The Abortion Barriers and Needs of Black Women

By Daniela Mansbach & Alisa Von Hagel

Anti-abortion organizations aim to make abortion illegal for all women – or, barring that, to make abortion as difficult as possible to access. The war on abortion access has many fronts, including mandated delays, special counseling rules, and rules limiting the reasons a woman can offer for wanting to end her pregnancy. At the end of 2017, for example, Ohio passed a law that bans abortion for women whose fetuses have been diagnosed with Downs Syndrome. Ten states bar women from ending pregnancies based on the sex of their fetus, and some state legislatures are currently considering similar bans for abortions based on race. Regardless of the intention of these laws, they create barriers to reproductive care and can also ignore the typical reasons women seek abortions – because the pregnancy was unintended and unwanted and they do not believe they can financially provide for a new child. Many barriers to abortion disproportionately affect Black women.

How the Anti-Abortion Movement Makes Racial Arguments

As part of their broader strategy to restrict access to abortion, many pro-life organizations claim that higher rates of abortion for Black women are evidence of racism on the part of abortion providers and advocates. Of the 160 pro-life websites we surveyed in the course of our research, almost 20% make this claim explicitly, arguing that abortion clinics and doctors target minority women in a systematic and purposeful way. The organizations that link abortion with race often compare abortion with the Holocaust, genocide, and slavery. For example, one such group, Abortion in the Hood, uses images of the Planned Parenthood symbol and the Confederate flag under the headline “which one kills 266 black lives everyday?” One of the most radical organizations we studied, Klan Parenthood, goes so far as to equate pro-choice advocates to Klan members, featuring an image of a doctor wearing a Klan outfit with the slogan: “Abortion, because Lynching is for Amateurs” on their website’s homepage.

Pro-life organizations deploy such messaging about increased abortion rates for Black women to argue that the fight against abortion is the civil-rights struggle of the day, co-opting the rhetoric of anti-racism movements. For example, the anti-abortion group Protecting Black Lives writes that “if the current trend [in abortion rates] continues, the black community may cease to make a significant positive contribution in society.” A similar organization, Black Genocide, emphasizes the political implications of abortion, falsely stating that African-Americans “are the only minority in America that is on the decline in population. If the current trend continues, by 2038 the black vote will be insignificant.” While some might assume these extreme comparisons and imagery would be relegated to the fringe of the abortion debate, they actually have a direct – and growing – effect on state-level policy. This is evident in the increase in laws that restrict access to abortion based on the race of the baby. One such example is the passage of an Arizona law in 2011 that banned abortions based on the race of the fetus, justifying it as a tool for addressing “race-related discrimination that exists in Arizona and throughout the nation.”

The Real Link between Racism and Reproductive Health

Anti-abortion groups find it possible to make extreme racial claims because statistics, such as data from the Guttmacher Institute, show that women of color have higher abortion rates than white women. Despite significant declines for all groups in the past decade, women of color still obtain abortions at a rate two to three times higher than the rate for white women. According to data from the Centers for Disease Control, while non-Hispanic Black women account for only 13.3% of the U.S. population, they receive approximately 35% of all abortions.

Yet even though it is accurate to say that Black women have higher rates of abortions in proportion to their share of the general population, research shows that this is due to higher rates of unintended pregnancy among women of color in general, and Black women in particular. When researchers control for rates of unintended pregnancies, Black women do not have a higher percentage of abortions.

  • In 2008, 69% of all pregnancies among Black women were unintended, compared to 56% of pregnancies unintended for Hispanic women and 42% unintended for white women.
  • According to the Centers for Disease Control, from 2006 to 2010, 9% of births to non-Hispanic white women were defined as unwanted, compared to 18% for Hispanic women and 23% for Black women.

The percentage of unwanted pregnancies that end in birth rather than abortion suggests that Black women are actually more likely than women of other races to carry an unwanted pregnancy to term. Further, given that many more of their pregnancies are unintended, it is not surprising that the abortion rates of Black women are higher than those of white and Hispanic women.

Why do minority women in the United States have higher rates of unintended pregnancies? There are many reasons, but limited access to affordable and effective contraception is among the most important causes. Limited access, in turn, is often attributed to funding cuts to programs that provide contraception to low-income and minority communities, plus the scarcity of reproductive healthcare providers in neighborhoods where high concentrations of minority women live and work. Other recent studies – such as the Turnaway Study of women who did and did not receive desired abortions – find that many women of all races cite economic reasons for terminating a pregnancy.

The overall picture is that Black women in the United States often face difficult socio-economic circumstances, which influence their reproductive access and choices. As long as pervasive racial disparities in health care and economic wellbeing persist, Black women will face disproportionate risks of unintentional pregnancy – and many of them, as well as many white women, will choose abortion.

Abortion providers are hardly the ones discriminating against Black women. Instead, they are trying to address their needs and choices. Abortion providers will continue to serve the unmet needs of Black women who are making the best parenting decisions they can for themselves and their families.

Why Understanding Black Women’s Beliefs About Motherhood Can Help Improve Reproductive Health Care

Chanel, now a middle-class mother of one, is just one of many women who have used abortion to end a pregnancy. “In college,” she explained, “I had two abortions and I had them not because I didn’t want to be a mother but because I wasn’t ready. I wanted to finish school and I just felt like I was too young… [M]y mother really stayed on me about not having kids and I saw what it was like for her to have kids at such a young age and to be unmarried… I never wanted to do that.” Researchers can distill Chanel’s lived experience down to the briefest of statistics: Black woman, college-educated; three pregnancies, one child. But her candid testimony sheds needed light on the complexities of personal choices about pregnancies. When I interviewed her, Chanel made it clear that her abortions were her own decision. But such decisions are always made by women in the context of external forces that constrain their options.

Decades of previous research have illuminated the significant racial and economic disparities that affect women who seek access to reproductive health services. Black women, especially, bear the brunt of socioeconomic and political factors that impede their full autonomy in making reproductive choices. Much has been made of data from the Guttmacher Institute showing that abortion rates for Black women are almost three times higher than for white women, and that unintended pregnancies are nearly twice as frequent for Black women. Meanwhile, abortions are increasingly concentrated among poor women, who accounted for nearly half of all abortions according to the latest available 2014 data.

What might create more favorable and equal conditions for Black women dealing with reproductive health issues? Studies have suggested many possible solutions – including better sexual health education for young people; expanded health insurance coverage; and increased access to reproductive care, including all forms of contraception, abortion care without stigma, and quality pre- and post-partum care for mothers and children. Many scholars are now also probing the ways in which institutional racism undercuts good health care for Black women.

Effects of Wealth, Class on Black Women’s Ideas about Motherhood

Although a focus on collecting and analyzing systematic data contributes to our overall understanding of women’s reproductive decisions and consequences, my research using in-depth interviews seeks to fill gaps left by previous studies. Discussions about abortion and contraception for Black women, I find, are often influenced by Black communities’ understandings of the centrality of motherhood in the reproductive life course. A richer understanding of the importance of motherhood to the Black community may help researchers and policymakers provide resources and programs grounded in the realities of Black women’s reproductive lives.

My conversations with research participants highlight the role of class in Black women’s definitions of motherhood and interpretations of “choice.” For poor and lower-class women, womanhood is deeply imbued with the value of motherhood. These women largely approach motherhood as destiny rather than as one choice among many. In contrast, upper- and middle-class women grapple much more with the “hows” and “whens” and “with whoms” – with the mechanics of fitting motherhood into their lives. Kim, a young working-class mother of one, explained that her own mother controlled some of her early reproductive health choices: “When I was younger my mom put me on [birth control] and said it was for my periods.” In contrast, Mia, a 33-year old middle-class women with no children, described a more deliberate decision to avoid pregnancy: “Kids are expensive… It’s cheaper to take birth control than have the kid. [laughter] so um yeah I’ll just keep taking birth control until I hit the lottery.” Both women exercised reproductive autonomy by taking birth control, but only the higher-income woman expressed the feeling that preventing pregnancy was her own choice to make.

Including Understandings of Motherhood in Reproductive Health Policy

As they make reproductive decisions, Black women struggle with expectations and obligations about motherhood. Devising policies that take account of community expectations and constraints may help reduce unintended pregnancies, increase access to reproductive healthcare services, and improve health outcomes for Black women. Exploring the meaning of choices made by Black women can reveal how variously situated women make different decisions. This, in turn, will allow more equitable provision of reproductive services.

My work begins to paint a detailed picture of Black women’s reproductive health journeys. But more research remains to be done. To combat the obstacles Black women face, we must interrogate and supplement quantitative data with qualitative explorations of personal experiences and beliefs. Data and interviews so far suggest a number of useful steps to be taken by key stakeholders ranging from policymakers to doctors:

  • Increase access to insurance to reduce the financial burden of preventing pregnancies or bearing children.

  • Foster cooperation among researchers, clinicians and educators – to improve understandings of beliefs important to the Black community, including ideas about motherhood and the meaning of womanhood. Such understandings can help providers improve the dissemination and reception of reproductive health education and services in the Black community.

  • Earmark funding for more research about the ways Black women in various social positions understand their reproductive lives. And encourage studies that encourage community participation and place a central emphasis on hearing Black women’s voices.

Black women make all sorts of reproductive choices, from using birth control to having abortions to raising babies. As their stories reveal, every choice is influenced by social class and the expectations of their families and communities. Researchers and advocates who want to improve reproductive health outcomes for Black women would do well to listen to what Black women have to say and view individuals’ choices as profoundly shaped and limited by social circumstances and cultural ideas and expectations.

Is the #MeToo Movement Leaving Black Women Behind

Women have been sexually exploited for centuries and its foundation is heavily rooted in American history. But what about the black woman and her story? With all of the sexual harassment allegations and mayhem involving big names such as Weinstein, Moore, Spacey, and now Matt Lauer; it should come as no surprise that black women are included in the ever-growing list of victims.

However, it couldn’t be further from the truth. It has been amazing and yet difficult to digest the responses to the black women who have come forth with allegations of sexual harassment. The skepticism and scrutiny to which many have been subjected to is both distasteful and heartbreaking. How is it that in 2017 our stories still don’t matter?

It is of strongly held opinions that the black woman was the original victim of what we now know to be sexual abuse/harassment/violence. The historic amnesia that America has denied for centuries has found a way to rear its ugly head only for the sake of whiteness and other contemporary motives yet the black woman is still forgotten.

Lest we forget that it was the black woman who was raped, killed, exploited, molested, and subjugated to adapt to cultural norms that she may never receive full acceptance into despite her many contributions and heavy influence on this culture. Rooted in racist ideology that perpetuates systems of superiority, power, and control; it is evident why the black woman’s story is unbelievable.

Pair that with a century’s long narrative that has painted a picture of the black woman as an over sexualized seductress whose very anatomy is both revered and seen as threatening, and we now have plausibility to deny anything that comes out of her mouth claiming victimization. When a black woman claims that she has been victimized, why is she automatically seen as the perpetrator or instigator?

Case in point, Harvey Weinstein quickly refuted claims from Oscar-winning actress, Lupita N’yongo, but for the most part, remained silent on claims from other women. It is important to note that N’yongo is the only black woman who has come forth with allegations of sexual harassment by Mr. Weinstein. Are we to believe that Weinstein had an ‘off switch’ when it came to Lupita N’yongo? Pssshhh, I think not!

Surely people are not naïve to the fact that black women have and continue to experience sexual harassment and exploitation at alarmingly high rates. In fact, a quick Google search on black women and sexual harassment will render a host of information chronicling our fight against sexual harassment.

One will even learn how it was the struggles of a collective group of black women that helped shape sexual-harassment laws and the many protections it provides on the books today. It is also important to note that when the perpetrator of sexual misconduct is a black male whose victims are typically black women, little to no attention is brought to these issues.

For instance, when you hear the name, R. Kelly, not only is it synonymous with music and pop culture, but you may also think ‘affinity for young girls’ as well. Despite decades of suspicion, allegations, and videos of sexual misconduct, Kelly’s career has persisted and even thrived. This is an unlikely paradox given the current environment that has resulted in many high-powered men losing nearly everything they have worked for.

Even Bill Cosby was shunned for his actions. So why the difference? Again, when you compare Kelly up against other men, the only real difference is the victims. Kelly’s victims are typically young black girls and women whose lives and stories simply don’t hold as much value as their white counterparts.

There is little doubt that the black woman’s mind body and soul have been invaded in an effort to dominate the very space that she occupies. Slavery taught us that while the black male was indeed the head of the family, leader of the tribe, and physically capable to withstand formidable circumstances; it was the black woman who was the driving force behind black people’s survival.

Even still today, she has had to take on all of these roles in the absence of the black male due to the continuous assault on his life while attempting to maintain some semblance of normalcy for both herself and her family.

Somewhere along the way, black women were placed at the bottom of the barrel and devalued, or perhaps she was never valued at all. Society has stripped her of every human right you can think of. She has been poked, prodded, studied, raped, exploited, coerced, deprived, abused, and so on and so forth.

History has shown us that the black woman is a part of one of the most disenfranchised groups and that despite the many strides she has made in overcoming adversity, society still seeks to invade her space, and steal her virtue all while denying her claims that give truth to her existence.

Exploring the Traumatic Impact of Criminalizing Policies on Black Women and Girls

Black Youth Project 100 with Freedom Side in New York City August 2014. (Photo: Caleb-Michael Files)

The truth is, “black girls and women are still some of the most vulnerable members of society, thereby putting us more at risk for adverse childhood experiences (ACEs). Black teen girls, in a given year, are more likely to attempt suicide and become trafficked at younger ages than their racial counterparts. Additionally, black girls are at a significantly higher risk for sexual abuse, physical abuse, and child neglect.

Stressors that occur during black and brown children girlhood, such as loss, grief, substance abuse, mental illness, exposure to violence and parental incarceration are identified as adverse childhood experiences (ACEs). A tool to “assess the cumulative effect of trauma on a person’s life”, ACEs identifies household dysfunction by exploring childhood experiences through a series of questions. At the conclusion, the response totals are utilized to assess the likelihood of risk factors for negative physical, mental and behavioral health outcomes (i.e. – asthma, early experimentation with drugs, suicidal ideation).

The National Survey of Children’s Exposure to Violence indicates that more than 60 percent of children from birth to 17 years experience victimization and 38 percent witness violence sometime during childhood. While our recent focus has centered on the black and brown #missingDCgirls, who are disproportionately pushed out of the educational system, the community needs the conversation expanded in order to continue to coalition build and support efforts for black and brown girls affected by many of the issues that girls face, within their families, schools, and communities.

Faced with significant trauma and limited coping skills, many girls engage in behaviors that impede healthy socio-emotional development and positive overall well being. Cutting, drug experimentation, poor diet, violent outbursts, social isolation and displays of depressive emotions are just some of the behaviors that precede unaddressed stress and hopelessness, particularly in black and brown girls’ lives.

Restricted by geographic location, lack of resources, lack of knowledge of supportive services, healthcare access barriers due to age and parental rights and adolescents are left with no options. It is the foundation for a perfect storm hopeless feelings and stress.

Exploring the Impact of Criminalizing Policies on African American Women and Girls

In September 2015, scholars, community members, activist, and advocates gathered for a roundtable to discuss the impact of incarceration and mandatory minimums on survivors. With goals that focus on black women and girls, survivors of domestic violence and sexual assault highlighted criminalizing policies, mandatory minimums, and challenges in reform initiatives.

The summary report highlighting the US Department of Justice Office on Violence Against Women key points and recommendations from the roundtable was issued in January 2017. The report captures these critical issues at “the intersection of multiple aspects of a person’s identity (i.e., gender, race).” When examining the “impacts of increasing incarceration and criminalization,” public health issues faced by black women and girls, such as domestic violence, sexual assault, mental illness, disability and chronic health ailments are often an afterthought. While acknowledging, the roundtable did not further discuss the impacts due to expression or exploration of sexual orientation.

“…participants noted that efforts to end violence require a deeper analysis of the intersecting factors that shape an individual’s identity. For example, it is important to take into consideration the additional barriers and risks experienced by lesbian, gay, bisexual, transgender and queer (LGBTQ) girls and women. Participants also highlighted the need to take into account the particular challenges and exploitation of transgender women and girls.”

The criminalization black women and girls face due to the inability to cope, runaway status, nonreporting of parental abandonment and all “the ways in which conditions and experiences related to domestic violence and sexual assault intersect with girls’ experiences in the child welfare and social services systems.” This an area of inquiry for further research and development of culturally relevant and trauma informed programming. As evidenced by the short and long term effects of adverse childhood experiences (ACEs), the correlations to pathways involving hyper-regulation and criminalizing trauma are the opposite approach to rehabilitation.

Critical race and black feminist theory are the foundations of my clinical and sociological perspective when presenting bio-psycho-socio-emotional histories. Social workers in clinical roles such as substance abuse and mental health are trained to not only “acknowledge, be supportive and discuss the problem” but also help the client navigate institutions and systems.

As an effective therapist, it’s imperative to not pathologize behaviors but to also understand individuals, communities, and organizations within the context of the social and cultural climate.

Know Her Truths: Why Black Women and Girls Matter

Know-Her-TruthRecently, I had an amazing opportunity to attend the Know Her Truths: Advancing Justice for Women and Girls Conference hosted by the Anna Julia Coopr Center (AJC) at Wake Forest University.  The AJC, as it’s commonly referred to, is directed by Melissa Harris-Perry, and named for scholar, educator, and author Anna Julia Cooper, a Black Woman whose pioneering scholarship and activism laid the foundation for black American feminism and insisted on the importance of Southern voices in American politics.

The Anna Julia Cooper Center is an interdisciplinary center at Wake Forest University with a mission of advancing justice through intersectional scholarship. The conference was held April 29-30, 2016 and is part of an initiative to develop a meaningful research agenda on women and girls of color.

Scholars, students, community organizations, researchers, policy makers, foundations, and activists were brought together for an intensive series of discussions about the circumstances, challenges, and opportunities facing women and girls of color and the ways that we can identify, access, shape, and utilize research to address existing gaps and increase our collective knowledge.

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Some of the featured panels included: School Discipline Disparities and Educational Equity, Sexual Abuse to Prison Pipeline, Using Participatory Action Research to Investigate Interpersonal Violence Against Women of Color, Picture This: Using Photography to Tell a Black, Girl’s Truth, Translating research to policy, and Engaging Latino Men to End Violence Against Women: Te Invito Primary Prevention Initiative.  Organizations from all over the country were represented at Know Her Truths including The National Black Women’s Justice Institute, Girls for Gender Equity, SisterSong-The National Women of Color Reproductive Justice Collective, Advocates for Youth, and the Center for American Progress.

I also co-presented on the Reproductive Justice & Unplanned Pregnancy panel with some of my reproductive justice comrades from National Latina Institute for Reproductive Health, All* Above All, Unite for Reproductive & Gender Equity, and The National Campaign to Prevent Teen and Unplanned Pregnancy. The panel discussed how women and girls are criminalized in birthing and parenting, how the lack of comprehensive sex education and access to reproductive healthcare further perpetuates poverty and exposure to reproductive oppression, and the need for ongoing research particularly in the South in the areas of maternal mental health and infant mortality.

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As a Licensed Psychotherapist, fellow academic, and Reproductive Justice advocate, I appreciated the abundance of research, evidenced-informed practice, and the intentional focus on race, culture, history, and geography.  Black women and girls, especially in the South, disproportionately experience discrimination, disparity, criminalization, and reproductive oppression compared to non people of color.

Research has confirmed that Black girls are disciplined and suspended or expelled more than their white counterparts; that Black girls are pushed out and criminalized in essence for being Black, and that people of color are less likely to access mental healthcare due to complex and intersectional oppressions.  Black and brown people, particularly Queer and Trans* with excessive and consistent exposure to violence and poverty, are less likely to break these harmful cycles due to systemic oppression permeating through every social system in all levels of society.

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Melissa Harris-Perry and Reia Chapman

Melissa Harris-Perry also took special note to address House Bill 2 (HB2), the harmful legislation passed in NC making it legal to discriminate against the LGBTQ+ community.  “HB2 is scary, dangerous, and violent.  When the Wake Forest campus heard what was happening the campus came out very strongly against HB2 and even worked to create some ‘All Gender’ bathrooms.”

Valerie Jarrett, Senior Advisor to President Obama even made a special appearance via video message to discuss the White House Council on Women and Girls and the investment the Administration has made to address research gaps and existing cultural challenges.

We understand the risk and adversity for women and girls of color as well as the strengths and protective factors needed to improve outcomes. Research gaps identified include: there is currently no reliable national prevalence for sexual violence or trauma experienced by girls of color including due to exposure to police violence.

Know Her Truths was and is so important to the discourse and praxis concerning women and girls of color.  As MHP stated, “this conference is not the ending point.  It is a contributing part of a ton of work already happening to advance research with and by women and girls of color.” In case you missed it, you can review the conversation on Twitter using #knowhertruths.

New Tennessee Law Will Criminalize Pregnant Women

by Katherine Bisanz and Maggie Rosenblum
of Social Workers for Reproductive Justice

As we speak, the law in Tennessee is turning against women and families. The General Assembly has approved SB 1391, a bill that would turn pregnant women and new mothers into criminals.

SB 1391 takes a law that was intended to protect pregnant women from violence and instead turns them into assailants. The law would permit prosecutors to charge women with assault for losing pregnancies, or giving birth to babies with health problems at birth. The targets of the law are women who are in the most need of support: largely women who struggle with narcotic addiction during pregnancy.

Pregnant_woman2This is all happening under the guise of “finding a solution” for neonatal abstinence syndrome according to the State of Tennessee. They claim that the law is a way to use misdemeanor charges to get women into treatment. Anyone aware of the criminal justice system in our country knows that assault charges can heavily impact the course of a person’s life.

A prison or jail sentence could mean that women will be unable to be present to care for the families they already have or sustain the employment necessary to support a family and get through a treatment program. In a nutshell, Tennessee lawmakers seem to believe that they can “keep babies healthy” by punishing their mothers and don’t seem to grasp how terribly backwards and simply unrealistic this idea is.

It’s clear that no evidence-based information is backing this law being that research around the issue of child health have shown that babies are healthiest when pregnant women are treated with care, and when babies are kept close to their mothers after birth. Even women who struggle with addiction love their babies, and can have healthy pregnancies if they can form supportive relationships with their maternity care providers say Connecticut Affiliate of the American College of Nurse-Midwives.

Groups like National Advocates for Pregnant Women (NAPW) have made clear in past cases that punitive measures are the wrong approach in dealing with the “decades-old” question of how to handle pregnant women who take drugs. As opposed to taking a punitive approach that scares women away from seeking help, the state should treat pregnant drug abusers as addicts with medical problems, NAPW states.

Given their role as gatekeepers and mandated reporters, this law could have serious implications for the roles of social workers in the lives of their substance abusing clients in Tennessee.  Social Workers we are trusted to protect clients self-determination and strive to work with clients to empower and better their lives and this bill could compromise our ability to fulfill this imperative and not to mention obligatory aspect of our work.  Despite Rep. Weaver’s (R-TN) comments to the contrary, it’s hard to believe that child abuse allegations akin to those that have popped up in years past won’t arise in some form and in turn question social workers role as mandatory reporters.

This law will also erode choice as it relates to pregnancy. This law may be used by those who wish to prevent a woman from having an abortion who can now just report their concerns that a pregnant woman is using illegal narcotics in order to have her arrested so she will not be able to access abortion care.

Furthermore, this law may pressure some women into having an abortion they do not want in order to avoid prosecution under SB 1391. One study reported that “two-thirds of the women [surveyed] who reported using Cocaine during their pregnancies … considered having an abortion… (Jeanne Flavin, Our Bodies, And Our Crimes: The Policing of Women’s Reproduction in America 112 NYU Press 2009.)

Additionally, while the bill appears race-neutral at first glance, prosecutors and judges will wield the law against Black women more so than white women, based on a long tradition and culture of deeply embedded racial stereotypes about Black motherhood and drug use. The law would likely lead to Black women being thrown in jail for up to 15 years for aggravated assault should they choose to carry a pregnancy to term while struggling with an addiction to illegal narcotics. Should social workers be mandated to take part in this, they would directly be violating the discrimination clause of the NASW code of ethics, which includes the responsibility to racial justice and gender justice.

The NASW Code of Ethics states that, “Social Workers should act to expand choice and opportunity for all people… (NASW 2008).” If SB 1391 is signed into law it will limit choice and opportunities for all Tennessee families. We strongly urge the National Association of Social Workers and its Tennessee chapter as well as individuals who identify as social workers across the nation to speak out against TN SB 1391.

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