Birth control and abortion are constant flash points in contemporary politics, and they’re often described as signs of a rapidly changing society. But women have always had ways (though not always quite as effective ones) to control family size through contraception, and early American women were no exception. Understanding the role that reproductive rights has played in American history provides critical context to today’s debates. Have we always had these kinds of debates? How did Americans think about abortion in the late 18th century, or the 19th century? In this episode, Elizabeth and Sarah start a three-part conversation about women’s reproductive rights in United States history by talking about birth control methods and abortion in the 18th and 19th century.

Listen to the episode now!

 





Transcript for: Early American Family Limitation and Contraception

*This is a re-release of an older episode.

Sarah: Historically, women have had control over their family size, though not always particularly effective ways. They were often able to use various of methods to avoid conception or induce very early abortion.

Elizabeth: It’s also important to understand that birth control was not invented in the lab by doctors of scientists but comes to us from our collective folk culture and from century’s old female knowledge. Essentially, women have been practicing birth control since time immemorial.

Sarah: Today we’re going to be focusing on mostly the 18th and 19th centuries in the United States.

I’m Sarah

And I’m Elizabeth
And we’re your historians for this episode of Dig.

Sarah: The Egyptians used pessaries that I think were called tampons, made out of balled up linen that was soaked in essential oils for millennia, I would probably.. More accurate.

Elizabeth: Forever…

Sarah: Women have relied on the rhythm method, so that if they could control their partners sexual urges, (which not all women had that power), they could organize their sexual relationship around their fertile and non fertile days. Perhaps the most common was breastfeeding: women are generally less fertile while breastfeeding, so it was exceedingly common for women to breastfeed for at least 2 years. This helped to space children to a one every 2 years – in New England in the late 18th early 19th century, this was the demographic norm, which means women were actively doing something to slow their fertility. Which means that women were actively doing something to slow their fertility. It was not an accident.

Elizabeth: As the economy moved to a more industrially based economy, the monetary value of large families decreased. The high cost of urban dwelling and the decrease of monetary contribution that children could contribute to the family economy, made children cost more than they could contribute. So of course this wasn’t the case everywhere, but we start to see a slowly spreading, general trend over the last really five centuries of decreasing family size.

Sarah: For the most part – as is true today – however, women remained largely in control of their fertility. After all, they were generally the ones that bore the brunt of the consequences of conception. So women were the ones that held the wisdom of how to space their births, how to prevent conception, and how to restore menses when necessary.





Elizabeth: And as proof that birth control wasn’t invented in the modern clinic, records from the earliest European and American birth control clinics at the early twentieth century, show that the majority of the patients who visited the clinics for the first time had previously used contraception. So this kind of knowledge was passed generationalY through female channels although sometimes sporadically. And obviously a lot of that folk knowledge has been lost.

Sarah: So just to explain a little bit more about why we kind of keep hedging our language and talk about uh, the restoration of menses rather that referring to it as abortion we should probably explain how women and doctors in general thought about medicine and through about health up until the mid to late 19th century. Until the mid-19th century, women’s reproductive health was understood in terms of a balance of bodily fluids. (based on humoral theory of medicine). Sickness caused by blockages or imbalance of the fluids of the body – important to put those things back into balance by vomiting, bleeding, peeing, voiding bowels.

Elizabeth: People living in the you know up until the 18th and early to mid 19th century still understood the body in a Galenic ideology of a bodily balance and flow. So therefore their experience of illness was different because they perceived the body in a different way than we do today. The body was in a state of balance or unbalance. So remedies such as bleeding and purging would be practiced in order to get the individual body back into health. A blockage of the menses could be a sign of imbalance because the body was not purging itself on its monthly schedule. And its backup of menstrual blood could lead to ailments in other areas of the body. In this sense its easier to understand why 18th century patients and doctors might speak of say breast milk escaping through the menses. Or urine escaping through the saliva. So orifices were just points where the body could expel these excess matters or humors.

Sarah: Right, and keep the body in balance. So sickness was caused by blockages or imbalance of fluids in the body and it was important to put those things back into balance by vomiting or peeing or voiding the bowels. So when women stopped getting their periods (before menopause) this was understood as an imbalance. The fetus simply was not considered until “quickening,” or when the fetus began to move in the womb. This meant that a pregnancy was considered more of a blockage of menses until somewhere around 15-20 weeks gestation.

Elizabeth: The idea of quickening comes from medieval times or even earlier when the fetus was endowed with the soul. Now by the 18th century quickening was more understood as just the point when the fetus became more than an inanimate object. At this point a woman could be certain of her pregnancy because she could now feel the fetus moving. And its tricky for the modern scholar to assume that people in the 18th and the 19th century and obviously earlier, thought that an obstructed menses thought that it was in fact a pregnancy. There was no definitive method for verifying pregnancy until 1926 when Cecil Vogue created the rabbit test. And it wasn’t until the 1960s where they got more accurate results. So before that, pregnancy wasn’t a certainty until the woman felt the quickening or the movement of the fetus. And this put the domain of pregnancy specifically in how women experienced their bodies. The large, hard stomachs of the dropsical or worm infested or malnourished could very much like the stomach of a pregnant woman. And so when a woman didn’t have her monthly menses and didn’t feel the quickening it could be contributed to rheumatism, consumption, pleurisy, intestinal worms, or a host of other really fun ailments. [laughter] …attributing to an unnatural stoppage of the menses. In order to get the body back to a normal state, a resumption of the menses was in order.

Sarah: Women took herbal remedies and patent medicines (later) that were designed to “remove the blockage” and restore the menses, called emmenagogues

Elizabeth: During the 18th and 19th centuries in America, the emmenagogue or recipe to restore menses most commonly mentioned was European Savin or the American juniper or red cedar plant. Aloe, rue, pennyroyal, tansy, mint, lavender, ginger, and many other abortifacient herbs were also recorded. Seneca snake root became a commodity for its emmenegogic benefits and was harvested in the south and shipped to Philadelphia where it was sold by Benjamin Franklin and others in the 1740s. Most of these herbs were dried and steeped to make tea, or ground up to powder form.

Elizabeth: Starting in the middle of the 18th century, commercial emmenegogues were sold as Hoopers Female Pills, Dr. Ryan’s Worm Destroying Sugarplums “highly serviceable to the female sex” and other such marketable names. Health manuals written in English listed emmenegogues specifically as a means to restore or unblock the menses. German language health manuals from Pennsylvania printed between 1762-1778 listed the same emmenegogues for restoring the menses but these identical recipes could also “expel dead fruit.” Midwifery manuals later in the century from Pennsylvania gave the same recipes in expelling the fetus “be it alive or dead.” Common books listing emmenegogues could easily be found during the 18th and 19th centuries. William Bukins “Domestic Medicine” first published in 1792 listed several ways a missed menstrual period could be restored. He also listed numerous causes of abortion later in the book. Samuel K. Jennings book, “The Married Ladies Companion” had its second printing in 1808 and listed several emmenegogic abortifacients. In 1910 Joesph Brevits “The Female Medical Repository” was published in Baltimore and listed many emmenegogues after cataloging multiple external causes of abortion such as falls and jumping. He added an asterisks and a footnote in the American edition deploring the “horrid depravity of human weakness to procure abortion by these means.” And the fact that he had to make this aside stresses the fact that women were using these means in these books to induce abortion.

Sarah: For example, Martha Ballard’s diary notes providing a young woman named Genny Cool a concoction “particular herbs” to cure an “obstruction” of her menses. Historian, Leslie Reagan: “this age-old idea underpinned the practice of abortion in America …. the legal acceptance of induced miscarriages before quickening tacitly assumed that women had a basic right to bodily integrity.” So, this is the key point we’re trying to make here. Is that this was seen as the purview of women and women only. This wasn’t really a medical or a moral issue, it was something that women controlled and that women did.

Elizabeth: And the experience of women and their bodies. So before feeling the quickening, they might just feel constipated. You know, it’s there own experience that they were feeling.

Sarah: Right and often in the beginning of a pregnancy, you are often sick. So you just might interpret that as being sick, and would want to just bring on better health.

Elizabeth: So we learn a lot about early American ideas about abortion in America from printed books and pamphlets and the advertisements for these abortifacients. And we also glean a lot of information about early birth control and abortion from early court records. So quickening was part of a woman’s understanding of her own body. There was no pregnancy there because the woman had not experienced the quickening, or movement of the fetus.

Elizabeth: We learn a lot about early American ideas about abortion from printed books, pamphlets, and advertisements. We also glean a lot of information about abortion from early court records.
The 1745 Connecticut case of Rex v. Hallowell provides a rare and well documented look at abortion in New England. In this case, Sarah Grosvenor became pregnant by her lover Amasa Sessions in 1742. They were both children of well-to-do families in the town of Pomfret and needed to cover up their illicit affair. Sessions procured an abortifacient potion from the self-proclaimed “practitioner of physick,” John Hallowell. Later that month, Sarah Grosvenor admitted to her younger sister that she was pregnant but had been “taking [the] trade to remove it.” The trade was a commonly used word for an abortifacient in New England, and the fact that Sarah and her sister understood what this word meant sheds light on the commonality of abortion in this era. After taking multiple doses of the “potion,” Sarah believed she was still pregnant and did not want to take more as she “Thot it an Evil.” John Hallowell convinced her that she would die if she did not restore her natural balance of humors, and that the fetus most certainly was dead. She agreed to let Hallowell deliver her but told him to stop if he detected any sign of life in the fetus.

Elizabeth: And so I’ll just pause for a second here and just point out that its 1742, so mid 18th century, we see ideas in this court record of ideas of quickening changing. So Sarah she’s trying to return her menses but she had an inclining that she’s pregnant but she hasn’t felt the quickening and she wasn’t Hallowell to stop if he detects any life.

Sarah: Right, so you -there’s a lot there. I mean there’s she sort of believes she is pregnant even though she hasn’t felt the quickening but she still needs to restore her menses. And I think it’s really interesting that its him saying, “you’re going to get sick.” So he either is generally concerned about her health, or that he wants to get rid of this problem.

Elizabeth: Or, and this may be reading too far into it, he knows the fetus is dead so she HAS to expel it or she really will get sick.

Elizabeth: Court testimony by Zerphia Grosvenor, states that Hallowell took an “instrument” from his bag and inserted it inside Sarah. The record is unclear on what type of instrument he used. The curette, a metal instrument used to induce abortion, was invented in France in 1723. It is possible Hallowell used a curette in this instance but he also could have used any number of implements such as a sharpened piece of slippery elm. The ensuing graphic testimony accused Hallowell of trying to “take the child away” through force which triggered Sarah to faint, and caused Hallowell to leave town. Two days later Sarah delivered a stillborn infant. Ten days later Sarah became sick with convulsions and fever and died shortly thereafter. Two and a half years after Sarah’s death, rumors spread about a murderous abortion and two county magistrates began an investigation.

Elizabeth: The trial initially went forward charging all parties in the murder of Sarah Grosvenor but failed on technical grounds. In a separate trial in 1747, John Hallowell was convicted of the “highhanded Misdemeanor” of attempting to destroy both Sarah Grosvenor’s health and the “fruit of her womb.” It would seem here that the courts were more concerned for Sarah Grosvenor and her murder as opposed to her fetus. Hallowell was sentenced to 29 lashes and two hours of public humiliation at the town gallows. There were no statute laws on abortion in either America or England at this time. It must also be noted that this case probably would have never been documented had Sarah Grosvenor not died. Rex v Hallowell allows us to explore the use of abortifacients. This case does not explicitly say what kind of physick or potion Sarah took, just that it was in powder form. It is evident from the court documents that the individuals involved with the case were familiar with abortifacients, even if they were unsure of how to make them.

Elizabeth: In another court case In 1812 the Massachusetts Supreme Court ruled in Commonwealth v. Bangs that an abortion before quickening was not a crime. In this case, Isaiah Bangs prepared and administered an abortifacient potion to a woman. He was freed by the justices because it could not be proven “that the woman was quick with child at that time.” Commonwealth v. Bangs remained the ruling precedent in abortion cases in the United States for the next sixty years.

Sarah: This began to change in the 19th century as lawmakers began to make the sale of abortifacients illegal. Women, however, grew their own herbs like pennyroyal, tansy, and rue and concocting their own remedies; not uncommon for midwives to be skilled in preventing pregnancy alongside their skills in caring for laboring women.

Sarah: Pop culture example: Belinda Gibson & Aurelia Johnson in Mercy Street. Raises interesting points bc enslaved women also had these remedies, but they were under increased pressure to not use them because babies benefited their masters (increased their wealth). Masters were constantly concerned that their slave women were using methods to stop pregnancies; cotton-root common in the South. So there was always the concern that could be going on under the master’s nose without his knowledge.

Sarah: The medical profession was becoming progressively specialized and self-regulated during this time. Physicians increasingly attempted to separate themselves from lay healers and folk doctors by taking on the name “Regulars”. These doctors tended to be graduates of prestigious medical school or those that practiced with them. Regulars regarded their advancing position as important as the field of law or theology, and they intensely opposed what they considered quack theories. In a Foucauldian sense, the medical knowledge that the regulars claimed became a source of power in the larger system of nineteenth century civilization. As long as women maintained control over this aspect of their lives, doctors had less professional power; they did not have a corner on the medical market, in other words

Elizabeth: In addition to fighting for a level of prestige, Regulars were also concerned with the numbers of “irregulars” that were cutting into their livelihoods. One study of Rochester, NY during the mid-nineteenth century, found that many physicians had to work in additional areas of employment in order to earn a respectable living. In an attempt to protect their medical ideals and sources of revenue, Regulars began pressing for increased legislation pertaining to medical practice. As a result, between the years 1821 and 1841, ten of the twenty-six states in the union enacted statutes in regards to abortion.

Elizabeth: Connecticut became the first state to enact a law specifically pertaining to abortion in 1821. Between section 13 pertaining to “intent to kill or rob,” and section 15 dealing with the “secret delivery of a bastard child,” section 14 stated “every person who shall…administer to…any deadly poison, or other noxious and destructive substance…thereby to murder, or thereby to cause or procure the miscarriage of any woman, then being quick with child, … shall be thereof duly convicted.” This law thus prescribed into law what had already been practiced in common law and upheld in Commonwealth v. Bangs, that a woman quick with child, could not be given anything that would purposely cause abortion.

Elizabeth: In their effort to upgrade the standards of their profession, Regulars were opposed to abortion on ethical and scientific grounds. Ethically, the Hippocratic Oath condemned abortion. Therefore, in an attempt to rise above their competition and uphold higher moral standards, Regulars opposed it. Also, scientific medicine had shown that the continual growth of the fetus would begin at conception if left unimpeded. As a result, many regulars saw quickening as only a stage of development, no different from the period before or after quickening.
By 1841, ten states and one territory had enacted laws pertaining to abortion. Five states explicitly stated abortion was illegal after quickening. The other five stated abortion was illegal at any time during pregnancy.
In reality, the laws were unenforceable as there were no pregnancy tests at that time. Four of the ten states listed their abortion laws under “poisoning.” Every abortion law during this period was enacted within omnibus “crime and punishment” bills. These were large revisions of criminal code that held many alterations to current laws. There was no major coverage of the enactment of these laws and revisions in either the popular press or the religious press during this time.

Elizabeth: During the 1840s there was a surge in the volume of abortions being performed in the United States. Historian James C. Mohr estimates one abortion for every five or six live births occurred during this time. One reason was the increasing commercialization and advertisement of abortifacients in popular papers and magazines.

Elizabeth: The infamous Madame Restell began her abortion business in New York during the 1830s. She was arrested for the first time in 1841 and New York papers printed her name and occupation, giving her great publicity. By the late 1840s, Madame Restell’s abortion practice had branches in New York, Boston, and Philadelphia. Street peddlers would sell her abortifacient pills throughout neighborhoods and they were available by mail order as well. But by no means was Madame Restell alone. A quick look through most any paper in the 1840s would show multiple advertisements for abortion providers and abortifacients. Dr. Peter’s French Renovating Pills were sold as a “blessing to mothers’…and although very mild and prompt in their operations, pregnant females should not use them, as they invariably produce a miscarriage.”

Elizabeth: The rise in sales of abortifacients may have only produced a low amount of actual abortions yet the number of pills sold indicates that women were trying them in high numbers, and then possibly resorting to surgical means if the abortifacients didn’t work. A study by a physician-pharmacologist in Syracuse, NY in the late 1860s, found six out of ten different abortifacient pills he purchased to have high abortifacient properties, two of the ten to be mild laxatives, and the other two were inert drugs. Thus, women could achieve an abortion through commercial abortifacient pills if they knew where to look or were lucky (or unlucky) enough to happen upon the right ones.

Elizabeth: A second possible cause of the increased abortion usage during this time was a trend among white, married, Protestant women to utilize abortion as a means of limiting family size. The white, Protestant American family had been decreasing in size since the Revolution and the 1840s saw an upsurge in deliberate family planning by middle-class women. This prompted a serious backlash by Regulars and nativists. Married women who sought abortions were criticized for abandoning the self-sacrifice required of motherhood. Young, single women who sought abortions had been pitied as helpless and troubled dependents, but married women seeking abortions had “no excuse…for their heartless depravity,” as the editor of the Boston Medical and Surgical Journal stated in 1844. Dr. Horatio Storer, a leading opponent of abortion, equated a childless marriage as legalized prostitution.

Elizabeth: This backlash was part of a larger upheaval in changing gender roles. At this time feminism was gaining popularity with middle-class, Protestant women as the abolition, temperance, voluntary motherhood, and suffrage movements gained momentum. Although feminist groups avoided or condemned abortion during this time, feminists were still seen as a threat to the status quo and mounting gender role evolution.

Elizabeth: The mid-nineteenth century was also a time of increased immigration which spurred nativist sentiments. As native-born, Protestant birth rates were declining, Catholic immigrant population numbers were on the rise. This led to grave fears of the white “race suicide,” or “the demographic failure of the American family.” Native Protestants feared that Catholic immigrant populations would surpass them and the “Puritan” blood line of ’76 would be diminished. This argument also marked the beginning of the eugenics movement as native-born Americans worried that their “good stock” would be over-run by aliens. The fact that white, native-born women were procuring abortions doubled the eugenicist’s anxiety.

Elizabeth: The American Medical Association (AMA) formed in 1847 as a professional, nationwide organization for physicians. This group of Regulars continued with increased fervor the push for enacting more abortion and general medical legislation. Horatio Storer, one of the most outspoken opponents of abortion, spearheaded the AMA crusade in 1857 against criminal abortion. The campaign gained momentum among Regulars across the country and put enormous pressure on lawmakers to enact medical and abortion legislation. It should be noted that not all physicians were on board. One Boston physician stated anonymously that Storer “seems to have thrown out of consideration the life of the mother, making that of the unborn child appear of far more consequence, even should the mother have a dozen dependent on her for their daily bread.” As this quote suggests, not all Regulars viewed abortion in the hard and fast lines that the outspoken majority did.

Sarah: The AMA set out to influence legislation and public opinion. Regulars bemoaned the country’s “general demoralization” as attributed to the public’s ignorance on quickening, doctors performing abortions to make money and retain patients, and lax laws against abortion. The AMA determined to deconstruct the prevalent quickening ideal among the general populace by lecturing their patients and producing books and manuals debunking the quickening doctrine. They largely succeeded and by 1868, thirty of the thirty-seven states in the union had abortion laws and the common discourse on abortion was changing. Only three of the state laws deemed abortion after quickening a crime. Almost all of these laws held the woman receiving the abortion liable as well as the practitioner but it is important to point out that these crimes always carried lesser sentences than homicide cases. Between the years 1841-1868, the country made a dramatic change from one that listened to women’s perceptions of their bodies in relation to their pregnancy and fetal movement, to one that specifically rejected that concept and insisted all pregnancies be carried to term.

Sarah: Around the time of the CW, abortion started to become illegal nationally.1857, AMA advocated against abortion, declaring pregnancy and childbirth the domain of physicians. Became medical conditions to be monitored and controlled by doctors, rather than the purview of women alone

Sarah: Outlawing abortion was directly related to the attempt of the AMA to place medical knowledge in the hands of elite professional physicians. Quickening stopped being the turning point of pregnancy, and instead pregnancy began when menses stopped; by roughly 1867/1870, most states had made it illegal after this point to end a pregnancy. The legislation push by regulars continued and by 1880 every state in the Union except Kentucky had laws making abortion illegal at any stage except when deemed necessary for the women’s health by a respected physician. Most laws also made the advertisement of abortion services or abortifacients illegal. The Comstock Act of 1873 drastically increased the regulation of advertising “women’s services.” Increased regulations and a change in public perception also altered the demographics of who was obtaining abortions. They decreased among native-born, Protestant women and again became more common among young, single women and poor immigrants. The decrease of white, Protestant women receiving abortions also coincided with the increased availability of contraceptives. Abortions were by no means eliminated as they were gradually pushed underground. At a time of increased scientific knowledge and ability to make abortions safer for women, physicians were refusing to perform them, making illegal abortion increasingly more dangerous for women who needed them.

Sarah: As abortions were being pushed underground with increasing regularity, discourse on the matter gained prominence. Physicians still complained about the public’s acceptance of abortion before quickening and they increasing used more shocking vocabulary and stories to repulse the public. By the 1870s professional and popular journals were filled with the abortion issue. The New York Times continually ran salacious stories highlighting the “Evil of the Age.”

Elizabeth: In 1888 the Chicago Times ran a month-long undercover story charging that abortion was widely available in the nation’s second largest city, despite a strict Illinois state law. The journalists found that many physicians and midwives would perform abortions, and if they did not most were willing to refer the undercover journalists to someone that did. Dr. George M. Chamberlain, one of Chicago’s most prestigious doctors, member of the AMA, and the Illinois State Medical Society, agreed to perform an abortion on one undercover journalist. Dr. Milton Jay, dean of the Bennett Medical College also agreed to perform one. The paper named forty-eight physicians who agreed to help one undercover journalist obtain an abortion. Thirty-four agreed to do it themselves, twelve referred her to another doctor who would perform an abortion, one referred her to a midwife, and one sold her abortifacient pills and sent her to another doctor. Thirty-two of the forty-eight doctors were Regulars, several belonged to the AMA. Many others belonged to the local medical society.

Elizabeth: Overall, the story highlighted the conflicting relationship many Regulars had with abortion. It also showed that “respectable” physicians with close ties to “respectable” ladies were frequently performing abortions, exposing the hypocrisy of the upper classes in their condemnation of the lower classes and abortion. The undercover journalist commented on her surprise that it was “married society” women more than poor shop girls and immigrants who were procuring abortions.

Elizabeth: The Chicago expose also went into the poorer neighborhoods where most obstetrics were performed by midwives. The paper published the names of sixteen midwives who agreed to perform an abortion or who would refer the undercover journalist to someone that would. Some of the midwives that refused offered to keep the pregnant girl with them until she delivered and would aid in finding a foundling house for the baby.

Elizabeth: Chicago specialists in obstetrics won increased state supervision of midwives in 1896, 1908, and 1915 by identifying midwives as abortionists. Yet, a 1917 study at the Washington University Dispensary in St. Louis found that physicians and midwives attributed in equal amounts to the illegal abortions they tracked. In a New York study of 111 convictions for illegal abortions between 1925 and 1950, investigators found that midwives were responsible for 22.5 percent of the cases and physicians for 27.9 percent. Although these numbers do not give definitive results for rural and urban populations, it is a good indication that abortions were being performed by doctors and midwives in equal numbers.

Sarah: Most of the available numbers on abortions are from deaths and criminal cases or from hospitals admitting women with complications from illegal abortions. It is unknown how many abortions were executed safely and without comment. Most discourse on abortion happened in private spaces between families, and among networks of females.

Thanks for listening.

Sarah: see ya!

Show Notes & Further Reading 

Dayton, Cornelia Hughes. Women before the Bar : Gender, Law, and Society in Connecticut, 1639-1789 (Chapel Hill: University of North Carolina Press, 1995).

Duden, Barbara.  The Woman beneath the Skin : A Doctor’s Patients in Eighteenth-Century Germany (Cambridge, Mass.: Harvard University Press, 1991).

Gordon, Linda. The Moral Property of Women : A History of Birth Control Politics in America. 3rd edn (Urbana and Chicago: University of Illinois Press, 2002).

Klepp, Susan E.  Revolutionary Conceptions: Women, Fertility, and Family Limitation in America, 1760-1820 (Chapel Hill, 2009).

Mohr, James C.  Abortion in America : The Origins and Evolution of National Policy, 1800-1900 (New York: Oxford University Press, 1978).

Ulrich, Laurel Thatcher. A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812 (New York: Vintage Books, 1991).

Learn about contraception in early America. women have always had ways (though not always quite as effective ones) to control family size through contraception, and early American women were no exception. Understanding the role that reproductive rights has played in American history provides critical context to today's debates.


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