 What we've seen over the last few years in a couple of decades is this tripling of the number of women who are dying during childbirth. So this becomes an enormous problem for our society. Unfortunately, when you do a cesarean section, which by the way is a wonderful operation when it's needed, but when it's unnecessary it carries the weight going forward in subsequent pregnancies of a lot of problems that we don't see in women who deliver vaginally. What we're doing here in California and really trying to do all over the country is focusing on preventing that first cesarean section. So we do a number of things that allow us to reduce the chances the mother needs a C-section. California started this journey a little over 10 years ago and what we've seen with our maternal mortality rate is that we brought it back down to the baseline rate that we had back at the turn of the century. Unfortunately, the rest of the country has continued to increase and so we're hoping to spread a number of the things that we've done over the past few years. If you really look at it, the cases that were causing harm in, we clearly can prevent each and every one. It just takes getting everybody informed, everybody moving in the right direction and so to that extent we can. Well, we prevent all you know bad outcomes of course not because there's things we can't do or that we don't cause but the ones we ourselves are causing we can prevent those and I think that's what most of the folks working on this movement believe.