What does gender trauma and culturally responsive psychiatry have to do with reproductive health? Especially reproductive health, as it relates to women of color and reproductive health service providers in our post Roe V. Wade political system? That's a big question isn't it?
To answer that question, I couldn't bring on just anybody. I brought on an incredibly special guest Dr. Candace Norcott. She is a doctor of psychiatry. She's a licensed clinical psychologist, a national consultant and a public speaker.
She is an alum of Brown University at the University of Connecticut, and she completed her pre and post-doctoral work in the Department of Psychiatry at Yale university. Her. Biography is phenomenal. Dr. Candice Norcott works as an Assistant Professor and Clinical Director of the Obstetrics and Gynecology Mental Health Program at the University of Chicago.
Her work encompasses coordinating and providing trauma, gender, and culturally responsive psychiatric services to patients referred by the department of obstetrics and gynecology.
She is also the director of graduate medical education wellbeing for the University of Chicago, where she brings her trauma informed approach to resident, and physician wellbeing.
Dr. Norcott speaks internationally on issues related to trauma, gender, and race. She was featured on the lifetime docu-series "Surviving R Kelly" and is a recurring guest on Jada Pinkett Smith's Red Table.
Other episodes you will enjoy:
Women's Right to Choose: What Does Valuing Life Really Mean?
Unbroken: Healing from Trauma Through Storytelling with Guest Madeline Black
Radically Claiming Our Sexuality with Guest Azaria Menezes
Let me know what you thought of this episode!
DM me on IG @tiphanykane
Check out my website: www.tiphanykane.com
Heck Yes! Mastermind Application
Contact Dr. Norcott here:
IG: @drnorcott
Twitter: @drnorcott
LinkedIn: @drcandicenorcott
YouTube
I want to hear from you!
Support & Subscribe- your support helps me to keep making this podcast! Become a supporter and I will shout out a thank you on my next episode!
DM me on IG @tiphanykane
Check out my website: www.tiphanykane.com
Leave Tiphany a Voice Message to have a spotlight on the podcast
Produced & Edited by: KaSa Media Productions
What does gender trauma and culturally responsive psychiatry have to do with reproductive health? Especially reproductive health, as it relates to women of color and reproductive health service providers in our post Roe V. Wade political system? That's a big question isn't it?
To answer that question, I couldn't bring on just anybody. I brought on an incredibly special guest Dr. Candace Norcott. She is a doctor of psychiatry. She's a licensed clinical psychologist, a national consultant and a public speaker.
She is an alum of Brown University at the University of Connecticut, and she completed her pre and post-doctoral work in the Department of Psychiatry at Yale university. Her. Biography is phenomenal. Dr. Candice Norcott works as an Assistant Professor and Clinical Director of the Obstetrics and Gynecology Mental Health Program at the University of Chicago.
Her work encompasses coordinating and providing trauma, gender, and culturally responsive psychiatric services to patients referred by the department of obstetrics and gynecology.
She is also the director of graduate medical education wellbeing for the University of Chicago, where she brings her trauma informed approach to resident, and physician wellbeing.
Dr. Norcott speaks internationally on issues related to trauma, gender, and race. She was featured on the lifetime docu-series "Surviving R Kelly" and is a recurring guest on Jada Pinkett Smith's Red Table.
Other episodes you will enjoy:
Women's Right to Choose: What Does Valuing Life Really Mean?
Unbroken: Healing from Trauma Through Storytelling with Guest Madeline Black
Radically Claiming Our Sexuality with Guest Azaria Menezes
Let me know what you thought of this episode!
DM me on IG @tiphanykane
Check out my website: www.tiphanykane.com
Heck Yes! Mastermind Application
Contact Dr. Norcott here:
IG: @drnorcott
Twitter: @drnorcott
LinkedIn: @drcandicenorcott
YouTube
I want to hear from you!
Support & Subscribe- your support helps me to keep making this podcast! Become a supporter and I will shout out a thank you on my next episode!
DM me on IG @tiphanykane
Check out my website: www.tiphanykane.com
Leave Tiphany a Voice Message to have a spotlight on the podcast
Produced & Edited by: KaSa Media Productions
Candice Norcott
[00:00:00] Welcome to the Radical Audacity podcast. I'm Tphfany Kane, your host on this podcast, you are going to meet people that walk their own path, live life on their own terms. Let go of other people's rules and expectations and the shoulds in life. And instead live life in their own truth, integrity, and authenticity.
This podcast will give you the inspiration you need to live your own radically audacious life. Enjoy the episode. What does gender trauma and culturally responsive psychiatry have to do with reproductive health, especially reproductive health, as it relates to women of color and. [00:01:00] Reproductive health service providers in our post Roe V Wade political system.
Wow. That's a big question. Isn't it? It's a big question. And to answer that question, I couldn't bring on just anybody. I brought on an incredibly special guest I have for you today, Dr. Candice Norcott. She is a doctor of psychiatry. She's a licensed clinical psychologist, a national consultant and a public speaker.
She is an alum of Brown University at the University of Connecticut, and she completed her pre and post-doctoral work in the Department of Psychiatry at Yale university. Her Biography is phenomenal. You guys, I was [00:02:00] gonna ad lib a lot of this biography, but I think I just need to read it because it will below your mind away.
So get ready. I am going to read this and wait till the end and you will see why I am so excited about this interview today. All right, so let's continue Dr. Norcott’s biography. She works as an assistant professor and clinical director of the obstetrics and gynecology mental health program at the University of Chicago.
Her work encompasses coordinating and providing trauma, gender, and culturally responsive psychiatric services to patients referred by the department of obstetrics and GYN. So these patients that she serves are referred to her because they are having behavioral health presentations regarding issues around family planning, [00:03:00] reproductive health, aging, and relationship conflict.
She is also the director of graduate medical education wellbeing for the University of Chicago, where she brings her trauma informed approach to resident, physician and fellow wellbeing. So for residents and fellows, she's looking into their wellbeing. Now, if that is not enough to say, wow, Dr.
Candice Norte is an incredible person to have on the podcast. Listen to her speaking resume. Dr. Norcott speaks internationally on issues related to trauma, gender, and race. She was featured on the lifetime Docu-series “Surviving R Kelly” and is a recurring guest on… Wait for it… Jada Pinkett Smith's Red Table Talk as an expert discussing the impact of sexual abuse on girls and young women and the intersection of [00:04:00] race. Yes. Jada Pinkett. Smith's red table talk. I love that series.
Throughout her career. Dr. Norcott has been committed to trauma informed and gender responsive services for girls and women, minority advancement in psychology and cultural responsiveness in the health field.
This is an interview you do not want to miss. Now today's discussion is a little on the long side because. Dr. Norcott has a lot to share. So dig in, stick with us till the end. It is 100% worth it. This is a powerful conversation that we are gonna have today about a few different areas that are not currently being talked about on the issue of reproductive health in this post Roe V. Wade environment. Thank you for hanging out today and enjoy the episode.
Hello, welcome to a really, [00:05:00] really special episode of radical audacity. I have somebody here today. I told you about her in the intro, and I'm just really, really excited to be spending this time with Dr. Candice Norcott. She works very closely with mental health and reproductive health providers, and she just has a wonderful perspective to share with us a different viewpoint, a different voice on reproductive health and all of the things that are going on in the news and politics now.
And I'm Candice. I am just so excited for this conversation today, so welcome. Thank you. Thanks so much for having me. I'm excited to be. So thrilled. Okay. So we met through a mutual friend, which I am so thankful. Shout out to Katrina. Yes. She was a guest on this podcast too, and I love her. Um, but Katrina said, oh, Tiphany, you need to talk to Candice.
Candice is amazing. [00:06:00] And so I'm thrilled. You're here today. And I would love to dig in before we dig into the work you do with reproductive health and all of that, I know my listeners would love to get to know you a little bit more. Will you tell us a little bit about you? Sure. Um, I'm a licensed clinical psychologist, which means I have a PhD in clinical psychology.
I'm from the east coast and I live in Illinois now. And so I've been here about 11 years and I really love what I do. Whenever I'm wrapping up with clients, I often am just really humbled by how the, the, the courage that it takes to share. You know, such intimate and deep pieces of your life and places in your life.
People often come to me, um, you know, not at their best, highest moments in life. And so taking a risk and, and being part of somebody's journey like that. I just I'm so humbled by, so I love what I do. So I think that's a big part of who I am, is being a psychologist. [00:07:00] Um, and also I have, you know, nieces and nephews that I love, I'm proud aunt.
I have amazing parents they're back in Connecticut. And so, yeah, that's a little bit about who I am. I think, uh, love family, and love, love, love providing psychology and therapy to people. What brought you to psychology and therapy and specifically psychology and therapy in the reproductive health side of the world?
Well, my mom would say that it was when, I played Louise Bates Ames, who is a child psychologist in my second grade play. Um, but, but I don't know. I really, sometimes I'm like, how, how did I know who that was? That when I was that young, but so that's kind of like a random tidbit, but, um, you know, it's odd, you know, I was misdiagnosed with non-Hodgkin's lymphoma when I was, uh, a child.
So I would think I was in sixth grade and part of, so I went through chemotherapy, spinal taps, and part of the work that they did in preparing me for treatment, [00:08:00] um, was a psychologist would come in and take me through guided imagery. But there was something about that experience that just, was really meaningful to me.
And I always thought about it. I always thought about like how, you know, this 20 minutes before these invasive procedures actually were part of a treatment and part of like bringing my blood pressure down, getting me calm. Wow. And, um, and so I think that that was, you know, along with the second grade play, that it was that experience that just had me thinking like, oh, if psychologists do a little bit more than what I think that what I thought they did or, you know, and, and, you know, back then, people weren't really talking about psychologists.
It was kind of a dirty little secret if you were talking to a psychologist. So these little ways that they showed up in my life and just, I think, seated interest. Um, and then I went to, um, I did my undergrad at brown university and I had an amazing abnormal psychology professor that got me so interested.
Um, and then it was just people I met along the way I, when I was, I [00:09:00] graduated from college thinking I was gonna be a standup comedian. So I took two. So for two years I was a research assistant and I was doing standup. Nice. Um, and then, you know, decided to kind of do, uh, pursue psychology. And again, just met this amazing woman.
And when I went into graduate school, I thought I was gonna talk a lot about and do research and racial identity mm-hmm um, cause I had thought a lot about that as a light skinned black woman about like race, how it plays out in people's lives and identity. A and then I met this woman who was doing a lot of work with trauma, with gender, with sexuality, with addiction, and it all fell into place.
It was like, you know, there are moments in your life where like somebody's talking and you're just like everybody else was speaking Greek and this person is speaking the language that I can understand. So, um, and her name was uh, Dr. Stephanie Covington. And so I just started kind of learning from her, traveling around the country, behind her learning, how to be a public speaker, learning [00:10:00] more about, um, how we're socialized, how gen you know, how we see the world based on gender socialization, both.
The messages we receive. And then what we tell ourselves as a result of the messages we receive, and it just shaped the, the course of my life, really. And so, you know, I've had jobs, but really there's just been a thread. That's always led me to opportunities where I've been able to accumulate different things.
So if you were to look up my resume, you'd be like, how did these things kind of work? But when I sit where I am right now doing the work that I'm doing, it all has been building to this. And so, um, that's a long way, to answer your question. But that's how I, I a very, um, circuitous route. Um, but it's also felt serendipitous as well.
I love circuit I do. I love the roots that don't take a normal path. That might be just a little bit different and. [00:11:00] Take us somewhere that we weren't anticipating before Absolut. So I think that's really beautiful. Now, are you still working a little bit with standup comedy? I would imagine you've got, got a lot of good you've got some good material.
I haven't done it in a while, but it's always, you know, it's, it's like a skillset, right? You're always having your back pocket. Like could I do a tight five? I think I could do a tight five. I love it. I love it. You have a fun person to have a at a party. Okay. So now you, where are you now? So now I'm at the university of Chicago.
I'm an assistant professor and I am the clinical director of the mental health program that supports the department of obstetrics and GYN. Wow. That's that's really important. Okay. And that brings us to our topic today and what connected you and I, because I really wanted a different voice on this reproductive [00:12:00] health topic.
Obviously Roe V. Wade shook up a lot of people in a lot of different ways for a lot of different reasons. And I have been able to talk to some really fascinating people and, and hear their ideas and their stories. But what was missing for me was more of the, the medical perspective on this, as well as.
The professional, like what happens on the professional side of this? You know, what does this mean for the, the actual providers and what for you, what do you see with the patients? And so I just had so many questions. I was thrilled when you and I connected cuz I thought, oh my goodness, I don't hear this being talked about a lot.
And I think this part of the conversation really needs to happen. So I am thrilled to start this part of the conversation now well, I'm, I'm thrilled that you are inviting me in to be a voice. It you're right. You [00:13:00] know that people aren't talking about these experiences, it's stuck on this very black and white dichotomous debate.
Yes. And, um, it's, you know, it's layered. It's so very, very layered. I, and that to me is. One of the most important parts of when we think about this, because I think both sides of the argument, the pro-life, the pro-choice we can be so, um, divided and polarized and not be well let's actually think about the human being part of this rather than the political piece or the ideology piece of this, but we're humans.
And when we dehumanize each other, that's when we are able to hurt each other, no matter what side you're talking about and even think about the language that we use, right? Like pro-life, mm-hmm right. The assumption then becomes anybody who, um, supports access to abortion care is anti-life right. And, and so it creates, it [00:14:00] creates a false choice, right?
Yes. And I would think that, you know, what we're doing is we're saying that people have the right for bodily autonomy, mm-hmm and so much, you know, and reproductive justice is like this grassroots thing, right. Mm-hmm , it's from the community and it's, and abortion is a piece of that, right? Yes.
But it's really about, I want the right and, you know, women and people, uh, birthing people deserve the right to decide how they wanna have and raise families. Right? Yes. A lot of people that have abortions already have children mm-hmm right. And so, you know, those kinds of choices. So, so even the language we use starts hedging us into these, um, corners where things just can't productively be discussed.
And when we say, well, in the case of rape or incest, it should be okay, well, you know what, we, it shouldn't just be that people have a choice in times of intense. Trauma. [00:15:00] It should also be you have a choice, like mm-hmm, your mental health is a huge part of your physical health. And if this is going to damage your mental health in some way, if this is gonna damage your family's dynamics in some way, then that's a huge concern as well.
And it doesn't always have to be that big dramatic thing. Yeah. One of the most painful things that I hear when I'm, um, in conversation with clients that I work with, uh, and patients that I work with is, you know, I don't believe in abortion, but I have to have this because of X, Y, Z reason mm-hmm and it becomes this, um, identity that people feel like they have to distance themselves from.
Right. And it's really painful because here they are feeling like, you know, um, feeling like they have to describe themselves or what they're doing in a way. Um, And they're carrying so much shame and stigma associated. Yes. And often what I'll say to people is, you know, [00:16:00] we believe in supporting women for making this decision no matter what, the reason.
Yes. And, you know, I hope that you can release yourself from whatever judgment that I'm hearing you experience, because the reason why you get to make this, uh, decision is because everybody gets to make this decision. Mm. And we don't think that there's one reason that's better than another. And, and it's one of, you know, I think in psychology often, you know, our, the old school way is that, you know, stay out of the room.
Right. Like as the therapist, like, you don't need to flag your values and don't talk about you. But I think sometimes there are places and ways that you have to kind of flag your, your values. Right? Yeah. And, and it's because you're. This is a non-judgmental space and I'm, and, and you're bringing a judgment in that I don't think is very helpful to you.
And certainly not to the, to the broader community that, that, you know, I'm working to, to serve and to support. So this brings me then to one of the big questions I had for you. [00:17:00] This brings me into connections between all the misinformation about our reproductive health that's out there mm-hmm and then the trauma that creates for the patient, for the person having to make these reproductive health decisions.
You specialize in that. What, what misinformation are you seeing and how does that affect people? So there is, there is a lot of bad junk science, um, Tries to tell people that mental health is adversely affected from the abortion decision, from the decision to have an abortion. And, uh, what there was, you know, there have been, um, system systemic reviews or systematic reviews, which are basically just people that do rigorous research, gathering up all of the research studies and papers that have been written, looking at the methodology, running them through like tests and reviews.
And [00:18:00] what they show is that the, the, the studies that have the poorest methodologies, right, that use the sloppy science, those are the ones making kind of spurious, uh, correlations and, and the relationship between, uh, mental health being adversely affected by abortion care and the ones that are doing the best science that are the most rigorous that are the, you know, highest reviewed and monitored are the ones that say that there's, uh, you know, there's no association between.
Um, adverse, uh, mental health effects and getting an abortion. And in fact, um, there was a really big study. I think it came out a few years ago, um, that showed that, uh, it was a, an immediate follow up. And then five years later, and 99% of the people that had gotten abortions were would've made the same decision again and reported it was the, still the decision for them.
Right. Wow. And so right. Five years later. Right. Wow. And in fact, what, what some of the, some, what some other research is showing is that, um, restricting abortion and keeping, um, [00:19:00] people from accessing abortion actually has worse short-term, uh, effects on people, uh, than kind of whatever associations are trying to be made about, you know, um, the impact of having an abortion.
Mm. So, you know, I think when people really have access and look at the research, you know, that's what they see. What are some of those worst short term effects that are being seen in the research? Um, I. Oh by, oh, by being, um, restricted access to abortion. Yes. Well, I mean, yes, restrict access. I mean, having to carry to term it's it's stress mm-hmm I mean, it's just stress it's, uh, it's economic stress.
Um, you know, it's toxic stress, it's unrelenting. Um, mm-hmm and I think, you know, hopefully more and more research is gonna be, uh, be conducted, but it's also a hard position to put people in. Right. Yeah. You know, um, you carry a pregnancy, you have a child, and then you ask them, you know, what do you think of this child?
Like, there's so much St. [00:20:00] There's so much. Right. What do you think about having this child? There's so much stigma against women, right? Like there's so much that's expected about how they should mother having an instinct to mother, like wanting to, and you know, it, it, it, I think it creates a real, um, barrier from get from really accessing how people feel there in that five year study.
Um, one, uh, it was, there was a qualitative portion, which means that they asked for quotes and interview, you know, they interviewed women and one woman said, um, I feel guilty that I don't feel guilty. Oh yeah. Right. Like, like the, the decision, like I, I made the decision that was best for me yet. You know, the, the conversation around me is that I should feel bad about what I, what I decided ultimately.
And that's, you know, that's messed up, you know, like you can't really say it, say, uh, more eloquently than that. That's, that's ridiculous. It is. It's totally messed up. It's there. [00:21:00] I, what you said about the stigma put on women as mothers is so pervasive. Mm-hmm . If you hear someone say, well, I don't want another child because it will affect my way of life.
You know, the children I have are almost grown and out of the house and I see light at the end of the tunnel. I'm finally getting to do my things in my hobby and thinking about my career and if I have another child and it's perfectly, that is such a perfectly normal, healthy thing to say. I'm about to have time for me.
And yet the stigma that like, oh, that's so selfish. How could you want time for you? And yet, you know, if the gender roles were reversed, I don't think we'd be having those conversations with men. Oh, um, without a doubt. Yeah, absolutely. I mean, what's interesting is that, you know, There are there are women coming into clinics now that are asking for, [00:22:00] um, uh, you know, tubal allegation mm-hmm right.
They, they know they don't wanna have children and they're having, um, and it's, and I think providers aren't really sure how to handle that. Right. Mm-hmm um, how to, how to handle that request. And so here we're having, you know, people saying, I don't wanna have children, but we're also not gonna allow you to, you know, get a, you know, we'll let you get pre you know, are you sure?
Are you sure we'll let you get pregnant? You could take contraception, but contraception isn't a hundred percent. Nope. I mean, that's another thing we have all, we have this picture about who gets pregnant and there are some people, you know, there are some people that have sex, get pregnant, want an abortion.
Yeah. Except, you know, right. Yep. Okay. And then there are some people that use contraception. Um, you know, it's not a hundred percent people can be on contraception and get pregnant. Yes. And still not want to continue the pregnancy. Yes right there. And, and I think one of the, I'm kind of going all over the place just because this gets me all [00:23:00] jazzed up, all fired up.
I love it. But there's so much about people that are making these decisions that don't even know, um, uh, female anatomy or don't don't know, don't know anatomy don't know about, um, how reproduction works, uh, and the reproductive systems work. So anyway, um, yeah, so that's all to say. It's just, it's, it's maddening.
Sometimes I was 42 years old and a single mom of two children. Both my pregnancies had been life threatening. I had like very, very dangerous for me and for the babies. And so here I am single 42 and definitely didn't want more children, you know, It's life threatening for me. And if I had another child life threatening for that child, and I have two healthy children, I need to take care of.
And I'm 42 and, um, I was having some, um, you know, re reproductive health issues anyway. And so I needed to go in and [00:24:00] have surgery and I asked the doctor while you're in there, can you just take my tubes out? Like you're already having to go in and take care of some problems and I don't want more children.
It was such the hoops I had to jump through at 42 years old, already having two children to say, yes, I want my tubes removed the papers. I had to sign the counseling. I had to have the, it was like, are you kidding me? I'm done. Like, this pregnancy is life threatening to me. I don't want more children.
Mm-hmm and it blew me away. It blew me away that we can't make those decisions for ourselves. That the doctor can't say, okay, this is decision you want. All right. You understand? It's not reversible. Okay. there we go. It's it's your body . And so much of that is seeped in race, class, and gender, right? Mm-hmm gender in the sense that it is the biological imperative to have children and why women would you want to change that?
Right. And then, and then [00:25:00] white woman, why would you want to, you know, put any sort of cap on your reproduction, because if you were a woman of, because if you were a woman of color that might, you know, for many women of color it's happened without their knowledge or permission, right. And so if you were a woman of color, would a provider just gone?
Oh, I get totally. I get it. Let's let's, let's nip this in the bud, right? Like, oh my, whether it was that overt or not, um, and then class, right? Like, you know, you, you can handle, if you got another kid, like you, you know, just making all these assumptions about what, you know, what you should be doing as a woman.
Yes, um, in your position and when, you know, when I say layered, that's what I mean, it's all of those things that are going into how the health system, how politics is playing out in the decisions that, um, women are making about their bodies and, and birthing people are making about their bodies. Mm it's.
In it's it's so layered. It's so insane. Can we talk a little bit more about the racial piece? Yeah. That's a piece that, um, I don't think is being [00:26:00] talked about enough as well. Roe V. Wade is definitely disproportionately affecting people of color and people in lower socioeconomic statuses. What are you seeing as a medical professional in this area?
Well, some of the, um, so the, the gut mock, the gut mocker Institute, um, I'm making sure I'm pronouncing that right, but I'm getting you close so you can go online but they're, they do a lot of. The, you know, really the up to date, um, research on abortion, uh, in this country. And so, you know, they have, um, really helpful articles and updates about just some trends that they're and projections that they're seeing as a result of, of what's going on right now.
Um, and so what they see is that, you know, um, abortions, uh, decrease the farther that people have to travel. Right. Cool. And so, you know, um, if you have a clinic that's really far away, right? Like, I mean, it's kind of intuitive, right? Like [00:27:00] it makes sense, right. If you have to travel far, it's gonna be harder to get to.
So that's why they're, you know, restricting access. And so you can't get it here if you want it, you've gotta travel across state lines, but we're also trying, you know, they're trying to stop, um, people from traveling like women are even getting stopped on highways being asked where that's insane, where you going?
What, what do you want? Um, and so when we think about the communities that have been historically marginalized in our countries, right? Who can't, who don't have mobility across state lines, like other people do, you know, we're seeing that those are disproportionately women of color, right? Mm-hmm and, and people of color that can't travel to neighboring states or to other states to receive these services.
And so, um, you know, those are gonna be the communities that are disproportionately impacted by these restrictions. Right. Um, you know, we're gonna see, you know, um, uh, women of color are already, uh, criminalized for, you know, behavior sometimes like behavior that [00:28:00] they take to stay safe. Yes. Right. From partners from.
And so, you know, I think over the next few years, we're gonna see a lot of unfortunate ways about how, um, the creativity that people are gonna have to, um, Utilize around unplanned pregnancies or unwanted pregnancies, um, I think is gonna be criminalized. And then again, the communities that are gonna be disproportionately impacted are gonna be, uh, those communities of color.
Mm. Criminalized your own health criminalized. That just blows me away. it blows me away. It's it's it, it is so backwards that that we would be at risk of going to jail for wanting to take care of our own health, mental, physical, emotional reproductive. Hmm. Yeah. And there's, you know, I think one of [00:29:00] the arguments that's often used is this issue of regret, right?
Mm-hmm right. Um, it's used as a real kind of, um, uh, reason that motivates some of these debates and. I, I think working in this space, something that I talk a lot about is the difference between and, and people who write about abortion, um, uh, write about is decisional regret and situational regret mm-hmm
And so, you know, with any decision, people are gonna have regret about it, of course, but most often what people are experiencing is situational regret, right? Like I regret that I'm in this position to make this, have to make this decision mm-hmm right, because it is an emotional decision. Absolutely. Right.
It can be hard for a lot of women for some women. It's not right. The most common, not the only, but the most common emotion that's reported is relief. Mm-hmm after an abortion. Right. But there are a lot of other emotions, right. It can be really complicated. It can be a hard decision. People can be ambivalent about it and are allowed to mm-hmm [00:30:00] they're also allowed to own their decision about what they need to do.
And we often talk about the use of the, the word decision versus choice, um, because. Choice means that you had choices and many women and many people who get pregnant don't have choices. Right. But they have to make a decision. Right. They have to look at the landscape of their lives and make the best decisions for themselves.
Oh, that is such a powerful, I haven't heard that before. That's can we lean into that just for a second? Mm-hmm just talk about that. Just a little bit more choices, decisions. This is, I, I feel like this is important for us to really, really grasp well, and the other thing is that, you know, people choose what donut they're gonna eat.
Mm-hmm right. Like you have like an array of choices, many women, you know, they, they don't have a lot of choices when they're looking, you know, about whether to continue a pregnancy or not. But a decision [00:31:00] means that you, um, you know, you look at, you know, I've got two kids, how will they be impacted by this decision?
You know, I've got a partner who doesn't support, you know, who, you know, the relationship is Rocky. Um, or, you know, there are some women who have been diagnosed with a fetal anomaly, and they're kind of coming up against that 22, 23 week decision point where you can't get a procedure and they're waiting for genetic tests to come back.
Right. And they're, so they've got some statistics and probabilities about what's happening with their pregnancy and they've gotta make a decision. Mm-hmm right. That's not a choice. That's a decision. No, and it's a heartbreaking one. Absolutely heart one. Absolutely. And it, and, and I think it's important to honor the challenges.
And I think sometimes this conversation about abortion, people are reluctant to talk [00:32:00] about the challenges of making these decisions. Mm-hmm because it feels like we're gonna fuel the argument or the debate for the other side. Um, You know, because it becomes then, oh, well then it's just bad. It's like, no, there's lots of hard decisions we have to make.
Yes. Right. And we don't take away. We don't take away heart transplants. We don't take away, you know, uh, other medical decisions that, you know, that we're unsure of. And we've gotta, you know, make our best guess at a, at what decision is gonna, you know, be the best for us at this moment. Um, but for some reason we're like debating abortion so much.
And it keeps us from talking about how can we support, um, mm-hmm, the health of our communities, right? How can we support family health? How can we support and give people what they need to live healthy lives? It's oh, this is so refreshing. I, the premise of radical audacity is that it's all about you make those really, really hard decisions.
And you're often doing the [00:33:00] harder thing because it's the right thing. Mm-hmm, , it's kind of. Easy to, to do the easy thing. Right. And that's not usually the right thing. and I'm not saying in the situation there's a right or a wrong answer. I'm just saying just cause it's hard and painful doesn't mean it's wrong.
So if for so many of us that hard, painful decision was the absolute correct decision, whether it was a divorce, whether it was changing a job, whether it was, um, moving across the country, whether, you know, like there's so many really hard, painful decisions that we have to make throughout our lives. That just because it was hard and painful and maybe it was the rockier path didn't mean it was the wrong one.
And, and I just, I'm just agreeing like why in this situation, just because it's a hard, painful decision, does it make it wrong? And, you know, for better or [00:34:00] worse, we often look at we where we're standing and our satisfaction with our lives right now to justify decisions we made years ago when we were different versions of ourself.
Mm-hmm right. And so there might be a woman who is, you know, maybe had a miscarriage later, and then she goes back to that point where like, oh my gosh, God's punishing me because I had an abortion when I was 20. Right. Yeah. And that's, and, and so some of the things that predict, uh, coping and, and adjustment after abortion are like being able to, to frame and reframe the experience mm-hmm and society, the, the forces and the messages that you're getting often try to frame any abortion as any problem you have later on in life.
It's because of your abortion, right? Oh yeah. Chuckling because that's absurd, right? Yes, totally. So what, what I often urge my patients and my clients to do is remember the person and the position you were in, when you made that decision, you cannot judge past decisions [00:35:00] based on where you are in your current life.
Right. You can learn, right. You can assess and, and reevaluate. And as, you know, have that inform again, the landscape that, and your new landscape and how you're making decisions. But part of it is just extending grace to the person and the position that he or she was in when you were making those decisions.
Mm-hmm um, and, and so, and part of that is, again, the, the framing and the reframing of, of, you know, why you're making this decision, um, you know, what you're utilizing, what you're calling upon to make the decision. And then the other things that, um, support, uh, adjustment in coping after an abortion are support, help seeking mm-hmm
Um, and, uh, you know, that's huge. And I think when you have stigma, when you have people protesting, when you've got billboards, When you've got people in a health center talking about abortion and people who get abortions in toxic ways, you know, you're not really gonna seek help. No. So again, we're seeing that it's not the abortion service [00:36:00] itself, but it's all of the ways that we, um, stigmatize demonize, um, this one aspect of reproductive health and justice mm-hmm , um, and keep people from accessing the services they need.
And, and so I, part of my work is, um, uh, and, and one of the reasons, uh, one of my entries into the work that I'm doing now at the university of Chicago has been to provide, um, behavioral health support to our abortion providers. Um, oh, I'm so glad you're talking about this. Cause I want to dig into this.
These are the people to me, these are the forgotten. Yeah. Like what is life like for them right now? Okay. I didn't mean to interrupt you continue. No, it's fine. But, but you know, it's, it's a couple things because, you know, One of the, really my, my position has, has evolved, but when it started it, you know, it was the, it, it was the, it came about from this idea between an OB GYN and a donor, right.
Somebody who was donating money to create, um, a [00:37:00] behavioral health support system for this, for this service mm-hmm . And what they were saying is, you know, people are generally fine after abortion, but oftentimes what complicates, um, what complicates their experience is, are like relationship challenges, financial challenges, housing insecurity, mm-hmm and, and patients oftentimes go to their OB GYN more than their primary care physician.
So it just be so, so supporting, um, uh, you know, supporting people, seeking abortion care, like having a, a mental health support in house. Is just another like point of intervention, right? Mm-hmm so 75% of people are like, no, thank you. It was really nice to meet you. You're a psychologist. Okay. Maybe if something comes up, I can call you.
Okay, great. You know, which, which is wonderful. Mm-hmm and then some people, you know, I, I, one of the re one of the things that was so validating to me in, in the early days of my work has been, um, first of all, I don't wanna see, I don't wanna see a mental [00:38:00] health professional, and I'm like, well, you're talking to one and they're like, oh, you are okay, well, I could talk to you.
Right. um, and then also people that say, you know, can I, do I have to talk about the abortion? Or can I talk about other things? Right. So, so many times it's the abortion and, and coming in for services that allows me to meet patients. Mm-hmm , but actually what they need help with are other aspects of their lives.
Right. You know, other aspects of their lives. So again, when I talk about like really wanting to like myth bust, that's a, that's a big, that's a big one. And, and so then part of the stressors that, um, you know, I don't wanna speak for, um, speak for abortion providers because I'm a psychologist, but, you know, I think going through so much schooling, so much, so many years of education, and then to have the delivering of your service, be something that could get you in trouble.
And can you lose your license is stressful. Yes. Having increased [00:39:00] Val volumes, right? Because we're, we're in Illinois, you know, I'm in Illinois. And so people are coming from neighboring states that have restrictive laws, they're coming into Illinois to get abortion. So that's driving up volume. Right.
Mm-hmm and you know, when you're an abortion provider, You know, to be so lucky to feel like your work is purposeful and have the work that you do be so inherently tied to your values. But the flip side of that is that it can be exhausting. Mm-hmm right. Going on vacation saying no, having to say, I can't see more patients this week.
You know, it, it means something different than if you were, you know, I don't wanna, you know, than if you were say like a podiatrist or somebody, you know, somebody like, like having to it, it, it, it just, um, it's different, you know, it's not about comparing, but it's about, I think it's unique. It's very unique.
Well, it's a very time sensitive issue. Cause like you said, depending what state you're in. [00:40:00] You know, it's a matter of weeks of mm-hmm where you have to make this decision of some states. You have to make it by six weeks, which I never, neither of my pregnancies, I knew I was pregnant by six weeks. It was like mm-hmm 7, 8, 9 weeks.
So, um, you know, for, in some states, it's that some states it's in your first trimester, some states it's 20 weeks. So that, I think that adds to the, probably the stress for the providers of this is a very timely, it's not like we can say, all right, we'll see you next month. Mm-hmm , you know, that's our next opening that, that may not, that's not gonna be helpful for most women mm-hmm and you know, we're lucky we've got partners here that are, that are also providing services, um, that we work closely with in, in, in Chicago and Illinois.
Um, but there are some people that, you know, they're the only clinic in town, right? Mm-hmm , they're the only clinic in their state, in their half of the state. Um, And again, you, you know, this is [00:41:00] work, that's meaningful, right? Mm-hmm, , it's it's activism. And, and I think one, one of the things that we've learned a lot is like with black lives matter, um, uh, with other types of fighting for civil rights, right?
Is that there's a mental toll yes. To doing activism, right? Yes. To doing activism and, and advocacy. Um, and so rest is imperative. Mm-hmm right. But resting when it feels like the world's on fire can, can, can feel like, well, I don't have time to do that, but it's really imperative. It's vital. Mm-hmm vital.
Would you be willing of course, with keeping everything very anonymous, but would you be willing to give us a little bit more of a concrete example of what some of the, uh, mental health challenges might be, or maybe some of the ways that you. These, these reproductive providers, how do you help them manage their mental health [00:42:00] and, and maybe like a concrete example of what are some of the things that you're specifically working on?
So one of my roles is, um, at the university is also the director of graduate medical education, wellbeing. Mm-hmm , which means that I'm always thinking about kind of physician and physicians and training the, the wellbeing of their, of, uh, as they go through their years of training. And so I think it it's really complimentary when I, in, in the work that I do and I support, uh, support the providers.
And I think one is just allowing them to do what they were trained to do. Mm-hmm . And so just being, you know, you know, they see somebody, they see somebody struggling with, with all of these kind of life issues. And for them to be able to say, I want you to meet my colleague, Dr. Norco, like she's somebody that can talk to you.
And, and just being able to, we call those warm handoffs in health psychology. Mm-hmm like being able to that, just, you know, [00:43:00] I, I think it helps, um, providers, you know, abortion care providers feel like, okay, I'm not just sending her this person back out to the, to the wolves, right. Mm-hmm, , I'm not hearing and absorbing all this pain, but really not have much to do for her, you know, or for this person.
And so I think that there's some care taking there's some collaboration, um, In that. And so I think, I think that there's some comfort in that for providers. Certainly that's, you know, that's been shared with me. I think we also just have conversations. I think medical doctors, um, I'm making wild generalizations right now, but medical doctors are very like type a and especially OB GYNs.
They're basically surgeons. Right? Mm-hmm so they've got that, like, you know, I don't talk about emotions. Like I don't understand psych, I don't understand that psychology stuff. I don't know how it's relevant for my life. Um, but then you're also absorbing these stories about people. Yeah. And so, you know, I, and the conversations that [00:44:00] I can invite, um, you know, medical doctors into can just be different ways to talk about feelings.
Mm-hmm right. Different ways to talk about the experiences, the stories that they're absorbing. Um, and you know, oftentimes there's no fix, but you just have to kind of open the release valve mm-hmm and, and take a moment and talk. So we have those conversations. I also talk about like, Sitting with ambivalence, which can be really stressful, right.
Sitting with somebody who, um, is, you know, I want this I'm here for this. I've decided that abortion is the best decision for me. Um, but I don't know. Can you just tell me what I should do? Right. And, and kind of talking through how you sit with ambivalence with somebody mm-hmm , um, can be really stressful and, you know, talking about strategies and, and ways for patient provider communication is also something I do.
Um, but it's, and it's so reciprocal, right? [00:45:00] There's so much about the work that they've taught me. And, you know, part of, part of, I think sometimes part of my role is just giving them a different language and a different outlet for talking about their experiences. That's so fascinating. Yeah. Sorry. I can go on and on, but there's also, I love it.
There's the reality too, that, um, You know, people are targeting abortion care providers. And so people are under threat from their community and from other people, I mean, what not a lot of doctors have to experience that. No. Right. Like, I, I think there are many people who don't remember, um, the abortion care providers that were killed.
Yep. Right. Like there are real extremists and domestic terrorists that, um, that threaten the lives are really ominous. Right. Mm-hmm they, um, uh, you know, they both like virtually and, uh, you know, physically [00:46:00] intimidate, um, people, um, and providers and it's, it's really scary. So it it's more than just, it's more than just, uh, an in-office procedure.
I think. With that. So, okay. So I, I come from a religious background where I was raised. It was basically a cult like religion, pretty much a cult. And, you know, the absolute, I mean, abortion was not even like, that was like a, no, we don't even talk about it. I was, I was one of those people like giving speeches about it in school of like, this is just terrible and blah, blah, blah.
Um, because I didn't understand it. I heard all of the terrible stories of baby killing and the pictures of, of what an abortion is and, and all of this stuff. And you don't, and I think with the, the giant misinformation, um, campaign [00:47:00] mm-hmm, really, that has gone out there that puts these terrifying pictures in people's heads of exactly what abortion is that.
It becomes easy to villainize providers because it's not understood. Mm-hmm, , it's not understood, you know, they, they put these pictures around of these perfect little babies, you know that, oh, they were perfect. And look, somebody killed this baby, and that's just not what it is at all. I, I think the past three years has really shown, or maybe what maybe five or six years has shown us the power of information and misinformation mm-hmm um, and how it can weaponize people.
Yep. Um, how it can, um, be used to have people act against their own, uh, best interests. Yep. Um, and, uh, and so yes, I mean, that, that piece is really scary, I think, and there are a lot of, [00:48:00] um, religious leaders and there are a lot of people who, um, uh, you. You know, who, who lead communities spiritually, who believe in the, the ability to have bodily autonomy, mm-hmm right.
But some of the loudest voices, you know, are galvanizing in these really toxic ways. Yep. They are. Okay. So on a, more of like a raising the vibe just a little bit and giving some hope to the people that are listening mm-hmm are you seeing any hopeful trends? Are you seeing anything happening where it looks like?
Well, well maybe as awful as this, the overturning of Roe V Wade was, are you seeing anything positive coming out of it? I think that, um, let me think about this, cuz it feels really terrible. It feels awful. It, it does feel awful. Um, I think [00:49:00] it's really powerful for, for people not to take their civil rights for granted.
Mm-hmm . And people ha and, and I think many, um, people in the United States ha have done that. Yes. Right. Have, have felt like some things can't be reversed and, and are realizing the ways in which, um, I mean talk about misinformation. I think not a lot of people understand how government works about voting, about, you know, elections, gerrymandering, those kinds of things.
And I think this is an opportunity for, to, to have people get involved. Mm-hmm at state and local levels. Um, you know, it's, it's, um, been difficult to access abortion for a lot of people. Mm-hmm right. For a long time, right? Yes. There, there, there are some who, you know, last year it was just as hard to get an abortion as it is and will be next year.
Um, and so I think, um, having people start, um, Thinking about where they can send money. I know that there are, [00:50:00] um, organizations that help people travel. There are organizations that help people, um, you know, the national abortion fund, um, abortion access, um, and, uh, you know, even, uh there's if anybody goes to my, um, Instagram at Dr.
Norco, I have a link to a local place. If you're in Illinois where you can, uh, donate your money and, um, and support, uh, you know, sometimes people need a hotel room. Sometimes people need a bus fare back, right. They spend all their money getting to us and then there's, they have no place to stay. You no place to get back to.
So, and, and I think people are starting to both shout and yell and get involved, and they're starting to donate, um, in ways that are helping people. I do think that's hopeful because I think for many of us, and I'm gonna raise my hand to that. Um, we were. I don't know if lazy is the right word, but just kind of, um, comfortable in thinking [00:51:00] that, you know, we have rights, we have choice and, and that's not gonna change.
And then when we see, oh, this, this can change, this can be taken away. And it's been this way for a lot of people for a long time. Mm-hmm and yeah, maybe shaking you to your core, but they've been fighting this battle for a long time and that this actually is bigger. It's bigger. Mm-hmm this to me is the tip of the iceberg.
Like when our political system does not represent the will of the people, because pulls show mm-hmm that the majority of people support choice and reproductive health mm-hmm then. That gets scary. And that's really important to take note of. And so to me, that's the hopeful part of this is I think a lot of us are waking up and going, wait, wait, wait, this has been going on for a lot of people for a long time and this isn't right.
And we need to start making a change. So,
um, okay. We're coming up on [00:52:00] the last little bit here for all of my guests. I do a fun little game, so, uh, I'm a big giant book nerd. So are the people that listen to this podcast, we love to know what book are you reading right now? This question gives me sweaty palms because I can never just pick. And I'm often reading more than one book at a time, so it just always been stress.
But so the books that I'm reading right now are the fire keeper's daughter. It's I love that book so good. Um, and I just love how indigenous stories are being more represented. Um, In television and movies. So I, I love that. I love that. And so that, book's amazing. And I'm reading also, I just actually finished cloud cuckoo land.
It kept me up until like 1:00 AM for like five nights in a row. Um, I'm holding up fire keeper's daughter right now. Yeah. love that. So good cloud COO land cloud cuckoo land I saw on your Instagram. What so good. Tell me about that one. [00:53:00] So it's so, oh my gosh. So it is cloud cuckoo land. Is this story that, um, was, I'm gonna put somebody's screaming, like you're telling it you're doing a terrible job, but it's basically like all of these different characters and how this ancient tale has been woven into each of their experiences and actually connects them.
And so it was. Like parts of it. So it was written like, like, you know, in ancient times and parts of it have been interpreted and found and, you know, the scrolls that it was written on were degraded and people had to like dig up this story. Um, but it's, and so it's both the, you understand the meaning of this story.
Mm-hmm of, of like inspiration and, um, decision making and going home and you just get these characters and it, it weaves it into these, the stories of these characters, I'm doing a terrible job. It's so complicated. [00:54:00] um, but it was just, I'm still kind of wrapping my head around what it was about. Um, so, so yeah, I recommend that.
There's also another book called, um, take my hand by Dolan Perkins, which is about reproductive justice. Oh. And the billboard, which is a play by Natalie Moore. Um, And so if anybody's looking to read kind of works of art, uh, you know, works of literature around the topic of reproductive justice and race and, um, uh, a little historical, uh, nonfic, uh, historical fiction, uh, with take my hand and, and both the billboard.
So those are really great reads as well. Beautiful. Thank you. Thank you for that. Okay. Hardest question of the day, they're making a movie of your life and you get to pick three songs for the soundtrack. What would they be? Okay. So I love Lizzo mm-hmm I mean, who doesn't right now. Right, right. Um, and so I think I could have picked any [00:55:00] song that she sang, but I think, um, special off of her new album, her newest album special is definitely one of them.
Um, I also think adore by prince. Again, I love everything about prince mm-hmm and I think that the song adore is just like a love story. And I think it's about like, just such like deep, beautiful love and adoration. I don't know. And, and it's a beautiful song and, um, and I think it's how I feel about people in my family.
It's how I, you know, when I love somebody, I love them hard. And so I think mm-hmm , I don't know. So I love that. I love that song and, um, uh, what is, oh, and then there's a, uh, a song called keep on living by LA LA tiger. LATI Graham. I might say that wrong. And, um, I have to admit, I got, I came, I was watching, uh, Jessica Jones on, I think Netflix.
And so it, that was a song in it and I was like, what is this song? I love this song. And it's just about like, it's a punk rock [00:56:00] song by this girl band, a woman band. And, um, it's just, the refrain is keep on, keep on living. Mmm. And it's just so punk rock and I think being a mental health provider and also going through, you know, I'm human as well.
And so I've had my own personal challenges and sometimes it's not about like a perfect analysis. It's not about like, you know, oh, let me understand. It's just, you wake up and you keep on living. Mm-hmm . And so, especially in like the, just how heavy things feel you keep on living, you know, there's a line that says, you know, look up to the sky sky and it's just, it's gotta keep on, keep on living.
So I love that song. So that would be in there too. You have a good soundtrack. I like this I'd watch. I would watch the movie of your life. I like it just for the sound time. Great question. I mean, it asks me like, I don't know. Yeah. So I love that question. That's the one everybody's like, oh my God. Only three.
This is so hard. Okay. Last question. So this podcast is all about radical [00:57:00] audacity. Doing the hard things, making those hard decisions, living life in the way that is true to you, even if nobody else understands it. So what is something of that you have done lately that embodies radical audacity for you?
This, this is a, a hard question. So I like the other ones, but I think this is hard because I find that I don't see myself as a radical, radically audacious person. I feel I kind of see it as like you get up and you do the things and you try to make other people's lives better. Right. And I take value in that.
And so I think something that I have struggled with in my life, I, so I don't have any children. Mm-hmm um, and I think challenging notions of what a wo woman is. Mm-hmm , I don't necessarily think I'm doing anything extra, but I, but I do so, so two things I think, so I think standing in my life and experience and choices.
[00:58:00] Without apology. Mm-hmm I think as a woman, as a, as a woman, without children and people, you know, you don't wanna have kids, you never wanted to have kids, right? Like these kind of assumptions that people make about you. Um, and being able to stand unapologetically, not sad about anything of my, you know, like that feels like it's kind of crazy that it has to be a choice and it has to be audacious.
Right. Mm-hmm um, but it is, I think, as a woman, not apologizing for any aspect of my life, what people think my life should be. Um, I think is huge. I think has been, has been the biggest thing. I also, you know, I'm like, no one else you'll meet. And I think being able to say that. You know, I'm not better, I'm not worse, but I'm, I'm unique.
And now I'm not gonna apologize about that. Um, so that's, so I think that that is, I think a little thing that I just do and carry every day. And I try to be intentional about that because the world will try to tell you that you're wrong. You're too big. You're too. This you're too that, and you will be [00:59:00] spinning trying to keep up with the thing that you're not, and never be following and establishing what you are.
Um, and so I just, I think the decision to do that, and I hope models for people that they can do that too. I, I, you brought tears to my eyes. I just have to say I'm feeling very emotional right now. I feel like this is some of the most beautiful, radical audacity out there. I think there are some misconceptions that it has to be this big, giant firecrackers going off, but living who you are unapologetically and saying, I am like no other, I am me.
Mic drop right there. There's not much more to be said. That is. And I think if anybody walks away with that, holding their head up high, saying, okay, if Candace says that I can too, you know, like I think that's a powerful, powerful thing people can walk away [01:00:00] with today. Thank you. Thank you for this gorgeous conversation.
Thank you for showing up 100% as yourself and having this Frank conversation with us and helping us to see this topic a little bit differently. I really, really appreciate having you here today. If people wanna reach out to you, how can they do that? So I'm on Instagram, Dr. Norco, I'm on LinkedIn, Candace Norco.
Um, and, uh, I'm on Twitter at Dr. Norcott try to kind of capture all those things. So those are, those are places that I'm not going anywhere. I'll be there. I've aspirations of a website. You know, there's always some, there's always something else to do, but, uh, beautiful. Um, but those are, those are three places.
Beautiful. Well, thank you so much for being here with us today and I hope my listeners reach out to you. It's been wonderful. Thank you for having me.
How phenomenal is Dr. [01:01:00] Norco? She is such a wealth of knowledge and information. I can see why Jada Pinkett Smith loves to have her on the round table. what really stood out to me today was the way Candace talked about the misinformation that is out there and how the misinformation around reproductive health can be very.
Oh, damaging very damaging and very weaponized to have people act against their own best interest. And we see this so many times where women are going against other women when it comes to our reproductive health issues so much. So to the point that we end up harming ourselves as women. And it's because of all of this misinformation.
And so I love how [01:02:00] she really is working on trying to quell that misinformation, trying to stem the tide. I also am really impressed with the work that Dr. Norcutt is doing to care for. Reproductive healthcare providers. She said something that just resonated with me just made me think a little bit differently about the people that are taking care of us as women.
She said that activism is hard work and that all of these E B GYNs are activists. They are out there trying to help women see what your opportunities are, what your choices are, what these decisions are that you need to make. And often they're very difficult, painful decisions. And our OB GYNs are out there to take care of us and to be activists for us.
And it's so hard for them when we are [01:03:00] ambivalent and when we are leaving the choice directly in the doctor's hands. And so to be better informed patients. To be better informed women. And to say, this is what I need. This is the best form of action for me to be able to have those conversations with our doctor and feel like we are in a partnership with them is so very, very important.
And as Dr. Norcutt brings out in today's interview and just in all of the activism work that she does, we know that. Cultural responsiveness around reproductive health is so vitally important. There are whole communities of women that do not have choice, and that have not had choice for a very long time.
These rights have [01:04:00] been eroding for a long, long, long time. And for us to now say enough enough,