Controlling the Means of Reproduction: An Interview with Michelle Goldberg

Mandy Van Deven

In her new book "The Means of Reproduction," Michelle Goldberg puts forth a convincing argument that women's liberation worldwide is key to solving some of our most daunting problems.

Editor’s note: For more information on Michelle Goldberg’s new book and for links to where to find the book, please visit the web site: www.meansofreproduction.com.

On January 20th the first self-identified feminist was named President of the United States of America.  Just two days after taking office, Barack Obama performed his first presidential act of solidarity with women around the world by repealing the Global Gag Rule. Established in 1984 by President Reagan, the Global Gag Rule denies aid to international groups "which perform or actively promote abortion as a method of family planning." The Global Gag Rule has come to be seen as a litmus test of the current US President’s stance on women’s rights, though it is just one aspect of the complicated story of the impact of American reproductive rights policy in countries around the globe.

After witnessing the impact of President Bush’s reinstatement of the Global Gag Rule, Michelle Goldberg, journalist, author, and long-time critic of the Bush Administration’s policies on sexual and reproductive health, decided that a book about the global battle for reproductive justice was long overdue. So she wrote The Means of Reproduction: Sex, Power, and the Future of the World. The cover art depicting a woman holding the Earth on her shoulders is more than appropriate for this deeply-researched, historically-informed examination: fifty years worth of research about four continents has convinced Goldberg that women’s oppression is at the crux of many of the world’s most intractable challenges. She illustrates how US policies act as a catalyst for or an impediment to women’s rights worldwide, and puts forth a convincing argument that women’s liberation worldwide is key to solving some of our most daunting problems. "Underlying diverse conflicts – demography, natural resources, human rights, and religious mores – is the question of who controls the means of reproduction," she writes. "Women’s intimate lives have become inextricably tied to global forces."

Mandy Van Deven: I want to say upfront that I really enjoyed reading your book; it’s quite impressive that you’ve packed so much information into just 250 pages. And the timing of its release is impeccable. When did you embark on this project and did you consider the political relevance it might have for the 44th US President?

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Michelle Goldberg: I started the book almost three years ago, not long after my first book, Kingdom Coming: The Rise of Christian Nationalism, came out. That book was about religious fundamentalism in domestic American politics, but while researching it, I was struck by how the movements I was covering were branching out into global issues. In a way, the American anti-abortion movement has had more of an impact abroad than at home. The Supreme Court has limited the movement’s scope for action here, so Republican presidents have rewarded their base by giving them tremendous influence over international policy on women’s health – an area few Americans pay attention to.

Part of the impetus for the book was that I found the globalization of the culture wars fascinating. But I also wanted to provide some kind of historical and big picture context for the battles that were inevitably about to be fought over things like the global gag rule and the funding of the United Nations Population Fund.

MVD: The US spearheaded the movement for global family planning by pushing for the creation of the United Nations Population Fund in 1969, which is why it is ironic that it has done so much in recent times to dismantle that movement. What has prompted the change of heart?

MG: It had everything to do with the rise of the Christian right and the transformation of the GOP into a populist, religiously conservative political party. Republicans used to champion family planning because they saw it as key to international security. In the 1960s, many hardcore Cold Warriors were in a panic that overpopulation was going to cause such misery worldwide that countries would succumb to communist revolution. George H.W. Bush was so obsessed with distributing contraception that he was nicknamed "rubbers!"

Things changed in the 1970s and 1980s. Women’s rights advocates really seized control of a lot of the population infrastructure, and turned the focus from demographics to women’s health and freedom. With that, a lot of the national security types lost interest in the field. At the same time, the American anti-abortion movement rose up and came to dominate the Republican Party. Thanks to Roe v. Wade, there was only so much that Reagan and subsequent Republican presidents could do for their anti-abortion base at home, so they had much more latitude to reward them by doing their bidding at the global level.

MVD: Many of the problems that you discuss in the book could be solved by fighting poverty and wealth disparities that emerge from a capitalist economic system. Why isn’t that where the focus should be?

For some people, that is where the focus should be. My book is about the realm of reproductive and women’s rights – that doesn’t mean that I think it’s the only realm that’s important, or that it’s not connected to other systematic problems. At the same time, you’re never going to get a less stratified economic system as long as women are oppressed. It’s fascinating how much research there is showing the connection between women’s rights and economic development. Giving women more control over their bodies and their lives is one of the most important things you can do to fight poverty. One of the things I hope this book does is show how that works.

MVD: Most wouldn’t immediately draw a connection between the War on Terror and reproductive rights. What does the demonization of Muslim regimes have to do with reproductive rights?

MG: Although it is true that conservatives have used their very selective outrage over the abuse of women in the Muslim world to garner support for their foreign policy, what’s tremendously ironic is the way that, even as Bush railed against [abuses against women in] countries like Iran and Sudan, his administration was working with both of them to thwart or roll back international agreements on women’s rights and health. Parts of the American Christian right did the same thing, even as they demonized Muslims in front of domestic audiences. It was an amazing axis of hypocrisy. And as the book shows, there’s a long precedent for this sort of thing. The Vatican once offered to help Libya reconcile with the West after the Lockerbie bombing in exchange for supporting its stand against the global reproductive rights movement.

MVD: You observed the way in which indigenous movements for women’s rights are much more effective than movements led by outsiders, though you point out that indigenous struggles also need outside assistance. One example you cite in this book is of Agnes Pareyio in Kenya. How can Westerners get involved in indigenous women’s movements without coercing or compromising the integrity of the organization’s work?

There are a number of organizations that are really good at channeling aid to women working at the grassroots. The Global Fund for Women, for example, does amazing work. On a more macro scale, people in developed countries often have access to levers of power that people on the ground don’t. Agnes Pareyio’s story is instructive. She’s an amazing Masai woman in Kenya who runs a shelter for girls who have run away from home to escape female circumcision. She enrolls the girls in boarding school, and, because circumcision is such a right of passage among the Masai, she has created an alternative ceremony that offers girls a meaningful transition into adulthood. No outsider could do what she’s doing. But one reason that her work is possible is that the United States and other developed countries have pressured Kenya to ban female circumcision. One result of that is that parents can’t enlist the police against Pareyio when she shelters their daughters.

One of the things I tried to do in this book is to show the real connections between some of the seemingly abstract debates that happen at the international level and the experiences of women on the ground. Through the international feminist movement, women working at the grassroots can sometimes leverage the privilege of their allies in rich countries. Alex De Waal described how this process works in his fascinating book AIDS and Power: "Blocked from direct routes of access, African activists meet with their Western counterparts, who have access to policy makers in Washington and Brussels, who in turn squeeze African governments." He was talking about HIV activism, but the same dynamic exists in the realm of women’s rights. It’s kind of a strange way to effect social change, and it raises all kinds of really knotty philosophical questions about democracy and sovereignty. But people have to use whatever tools they have.

MVD: How have legitimate concerns about cultural imperialism — a critique originally raised by liberals in opposition to racist claims made by conservatives about the "necessity" of population control in the "undeveloped" world — been co-opted by the anti-abortion movement in conversations around family planning? 

MG: Before the rise of the religious right, the United States had a long and controversial history of bringing contraception and safe abortion services to the developing world, and encouraging changes in cultural norms and desired family size. This was generally driven less by concern about women’s rights than by terror of overpopulation, which was incredibly intense in the 1960s and 1970s. Since then, women’s rights activists have mostly taken over the structures created by the population controllers, and they’re also doing work that helps women around the world challenge prevailing power arrangements. Partly as a result, conservative and fundamentalist forces accuse feminists of being American imperialists. In Nicaragua, Daniel Ortega’s Sandinista government cloaked its draconian abortion ban in anti-colonialist rhetoric – even though his policy mirrored that of the hated United States! At the same time, both American conservatives and representatives of the Vatican revel in posing as the staunch defenders of traditional cultures under assault by decadent cosmopolitan elites. They really enjoy turning traditional leftist critiques against liberals.

MVD: This book’s agenda is explicitly feminist. What were some of the ways your perspective was challenged during the course of this project?

MG: The stories that challenge my own preconceptions and that don’t lend themselves to easy answers are always the most absorbing to me. There are several of them in this book. Being in India and seeing the way sex-selective abortion is both devaluing women and sowing the seeds of demographic catastrophe really challenged some of my deeply help beliefs about the primacy of reproductive choice. Also, when I started writing this book, I didn’t take fears about European population decline that seriously – they seemed to me to be rooted in racism and a fear of immigration. But the more I learned, the more I realized that the kind of really abrupt fall-off in birthrates that we’re seeing in countries like Poland, Italy and Japan has very serious consequences for the future, and in Europe, it may threaten some things liberals really cherish, like generous welfare states.

MVD: You briefly mention the use loaded terms like "female genial mutilation" and "female feticide." Can you talk a little bit about the choice of language in discussing some of these issues?

MG: Both of those terms are really controversial, for different reasons. There are some African women who feel that "female genital mutilation" is horribly judgmental. One of the women I quote in the book says, "I may be different from you and I am excised, but I am not mutilated. Just like I will not accept anybody calling me by the ‘N’ word to define my racial identity, I will not have anybody calling me by the ‘M’ word to define my social identity, my gender identity." At the same time, others will argue that using more neutral terms like "female genital cutting" or "female circumcision" downplays the horrors of the practice, and implies a kind of relativism. The fact that the terms are so loaded underscores how polarized the debate is – it’s really hard to discuss something if you can’t even agree on what to call it.

"Female feticide" is a little different. Almost everyone in India uses it to refer to sex-selective abortion. To a Western feminist, it sounds quite jarring, because it echoes the kind of language that the American anti-abortion movement uses. Since there isn’t much of an anti-abortion movement in India, there’s less sensitivity about such rhetoric. Still, some people there worry that the campaign against sex-selective abortion could morph into a campaign against abortion more broadly, and they’re troubled by the use of the term. At the same time, you have to speak in language that people understand. After a few weeks in India, I found myself using the phrase "female feticide" myself – it’s just so much a part of the conversation.

MVD: The stories you recount tend to be very extreme yet moving examples of what the horrific consequences can be for individual women when reproductive rights policies don’t take the reality of their lives and needs into account. The stories lend a sense of humanity to the issues themselves that tends to be lost in the debate. Was there a story that you wanted to include, but didn’t?

MG: I’d have loved to tell the story of Manju Rani, this really inspiring, unstoppable women’s health advocate in Haryana in Northern India. She went through hell with an abusive husband who tried to force her into prostitution. [She then] escaped the relationship, but found that she had no place in the world as an unmarried woman. Her family pressured her to find a new husband, but as a divorcee, she ended up having to marry a very poor man. Her life has been so hard, but she’s a dynamo – she’s this tiny little person who talks a mile a minute and has this radiant, infectious grin. She’s had no formal education, but is a really strong feminist whose politics grow out of her own experience. She works for a local NGO distributing family planning and reproductive health advice in her region, and is also involved in local politics. She’s a total inspiration.

MVD: You dedicated a substantial amount of this book to the role that Christianity and Catholicism play in the global reproductive rights movement, but you only touched up on other religions (Islam, Judaism, Hinduism, Buddhism). Why didn’t they warrant as much attention?

MG: I’m not sure I agree. I write quite a bit about the alliance between conservative Muslims and Christians to fight women’s rights at the UN. I also deal with the connection between Islam and female circumcision. The chapter about India’s missing girls is set in the context of Hinduism and Sikhism. That said, the international anti-abortion, anti-family planning movement is largely driven by Catholic and evangelical groups. One major theme of this book is the global fallout from the culture wars in the United States, and Christianity plays a much bigger role here than any other religion.

MVD: How much funding for family planning and abortion services in the developing world comes from the developed world?

MG: That’s a hard question to answer, because it varies so much by country. Asian countries cover much more of their own costs than poorer countries in Africa, for example. And of course there are so many different funding sources – governments, foundations, NGOs, etc. But according to the Guttmacher Institute, donor agencies in developed countries were responsible for just over $2 billion of the approximately $11 billion spent on sexual and reproductive health services in the developing world in 2000.

MVD: Do you worry that writing this book might be seen as an example of the "white man’s burden"?

MG: Sure, but what can you do? Writing about these issues at all from a Western perspective is obviously fraught in all kinds of ways. At the same time, they’re fascinating in part because there are so many taboos and political baggage surrounding them. I can’t really imagine not wading into a subject I find interesting because it’s somehow un-PC. Besides, the West, particularly the United States, is already deeply involved in shaping policies that have profound effects in other countries, so these issues need to be understood here.

MVD: For many of these issues you cover – like female circumcision, abortion, sex selection – it’s not the practice itself that is a problem, but the societal context in which the practice happens, which may limit a woman’s ability to freely make her own choice. Can you talk a little more about that?

MG: I’m not sure I totally agree with that. Certainly, in many cases, the fundamental problem is one of women’s power and autonomy. The problem is not that women are having too many children; it’s that, in many places, they lack access to contraception and are having more children than they say they want. But there are other cases – I’m thinking specifically of sex-selective abortion – where women, embedded as they are in their cultures, are making problematic choices. One of the dilemmas I tried to bring forward in the book is that sometimes the ideal of choice, venerated by Western feminists like me, conflicts with the goals of women’s rights advocates on the ground. Gita Sen, the pioneering Indian economist, put it really well, I thought: "A woman’s choice to have a sex-selective abortion may reflect the fact that she has very few rights."

MVD: Two issues that weren’t mentioned in the book, but are integrally related to the way women’s rights and reproductive rights play out globally, are adoption schemes in which children from the developing world are sold to Western couples, and the trend of women in the developing world being surrogates for Westerner’s children via In Vitro Fertilization. Did you see these as outside of your scope?
MG: There were so many important subjects I had to leave out! In order to make the book manageable, I had to impose some kind of structure on what might have otherwise been an endlessly sprawling topic. Both the subjects you mention – international adoption and fertility tourism – are incredibly significant and interesting, but I wanted to focus on the connections between global policymaking – which sometimes seems really abstract and disconnected from real life – with what was happening on the ground. I wanted to trace the way an agreement negotiated by development bureaucrats at some international summit redounded in the life of a woman in a city in Gujarat or a village in Kenya, and to demonstrate the connection between big global problems and individual women’s lives.

Third-world surrogacy and unregulated international adoption are part of another, intersecting story about capitalism and the creeping industrialization of childbearing. To be honest, both deserve books unto themselves. Maybe that’s what I’ll do next.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (D-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

CORRECTION: A previous version of this article included a typo that misidentified Sen. Tim Kaine as a Republican. We regret this error.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.