First pregnancy, what am I missing?

[BrownRiceBaby]

BG:
So, after trying -on our own - for two years, we are FINALLY expecting in October. Since we've been charting and keeping such close track for so long, we pretty much found out we were PG right away, but, unfortunately, did not yet have a Dr in our area. I called around to all my Mommy-friends, and then tried to make an appointment with the Doc that sounded most like what I wanted (talkative, informative, gentle, AND works with registered midwives in his office) but the woman who took my appointment said "We can't really tell you anything until ten weeks." Bwah? So, I have not yet had any sort of check-up or well-being advice, other than What to Expect, Guide to Childbirth, and The Thinking Woman's Guide to a Better Birth. Oh, and Google.

Here's the thing. I have so many questions, and I know that I don't even know the right questions to ask, so I probably should have more. I'm totally freaking out because I have had very little morning sickness, my breast aches are gone, I'm not really all that tired ever...it seems that my only PG symptoms are a new found ability to sleep in, and constant hunger!

The first two weeks of my pregnancy, I caught what people seem to be calling The Crud. I finally called my GP back in CO to see what I could take, and he recommended Robitussin for PG women, but now I'm freaking out that this has also damaged the baby.

I kept vomiting up the pre-natal vitamins I was taking, because of the Iron in them (I switched brands three times, and now just don't take ANY, if I'm just going to throw it up anyway!) and after I stopped taking them is when the "morning-sickness" stopped. But what if the baby has suffered because of this?

My appointment is tomorrow, and I am ANGRY that I have had to deal with this on my own for so long. I have been freaking out, eating constantly (only good things, though) and trying to figure out what I should be asking these people when I finally get to be seen. (Also, how to convey that I am VERY annoyed at having to wait SO long with NO pre-natal care whatsoever without coming across as a mama-bear-troublemaker.)

What I want to know right away: Am I actually pregnant? Is it ectopic? Do I have a blighted ovum? (Thanks for that one, google. :irked:) Is my baby going to be permanently damaged because I haven't been able to take vitamins? Is there a birth center in the area? If not, will these midwives assist a homebirth? How do you feel about homebirths? What's the epistiotomy/cesarean/forceps/vacuum ratio of this practice?

I really want to stay out of the hospital if at all possible. My husband is not exactly sold on the idea of a homebirth, but barring any birth centers in the area (no one seems to know of one), I don't see any other options for us.

What am I missing? Are there any other questions for a first-time Mom's first visit to her ob?

(Also, is that "ten week" thing standard? What the heck?)

[NotTheOnlyOne]

the ten weeks is standard for my OB office. I actually got in early because I know him outside of being pregnant :wink (I was his kids' nanny)

It is pretty crazy to just let you go on your own for 10 weeks. There are so mamy things a 1st time mom just won't know. ABout taking prescribed meds, otc meds, prenatals..... whats normal and whats not. I totally agree, its frustrating. they should offer at least a phone consult for quedstions to be answered.

The only thing you really should be taking prenatals for is folic acid. If you were taking some kind of multivitamin or prenatals before you got your BFP you dont need to worry at all. Even if you werent taking anything you are probably just fine......but thats what is most important. Lack of folic acid can cause nueral tube defects, like spina bifida.

I hope you get all sorts of good info tomorrow. COme back and update. Are you in the Oct ddc?

[chicasmama]

First, let me say there are a lot of women who don't even know they are pregnant and drink/smoke/eat horribly in the first trimester, but sustain a healthy pregnancy and have a healthy baby. Don't stress over the cough syrup or not being able to keep your vitamins down ( I always take mine before bed as they seem to stay down, jmo). As far as 'standard procedure' a lot of dr.'s offices won't see women prior to 12 weeks. I know this can be frustrating, especially as a first time mom, but the reality is many woman miscarry prior to that-and that is their rational for it. It sounds to me you are taking the best care of yourself as you can-and really what more can you do? Also your baby derives it's 'life supply' in the begining from it's yolk sac, once this goes away (usually around week 10-12) it is the placenta that takes over and at that point any alcohol, etc would pass from you to baby.
As far as a blighted ovum-that will typically result in a 'natural' miscarrage (meaning your body will expell it on it's own) You will see fresh blood and have cramps if this were happening. I know many people believe that "magic 12 week " mark. BUT the reality is your chances of miscarrage goes down dramatically by week 8, and then again by week 12. I think the worst thing you can do is stress about all this. I would write down any questions you have so you don't leave your appointment feeling you forgot something and any good doctor will take the time to answer your concerns. As far as stating your unhappiness w/ not being seen sooner- I would **personally*** skip that-only because the reality is-that's pretty standard at any dr.'s office. Maybe instead you could ask them why that is rather than coming across like your pissed about it, but that's jmo. Anyhow I wish you a happy and healthy 9 months:love

[GISDiva]

My advice is to stop reading "What to Expect"...others will back me up on that one.

Try not to worry too much, lots of people experience almost no symptoms until well into their pregnancy. And think of all the people who didn't know they were pregnant for a good long time and ingested god-knows-what and their babies turned out just fine.

What PP said, folic acid is the most important vitamin right now, and as long as you're eating a well-balanced diet, you'll be just fine. And your baby is not damaged from the throwing-up thing, they are very small and will get what they need from your body. Lots of mammas have really bad morning sickness that keeps them from eating much of anything and turn out just fine too.

Hugs to you!

[LaurenAnanas]

I'm sorry I don't have much practical advice (it's my first pregnancy too), but 10-12 weeks seems to be the normal time frame for first visits with an OB... Which is one of the reasons why I went with a midwifery practice. Mine does initial visits at 6-8 weeks.

Maybe you could just call (say you're waiting for your initial visit) and ask to speak to a midwife because you have some questions? The OB might not be able to answer your calls, but a nurse or midwife might. Also, be aware that some OB practices only use midwives for pre- and post-natal care, only the OBs actually deliver babies.

Oh, and I have to take my vitamins with a full meal, otherwise they make me sick too.

You can try posting in your local tribe here on MDC. That's how I found out about my midwives and other local options- OBs might not want to advertise for their "competition."

[merry-mary]

BG:

I kept vomiting up the pre-natal vitamins I was taking, because of the Iron in them (I switched brands three times, and now just don't take ANY, if I'm just going to throw it up anyway!) and after I stopped taking them is when the "morning-sickness" stopped. But what if the baby has suffered because of this?

My appointment is tomorrow, and I am ANGRY that I have had to deal with this on my own for so long. I have been freaking out, eating constantly (only good things, though) and trying to figure out what I should be asking these people when I finally get to be seen. (Also, how to convey that I am VERY annoyed at having to wait SO long with NO pre-natal care whatsoever without coming across as a mama-bear-troublemaker.)

What I want to know right away: Am I actually pregnant? Is it ectopic? Do I have a blighted ovum? (Thanks for that one, google. :irked:) Is my baby going to be permanently damaged because I haven't been able to take vitamins? Is there a birth center in the area? If not, will these midwives assist a homebirth? How do you feel about homebirths? What's the epistiotomy/cesarean/forceps/vacuum ratio of this practice?

I really want to stay out of the hospital if at all possible. My husband is not exactly sold on the idea of a homebirth, but barring any birth centers in the area (no one seems to know of one), I don't see any other options for us.

What am I missing? Are there any other questions for a first-time Mom's first visit to her ob?

(Also, is that "ten week" thing standard? What the heck?)

Re: prenatals: you can try Flintstone's Vitamins, the chewables for kids. A dear friend of mine had similar issues and couldn't keep anything down and her OB suggested Flintstone's. I agree - folic acid is most important so if you can't stomach a vitamin with folic acid, then just try to add folic acid-rich foods to your diet (orange juice, broccoli are a couple).

Re: the 10 week thing: it's pretty standard. My OB practice won't see patients until you're 8 weeks at a minimum. It is an awful wait, I know. But sadly, it seems to be the norm among OB practices. I don't know if it's normal for midwives as I use OBs.

I think your list of questions are good. Frankly, if you ask those questions of an OB, the OB may happily refer you to a midwifery practice. I know that mine did when I made my birth wishes be known. For many reasons, I stayed with my OBs (who were very supportive of my choice to have an entirely natural birth in a hospital setting). But several of the docs in the practice did suggest that I at least consider midwifery. I second the suggestion of looking for reconmmendations on your tribe here on MDC. Just ask people to send you a private message.

I think the most important things for you to determine at this point are: (1) confirmation of pregnancy, which they should do with blood and/or urine test (don't sweat the symptom thing - I never had a lick of morning sickness with my first baby, and the pregnancy was perfectly fine); (2) the prenatal thing; and (3) whether you are going to stick with this practice or consider midwives/homebirth/birthing center. Good luck!

My advice is to stop reading "What to Expect"...others will back me up on that one.



:yeah: Toss it. It's a useless book filled with misinformation.

[newmommy7-08]

Ok first off Congrats!!! Welcome to the world of worried moms! :hug

Next... yes, it is totally normal for the doctor to not see you until 10 weeks or so. Mine sees you at 9 weeks.

It is also normal for you to worry about EVERYTHING especially after trying so long. I know... I lived it to :) Symptoms do come and go so try not to freak about not feeling pg. At this point most women either feel miserably sick... or disgustingly good (to those of us that were sick that is)

I didn't take prenatals the entire first 4 months of my pregnancy. I gagged on them, had to do with the size of the pills. My suggestion is to get a folic acid, and maybe a regular old womens multi vitamin if you can swallow it. If you can't don't worry about it. Baby takes all the nutrition it needs from you, and you're stuck with the leftovers so just try to eat a well balanced diet w/ lots of veggies and good protein. There are women who don't even know they're pg till 12-14 weeks and their baby's are fine without prenatals.

Now, as far as ectopic or blighted ovum, your dr. should be able to tell this just by the exam tomorrow. Keep in mind that the heartbeat isn't usually able to be heard w/ their equipment until 13 weeks or so, so if they try and don't hear one that's nothing to panic.

Honestly I would not convey annoyance when you meet with them tomorrow. 10 weeks is normal. It sucks but it's normal. I was lucky since we did fertility treatments I had treatment and u/s twice before going to my ob... but if I hadn't been seeing them I would have been in your shoes.

Good Luck tomorrow and I hope you get all of the answers you are looking for.

[BrownRiceBaby]

Whew! I feel a little better now. Thank you!

NotTheOnlyOne, I'd been worried about folic acid and vitamin C (when I first got sick, I tried to drink OJ: no dice.), but I've been eating tomatoes and strawberries, and spinach and kale pretty much non-stop, so I feel better about not taking the vitamin. Thank you!

chicasmama, I didn't know that about reducing miscarriage risks at eight weeks: that's a load off my mind! I thought it was only every three months, the risk went down. (I have to say, though, it seems to be a pretty lame reason for an OB to refuse to see you. Seems to me we might know a lot more about the causes and prevention of miscarriage, if there were more early-pregnancy histories taken and women monitored...but then again, I'm new at this, so what do I know? :D) I'm taking your advice, though, and I'll only be asking why I had to wait, NOT complaining about it! :thumb

GSDiva and merry-mary, yeah, my sister (five kids) said the same thing. SHe also said to step away from the Google. I wish I could ask her for advice more, but I hate to bug her: she's busy homeschooling her five!!

LaurenAnanas, I'll find my tribe and see what they have to say about area resources. Thanks for your help!

merry-mary, I'll give the Flintstones vitamins a go. Yummy! The kids loved those when I was a nanny!

newmommy, thanks for your reassurance. I'll try not to freak about a heartbeat, and I'll be cool with the wait. :shy

Thanks again, all of you, for your help and advice

[honeybee]

Well, I don't see a mw until 13/14 weeks, when baby's hb can be heard by doppler. She does NOT recommend prenatals before then because they exacerbate m/s. So, I just took folic acid in the beginning. However, she is always available for questions and "hand holding" before that first appt. I :love midwifery care.

If you are interested in hb, interview a few mws. You will have much nicer, longer appts with plenty of time to chat and get all your questions answered. And, I would not ask the docs about hb (unless you're in Denmark or someplace like that), as you will most likey get a biased answer.

And, I agree with pps, burm WTE! :thumb

[Sour-Jane]

Congratulations and welcome!

I agree with the PPs, BURN What To Expect... It should be called "Everything That Could Possibly Go Wrong In A Pregnancy, And Will" I've known a few women who suffered symptoms of complications that they did not have because "the book says if you have a headache, it means you have blah blah blah" and they read so much into it that they gave themselves the symptoms.

Write all your questions down in a notebook, and bring it and a pen with you to your appointment. First appointments can be quite overwhelming, plus all the emotions that go with being pregnant. It can be information overload, so I suggest taking brief notes, or if you have a portable voice recorder, bring that, so you have everything word for word. My fella bought me a digital voice recorder for doctors appointments that he was unable to attend, and so I wouldn't forget anything. We also have the first time hearing the heartbeat recorded.

Don't worry about not having sore boobs and not being sick, as those don't happen to everybody. Also, don't worry about the vitamins, it seems as though you eat a healthy, well balanced diet. Plus, they sneak folic acid into everything these days (just look on the ingredients list of pasta and bread.)

As bad as this is, when I first found out I was pregnant, I didn't have a doctor, I was playing phone tag with my fellas' doctor trying to get in to see him. I called one day saying I had a positive home pregnancy test but was concerned because of some weird feelings that kinda felt like cramps... I had an appointment the next day. Some would say that I shouldn't have done that and I could have "jinxed" myself, but it got me prenatal care.

I hope you have a wonderful pregnancy

[tinyshoes]

I really want to stay out of the hospital if at all possible. My husband is not exactly sold on the idea of a homebirth, but barring any birth centers in the area (no one seems to know of one), I don't see any other options for us.

You mention this, and you also mention choosing an OB as your care provider. Keep in mind obstetrics is a surgical specialty, and OBs are physicians who are trained to perform surgery on pregnant women.

In contrast, a midwife is a care provider who is not trained in surgical procedures. Since you even mention the word "homebirth", you might be a person who would connect better with a less medical-management-minded style of care provider.

.....congratulations!

[pixiepunk]

Well, I don't see a mw until 13/14 weeks, when baby's hb can be heard by doppler. She does NOT recommend prenatals before then because they exacerbate m/s. So, I just took folic acid in the beginning. However, she is always available for questions and "hand holding" before that first appt. I midwifery care.

If you are interested in hb, interview a few mws. You will have much nicer, longer appts with plenty of time to chat and get all your questions answered. And, I would not ask the docs about hb (unless you're in Denmark or someplace like that), as you will most likey get a biased answer.

And, I agree with pps, burm WTE!

:yeah:

my first prenatal is usually around 12/13 weeks because i'm sure to be able to hear the heartbeat by then with a doppler. unless there's a problem there really isn't any reason to see your care provider prior to that.

and ITA with interviewing some m/w's - it is just night and day the kind of care you will typically receive, especially from a homebirth midwife. mine comes to my house for appointments, we sit in my living room and chat, it's like getting together with a girlfriend. i don't really have too many questions this time around since it's my 3rd, but when i was pg the first time around the m/w's i was seeing were wonderful about taking time to answer my questions, and also to *ask* questions - it wasn't an assembly line, they really wanted to get to know me as much as i wanted to get to know them, and they wanted to be sure i was healthy and happy and doing well each and every time i went in for a visit.

congrats on your pregnancy!

[sapphire_chan]

Folic acid is more important before conception. This is why, even if you don't have plans to TTC, you should eat things high in folic acid.

For me, in the first 12-ish weeks I could only take my multivitamin+folic acid pills with a fuller stomach, and it was generally easiest to just take them in the evening.

Nothing says you've got to take the pills in the morning.

[Juvysen]

You mention this, and you also mention choosing an OB as your care provider. Keep in mind obstetrics is a surgical specialty, and OBs are physicians who are trained to perform surgery on pregnant women.

In contrast, a midwife is a care provider who is not trained in surgical procedures. Since you even mention the word "homebirth", you might be a person who would connect better with a less medical-management-minded style of care provider.

.....congratulations!

:yeah:

Also, a lot of OBs try to scare the heck out of women who tell them they want homebirths... c-sections make them more money than natural birth, and the OBs get NO money if you go with homebirth. I wouldn't ask at an OB practice about homebirth... just see if you can find a HB midwife in your state and talk to her to see if hb is right for you.

[tinyshoes]

... just see if you can find a HB midwife in your state and talk to her to see if hb is right for you.
:nod

[alexsam]

My advice is (if at all possible) try to relax :innocent. I know that is totally hard and after trying for so long and wanting it so bad the last thing you want to do is wait... But it's actually fairly normal. Even after that first appointment it will most likely be 4 weeks before the next one, and that first one they don't do much more than reccomend vitamins and introduce themselves. As for all those fears, doctors do not specifically check for those conditions. At a first appointment, they do not do any specific tests or anything for blighted ovums or ectopic pregnancies or any of that anyway, as these things are really reactionary and they could not prevent them. In very early pregnancy, there is not much to do but cross your fingers and have faith and report any problems you have right away.

Also, just because you have not yet had an appointment does not mean you can't call for advice when you have a question. I just had my "first" appointment, but I was having lots of pain before that so I have already been into the office 3 times... They are used to lots of questions and so you will frequently be calling them between appointments, so if you have pregnancy related concerns, you should feel free to call. As for the Robetussin, that is a drug my OB said is ok... And a family doctor (who knows you are pregnant) should be able to give you reliable pregnancy drug advice. And if you were unsure you were pregnant and that insetad you may be having a gynecological problem, you can certainly request an appointment for that (or you could ask them for a pregnancy test without an appointment). I guess what I am saying is that you don't need to go to your first appointment to start utilizing the doctor as a resource.

Pregnancy is a really hard time not to worry. There are a million things to worry about. And it doesn't get any easier (people have a really strange thing about telling pregnant people about all the horrible things that happened to their "friend" or "co-worker" during pregnancy). Its hard, but it is important to try to find a way to say "This pregnancy is contuning because it is meant to be and I trust that things wil be right". That is not to say that you ignore real medical concerns, but it is to say that at some point, you have to find peace with all the potentially bad things that could happen. Really, I'm saying this because for my first pregnancy I spent it all worrying. For this second, I vowed that I would enjoy it more and though I have moments of worry, I am much happier overall.

[berkeleyp]

ITA with everything already said here. Definitely call around and talk to different midwives. It sounds like a midwife is more up your ally than an OB. There are two types of midwives: Certified Nurse Midwives who generally work in OB practices and hospitals but sometimes are independent and do homebirth and Certified Professional Midwives who may or may not be legal in your state who do home birth exclusively. With my first pregnancy, I interviewed one practice of each type and made my decision. They each sat down with me for almost an hour and answered any questions I had - it was very comforting. Also, if you just want a blood or urine test to confirm your pregnancy - any doctor should do that for you at any time, not waiting until the 10 week mark. I would just call your General Practitioner or even a clinic like Planned Parenthood.

As to not getting down the pre-natals: millions of babies are born to mommies who do not have access to prenatal vitamins or do not take them and I was told that Robitussen was safe in pregnancy by my midwife if that makes you feel any better on that count. It sounds like you are doing everything right so far but I would just try to relax and not stress too much.

The Henci Goer book is excellent for having good information but I would recommend a few other books that more address your state of mind:

Spiritual Midwifery and other books by Ina May Gaskin
Birthing from Within

Good luck to you. I am sure you will find loads of great info and advise on this forum.

[BrownRiceBaby]

Thanks to all for your advice and encouragement! My appointment went very well, and I didn't even see the doctor. (Which was fine with me!) (He is a GYN as well as an OB, btw, sorry about that!) There are three midwife practitioners in his practice, and as I will be having regular appointments, I will meet all three of them, and, of course, at least one of them will be with me throughout the birth.

The two N.P's I met with today were very supportive and encouraging, open to a no drugs birth (which I want), reassuring about the atmosphere of our local hospital's birthing center, and understanding about my aversion to hospitals. Although my husband and I may end up opting for the birthing center, we really feel much more comfortable with this practice than I initially thought we would be (which is good, since it IS the only practice that employs midwives in the area, and our insurance company is giving us an enormous run around on whether they'll pay for primary midwife care, and a home birth, which is making us think the answer is "no". And we can NOT pay for it ourselves.) Really, I just feel better knowing that SOMEONE (the midwife) who knows ME and knows what they're doing will be with me the whole time, no matter where we end up.

Thanks again for all your advice, and I'll definitely be checking out those books!

[BrownRiceBaby]

Long story short, the honeymoon with the midwife-OB practice ended :(, and I started casting around for a primary care MW. We found one whom I *love* and will work with us on cost if it turns out the insurance company won't step up, but DH switched providers, and it looks like the new one will :joy:. So, again long story short, we are full steam ahead for First Baby, First Homebirth, and we are SO excited! As soon as we met with the Primary Care MW for the first time, all my anxieties were GONE, and I feel so confident that I can do this, whereas with the OB-GYN midwifery practice, I'm seeing now that they were what I've seen referenced as "med-wives". I was surprised by how interventionist they were, which was a big indicator to me that they would not ultimately be supportive of a natural birth in a hospital environment.

I'm really excited, and even though I did finally sign up here, I've only been lurking since then, but I've learned a lot, and I've been devouring our new midwife's lending library as well...:love

[MaryLang]

Wow! Congrats on your decision to homebirth!!!!
The best way to avoid hospital interventions, right?

[MamaMonica]

Congratulations, BrownRiceBaby! I'm glad you found a midwife you're comfortable with. Good luck and thanks for the update.

[LROM]

Hi there, I am just reading your original post for the first time, but it's interesting that you ended up changing practices - my reaction to the fact that the office wouldn't even let you give them a list of questions or talk to a NP before your 10 week date was "that seems very inaccessible!" so I'm not suprised you ended up changing. Hope you continue to be much happier!

Also, I got the same feedback about burning "What to Expect..." but in case no one else offered you good book alternatives, I've been very happy with the 2 books that were recommended to me by a midwife friend: Sears and Sears "The Pregnancy Book", and I forget the name of the other book but it's by a Cert. Nurse Midwife named Sheila Kitzinger and they're kinda different in how the books are organized but between the 2 I felt like I had really good info.

Hope you feel more informed - when you get way further along (like month 6 or 7) I highly recommend a good birth class like finding a good Bradley Method class because that's another good way to get good info for the last trimester and birth.

Good luck & congratulations!!!

[alyk]

I have the Kitzinger book (...pregnancy and childbirth...) - it's great. there's also one by Penny Simkin that came recommended in my doula training course, but I haven't checked it out. I also have 'having a baby naturally,' published by mothering mag - there's some good info in there esp on nutrition.

[hsofia]

Congrats on finding good care provider and choosing a home birth!

[BrownRiceBaby]

I've been LOVING the Sears books, and Sheila Kitzinger is great! I'm due anytime, now, though, but part of my midwife's service is her extensive lending library, so I've been reading up a storm this whole time! :wink

[kailotus]

Long story short, the honeymoon with the midwife-OB practice ended :(, and I started casting around for a primary care MW. We found one whom I *love* and will work with us on cost if it turns out the insurance company won't step up, but DH switched providers, and it looks like the new one will :joy:. So, again long story short, we are full steam ahead for First Baby, First Homebirth, and we are SO excited! As soon as we met with the Primary Care MW for the first time, all my anxieties were GONE, and I feel so confident that I can do this, whereas with the OB-GYN midwifery practice, I'm seeing now that they were what I've seen referenced as "med-wives". I was surprised by how interventionist they were, which was a big indicator to me that they would not ultimately be supportive of a natural birth in a hospital environment.

I'm really excited, and even though I did finally sign up here, I've only been lurking since then, but I've learned a lot, and I've been devouring our new midwife's lending library as well...:love

Congratulations! You will be so happy with your choice.:love

[abigail_b]

First of all, I agree with everyone that you shouldn't worry about the vitamins, cough syrup etc.
However, I have been REALLY suprised by everyone saying that 10-12 weeks is standard. My OB/MW office schedules the first visit for 6 weeks or sooner, and it seems like most of the people in my DDC have seen someone between 6 and 8 weeks. The first appt for me consisted of all the standard pre-natal blood work, genetic questionnaire, lots of other health questions, and tons of information. They told me things that are different than what my books say- for instance to avoid ALL over the counter medications during the first trimester- that advice would be useless if the first appt wasn't until 10 or 12 weeks! Also, they went over the latest recommendations on consuming fish, delit meat etc. One of the most useful things they did was emphasize over and over that they are available ALL the time for ANY questions no matter what time of day. I thought that was really wonderful, and useful for easing first tri anxieties. Long story short, if it were me I would definitley express that it was a little upsetting to you that you weren't seen sooner, and I would get as much information as you can about how available they will be for questions before you decide to stay with this office. Lots of little things will come up and it is nice to know that you can pick up the phone and ask someone you trust rather than consulting scary books or google.
good luck at your appointment! :hug
Editing to add- I just caught up with the thread and see that you already had your appointment- I am SO glad you ended up finding a provider that you love ! :)