Black Birth Joy: Honoring Black Birth Justice Organizations and the Lives They Impact

As you may know, within VBAC Facts® Professional Membership we offer grand rounds, an opportunity to review latest VBAC research, so our members can easily integrate the latest evidence into their practice and communicate what it all means to their clients. Again and again, studies illustrate disparities in healthcare and VBAC access for Black parents.

In honor of Black History Month, we celebrate and honor the people who endeavor to change these disparities. So today we are going to take a look at organizations that are actively working to reduce Black infant and maternal morbidity and mortality in the United States. We want to acknowledge and support those who are making maternal healthcare for Black parents more equitable.

We are all in this together, so join us for “Black Birth Joy: Honoring Black Birth Justice Organizations and the Lives They Impact.”

Transcript

<SLIDE: Improving Black Maternal Health> Hi, I’m Jen Kamel, VBAC Facts® Founder and welcome to “Black Birth Joy: Honoring Black Birth Justice Organizations and the Lives They Impact.” As you may know, every month within VBAC Facts® Professional Membership, we do a grand rounds, but this month, we are doing grand rounds a little bit differently in honor of Black History Month. We usually review new research related to VBAC so our members can easily integrate the latest evidence into their practice and communicate what it all means to their clients. Again and again, studies illustrate disparities in healthcare and VBAC access for Black parents. However, this month we are celebrating and honoring the people who endeavor to change these disparities. So today we are going to take a look at organizations that are actively working to reduce Black infant and maternal morbidity and mortality in the United States. We want to acknowledge and support those who are making maternal healthcare for Black parents more equitable. We will  use  the word maternal often, to match the language of the organizations we are highlighting. But VBACFacts acknowledges that not all Black parents who birth are mothers and that for Black transmen who are pregnant and birthing, organizations like these are even more essential.

<SLIDE: The Organizations> As we share these amazing agents for change we will give you their websites so you can look into them further. There are so many agencies we could talk about! We are only able to bring you a few in the hour we have, to give you a glancing overview of the work they do. We do have an ask: that you choose one of these organizations, make a donation this month, and stay connected to offer ongoing support. Let’s start by discussing a federal congressional effort that is supported by many of the organizations we will highlight.

<SLIDE: Black Maternal Health Caucus> For decades, individual congresspersons have brought forward potential solutions to the Black maternal health crisis, and yet the US remains one of the most dangerous places in the world to be Black and pregnant. Oftentimes, these federal efforts do not look far upstream to the causes of health disparities. But, this past year we have seen that solutions can happen at the federal level when we have diversity and people who understand the challenges Black birthing families face in Congress. In 2019, co-chairs, Lauren Underwood from Illinois and Alma Adams from North Carolina, and 53 other congressional members formed the Black Maternal Health Caucus. In 2020, the number of supporting Congressional Members grew to 105. Hopefully, this year that number will grow yet again. You may want to check in with your Congressperson and see if they are a supporter of the caucus. In March of 2019, the Black Maternal Health Caucus introduced the Momnibus which takes a very different, broader look at improving Black maternal health.

<SLIDE: Momnibus Bills> The Momnibus group of bills takes multiple approaches to addressing the Black maternal health crisis in the US. So far they have passed at least two bills. The group of bills invest in community based organizations that promote respectful and safe maternity care as well as housing, childcare, nutrition, transportation, and clean water. It includes bills that work to and invest in improving the way we collect data on outcomes for Native American parents, parents who are incarcerated, and parents in the military. Some directly invest in prison programs to improve maternal health for people who are incarcerated, experiencing substance abuse, or mental health concerns. One bill invests in diversifying and expanding the healthcare workforce that serves pregnant people.  This includes nurses, doulas, and community health workers. Two others invest in health care payment solutions, and using technology for remote care to ensure that everyone has equitable access to healthcare while pregnant and postpartum.

<SLIDE: Stakeholders> The Momnibus already has a lot of support outside of Congress. So many organizations, from small local community organizations to national health force membership organizations, are supporting Momnibus that I cannot possibly list them all. Since the founding of the Black Maternal Health Caucus and its introduction of the Momnibus,  it has had the support of hundreds of maternal health organizations. The Black Maternal Health Caucus has hosted two stakeholder meetings with hundreds of entities including ACOG, American Association of Birth Centers, the National Association to Advance Black Birth, and Jenni Joseph’s Common Sense Childbirth. The Black Maternal Health Caucus’ widespread, relevant stakeholder investment is essential. Angela Aina of the Black Mama’s Matter Alliances said this: “The Momnibus, put forward by the Black Maternal Health Caucus, has the potential to be transformative for Black maternal health…by centering Black women-led organizations like BMMA in the process…prioritizing the needs of those most impacted by the maternal health crisis in the United States.”

<SLIDE: The National Association to Advance Black Birth> Actions like the Momnibus do not start at the federal level. Congressional Member actions almost always follow the efforts of  national and community based organizations. One of the organizations whose efforts led to the Momnibus is the The National Association to Advance Black Birth or the NAABB. The mission of the NAABB is to “To combat the effects of structural racism within maternal and infant health to advance Black birth outcomes.” Their work  to enact that mission. affects policies that lead to change. The Momnibus is just one example.

<SLIDE: The National Association to Advance Black Birth> The NAABB creates ways  to promote advocacy, research, educational programming, activism, supporting culturally appropriate models of care, and community birth workers who address the specific needs of Black birthing people. They successfully team up with other organizations so that more people are able to take action toward change. One of my favorite things they have done recently is the Black Birthing Bill of Rights which illustrates for parents, institutions and health care workers what to expect in respectful birth care.

<SLIDE: Black Birthing Bill of Rights>  I just want to take a moment and highlight some of the statements from the NAABB’s Black Birthing Bill of Rights which I will link to below the replay of this presentation. The rights include things like, I have the right to be listened to and heard. I have the right to have my humanity recognized and acknowledged. I have the right to be respected and to receive respectful care. I have the right to be believed and acknowledged that my experiences are valid.

<SLIDE: Black Mamas Matter Alliance> The Black Mamas Matter Alliance has the mission to “center Black mamas to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice.”

<SLIDE: Black Mamas Matter Alliance> By uplifting Black women leaders and centering the voices of Black mothers, they strive to affect policy, research, and expand the breadth of healthcare services. They host training webinars for care providers and many of these webinars are freely available. The BMMA publishes standards, articles, and reports for better Black maternal healthcare. They have developed the Black Mamas Matter toolkit to educate advocates on human rights in healthcare. They will be hosting the second Black Maternal Health Conference and Training Institute in 2021 and are developing regional summits. Finally, the BMMA founded the Black Maternal Health Week that we celebrate every April as part of the US National Minority Health Month.  You can find information on your local Black Maternal Health week on the BMMA website.  If your area does not have a local celebration, you can download a toolkit to start or sponsor one.

<SLIDE: National Black Midwives Alliance> The National Black Midwives Alliance is a membership organization for Black midwives. They advocate for the needs of Black midwives. They work to increase the number of Black midwives and to improve access to those midwives.  They provide Black midwives with tools, trainings and mentorship to address disparities at the local and national levels. They provide educational opportunities for midwives and student midwives in addition to counseling midwifery schools on best practices. Last year, they hosted two free webinars on the implications of Covid-19 for Black birthing families. In June of 2020, in conjunction with the Southern Birth Justice Movement, the National Black Midwives Alliance started the BIRTH JUSTICE FOR BLACK LIVES campaign. Their midwife crush gallery is a wonderful way to honor Black midwives from the past and the present.

<SLIDE: Midwife Crushes, Doulas and RJ> Speaking of midwife crushes, we have a few for you. There is a reason that Black midwives ought to be centered in any solutions to the Black maternal health crisis in the US.  The midwifery model of care is person centered, individualized, attentive, and encompasses practices of respect and informed consent. When Black midwives provide care to Black families, that care is made more powerful by a rich history of Black midwifery that precedes modern US midwifery. It is more culturally safe for Black families.  Black midwives rarely stop at midwifery care alone, as you will see. Their work often expands to address many other sources of disparity and community needs. Doulas are the icing on a midwife’s cake. Just as Black midwives excel at providing midwifery care to Black families, Black doulas provide wraparound services to Black parents no matter what their birth plans are or who their provider is.  As we now know, there is abundant research that shows that doula services improve health outcomes and birthing persons’ experiences in the birth room. We are going to talk about a few of our midwife and doula crushes in a minute, but first let’s take a brief moment to review the modern reproductive justice movement created by and for Black women and trans folks. Reproductive justice is a core principle for many of our crushes and is at the center of the next group.

<SLIDE: Sister Song> Sister Song is an Atlanta based organization founded in 1997 by women of color as a Reproductive Justice Collective. “SisterSong defines Reproductive Justice as the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” Sister Song promotes reproductive justice by looking at power systems, the intersectionality of oppression, centering the people who are most marginalized and creating alliances between multiple identities and issues.

<SLIDE: Sister Song> One example of the on the ground work that Sister Song does is leadership development for reproductive justice. Established workshops like “RJ 101: A SOLID INTRODUCTION TO THE FRAMEWORK” and other trainings that are tailored to an individual group’s needs.  They have started several movements that support reproductive justice. The Southern RJ Cohort unifies southern women of color and trans voices in the issues of reproductive rights policies. Sister Song promotes art and culture programs. The Trust Black Women partnership, along with other media efforts use voices of Black women to counter disparaging stereotypes and to support the Black Lives Matter movement. They are co-leaders and founders of the BMMA that we talked about previously working to create a database of Southern BIPOC birth workers.

<SLIDE: Commonsense Childbirth> Jenni Joseph has worked towards Black maternal health equity for 40 years. She founded Commonsense Childbirth more than 20 years ago and we are happy that it has become an entity that cannot be stopped. Originally started in Florida as an easy access midwifery prenatal clinic or a place that any pregnant person could gain access to prenatal care, Commonsense Childbirth continues to provide prenatal care to anyone who says they need it.

<SLIDE: Commonsense Childbirth> Using their mission to “inspire change in maternal child health care systems worldwide; to re-empower the birthing mother, father, family and community by supporting the providers, practitioners and agencies that are charged with their care,” they have grown to do much much more.

<Slide: Commonsense Childbirth> The JJ Way has become a Community-based Maternity Centers model for improving outcomes and reducing disparities at a local level. The Commonsense Childbirth Institute provides in person and distance training programs for healthcare workers. They offer  an accredited program for aspiring midwives that focuses on “equity, equality, diversity and inclusion.” One program within the Commonsense Childbirth Institute is the National Perinatal Task Force providing a place for birth workers to network about changes, statistics, ideas, and support in creating change.

<SLIDE: Ancient Song Doula Services> Ancient Song Doula Services is a Brooklyn based organization founded in 2008 as a way to offer doula services to low income women of color. Ancient song says they “focus on the whole and not the parts. Through community, advocacy, reproductive/birth justice and education we aim to tackle some of the issues affecting communities of color.”

<SLIDE: Ancient Song Doula Services> They offer full spectrum doula services on a sliding scale for  about 400 people a year for pregnancy, birth, and postpartum support.  They also provide care for parents in prison or who have had pregnancy loss or stillbirths. They offer virtual training for others nationwide who want to learn to be full spectrum doulas. Ancient Song’s Listen to Me Now storytelling project has provided a forum to gather and amplify the voices of parents, providers, communities and families sharing what birth care in the US really looks like for Black parents.

<SLIDE: Sista Midwife Productions> Founded by Nicole Deggins, Sista Midwife Productions is the next organization we want to highlight. They are based in New Orleans, Louisiana and have the mission “to improve pregnancy and birth experiences and to eliminate perinatal disparities by increasing the number of Black birth workers, teaching families about their rights and options; and creating transparency and accountability within childbirth education and the medical obstetrical system.”

<SLIDE: Sista Midwife Productions> Here is how they accomplish that mission. They offer the Birth Story Project including monthly story circles for Black women to discuss their birth experiences and an anonymous survey to gather stories from all people who have birthed in Louisiana. They sponsor the Art of Birthing which includes workshops, art experiences and a film festival celebrating birth justice movements. Sista Midwife has a doula training and a free online course on how to plan for a great birth. One of the things that research shows us improves outcomes for Black parents is having a Black provider, and Sista Midwife has one of the largest databases of Black midwives and doulas in the US. It’s a great site to add to your referral lists.

<SLIDE: Black Women Birthing Justice> Black Women Birthing Justice is an Oakland, CA based collective of Black women telling their birth stories that started more than 10 years ago when two mothers, Chinyere Oparah and Cherisse Harper, were discussing their birth experiences and wondering how their experience were far from ideal even though they were strong, educated and empowered women.

<SLIDE: Black Women Birthing Justice>  They committed to “creating a space for Black women to speak out about birth injustice and to build a national platform to transform Black women’s experiences of childbirth.” Since 2010, the members of this collective have done a LOT. They have published a report titled “Battling Over Birth: Black Women & The Maternal Health Care Crisis in California,” a book “Birthing Justice: Black Women, Pregnancy and Childbirth,” and a lot of research articles some of which we have featured. One of the amazing programs the Black Women Birthing Justice collective is part of is Roots of Labor Birth Collective which provides doula services to low income and incarcerated parents.

<SLIDE: Uzazi Village> Uzazi village, in Kansas City, Missouri uses education, support and programs specifically designed to reduce prematurity in Black babies. They do this using, in their words, “peer to peer education and support models, education that is population and culturally specific, promotion of innovative prenatal care models that attract rather than repel, and that build up rather than penalize, [and] empower women to create and implement their own reproductive life plans.”

<SLIDE: Uzazi Village> Uzazi village has a sister doula co-op offering a formal group of doulas and back-up doulas to serve clients sustainably. They offer a free breastfeeding clinic providing peer support and lactation services using both in home and clinic visits for new parents. Community events  include a free clothes closet to provide childrens and adult clothes, childbirth education to members of the local community, a babywearing fashion show gifting  baby carriers to all people who participate. They also do education in all these areas with a formal doula training, a breastfeeding support training, community health internships for birth workers. There are a variety of other workshops as opportunities present themselves.. Uzazi village provides research opportunities gathering statistics from their sister doula program outcomes, babywearing rates, breastfeeding success and Black infant mortality rate reductions.

<SLIDE: Abide Women’s Health Services> Abide Women’s Health Services is a foundation pursuing their mission to “bring professional, affordable, and accessible health services to women in the South Dallas community and surrounding areas.” Abide expresses the desire to “get babies to term and to their first year” by increasing access to midwives, birth workers of color, breastfeeding rates, reducing low birth weight or preterm births, and ending infant and maternal mortality rates.

<SLIDE: Abide Women’s Health Services> Abides values are strong, striking and deserve respect. They directly call for anti-racist work, reparations and redemptive justice to help right the wrongs for  hundreds of years that led to the disparities of health outcomes for Black birthing families. Abide has an easy access prenatal clinic. The clinic was opened as part of its 4-phase plan to provide  a community birth center. In crafting this plan  they have listened to the community about what local birthing people need. This lead to supporting the community with childbirth education, breastfeeding, and baby care classes, postpartum breastfeeding support, and addressing practical needs like clothing and diapers. One of the programs at Abide invests in long term change by providing scholarship to student midwives of color.

<SLIDE: Kindred Space> Kindred Space is a midwifery group that offers home birth in South Los Angeles. They also have associated supportive services like lactation work, childbirth education and parenting support classes. Founded by Kimberly Durdin and Allegra Hill, most recently Kindred Space is fundraising for a South LA birth center through their Birthing People Foundation. This will be the only Black-led birth center in Los Angeles country. Given the racial disparities in maternal and infant outcomes, Kimberly Durdin has said “Allegra and I haven’t been comfortable just being like, ‘Wow, that really sucks. All this terrible stuff is happening. We have literally pledged our lives at this moment to be a part of the solution.”

<SLIDE: Roots Community Birth Center> Roots Community Birth Center is a small midwifery practice and birth center in Minneapolis that provides routine prenatal birth and postpartum care by out of hospital midwives, but they don’t just provide midwifery services. Roots has a family practice clinic that provides wellness visits for the whole family; a doula internship program where doulas learn to provide labor support offered at no cost to their clients; and starting this year they will have a hospital birth program with services provided by their CNM and family practice doctor. Roots has a full staff of midwives, physicians, doulas, community health workers, and more, so families can truly get all their care in one location. They accept all insurance plans and have financially accessible options for people without insurance. Roots’ culturally sensitive care model has been lauded in journals as the model to combat the pregnancy and birth disparities created by racism.

<SLIDE: Frontline Doulas> Frontline Doulas provides doula care to Black families at no cost. They have a doula hotline that families can call to talk to a doula, and in the time of Covid, they have moved to virtual consultations, childbirth education, and continue to provide doula services to Los Angeles based African American people birthing in hospital with no other support. Frontline Doulas is completely free and rely on donations and grants. You can sign up for their newsletter or contact them via their website. Frontline Doulas also provided financial support to Community Doulas in Counties throughout California who are providing free care to their clients so that more birthing families could be served.

<SLIDE: White Coats for Black Lives>  Okay, it is true that midwives and doulas might be our favorites, but we also hold great respect for physician organizations that are combating racism in healthcare. One such organization is White Coats for Black Lives. You may have seen them in the news over the last year as they vocally responded to the disparities in healthcare and outcomes for Black people  suffering from  COVID19. But White Coats for Black Lives actually started in 2014 in response to police violence against people of color. It is a national group of medical students with a mission “To dismantle racism in medicine and promote the health, well-being, and self-determination of people of color.”

<SLIDE: White Coats for Black Lives> They do this by supporting actions that remove policing from education and healthcare. They create programs supporting educational opportunities for  providers of color, increasing compensation for hospital support staff, the majority of whom are Black, and insist on transparency at the educational and hospital levels. They have an online magazine called the Free Radical and a newsletter to keep community members, supporters and advocates  up to date on their activities and success. They also publish the racial justice report card,.  This document ranks medical schools with regard to racism embedded in curriculum, research protocols, diversity of faculty and students, racial integration of associated clinics, how workers are treated, and policing policies and practices.

<SLIDE: Birthing Project USA> Birthing Project USA: The Underground Railroad for New Life is the only global African-American maternal and child health program based in the US. They are “a volunteer effort to encourage better birth outcomes by providing practical support to women during pregnancy and for one year after the birth of their children.” They “envision a world in which we have the freedom to define ourselves, birth our babies, and live our healthiest lives.” Their first program, Sisterfriends, was founded in Sacramento, California in 1988. Sisterfriends volunteers support pregnant teens and women with the goal of reducing infant mortality and has expanded across the US into 70 communities and beyond, into 13 countries around the world. In response to the isolation caused by the pandemic,  Birthing Project USA launched  a national, virtual Sisterfriend program to support pregnant and birthing families. This social support, extended family model reduces stress and improves birth outcomes. Families stay connected until at least the baby’s first birthday. The Baby Bunches boast children who are now college graduates, and “little sisters” who now manage projects in their own cities. The International projects for Birthing Project USA provide thousands of Safe Birth Kits to people birthing in Africa and Latin America through fundraising and volunteer efforts These sterile materials protect mothers and babies from dying of infections and can be used in local villages as well as hospitals that can be days long journeys away. Birthing Project USA looks for ways to empower local leaders. Things as basic as building shelters for laboring women waiting for days and weeks outside of hospitals have made a difference. Where deaths were as common as 50% in some areas like Malawi and Uganda, where Safe Birth Kits are available they are almost unheard of.

<SLIDE: I want that too!> What do all of these organizations have in common? They are on the ground, doing the work that affects change, improving birth outcomes and experiences of BIPOC communities. This is exciting work and it is inspiring to all who want fair and equitable outcomes for Black birthing parents and babies. It is easy to get excited and sometimes the work is heavy. Mainstream organizations can get stuck in the how-to part of anti-racism work. There are leaders out there who have made it their mission to show the way. They set an example of listening to at risk community members,  and demonstrate the process for care providers becoming more inclusive, diverse, and culturally humble in equitable spaces. Here are a few.

<SLIDE: The Adaway Group> The Adaway group founded by Desiree Adaway, facilitates diversity, equity, and inclusion trainings for companies and organizations world wide. The Adaway Group says “love the collective more than you hate the system” inspiring us to focus on what is within our power to shift and change. The Adaway Group offers coaching, consulting, training, facilitation, speaking engagements, and my favorite, the equity audit where they will come into an organization and assess where it is in equity and inclusion. The audit provides concrete action steps for improving equity within the environment. There’s more. Whiteness at Work is a training program that looks at racism, anti-Blackness and the norms of “whiteness” in an organization. Their Freedom School is a year-long primer in social justice and Black feminist work with monthly classes, and quarterly topics including The Foundations, White Supremacy, Specific Issues, and The Politics of Social Movements. Participants can take all modules or enroll in specific classes as they see the need.

<SLIDE: Diversity Uplifts> Diversity Uplifts has consistently provided community support, provider education and support for community led organizations that work to improve outcomes for Black birthing families. They push legislation and policy that supports communities of color and other marginalized groups. They educate providers through consultation and formal coursework including classes on serving incarcerated women, maternal mental health, birth justice, human rights in childbirth, historical trauma, racism, and implicit bias. They financially support community programs, such as Kindred Space, Black Mothers United, and the Frontline Doulas, when those programs align with either goals. And, Diversity Uplifts has toolkits for organizations to do anti-racist work without exploiting the experiences of Black community members.

<SLIDE: Shafia Monroe Consulting> Shafia Monroe is a midwife, but oh boy she is so much more! Remember the first organization we spotlighted, The National Association to Advance Black Birth? Well, Shafia Monroe was the founder of that powerhouse of an organization back when it was called the International Center for Traditional Childbearing (ICTC). She has been called the Queen Mother of the Midwifery Movement and for good reason. Since Shafia Monroe was a teenager in the late 1970s she has worked through every possible avenue to improve health outcomes for Black birthing folks. She has through the years won awards, written books and articles, and been featured in news and television shows.

<SLIDE: Retirement for Shafia Monroe> Since “retiring” as a midwife Shafia has offered, through her counseling organization, a long list of programs that carry that work forward. Shafia Monroe Consulting offers full circle doula training and continuing education for birth care providers, ongoing trainings in Working with Diverse Populations in Maternal and Child Health and cultural competency. And, organization level trainings and services on Diversity and Inclusion, Healthcare Competencies, Knowledge and Awareness, Core Cultural Competence, Organizational Development, and, Mentorship and Consulting. She offers speaking engagements elaborating on the birth justice movement, the history of African American midwives, why cultural competency matters, how to prevent infant death, and the legacy of Black midwives.  Shafia Monroe consulting has a blog, regular webinars and events, and a podcast. Her organization hosts the Ayanna Ade Black Student Midwife Scholarship. Take a look at the organization’s timeline Black Midwives Through Time for a primer on the origins, marginalization of, and return of the American Black Midwife.

<SLIDE: Take Action> Now that we have highlighted several organizations, we really encourage all members to pick one of these or another organization run by and for Black birthing families and take some action. Here are a few ways you might consider doing that.

<SLIDE: 1 Stay Involved and Informed> Write or call your Congressperson and encourage them to support the bills housed in the Momnibus. Review the National Black Midwives Association midwife crush gallery. Learn about Black Midwives Through Time. Follow the work of Sister Song’s Trust Black Women partnership.  Get involved in the National Perinatal Task Force to find other birthworkers networking for change. And we will be including links to these resources and programs below the recording.

<SLIDE 2 Support Local Community Organizations> Look around your local community and decide who your midwife or doula crush is. Find the community organizations in your area providing comprehensive health services to Black families like the work we have seen by the Roots of Labor Birth Collective, Roots Community Birth Center, the Frontline Doulas or the Birthing People Foundation. Maybe donate to a scholarship to student midwives of color such as the one Abide provides or to a free breastfeeding clinic like Uzazi offers. Send them some love and financial support.

<SLIDE: 3 Develop your Resource and Referral Plan> Review and share the National Association to Advance Black Birth’s Black Birthing Bill of Rights.  Make plans to participate in your local Black Maternal Health Week sponsored by the Black Mama’s Matter Alliance. Send Black birthing families to Ancient Song’s Listen to Me Now story telling project to have a safe place to share their hard or traumatic birth stories. Then, refer them to Sista Midwife’s databases of Black midwives and doulas in the US so their next story may be better.

<SLIDE: 4 Do the Hard Work> Sign up for the Freedom School through Adaway Group, download the anti-racism toolkits provided by Diversity Uplifts, or consider Shafia Monroe’s professional services for your health care organization. [Update 1/20/23: Adaway Group has a new offering called Whiteness at Work. This is a training that you/your team should invest in, whether you work in health care or not.]

<SLIDE: > I hope today’s program inspired you but also moved you to take action in supporting Black-led organizations throughout the US and within your community. Until next time, I’m Jen Kamel, be well and I’ll see you at the next VBAC Facts® event. Take care everyone.