Doula Need It?

From Wikipedia:

“A doula is a non-medical assistant in prenatal care, childbirth and during the postpartum period.”

Tobyjoe and I are tight with cash right now and while I like the idea of a doula and what I’ve heard from those who have used one, I’m not sure it’s going to be feasible for us. But before making that decision, I want to do a little more research. Did a doula make a huge difference during your delivery? What do they do? Can we get by without one? How much does a doula cost? I scheduled lamaze classes, breastfeeding classes, and a class on childcare, but I am not sure we have the funds to pay for a doula as well. However, if it’s absolutely crucial for delivery – if we’re nuts to go into this without one – then I’ll figure out a way to pay for it even if it means selling the baby.

If you help me, it will be doula noted. (Come on, now. You all totally owe me after coming up with that awesome title.)

46 Comments

  1. didn’t people call that a “midwife” at one point in time?

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  2. greg, I am still very confused about this to be honest with you. My very, very limited understanding is that a midwife is medically backed whereas a doula is just some hussy who has had a few kids. ;]

    I, of course, know NOTHING about this. That’s why I’m trying desperately to gather information – as much as possible and from as many sources.

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  3. A midwife is the medical professional who is employed by the hospital A doula is a professional ‘helper’ who knows what’s happening, keeps you calm and provides practical and moral support. I think they’re a throwback to the days when most women gave birth without husbands or close friends present. If tobyjoe knows what’s going to happen (& I’m sure he does) then you don’t need a doula. Also, in this day and age, midwives are a lot more sympathetic than they sterotypically used to be.

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  4. it seems a doula is a stand-in for a deadbeat dad, i think you’re gonna be fine in that department!

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  5. hahahhahahahah

    See, I was thinking that knowing what I know about Tobyjoe, we should be fine in that department as well. He’s coming with me to class. And have you ever seen the way this guy researches things? By the time I’m ready to pop, I’m certain I’ll be in good hands with him. But it seems that everyone I know is hiring doulas and I, of course, feeling insecure about this because, well, I ain’t ever done it before, thought I might not be “getting” something.

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  6. Sorry, that’s not to say the friends I have who used them (a LOT have) are married to dead-beat dads. I had to clear that up. That came out ALL wrong.

    I’m not doing so well today.

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  7. Are you guys doing the childbirth classes provided by your hospital, or are you going to Bradley method courses (or some other class)? Kerry and I did both Bradley training and the health-care provided classes, and we were shocked at the difference. The Bradley classes provided great insight into the birth process, your options as a patient, and the risks/scenarios you would likely face. The sponsored program taught us how to remain calm and let the hospital make decisions for us.

    Educate yourselves. Write your birth plan. A doula can help, but if something is challenging, you’re going to have to deal with the obstetrician. Best to develop your relationship with her/him and choose one who respects your rights and is willing to listen to your concerns. It’s tough because of liability issues, but TJ’s job will be to serve as your advocate when you’re in labor.

    We got through three childbirths with no internal monitoring, no epesiotomies, and no anesthetics (although two required pitocin). Of course, Kerry is a tough cookie. That made everyone’s job easier ;)

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  8. Had we gone the Doula/Midwife route, there is a good chance that i would have lost my wife and child. I have nothing against the idea, but as far as pregnancy and childbirth are concerned – situations can change rapidly. A birth plan is really a wish list at best. As much as hospitals can truly suck, good nurses and doctors you trust are really really amazing.

    Charlie is dead on, enroll in the childbirth classes (lie about your birth date when you call, sometimes they schedule them really late). Watch the videos, talk with other parents and future parents. Some folks pull it off exactly as desired, many of the other new parents i met while my wife was in recovery ended up caught off guard.

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  9. I had a couple of friends who opted for natural childbirth that used a doula and liked them. They really helped to keep them focused and because they do it for a living they seemed to realize what they needed.

    Being one who had complicated pregnancies and deliveries, I think it is really important that you have an OB you really feel comfortable with before anything else. Also, make sure you know who will deliver you on a weekend or an off day. Birth plans are a great idea but in reality births rarely go as planned so make sure that you just remain flexible to change. I couldn’t even get Shep to keep a scheduled C-section and you can’t get any more planned than that:)

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  10. The practice I am a part of is not your typical hospital/health-care provider. I’m not worried about them forcing us into doing anything we don’t want to do. It’s a practice with 6 women doctors. They are highly educated and specialize in childbirth. They are adamant about sticking to the terms set by their patients. I have no qualms with putting all of my faith in their hands, my health, too. I do, however, want Tobyjoe to be there just in case I try and talk myself into something not planned.

    Yes, I did schedule classes through the practice and I will be attending a tour of their birthing unit as well as a spending an evening with the 6 women doctors on staff. By the time that day comes, I believe I’ll be in good hands even if an emergency arises.

    I have been meaning to write about this more and probably will. I feel very privileged to be giving birth in one of the best and most highly educated cities there is. I haven’t said this enough but I’m REALLY happy with the practice I got into. Thanks to Rachel for that one. I can’t imagine having to go through this in a small town like State College. I would probably freak out a little bit.

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  11. I think State College, being a college town and also a very child-focused place, is not that bad as far as a place to give birth. They do have Bradley classes, for example. And hospital is not bad. You are lucky to be in New York, of course, where nearly every kind of class promoting every kind of psychology is available. But I don’t think State College is some normal small town. (Hey, I feel a need to defend my hometown!) And I am certain it would be better than giving birth in Spain.

    As far as the doula, I agree with most of the above…If you have a supportive partner who is willing to and can deal with the birth (i.e. he isn’t squeamish with blood and fluids) then you should be ok. Undoubtedly you will have a nurse/midwife to check on you up to the 3rd stage of labor – the “pushing out” part. Until then, you may just want to be alone with your husband and family. Even though you would have met the doula beforehand, she would be essentially a stranger attending this very private and personal experience.

    It is important to write a birth plan, I think, even if you don’t end up following it. If nothing else it will make you research and consider the decisions you will have to make. And you shouldn’t worry about talking yourself into anything…it is going to be your day and it is your body and only you will be feeling the pain. It will really be your last real chance to be truly “selfish”, so take advantage of it!! Your husband should support your decisions above everything else, even if it is a decision that was not planned.

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  12. Yeah, perhaps I was a bit hard on SC. I do, however, still want to live there. :]

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  13. Hi Michele! Since this is my first comment since you found out the sex—yay for boys! I am the proud aunt of 2 tween and 2 toddler boys and they are great. Boys are so much fun and generally drama-free (and I am a psychologist, so that is a professional opinion).

    I am not a mother and can’t give any advice about the birthing process, but I did almost work as a doula many years ago (I didn’t take the job because it was SE DC and my family had concerns about my safety). The purpose of a doula is basically to teach a new mother how to be a mother. How and when to feed the baby, change the diapers, set up the nursery, hold the baby, calm the baby, etc. The doula is there when (or soon after) the baby is born and goes home with the mother and baby to help with that transition.

    If you have a good support system (and it sounds like you do), the doula is not necessary. The nurses and other specialists will teach you the basics at the hospital and some do home visits if necessary (like lactation specialists).

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  14. cyn! Hello! Good to hear from you again.

    I had NO idea they came home with you sometimes after birth! That’s actually pretty cool. Chances are, if Tobyjoe isn’t around to help for whatever reason (after the birth) then my mother will be around and goodness knows she did it right three times! Or, well, two times at least.

    See, this is why I like to ask you people questions. And I mean it when i say, if there’s anything I can do for you all, just say the word.

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  15. Oh, duh, had i read the wikipedia definition I LINKED TO, i’d have seen that whole postpartum bit. What if they come home with you and rob you blind?

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  16. If they come home with you and rob you blind you should file a police report ;)

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  17. A coworker of mine who recently gave birth paid out the nose for a doula to provide the kind of basic support a lot of other women get from husbands, mothers, sisters, and friends. The doctors and hospital staff conducted the actual birth, and the doula just kind of sat on the side and acted like a cheerleader. This ended up being good for my coworker since her mother lives out of the country, she had no sisters or close friends who were mothers, and she’d never actually held a baby (ever!) before she took her own home. Paying for a doula was like paying for a private mothering tutor, which was probably a good thing in that situation. It doesn’t sound like you guys will need that. :)

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  18. That’s the thing, they aren’t cheap. We paid for classes and we have some of the most awesome insurance out there, but it doesn’t cover these “extras”. I am leaning toward saving that huge sum of cash and tapping into the freebies – mom, husband, sister-in-law (You heard me, Melissa!) and you guys. heh

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  19. Yes, definitely save your money…you will need it!

    Also – and this is just my two cents – I would not take the childcare class if you have to pay. The hospital will probably go over the basics with you – bathing, feeding, etc – and your mom can probably get you through the rest. And a large part of it is instinctual as well.

    And the breastfeeding class – have you checked out your local La Leche League? I don’t know for sure but they may have free classes. That might also save you money. Or you could just risk it and assume that you won’t have problems. (By the way, getting the baby to your breast as soon as possible after you give birth – like within 10-15 minutes – is key, I think.) And if you do have problems, you can always get in touch with a lactation consultant.

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  20. Sadly, I already paid the fee. (In fact, they charged me TWICE, which is another story entirely and I’m still working through all the customer service reps in hopes of getting my money back sooner rather than later. [Side note: It sucks when you try and live in a credit card free world and so you use your ATM card/Check card to pay for something and they charge you twice and you’re totally poor until it’s worked out. You’re screwed either way it seems these days.])

    But honestly, it wasn’t a huge amount of money. I mean, it was hefty enough to piss me off when it went through twice, but it covers three classes so I was OK with it. Well, I will be when I get the cash they accidentally charged me back. :]

    Also: La Leche League? FUNNY NAME! Makes me want to join them regardless!

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  21. Many Doulas work on a sliding scale and will charge according to what the client can afford. Some also do probono work. I believe it averages btwn $800-$1400. Probably on the high end of that in NYC.

    There are birth doulas and post partum doulas. The birth doula typically you meet w/2wice before the birth. Then they are with you from start to finish of your labor..which may be a comfort since nursing and dr staff can change during labor. They assist after the birth with the first breastfeeding session and they do a follow up home visit about 2 wks after the birth. There are 2 main ‘certifications’ for birth doulas…DONA and CAPPA. Both have websites and you can get a list of doulas near you if you wanted to meet one or interview some…

    Post partum doulas help w/breastfeeding and light housework. Sounds devine, huh?

    If having a natural childbirth is a high priority, a doula can help to ensure that (within reason). If you are thinking you’ll be happy to have an epidural,etc, etc, Then don’t pay for a birth doula.
    HTH!

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  22. I gotta tell ya, Victoria, I am leaning toward an epidural. I pride myself on handling pain pretty well and all but from what I hear, I think I want to be the epidural.

    Also, have you SEEN the size of Tobyjoe’s head? It’s GIANT.

    Lastly, you guys are always a HUGE help. This is what I must remember when I receive (and delete) comments asking me to go f*ck myself or to “go ahead and die already”.

    Good times.

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  23. If it makes you feel any better, I liked our child care class. We took it through Inova in VA. It was probably the most useful class we took. The information was helpful and yes a lot was covered again when we were in the hospital. By that point, we were totally exhausted and a little freaked out they trusted us to take a baby home with us.

    The worst class for us had to be Infant safety and CPR. The CPR part was fine but they spent an hour on safety. We felt like we were in that episode of the Simpsons where Marge and Homer were declared unfit parents and sent to class. Don’t feed your kids poison people!

    I’m totally here for advice and help. Of course, your niece has said ‘Dammit, Shepard!’ to her brother at least twice (at least she uses it in proper context) and likes to sing the ‘Dammit!’ song so I am not sure we are the best parenting examples out there. I don’t think we have heard the word dammit in at least a month though so we might be improving.

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  24. If I remember correctly, and I think that I do because pops loves to tell me about it, my first word spoken was “Shit”.

    he teases me about it because it’s a two for one special; the only person in our family back then who swore was my mother. Bob does NOT curse. Ever. Like ever.

    Speaking of such, we’re doing everything we can to stop that from happening now that we’re with child.

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  25. Yeah, we really cleaned up the language to but Rob + sports = dammit! You know how he loves his sports and how he hates it when his teams lose. Of course, I can totally blame him for it so that is a plus.

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  26. I didn’t go the doula route, although from reading other people’s posts, it sounds like midwives around here do virtually the same thing, PLUS the medical stuff (midwives are covered by our medical insurance in BC). I went to a regular OB, and was very happy with the care I received. My labour was so fast, as I was induced, I’m not sure how much a doula would have helped. The nurses at the hospital taught us how to bathe the baby, change diapers, breastfeed etc.
    And our public heath nurse came to visit the day after I came home from the hospital to help with any other questions and care issues. Do you have public heath nurses in NY?
    We paid for a full day of prenatal classes, as we were too lazy to go every week for six weeks. It was great! We talked through the “stages” of labour, watched a few movies of babies being born, talked about baby care, and possible scenarios that may happen while we were in labour. Eg. the cascading effect of medications..leading to C-sections. It was done by an obstetrical nurse, and she was very pro-breastfeeding, and pro natural childbirth, which agreed me me. I think it helped my husband get a better grip on what was going to happen-I had read all of the books on childbirth, but he hadn’t.
    Regarding baby head size, we did a fun game at the beginning of our prenatal class-all the dads were given balloons, and told to blow them up to the size they expected their baby’s head to be when it was born. Then the nurse went around and measured the circumference. The average baby’s head is 35 cm in diameter I believe (about 13 inches), and most of the dads had balloons that were about 55 cm! And also, Mihow? The bones of the skull are not solidifed when the baby is born, and they can compress a bit as the head passes through the birth canal. Having said that-it will still hurt like hell unless you have some kind of pain medication! I’ll save the labour stories, I’m sure you don’t want to hear them!

    ;)

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  27. Actually, I might just start a post eventually asking for labor stories. It might be fun to compare!

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  28. We opted to not do the doula route because we couldn’t afford it. In retrospect I wish we did because after 25 hours of labour I would have liked to have someone in the room who knew our wants and who could fight for us when we were too weak to put up a fight. There were things introduced in my labour that I didn’t want nor need but the hospital staff though necessary to give me (like morphine).

    Also, most of the doulas I’ve met / worked with through yoga are trained in pressure points (for helping with the pain), massage, yoga (for positions that help the labour and delivery go smoother), and holistic therapies.

    A good book to read if your interested in such is “Preparing for Birth with Yoga” by Janet Balaskas.

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  29. I’ll doula you for free. If Toby can’t handle it, I mean. I’m great under pressure! I love telling people what to do!

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  30. I might take you up on that! You willing to get up and whatever time in the wee hours of the night? Leave work whenever? NOT SLEEP FOR 25 HOURS STRAIGHT?! ARE YOU?!

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  31. I don’t know. I like to sleep.

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  32. all i imagine is TJ and ms. doula both in the room, debating the finer points of birthing and wrestling for control of the situation.

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  33. And I can see Michele, in a moement of stress wanting to deviate from her birthing plan, uttering those famous words, “You’re being a no-fun Beaner.”

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  34. Now…. what about that circumcision?

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  35. haha! Sneaky, stfarmer. :]

    Well, we have decided what we’re doing about that one. We’ve discussed it at great lengths, actually. And i watched some videos and read some articles. But! I promised my husband that some things would be left off line and the discussion about our son’s genitalia is going to be one of those things.

    He (tobyjoe) sets very few rules for me on this site. So when he does I abide.

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  36. I was trying to distract you from all the childbirth talk. :{)

    My advice* (that and $4.95 will buy you a cafe mocha) is to take advantage of all the medical resources available to you for prenatal and perinatal care. Women have been having babies since the beginning of human existance (brilliant observation) but why deliver your baby in a cave when you can opt for a deluxe maternity suite.

    *Disclaimer – Advice is for entertainment purposes only and should not be interpreted as a medical opinion.

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  37. Doula without. I would say that it is not a necessity.

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  38. You’re awesome.

    No, I knew what you were doing…

    My mother called me last night to reiterate exactly what you just said. She said something really funny like, “Don’t worry! Back in the you’d be out in a field, baby would pop out as you picked some cotton and voila! You’d have a baby! None of this extra stuff they try and make money from.”

    She went on to state that it’s true, more babies and women died back then but my goodness! We really are getting to be a little weird about the whole experience, you know? There just seems to be so many options upon options and ways to do it the right way or the wrong way. Everyone has an opinion, I, the same. But, it’s the most natural thing there is for us to do!

    I need to remember that when I get all worked up over 1000 dollar strollers and whether or not I have the correct baby monitor.

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  39. Sorry, my comment was for St. Farmer. Diedre, thanks for the tip.

    We’re leaning heavily toward doula without. We just don’t have the extra cash right now and all the cash we do have is being sent to the vet for Schmitty’s extra expensive vet bills.

    (I’m talking a lot because I’m nervous. I have another Level Two Sonogram today in order to check the spine on the baby. I do hope all is well and that he’s no longer breeched so she can see it.)

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  40. It’s hard to know where to draw the line when you’re raising children. I think every parent struggles… if you buy the $1000 stroller are you doing it for the baby or for youself, do I give them everything they ask for or not? Every parent wants their child to have more than they did. It’s the American dream.

    Maybe in the end, parents just need to come up with a philosophy and stick to it. There is nothing wrong if children fail at some things. Maybe it’s more about providing the opportunities to succeed (or fail) that prepares them for life.

    Love, food, shelter and coping skills… what more does a child need? I have all the answers, now all I need is a child.

    I was a third child which probably explains why my parents did a much better job of raising me than my older siblings. They had the benefit of all that on the job training before I came along. :{)

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  41. I feel the need to put in a good word for the doulas… A close friend had both her children in a birthing center with only a doula present. She had nothing but good things to say about it. (I’m going to be graphic here for a sec…) She didn’t need to be cut at all. The doula manipulated the baby’s exit both times so well that she didn’t even tear. It was amazing.
    However, this was in California where they seem to be a little more into that sort of thing. And it’s certainly not for everyone. I’d be too afraid that something would go wrong to not have an MD present. Anyway, just wanted to put that out there…

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  42. Thanks, Flo.

    I want to say that I’m not against doulas, in fact, a a couple of my friends used them. I am just trying to figure out ways to make this as affordable as possible. :] Just wanted to make sure no one out there thought I was anti-doula. Quite the contrary. Sounds like an awesome job, actually.

    Just got back from the doctor! Baby’s spine looks awesome as does his kidneys. As of today, all vital organs are developed and working properly. I could not be more pleased. Now, for his brain! I wanna make my boy smart! :]

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  43. I haven’t read all the comments so I may be repeating but…

    When I had Lucie we were poor. I’d say dirt poor but who could afford dirt. Anyway, I called the midwife and Doula association and they put me in touch with six wannabe doulas. I guess they need to attend a certain number of births before they can call themselves certified. I was lucky that I had a well regarded progressive near midwife like GP so they were all clamouring to work with her. We interviewed them, chose one, and agreed on a very small sum of money. They can’t charge for their services but we paid for gas, food etc…so they don’t exactly not get paid.

    The doula really helped my husband help me. I’d almost say that she was his doula. He loved having her trhere because she made tea, and broth, and nourished us both and he could exert all energy on me.

    This was in British Columbia so may not apply to you at all however.

    Glad to hear everything is going perfectly. Make sure his brains get all the essential fatty stuff it needs.

    Meg

    PS Doula is greek for servant.

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  44. We went with a birth doula and never once regretted it. We paid $650 I think, total. But we are in Missouri. AND, I ended up with a c-section! We found out about 4 weeks ahead of time that our bean was breech, tried to turn her a million ways to Sunday, she would not budge. At that point, we could have cut the doula loose, people thought we were clinically insane for keeping her on for a scheduled surgical procedure. But, I have a horribly squeamish husband (he’s tough, he just has issues) and neither one of us felt confident that he was going to be able to provide me with the support that I needed during such an intense time.

    In addition to meeting us a few times before the birth and having unlimited access to her childbirth videos and books, she took us on a tour of the operating room and walked us through the whole procedure step by step. In a situation where essentially you have no control, this was very comforting to us.

    After the birth, she stayed with me while Daddy-o went to the nursery with baby and ran interference with family and friends. I underestimated how painful the c-section was going to be (don’t freak – everyone has a different tolerance to pain. mine was evidently very low) and her presence in those few hours after the birth were invaluable.

    We also had a ton of trouble with breastfeeding, and I saw three different lactation consultants in the hospital. Took all their advice, mashed it together with all the le leche league advice and came up with something that works for us. My goal was 6 months, I work full time, and the bean is now pushing 10 months and we are still kickin’ it in the boob department.

    You will have a great birth because it will be unique and special to you forever. Your son will be smart and you will have so much fun and you will quickly forget all you pregnancy worries and discomforts.

    Sorry for the long comment. I just get excited about babies.

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  45. Allison: Thanks for the comment. No need to apologize. That’s why I asked!

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