 And now it is a great pleasure for the Virtual International Day of the Midwife to present the last keynote speaker of this year's conference, Susan Crowder, who is currently Professor of Midwifery at Auckland University of Technology in Auckland, New Zealand. She has been in healthcare since the early 80s and a midwife for 27 years. As a midwife, she has worked in a variety of practices, leadership, educational and research roles and across several global regions. Her preferred practice approach is provision of midwifery continuity of carer, working with a caseload for the majority of her practice. Her current research interests are concerned with psychosocial, cultural and spiritual wellbeing around childbirth, role, maternity services and sustainable practice. She has recently published two books on spirituality and joy in and around childbirth. Susan is on the review and editorial boards of a number of peer-reviewed journals and a member of the ICM Research Standing Committee. So I will hand over the microphone to you, Susan. Okay. Hello, everyone. Oh, sorry. Okay. Please go on. Okay. Hello, everyone. Thank you for joining me and others in this final session of 2020 Virtual International Day of the Midwifery. What an incredible conference this has been and an insure of solidarity. And a special thanks and welcome to all our students at Midwifery joining too. You are also welcome into my home office here in New Zealand. It's nine o'clock in the morning on the 6th of May. So our International Day of the Midwifery was yesterday, but it's lovely to be the tail end of the rest of the planet. The world has indeed turned around a complete cycle since this conference started when we listened to Sheena Byron. Before I continue, I want us to take a pause to make yourself comfortable, put down your pens, paper and find a way to be relaxed. And now the words of the poem I'm about to share with you to find their way within you, poem by David White. Start close in. Don't take the second step or the third. Start with the first thing close in. The step you don't want to take. Start with the ground you know. The power ground beneath your feet. Your own way to begin the conversation. Start with your own question. Give up on other people's questions. Don't let them smother something simple to hear another's voice. Follow your own voice. Wait until that voice becomes a privateer that can really listen to another. Start right now. Take a small step you can call your own. Don't follow someone else's heroics. Be humble and focus. Start close in. Don't mistake the other for your own. Start close in. Don't take the second step or the third. Start with the first thing close in. The step you don't want to take. As I speak, I acknowledge the significance of COVID-19 on midwifery and childbirth globally. And how spirituality in terms of purpose and meaning has been foregrounded so much more through this disruption. As we all find new ways of providing exemplary midwifery. COVID-19 is challenging us on a deeply human level. When we think about survival as a human species, the importance of how and why we are around childbirth becomes even more significant. And for me, this raises some questions. Where is the spiritual care for families struggling with this difficult situation and the choices they're having to make? And where is the spiritual well-being for midwives? For us all to flourish as a profession and as a species, for us all to reach and extend beyond our full potential, we all need to refocus. And what a better place for us all to start than how we birth the next generation. So I said to the organisers of this conference that I would cover certain points. So this is just a bit of signposting of the areas that I'm going to explore through this session. And I'll start with some definitions. What is ecology? For me, this is about a branch of science that looks at relationships of environments and environments in their relationship with us. And for me, it speaks of holistic understandings of how we dwell in a system. The systems that we dwell within are maternity services and professional groups. And this manifests the types of experiences that we have. But there are some ecological concerns. Experience of care is significant when we speak of quality. I think we would all agree on that. Yet this is not always at the top of the agenda. For example, big data research does not tell us the how of the experience. And we know that there are too many interventions going on and they're used too soon. Yet at the same time, there are places in the world where there's too few interventions and when they use they're too late. In addition, intervention and problemized forms of research can lead to even more polemic or dichotomous thinking. For me, this creates an inertia which exists within complex large scale organizations and the services that we work in. And services are not always trustworthy. Even though there is a call for competency, honesty and reliability, they're not always transparent. Services are not always contextually sensitive and personalized to each family that we care for. The food of maternity surfaces is often fearful and this fear leads to risk aversion behaviors and overuse of interventions. But services need to go beyond just our physical survival. And according to the WHO a few years ago, it's also about us flourishing and thriving. We must stop doing the same things over and over again, hoping for a different outcome. It's obvious, of course, that childbirth is an embodied experience. It's physically within us, between us and with others. For example, to be touched is also to touch. This includes not only our bodies, but our interconnectedness to the environment. We are profoundly connected and so many levels. We know that childbirth is so important, but we need to find a way to build a bridge across this apparent divide between the experiences that we're having and what we're expected to do. There are further concerns. Our relationship to technology is the real concern. It's not the technology itself. And Mavis Kirkham and others have talked about this in the past. What it seems to be is how we positioned ourselves and situated birth within a dominant discourse of risk and technology, which may also be covering over and denying something of significance. The ongoing normal birth debates are important, yet they must not cover over what's unfolding day to day around childbirth and what is important. Regimenting services is problematic. Pulling apart community services from acute services and not enabling known trusted midwives to remain with women throughout, regardless of place or their risk factors, denies the social connectivity and the ability to nurture relationships over time. With increasing medicalization and its associated highlighting of risk, fear thus dominates much of the global birth culture and discourse. So this is a critical time for remembering and highlighting how birth is meaningful and significant, not just in terms of survival, but also in terms of spiritual wellbeing and personal and collective flourishing. So again, we need to build bridges. While sphere is often prominent in discussions about childbirth, the association between childbirth fear and spiritual awareness is also worthy of further discussion. Interestingly, end of life and spirituality is researched, and there is a body of evidence throughout end of life guidance and policy and practice protocols. Yet around childbirth there is often a lack of literature. Unless there's problems around profound pathology, or there's mortality, then spirituality seems to take centre stage. Despite a lack of literature informing practice directly, there is however an emergent body of work addressing philosophical and existential understandings of childbirth. But what's interesting about that literature, much of it's not written by midwives. So it is time to speak to the silence around spirituality within childbirth practice, and to bring these diverse approaches and ways of knowing into the culture of midwifery. 24 hours ago, at the start of this conference, Sheena Byrom explored humanisation and childbirth. In the work I do, I continually see how humanising birth and spirituality are essentially to the nurturing of a birth ecology and vice versa. They all feed into each other. So I'm going to start with the definition of what spirituality is. This was created through consensus in an international inquiry that I will return to later. So I'm just giving you this definition now just as to help set the scene and I'll read what it is. Spirituality represents an aspect of our lives that brings meaning, sense of purpose, unifies our life, narrative, feelings of interconnectivity and of deepening relationships with self and others, others being seen and unseen. It may be connected to religion and also a belief and a quality of divinity, but not necessarily. Spirituality is part of our well-being and includes psychological, emotional and cultural aspects of being and becoming. So is this different to positive birth or good birth? Let's take a look. So the WHO published various documents and provided a recipe, if you like, for positive childbirth experiences. There's nothing on there that would probably surprise most of the people listening today about the recognition of birth is significant. About it fulfilling a woman's prior expectations, the ability to thrive and reach a full potential to be safe, to have continuity of practical and emotional care, and to have skilled, competent care that's woman-centered, human rights-based and holistic. But is that the same as a good birth? The notion of what is a good birth, the notion of what is a good birth frequently changes challenges. False dichotomizing is unhelpful and fragmented way of providing care needs to be abandoned. Creating these dichotomous debates of this or this is unhelpful. It is all things together. It's this and that. For example, a caesarean section does not preclude spirituality as part of birth ecology. Every birth speaks to our being and becoming and a mysterious connection to life. So a good birth is a play of many things working together. Play is like a dynamic, having many quantities. For example, at each birth, there is emotions, a dance of those all involved. The player features in the birthplace. An experience of time that is extraordinary in some unique way. There are also practices that are culturally specific to a region, groups of people, and each person's beliefs and understanding. All these qualities are at play at each birth. Therefore, any generalizable concept of what makes a good birth eludes us. Yet we struggle to articulate what it is. What is highlight is the need for coming together of all these qualities and embracing the spirituality and mystery that we through childbirth. So this is another question. Is there harm in denying the spiritual at birth? So I helped, I led a recent systematic literature review which focused on this topic related to postnatal mood disorders and highlighted the need to address how we organize and enact care in and around childbirth. I can see Jenny Halls with us. She was one of the co-authors on this paper. The aim was to identify and synthesize the range of evidence available on psychosocial spiritual experiences around childbirth and foreground possible associations with subsequent perinatal mental health outcomes. The review found that unmet psychosocial emotional and spiritual needs for women may contribute to mood disorders. And it pointed to the importance of promoting meaningful relationships through developing sensitivity to cultural and spiritual values and beliefs. Whilst acknowledging and working with embodied manifestations of spirituality and enabling an environment in which spiritual growth and well-being are foregrounded as significant throughout the childbirth journey. The key insight and one that requires further attention is that neglecting spirituality as part of the childbirth experience could give rise to a breakdown in empathy, compassion and neglect of the self as an integrated whole. To ignore or deny this ecology of childbirth covers over something important that could put women, families and communities at risk. However, there remains a paucity or lack of research in the air or perinatal mental health and psychosocial spiritual childbirth experiences. So if there's anyone on here that's interested, please contact me and we can take that agenda forward. But let's go back to basics. This is about working with women and not on women, which develops a deep physiological appreciation and creates a shared philosophy. It builds empathy, a sense of empathic resonance, which builds relationships that honours the intuitional or indeterminate qualities around childbirth. Therefore, part of the ecology of childbirth is acknowledging that relational continuity builds trust, intuitive knowing and increases safety. And we have some evidence to support that. On a practical level, in all the royal midwifery search I have been involved in, trust and safety occurs when relationships are able to mature over time. I think Celine may be still with us. This was a chapter, Celine LeMay from Canada and Caroline Hasty from Australia. As a book editor, Jenny and I invited them to work together to look at the birth space, the environment and the space of birth certainly matter. This wonderful chapter is worth reading and I can't do it just as here, so you'll have to go and read it for yourselves. But it is so interesting how intuition and spiritual knowing in midwifery is so difficult to articulate, although we can readily say what it is not. In my own work, this space is informed or attuned to a special quantity of time shared by all those involved. Some of you may know this work that I've done in the past. Caires is a word that comes from ancient Greece. And it defines the right moment, the in-between time, referred as a supreme moment with something special happens. It's where all our growth happens. It is in these moments that we are sustained. These moments excite us and thrill us. They touch us profoundly and bring knowing. In these times we become aware of the unseen, the mystery, the invisible and all those other ineffable quantities of birth. This is not about clock time. This is the time like no other. And we are so privileged to be gifted the invitation to frequently experience this Caires in our working lives. There's probably no other job that quite fits that. But how do we do this? What type of midwife provides care that's contextually specific, relationally focused, on as embodied thought experiences and attunes to birth consistently with a celebratory affirming mood that doesn't worry so much about time and celebrates that shared natality and not focusing overly on mortality? So there was a concern amongst some of my colleagues globally and we met at an international conference and started a spirituality in Chabah, an international online cooperative inquiry. Our concern was that neglecting the spiritual nature of Chabah may negatively affect psychological emotion and physical wellbeing and a lack of understanding generally about how to attend to women's needs. I'm not going to go into the details of this piece of research, but I've just put up there the aims and questions. As you can see, it was about working collaboratively and through consensus, exploring ways that spirituality could be honoured in the 21st century maternity context. What I'm going to go to now is one of the end diagrams that we created at the end of this inquiry. And I'm not going to talk to all of it again because I'm just giving you a flavour of the type of work that I'm doing for this conference. But what I'm going to focus on is the four reflective themes that surround spiritual midwifing in the middle, which I'll return to. And I start at the left hand side of meaning and sense making. This is about honouring each human being as meaningful and innately spiritual and connected to seen and unseen otherness. Sense making concerns are being and becoming and is an existential concept of life that's both inward and outward facing. Thus through perception of all our senses in connection with the physical, the spiritual becomes more tangible to us and brings awareness of a depth of emotions which shifts our mindset and what we feel and what we know. And this brings about a more nourishing birth culture, which is the green circle at the top. Birth culture emerged as myriad complex interrelationships of psychosocial, social economic, material and technological and political landscapes varying across societies and time frames. We recognise that a dominant and influential, standardised biomedical-narricative shapes western contemporary birth experiences. What also concerned us is that this is a pervasive narrative exported to developing regions around the world. Despite this dominant culture, there is also an underlying unspoken shared birth culture that transcends regional differences institutional practices, professional groups, types of births and all guidelines. This is a resilient, timeless birth culture that appreciates childbirth as greater than the sum of medical or technological events. Seeing birth as a transformative experience, this birth culture is full of mystery and love that cannot be contained within a single discourse in any one model of care or regional culture. I moved to the orange circle on the right, embodied relationships and intuition. The embodied, sensitive nature of birth as felt by all involved is centred on respectful care and connection with women's feelings. This speaks to a groundedness and awareness of something imminent, primal and embodied, something beyond words that arises within us and reminds us each one of us of our shared humanity and a connection to life, to the earth, cosmos and other beings. Intuition in this context is considered an aspect of caregiving. An embodied union of minds and bodies point to in depth of knowing, arising from mind body environment. And all this joins with our available sensory and embodied experiences as well as our cognitive skills. The one at the bottom space, place and time. Birth appears at the borderline of different worlds or ways of being. A sense of being between, attuned to a sense of awe and anticipation and being part of life. This is about the bridge between the mysterious worlds of space, place and time at each birth. As such, place, space and time is a complex primordial interconnected quality that cannot be separated out. Moreover, something other also occurs in this space and time between us at birth. Something beyond our individual selves, resulting in an emergent wisdom that transcends everything out, yet informs the quality of our actions and our experience in the practical sense. If you like, it's like a well tuned instrument gifting a harmonic feeling of wholeness. And this offers us feelings of deep rightness and pleasure when we're at a birth. That was a summary of the types of things that we did in the inquiry. I'm not going to talk to the white circles now that was a more transformative and action. You can read about those elsewhere. But I'm going to return now to what do I mean by the central main theme, spiritual midwife, which was at the heart of all our transformative actions for the humanization of birth. This was a practice that incorporates values and sensitive practices within midwifery itself, but is relevant beyond anyone practice profession. This is relevant to anyone who finds themselves at birth. So I'm just going to run through some of the attributes of spiritual midwifing. Midwifery is framed around humanization in contrast to medicalization. Birth appreciated as a complex phenomenon that incorporates beliefs and practices within and beyond midwifery itself. And how we care rather than a professional affiliation, orientational biomedical understanding. It is more than spiritual care process. It is more than a tick box definition and religious practice needs. The ubiquitous question what religion are you and we tick the box and write the word. Birth is about life about being human slowing down from the constant business of providing providing a caring space. It's an approach to care that enables time to think, reflect and truly resonate with the specialness of birth. It's an approach to midwifery concern with being released and open to an unbounded and unfettered appreciation of what childbirth is. It's about a shared humanity. It's about meaning and being together. It involves a quality of being around birth that beckons to for us to stand back, pause and ponder who we are. It recognizes childbirth is always significant and profoundly relational, and it focuses on being totally present and entrusting connection. It's consistently concerned with meaningful guardianship. That's protecting things that they continue to be and a practice that embraces metaphysical and transcendental elements of birth. That's quite a list. So the question is, how do we manifest this with the evidence keeps suggesting that there is more to childbirth and the fragmentary biomedical perspective. And when Jenny Hall and I edited this book, we invited some amazing authors to write. And what we found weed for all the chapters is more unites us than separates us relationships were truly significant. Childbirth stories revealed spiritual experiences throughout all the chapters and overflowing unspoken meanings were there throughout modern maternity. But not all birth experiences are easy and not all births have the desired outcomes, but birth has the ability to heal and transform broken futures. Because childbirth is a time of transitions and transformations for all involved, and it requires a practice that is tactful, open and compassionate. But we also need to acknowledge the challenges to all of you as midwives working in pressurized environments that strive to keep busy services running with stretched resources. Now, this was a body of work that was initiated in New Zealand by Judith Makara Cooper who's online with us and around sustainability of midwives, but also around resilience which was headed by Professor Billy Hunter in the UK. So I'm not going to go into the detail of what's on this slide. What I want to do is just bring focus to two parts. It is good to remind ourselves as midwives that it is relationships that includes a shared appreciation of childbirth and philosophy of midwifery care and joy and love of practicing is consistent with these values. And it is this that leads to self care and our ability to work towards being autonomous and self determined because we're stronger and we're part of an ecology of birth. So this was a model, if you like, or diagram of an ecology of birth that I started a few years ago and it's built up and built up and the book that I published just before Christmas talks about this model as it is. So I'm just going to give you a summary as we go through towards the end of this presentation. An ecology of birth speaks to a non fragmentary human experience that is interconnected with no one part is more important than the other. There is no hierarchy here. Each part is in relationship with all the others and altogether are seamlessly connected. Other aspects to are informed by these parts. For example, the work of Hammond and for last year speak of the neuro biological effects on space and behavior. Hannah Dalans work and others have explored epigenetics and the microbiome. They're all within this ecology. And have you noticed the unique mood around birth that stirs us up if we turn to it. Do you experience that such a mood can be broken when those that treat the moment brutishly. I call this mood joy. If we honor if we honor and allow its presence to influence who and how we are something amazing happens. As a result of Kyrus we are changed and reminded of our shared humanness, a focus moves to a shared celebration of life, a shared being alive, a shared natality, a joy we through time between us and within us. And this joy brings a gift of us, it brings a gift and feelings of enduring wholeness and gratitude that's healing and transformative. We become close within and become reflexive and contemplated and open to what's going on. We see nothing has denied or hidden or left out and all that dichotomous thinking and debates, they dissolve. All these things in a sustainable harmony. To say to safeguard this preciousness, we must take care when pursuing any form of uniformity and any reductionist medical agenda. Such an approach only denudes birth of its spiritual meaning and birth ecological system becomes out of balance. And we miss meaningful encounters with ourselves, with women, families and our colleagues. I'm speaking of a deep birth ecology that calls us to a deep depth, a depth of questioning into the fundamental causes of our concerns. So this calls us to our own moral responsibility at each birth and the choices we make. This can be scary. And I'm reminded of Brenny Brown's work on vulnerability when she encourages to step up for us all to step up into our own power and be courageous. I'm speaking about each one of us and what we bring personally to each birth as we face resistance within ourselves to confront brutish actions and disempowering language. The next mission to you all is to choose to feel the scariness and fear around birth and respond proactively in whatever capacity you are privileged to be there. When it seems fragmented and falling apart, become aware of how you may be allowing your lived experience to cloud over with clutter and noise. In fact, there is an opportunity to reattune to embodied wisdom and allow your heart to break. Yes, be vulnerable and open to what is unfolding. Don't be afraid of drowning in the overwhelm at the moment when you open yourself up. I promise you, you still can breathe when birth's intoxicating mood floods over you. To all the joy and even the fullness of sadness at birth, it is an invitation to reach and extend beyond yourself. It is an encounter with a mystery that cultivates compassion, both for yourself and for others to be open to a deep ecology and allow it to inform who and how you are at each birth. Since I've been speaking over the last hour, so many babies have been born onto the planet. And I celebrate their arrival and honor all the mothers and the midwives who hopefully were able to be with them. Also knowing that many midwives may not have had that care. Many women may not have had midwifery care. Let us hope we learn many lessons from COVID-19, the shared experience and move to a place of positive change and growth. However, that manifest meaning for you. Remember that we stand together united in our passion to safeguard that which is most precious. I collect the futures of families, communities. This is about togetherness in ways that enhance human flourishing for all. So that each infant, mother and care provider can reach the full potential. We are facing an unprecedented time together globally. We are bombarded by so much information and we may be encountering flaws in our institution, which we believed existed to protect us. COVID-19 has shattered our notion of a world we thought was tamed by human scientific knowledge. There are so many theories and opinions about COVID-19 and it's hard to know what comes next. I, for one, do not wish it to go back to exactly how it was before. That normal was not working for us all. This is the time to practice compassion and non-judgment on ourselves and to others and embrace not knowing. This is a humble place individually and collectively. I recognise this is a call to reflect on our individual and collective paths and how we birth the next generation. Let's focus on what midwifery will need to be in this new dawn. You have heard many ideas over the last 24 hours. You may have reflected upon what needs to change in your context and for yourself. Change is challenging. So be gentle on yourselves. Trust the process. A good conversation with a colleague, friend or family can tease out concerns and find solutions together so the leap can be made. Finally, we return to where I began this talk. The only place we can start are sounds. Start close in. Don't take the second step or the third. Start with the first thing close in. The step you don't want to take. At the end of 2020, International Dare the Midwife, let us be kind to ourselves, to our colleagues. Keep close in to who we are. Be proactive from our hearts as well as our heads and take the first step, the step we often do not want to take. Thank you. Thank you so much, Susan, for a beautiful presentation. If some says out in the chat. I would like to hear if any of you have questions for Susan. You put them in the chat and you can also have the microphone to ask them in person. I would like to ask a couple of comments as you can see for one beautiful presentation. Inspirational presentation. I can ask a question of people is in their practice, wherever they are regionally, what prevents you providing what I've named spiritual midwifing? What is it that's preventing us taking that leap? Or you personally taking that leap? Oh, here's a question. How do we incorporate spirituality of birth with expectant cobbles and care? That's a very big question. I think one of the first things is tuning in to where that couple are in terms of their context and their understanding and belief systems. I probably wouldn't go in and start using the word spirituality and ecology with them. I'd probably talk about what's meaningful to them and what they find in terms of their purpose in life. Different people do different things. Starting a family will mean different things to different people. And that will be the lead into a whole conversation about the interconnectedness of themselves with their families and their extended family. So there's different ways of going about it. But some people I, when I was in case like practice, like the third of my case, they were exclusive brethren. So there was actually quite a lot of conversation about religious needs. Spirituality very rarely came up. So it depends on the language used by couples, the way that go in. It's also about having compassionate humane care that provides families with the opportunity to express what their real needs are. And I saw someone online talking about free birthing to get what they wanted to have that freedom to express themselves spiritually. But as I said in the presentation, an emergency caesarean section can be equally spiritual and special. There is a question for Jenny Hall. Do you think that there will be a positive impact of COVID toward this type of change in society? Thank you for that, Jenny. I think that I think I'm already perceiving certain shifts in terms of where midwifery is in the world. Certainly in New Zealand, midwifery is being foregrounded a lot more because of the type of work they're continuing to do in the community. Yesterday in the International Day of the Midwife, the Prime Minister herself praised the work of midwives across the country. When I was walking the dog yesterday, we're talking about midwives. So in terms of the shift of the focus where midwives are, I'm hoping that similar things will be occurring because midwives are at the front line. But I'm also beginning to see there's more conversation about the place of birth and how the place of birth needs to have that relationship with it. So someone was saying on one of the talks I was at yesterday was that women who'd got to know their midwife were separated from their midwife when they went into hospital. But it's become quite a global conversation. So in terms of the change towards a more ecology, more of a focus on the need for relationships, working together. And I think the greatest thing from a midwifery perspective is that we're talking much more together globally. This has become an in it together process. I see what Margaret's talking about. There is a lack of touch, which is terrible in COVID-19. I absolutely agree. I'm on call to provide support to more junior midwives around home births while COVID-19 is going on. I haven't been called out yet, but the idea of being gowned up with gloves and a mask horrifies me. But we can still smile behind our masks at people. I think Sheena showed a beautiful picture yesterday. We can touch people without having to physically touch. I'm looking at Judith's question. I think how to make the midwifery body of knowledge as powerful as the medical one. This is a really a very big question for midwives all over the world. I think that story is already beginning to unfold, Judith. I think since the publish of many randomized controlled trials as well, I'm sorry, the Cochrane Review back in 2016 with Jane Sandel and all the Lancet series back in 2014. I think midwives are taking more of a central stage in maternity services, and I think we need to keep doing more of the same. Unfortunately, for those who are researchers online, we'll all know it's really difficult to get research funding to ask the types of questions. For example, the stuff around perinatal mental health and its association with psychosocial spiritual well being and the role of the midwife, really difficult to get funding on that. I think it's about keep doing it, asking the questions, maybe changing the language so that we can get the funding and get in there and bring up what's going on for midwifery knowledge across the world. It also involves, I know this is dear to Judith's heart, is doing more audits and service evaluations about what midwives are achieving so we're less invisible in the research world. It was a beautiful comment before you did your presentation, Susan from Jenny Ross, a student midwife who says it's so important to hear anybody as a first year student speaks to the kind of midwife I'm trying to be. And that's wonderful to hear that, because I think Mary's not on with us when I was working in the UK I was one of the stakeholder meetings for the future midwife educational standards. And we had lots of conversations about ensuring that within the standards for future student midwives that spirituality was named within the standards that we needed to do that. Although emotional well being is important, sense of purpose and meaningful practice needed to be there and that's represented by more spiritual lens, but it was interesting conversations not everybody was up for that. It's nice to hear student midwives and absolutely spiritual midwifing is something that we would all aspire to wonderful comments. But I want to emphasize one of the slides I said a few slides ago is about this is also about self care midwives looking after themselves. I know from personal experience, it can be deeply challenging on a personal level when you're confronted by care that does not resonate with you, or it is in some way brutish, or is covering up on damaging that spiritual feeling or that special mood. It can make you go home feeling quite emotionally exhausted. So just honor how you're feeling in those moments and do connect with like minded midwifery practitioners, wherever you are. Thank you. I think that we bring this session to an end. There is a question about where they can get your book. I'm just going to write it. It's either Amazon or Amazon and Routledge. I'm also going to put here for people because then like, if they get stuck or they want to ask me anymore because I know that I covered a lot of ground there. There's my email address for everyone.