminist, nevertheless with a straight face she can write a book in which she is shocked about patriarchal birthing practices. And it gets published! Talk about the worst kind of erasure of women like me who are still living, thriving, working, breathing, hello.

      Really interesting what happens in Australia re birthing and how women clamor for establishment physicians. This I will never understand. Why on earth would you entrust yourself to men during pregnancy and birth if you believed or knew you had any choice?

      Branjor, doctors often create diagnoses which justify their decisions. A diagnosis of cephalopelvic disproportion is no exception. When women are forced to lie on their backs to deliver, as Tia describes, hooked up to monitors and IV drips, given various drugs to either hasten or slow labor or given painkillers, quite often their labor will slow or even stop. Then the doctors do stupid things, like tell them to push when they have no desire to push and pushing isn’t what’s going on with them. Then if they do this noneffective pushing, which they were commanded to do, and nothing happens, sometimes doctors diagnose “cephalopelvic disproportion” or other things, and on that basis, women get episiotomies or c-sections.

      When if they’d been allowed, as Tia describes, to get on all fours, to stand, to squat, to lean against a partner or a wall, their baby might have made his or her appearance very quickly.

      In the tiny number of cases when cephalopelvic disproportion actually is an issue, women are transported to hospitals. Midwives almost always work with ob-gyns who are supportive of midwifery and who agree to provide backup in hospitals where there is a genuine emergency, including cephalopelvic disproporition, placenta previa, issues with the cord presenting ahead of the baby, etc. These conditions are quite rare. They are rarer still in home births, because midwives screen carefully what patients they will take and if a woman has a history of something like this, they generally advise that the woman birth in a hospital or birthing center (even though they might provide her with prenatal care and might attend her birth). They have to be careful in agreeing what patients to take, given that they are watched like hawks by the patriarchs.

      Having said all that, all of the horror stories you hear about birth, all the women who say they labored 24-48 hours and nothing happened, or they had cephalopelvic disproportion, or they hemorrhaged– 9 times out of 10, you will find that doctors are responsible, because they induced, and the induction didn’t go well, and so there is this mumblety pegs going on of more pitocin gel, oops, too much, now we need drugs to slow things down, oops, now labor stopped, more pitocin gel, ow, now the mom is having really painful, violent, nonproductive labor, and after this goes on for 24-48 hours, mom is understandably freaking exhausted, and if a doctor says “We have to do a c-section,” she doesn’t argue. Or they hemorrhage because they were given too much pitocin and their uteruses are contracting violently and uncontrollably, or because someone pulls on the cord, or pulls on the baby or uses forceps (because heaven forfend they remain patient and allow the baby to come in her own time), or they didn’t really hemorrhage, but it looked like they did because they had such a gigantic episiotomy and their was blood everywhere, stitches, and that’s what they thought happened.

      So women’s horror stories about birthing have to be placed in context. I’m not saying women lie, they don’t. But doctors do all the time.

      Posted by womensspace | March 12, 2008, 3:41 am
    8. I alluded to and linked that article in the Barbara Seaman tribute, while we were discussing why feminists trust the medical establishment, which feminist health pioneers like Barbara Seaman and Ina May Gaskin put to shame.

      Posted by Aletha | March 12, 2008, 6:19 am
    9. What a beautiful tribute!
      I have never given birth, but most of my friends who have, had much better experiences at home – and one was totally alone and it went fine! – than in the hospital.
      Heart, in an earlier post, you said you had some of your babies in the hospital. Could you talk about why you made the choice to have them at home, and the difference?
      I’d love to hear from anyone who has had both experiences.

      Posted by liza | March 13, 2008, 3:45 am
    10. All 9 of mine were born at home.. i never considered giving birth in a hospital.
      As for the CPD..pelvis MOVE and babies heads mold and there are hormones being released to make muscles relax and be soft.. and if you give the hip bones a good firm squeeze the pelvis can open up by 2 cn!!! which is a LOT!!
      And ditto to all that heart said🙂 i would have said the same.
      Drs create disasters by the interventions they do… then everyone praises them for saving a life….
      Why have feminist ignored the misogynist practices of male drs and many females? Male drs have no business telling women ANYTHING about their bodies or their births or their labors…
      As a midwife i hear a lot of horrible stories from women being smacked during labor and told to shut up, to lied to that at 37 weeks their placenta is OLD and killing the baby so we need to do a CS to women given no support…
      I detest the system that does this to women… and Ina May has been fighting this for a LONG time

      Posted by moon goddess | March 13, 2008, 8:13 pm
    11. Thanks for this Heart – I was recently at the birth of my best friends baby, and I’ve been trying to make sense of the experience ever since. Everything I witnessed at the hospital was so horrifying – from the moment she was admitted and hooked up to the fetal moniter to when the doctor did an episiotomy without informing or asking my friend, none of her wishes were considered or thought of. I just reserved a copy of “Spiritual Midwifery” at the library, and I can’t wait to read it.

      Posted by Strong Swimmer | March 13, 2008, 8:52 pm
    12. I knew there was some comment I forgot to answer. 🙂

      I had my first seven babies in hospitals. The first was in 1972 during a time when birthing mothers were given almost no choices so far as anything in their birthing. If there were midwives, I didn’t know about them, although I had read “Thank you, Dr. Lamaze” and some other books about natural childbirth. When I arrived at the hospital in labor, I was immediately shaved, given an enema, and hooked up to an IV drip containing demerol and pitocin. This was HORRIBLE. The demerol drugs you enough that you are just out of it UNTIL you have a contraction, at which point you are jerked awake to experience the pain of it without having been able to ready yourself as you felt it build and the pitocin stimulates labor and creates a much “harder” labor than you would normally have. Throughout the doctors gave regular internal examinations at the *height* of the contractions. This is what they always did back then and probably mostly still do, and it is torture. I was refused water, which was their policy, though I was horribly thirsty. When I was in transition — the time when the cervix is opening all the way up so the baby can be born — I threw up (something I NEVER do; I have probably vomited five times in my whole life and two of those were during labor in hospitals! I believe because of the drugs). I was then given caudal anesthetic by injection into my lower back. I was then moved from the bed I was laboring in to a hard, high bed, arms strapped down, flat on my back, and wheeled into the operating room, stark, gray, bright lights overhead. Then my legs were forced straight up into stirrups. I couldn’t feel anything at all from my waist down, but I could feel my uterus violently contracting in ways that were absolutely not under my control, with nurses at my side telling me to pant, which was ridiculous. Nothing I could have done, let alone pant, would have stopped those artificially-intensified contractions. I was given an episiotomy (the doctors cut me) and my oldest baby was then born. I was able to hold him right away. It was a thrilling, thrilling moment despite everything that preceded it and despite the fact that I was now being sewn up. I stayed in the hospital for two days and was not allowed to have my baby with me. He was brought to me at regular intervals. When the caudal wore off I was in abject pain for days because of my stitches and swelling and could barely sit down. Although I stated my intention to breastfeed I was sent home with formula anyway.

      Eighteen months later, I gave birth to my second son, who weighed 10 lbs and 4 oz. This was before ultrasound, and I was x-rayed the week before I delivered to rule out twins. This birth was like my first, except that it was shorter, and I had a gigantic episiotomy that sort of veered out at an angle and cut through muscle. I can still feel that scar at times, 34 years later. For reasons unknown my baby was kept from me for a long time, hours and hours. I never knew why this was, though I kept asking. Nobody would tell me. I had to go look at him with all the visitors, through the glass of the nursery and listen to everybody point at him and say, “Look at THAT one! ” Because he was so big. Ha ha. He is still big. 🙂

      But after that birth I swore that never again would I allow myself to be drugged like that, or cut like that, if there was any way I could prevent it. I was 21 when my second son was born.

      About a year after his birth, which would have been 1974, a couple in the apartment building I was living in had their baby in their apartment with a midwife. I had never heard of this and didn’t know it was an option. I didn’t know these people very well and I was sort of afraid of of them. For one thing, I knew they used a lot of drugs and I suspected they took a lot of drugs (as many young people did in those years). They had a lot of visitors who also scared me. But the woman showed me the photos of her birth and I was struck by them, by the cosmic difference between her simple birth at home and my hospital births. I wanted to do this.

      I read everything I could get my hands on about natural birth, midwifery. By the time I gave birth to Jeyoani in 1975, I had planned not to be drugged at all, no matter what. My prenatal care for Jeyoani was wonderful– I had a nurse practitioner who did all of my care (I was on welfare at the time, as I had split from my first ex). She was AWESOME. It was *so* different from the care I received in the prenatal clinic with my oldest two. I’ll never forget going in for one of my prenatal visits with either my first or second, not sure which now, and two doctors were behind the counter. The clinic waiting room was huge with tons of people waiting, milling around. One of the doctors said loudly to the other doctor, “Why do you get all the glamourous patients.” UGH. Then I had to go back and get examined by that guy!

      Anyway, the nurse practitioner was a whole new world. I look back and think she must have been a feminist. She had that spirit I came to recognize and love of the early feminist health care women– respectful, encouraging, caring, smart, and she took me very seriously which I appreciated so much. Because I was on welfare, I had to deliver in the hospital with whatever doctor was on call, and she was not around, of course. But this time I didn’t allow myself to be given demerol or a pitocin drip or anything like that. I breathed and rode with the contractions for as long as I could. Towards the end, I got scared and asked to be medicated, and I was given a local anesthetic, a pudendal block into the cervix if I’m not mistaken. It didn’t dull the pain much, if at all. This was one of those births I had a couple of times where a smallish baby follows a largeish one. My number two son had been 10lb 4 oz., Jeyoani was my smallest baby at 7 lb., 6 oz. When that happens, sometimes the smaller baby takes a long time to be born, as was true with Jeyoani. I walked the halls of the hospital for most of 24 hours off and on. But her birth was thrilling and all the more so since I was not drugged. I did not throw up. I was not numb from the waist down. And I had a girl! By this time you got to keep your baby with you more of the time in the hospital, but they still called it “rooming in” when in fact, you only had your baby for a few hours at a time and then they took the baby to the nursery.

      My fourth child was my first completely unmedicated birth– no nothing. I was *shocked* by how much easier and quicker my labor and delivery were and especially by how *great* I felt immediately afterwards. He was also my first birth with no episiotomy. I was up and around right away, felt absolutely great, especially compared to my recoveries with my first three.

      I didn’t have another baby for five years. During the years I was bearing my first four I worked full-time outside the home, which I continued after my fourth was born, and I had maxed out. I had four babies under five years old and I was only 25. I was working full time and going to school three nights a week. I vowed I would never have any more kids and wondered what had possessed me to have four, as much as I loved and enjoyed each one of them and believed them to be the most wonderful children ever on the face of the earth (which they were and still are. :))

      But within that five years, I had become an evangelical Christian, as my now-ex husband had. I had my fifth child when I was 30, in a hospital, but with no medicines of any kind and attended by a D.O., a tad bit less patriarchal than most M.D.s and someone who, in general, I liked. I didn’t have any sort of medications with any of my children after my 3rd, even though they were born in hospitals. By the time I had my seventh child, I had purposed I would not go to the hospital at all until I was ready to deliver; that way no one could even suggest that I be shaved, etc. When I got to the hospital I was already dilated to 10 centimeters, which is fully dilated. But, she was “sunnyside up”, occiput posterior, the hard part of her head rested against my pelvis, and those babies are hard to deliver at times. I pushed for two hours. The doctor fell asleep at the foot of the bed. The nurse became nasty and told me I was “pushing wrong.” I thought I probably did have a sunnyside up baby, and I asked if that might be the case and she said no. I wanted to squat on the table, and she said no, I might fall. She kept threatening me that hospital policy was, if I didn’t deliver within 2 hours, I had to have a c-section. I swear to the goddess, by sheer force of will, under threat of c-section I knew I didn’t need, I forced my number seven child into the world. She is 21 now. 🙂 But I knew that would be the last child I had in a hospital. The next baby was born at home with the same midwife who delivered my 8th, 9th, 10th and 11th babies, except that she didn’t deliver number 10, because he was born in the car. 🙂 The main reason I didn’t deliver at home until number 8 (who is now almost 19) is that my insurance would not cover home births with midwives. By the time I had number eight, my insurance did cover the cost– over the years midwifery and home births had become increasingly accepted and were legal. The difference in cost was stunning. A home birth, from start to finish, all prenatal care, including labor, delivery and postnatal care/six week checkup for baby was around $2,400, paid for by insurance. This was so through the birth of my last nine years ago. The cost of a hospital birth, by comparison, with one day spent in the hosptial, the last time I did it, which would have been in 1987, was many thousands of dollars, $6-7,000 if I’m remembering correctly, and that did not include care for the baby, which was separate.

      So that’s the bare bones of my journey. It kind of parallels the journeys of the natural childbirth movement in this country, begins with a highly medicalized, drugged, birth, ends with the sweet births of my last four at home. My last birth was the sweetest of all in so many ways, and I was 46 when I had her. By this time home birth was completely accepted and legal in my state and fully compensated by insurance.

      Posted by womensspace | March 13, 2008, 9:06 pm
    13. Thank you so much for your stories! Absolutely amazing, and this only increases my respect for nature and the healing power of our own bodies.
      One question: are there negative effects from ultrasound?
      My experiences overall have been great with women doctors, except one, and often horrible with male doctors. I have questioned my women friends who go to male gynecologists
      why, and they get very defensive and don’t want to talk about it.
      My own personal experiences with male gyns are too painful to even write about.

      Posted by Liza | March 13, 2008, 11:15 pm
    14. Noone knows what the effects of US are… there are many thoughts and theories on what is can do to the fetus. And everyone agrees not to have too many but they do it anyone.
      Whats interesting is when the 3D US popped up in malls being done by a non-dr person, the medical community declared how harmful that can be…
      But they didnt apply it to themselves only to OTHERS

      Posted by moon goddess | March 14, 2008, 1:11 am
    15. THANK YOU for a splendid profile of one of our generation’s greatest women’s rights advocates!

      If you’ll permit me one nitpick, the term “lay midwife” is now obsolete in childbirth reform circles. The word “lay” implies non-professional, when Certified Professional Midwives (CPMs) like Gaskin actually hold 3-5 years of training and extensive clinical experience in out-of-hospital births. Opponents of normal birth will often employ the term “lay” derogatorily to leave the false impression that they are incompetent. Gaskin and her kin are anything but!

      Posted by Lady Guinevere | April 13, 2008, 3:14 am

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