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Harjit: Okay. Hello. I shouldn't do an accent either. I can't do an Indian accent.

Leen: I will do Arabic accent.

°ä³ó±ô´Çé: Oh my gosh. Nobody do an accent.

Harjit: Y'all, we're going to be so . . . Okay. Ready? Hey, it's the "Bundle of Hers." This is Harjit. Guess what my favorite day is, y'all?

Margaux: Your birthday.

Harjit: I love my birthday. So today we thought we would talk about traditions around pregnancy and birth in our different cultures. And today in the studio we have all of us, which I'm really excited about. I love it when we all can share our views on different topics.

Margaux:So these birth stories will really fit into our reproductive unit that we're starting this week. And I'm really interested to hear your birth stories.

Leen, I know you have an interesting one. Do you want to start?

Leen: Mine is not centered personally around my birth story, but in general around what Palestinians do for celebrating birth. I know a lot of these traditions also intertwine with a lot of Islamic traditions as well.

When I was born, they didn't do the ultrasound. My parents didn't know what it was. When the doctor was like, "Do you want to do ultrasound?" she was like, "No, that sounds terrifying," so she didn't do it. So I was a surprise. They had a list of names ready to name me the minute I was born.

But afterwards, what they do is usually the dad . . . at least my dad did this. So he takes us and then he does the call of prayer in our ears. And then usually family, friends, they'll bring us babies little gold charms in the shape of . . . what do they call it? The hamsa? The hand . . . It's against the eye. The hand of Fatima?

They bring little charms that will basically deter away the evil eye because people say, "Oh, babies are so cute, "and anything that you say like that will automatically possibly bring harm to the child, especially if you don't remember God when saying it. So if you don't say Masha Allah basically, people are like, "Oh, no. You have to say Masha Allah."

Harjit: Is it kind of like the bad eye?

Leen: Exactly. It's just like the bad eye. So this part is not really religious in the sense, the charms are not religious, but they'll bring little gold charms and they'll just pin it on the baby's suit, whatever they buy from that day. And so the babies all gold up the first day of life.

Harjit: That's cute.

Leen: I know this might be more Islamic, but in Palestine they also do something . . . They go and they buy an animal, for instance, some sort of livestock, whether it's cow, sheep, goat, and they'll sacrifice it and pass out the meat to family and friends as goodwill for celebrating, also as a blessing for celebrating this child.

And again, people 24/7 will come and visit the house, come and see the baby, and congratulate and bring little gold charms.

Harjit: So in Punjabi culture, being a part of a family is a huge thing. So a lot of the families live together. Usually the parents, if they have sons, all the sons live in the same house, and there's a middle courtyard where everyone hangs out.

Because of that, I think pregnancy is a huge deal, right? Moving forth the family name or creating more people a part of our family.

So basically, in our culture, what happens is the woman, when she's pregnant, she will usually go to . . . she lives in her in-laws' house because she generally is married before she has a kid. In the in-laws' house, the daughter-in-law usually has to do all the work at the house. They want her to rest. So then they send her to their parents' home.

You're seven months pregnant, go to your parents' home, and that's usually where the child is born. So the child is born in their maternal grandparents' home.

My mom told us how all three of us were born. She went back to her mom's house and basically they have this midwife and she has no formal training. It's just an art basically that she's perfected just by practice. I think her family maybe has that whole practice in their family.

So then she starts giving massages to my mom before the birth, and really pampering the mother so that she will have a healthy child. So basically pampering, giving them certain things to eat and making sure that everything is ready for the birth.

And then the three of us, we were all born in the same room in our village home. Actually, it was amazing because I went back two years ago and I remember going into that room and I was amazed how my mom had the three of us in this . . . It's like a 10-foot-by-10-foot room. It's really tiny.

So then the midwife helps and assists the birth. And then after the birth, she then gives a massage to the mom and the child, because apparently there's this type of oil that we use and it's supposed to make us stronger and healthy.

I think it's really interesting because I feel like a lot of care is taken around really taking care of the mother and the daughter or the son. And I think it's a beautiful thing. And so that's kind of what happened with my birth. I think it's really interesting because my mom did all that with a midwife who was never formally trained.

Margaux, do you want to talk a little bit about your thoughts around this too?

Margaux: I think I had a pretty standard or traditional birth story as far as U.S. goes. I was born in a hospital here in Salt Lake. And I think one funny part that I remember my mom telling me about my birth story is that there was a huge storm. So I was born in November. My dad had just moved here for residency, and it was probably an epic powder day and he was skiing while my mom was in labor in the hospital. He lost one of his skis in the powder and had to ski down on one ski and then made it to my mom before I was born.

But other than that, it wasn't very eventful. I mean, yeah, I was born. That was a big event.

But yeah, it's interesting to hear . . . I think that a lot of Americans also do home births with midwives. And so it's interesting to hear your story about it and how some people are now adopting that here in the U.S.

What about you, Bushra? Did you have a similar experience to Harjit? As if you could remember when you were born?

Bushra: Yeah. I have bits and pieces of my birth story. I know it was kind of an unexpected day.

So I went back to Africa this summer and I met one of my mom's best friends from when they were younger. She was like, "I was there the day you were born. It was a crazy day." And she was telling me about it, and she was like, "Yeah, your mom and I were neighbors, and she comes to my house, knocks on my door, and then she's talking to me. All of a sudden she feels . . ." The pain of birth is what she calls it. Birth pain. She's going into labor.

And so there was literally no one there. There wasn't anybody that could take her to the hospital. The hospital was a couple of miles away. They had to walk to the hospital. And so they were walking and she was saying my mom was leaning up against her to get to the hospital.

And so they're walking and they're walking, and all this time my mom is in the middle of labor. They get to the hospital and as soon as she gets on a bed, I was there. I was born.

But as far as resources go, at least back then, they didn't really go to an OB for a normal checkup. Prenatals weren't a thing then. And so I think when my mom came to the U.S. . . . I have three younger siblings and they were all born here, and her experience here was a lot different than what it was back then. She all of a sudden had this doctor that was . . . their sole purpose is to make sure that the baby and her and the pregnancy went smoothly.

It's kind of interesting. My mom chose her OB very purposefully. She wanted someone who kind of listened to her and her traditions about pregnancy and someone who could understand her, and so she had the same OB for all three of my younger siblings.

And I remember going to appointments with her. I was super . . . I don't know. I was always curious about medicine, even back then in elementary school. So it was kind of cool the interactions between everybody, the ultrasound people, the doc. Just this weird alien that's growing inside of my mother and just kind of seeing what it's like.

As far as after you're born, I think my culture and Leen's culture are pretty similar in the fact that they're both rooted in the Islamic faith, because the Adhan thing, the call to prayer in the ear, is done to babies as soon as they're born. And there's literally nonstop of people in the house visiting the baby and the parents and bringing gifts.

One thing that I thought was interesting that Harjit said was that her mom had a midwife with no formal training and that the family had been doing midwifery for probably generations, right?

Harjit: Well, the thing is I really don't know the story about the midwife. She's still in the village to this day. But I think that it's something that was passed on generation to generation.

Bushra: The idea of formal training, as if going to a university to learn this trade is all you need to be considered a real midwife, whereas I'm sure the person that tended to your mother had this experience and has learned the trick of the trade, for lack of a better word, throughout the decades that she's done it and the information that she has gained generationally. I thought it was interesting that you used no formal training. I think that's formal enough for me.

Margaux: I think that's also interesting too that you bring that up, Bushra, because I remember hearing somewhere that back in the old days, I don't know how old, but that midwives were basically considered more safe for delivering children because physicians wouldn't wash their hands and were dealing with all the infectious diseases that people had and then would go deliver a baby with poor outcomes. But the midwives wouldn't be dealing with the sick people, so they had much better outcomes.

And again, there's no "formal training" there, but it's all with the experience, right? And it's interesting that today you have to have this formal training, university training, in the U.S. at least, to give birth.

I haven't really explored it much, but I do know of a lot of my older friends who've had children either have . . . I think it's called a doula or a midwife.

Harjit: Yeah. I don't know much about it, but I really think it's interesting that she built a relationship with my mom before my mom had me, and then also after. Like I said, she would give massages to my mom before the birth and then after the birth to my mom and me.

And usually, in our culture, for a whole month the child usually stays at home because you don't want anyone to give them the buri nazar, which is the bad eye. Kind of similar to what Leen was saying in the beginning. So I also think that's really interesting that it's kind of like the same thought process, but then when they're like 41 days old, then they can go out.

Margaux: So I just looked it up really quickly on Wikipedia. Doulas do not have to have any formal training. We keep using the word formal training. They do not have to have any certification processes to practice in the U.S., and they're usually for maternal support.

And as my understanding goes, you're allowed to bring your doula to your hospital room while you're in delivery.

Harjit:That's nice.

Margaux:Whereas midwives are certified nurses, as far as I understand, and they have more of a role in helping the doctor in the actual labor and delivery process.

But yeah, this is something we should probably look more into. And it's interesting because I think the trend now for birth is to have a lot of different options, right? If you want to have a birth at home, that's still allowed. Or you can come to the hospital and have an MD do it, or stay at home with a midwife. And then more hospitals are open to alternate birthing options, like water birth or a more "natural birth."

So I think it'll be interesting as we go into our clinical rotations to see how what was once a very standardized birthing process is now becoming back wide open to maybe incorporate some of these different cultural needs and practices.

One other interesting thing I will say that I remember from history . . . I don't know where I get all these random history tidbits, but the fact that women lay on their backs as a traditional practice in the U.S. actually stemmed from King Louis XIV wanting to watch one of his mistresses give birth. And so he had her lay on a table so he could have a better viewing option. And that's why today women still lay on their back. So there's probably no real evidence that it's actually better for birth.

Harjit: That's so interesting.

Margaux: Isn't it?

Leen: Actually, to bring up a really interesting point that I saw while being around hospitals, at least my experience in Southern Utah was there was a bout of Muslim students that came to the university and a lot of them were women who were having kids. And it was interesting to see the cultural clashes where . . . I think I could be wrong, but in the U.S. after the birth, when people come to visit the baby in the hospital, they bring balloons and flowers and things like that, right?

And I think it's normal, at least for the U.S. culture, that both men and women can both enter the room. In the Islamic culture, only women go to visit at first. The husband can visit, of course, but men who are not related to the wife or to the mother, they don't usually come to visit unless it's at home because after birth you're not covered up. It's a mess of things.

When people came to visit, the nurse would be like, "Oh, yeah, just this room," and they would let them in. Then you'd quickly see the woman scrambling to grab sheets and cover herself and be like, "Whoa. No, get out." And then the nurse would be like, "Oh my gosh, that's so sad. You won't let them see the baby," and things like that.

We had to kind of explain to them. It's like, "Well, they can. You have to give warning because she's not covered. She's not dressed in the religious way that she needs to be dressed in front of men who are not related to her."

And so I think that's a very interesting point that maybe sometimes we forget in hospitals with cultural standards and things like that.

Harjit: So I have a question, Leen. During the birth, are men allowed to be present?

Leen: I think your husband can if he wants, but here's the thing. So in the Middle East, actually, I don't think men are allowed in the room unless they're doctors. But I mean, he's your husband, right? So by religious standards, I think. But maybe because there are many women in the delivery room at the same time, they don't want men in there for just privacy issues.

So I think religiously I don't see the issue with that. But being in a hospital setting, when you have many women giving birth at once, there's not privacy. There are not enough ways to keep everyone in private.

Harjit: What about people who are assisting with the birth? Could they be men as well? Or do they have to be female medical providers?

Leen: This topic kind of extends more into cultural preference than religious preference. Religiously, when it comes to health and healthcare, it does not matter whether your physician or healthcare provider is a female or male.

Religiously, when it comes to your health, that's the number one thing you should be focusing on and it's not time to be focusing on more private and modesty issues, because when it comes to health, as we all know as physicians, modesty is one of those things we have to always approach very carefully with patients. And so that doesn't apply there.

However, culturally, I have heard stories of men getting mad that the physician was a man or something like that. I have heard cultural stories like that. And I think that's when people come in and they're like, "Oh, we have to explain it. Religiously, that's okay." So I think culturally, if it's a very conservative culture, you're going to have issues. Religiously, though, it's not a big deal.

Harjit: Yeah. I think that's kind of the thing that I even see within my community as well. There are those cultural traditions, and then what is the correct thing and what is not the correct thing.

Leen: Right. Yeah. And another cultural thing I've kind of noticed is . . . It doesn't happen much nowadays, but in the past when a woman is about to give birth, she just sometimes leaves and then comes back with the baby, I've noticed.

So for instance, my grandma, she's just like, "I'm going shopping," and then I guess she had my uncle and came back. She's like, "Oh, by the way, here's your son."

Again, it's not probably universal around the Palestinian culture. But I think sometimes, it gets to a point where it's just another kid. We need to just go give birth and then come back.

Margaux: So speaking of cultural preferences and practices, I know that in the U.S. it's really common to know the sex of your child and to have gender reveal parties. How do your cultures handle gender? Is there a preference or . . . I know you said there are no ultrasounds really, Leen, but how is gender viewed?

Leen: I mean, they understood ultrasound could tell you the gender of your baby, but they didn't really care about it. For me, they're like, "Well, it doesn't matter. Whatever God gives us is what God gives us, whether it's female or male." So they came with a list of names ready to go and said if I was a boy, this was going to be my name. I think they were going to name me Hussein. And then if I was a girl, Tamara, but then my grandma freaked out. She's like, "No. Leen."

Harjit: You would've had the same name as Bushra's last name.

Leen: We would've been related somehow.

Harjit:That's so cool.

Margaux: If I was a boy, my name would be Thatcher.

Leen: Thatcher. Isn't that from the book? Oh my gosh.

I know culturally everyone is like, "Oh, we want a boy. We want a boy. The boy carries on the family name." But nowadays it's kind of interesting because now there's a pushback against that saying, "Well, girls are the ones who take care of the family. When something happens, girls are the ones who are there for their parents. When their parents get sick, girls are the ones who are there. Boys are out."

I don't know if it's a nurturing versus . . . if the culture raises girls more nurturing or not. So there's kind of a push going back and forth.

I know in Palestine I'm always getting in arguments. They're like, "Oh, I hope it's a boy." But then all the women will jump back and be like, "You're going to wish it's a girl when you're 80 years old," to their husbands.

Bushra: That's actually really funny because . . . There wasn't really ultrasound when we were living in Africa, so my mom . . . it was a surprise every single time. She didn't know what she was having.

But it was kind of interesting because I have seven siblings and she had four boys in a row, which any other family would've been ecstatic to have boys, like, "Oh my gosh, this is the most amazing thing. Our family name is definitely going to continue." And she was like, "If I have another freaking boy, I might go crazy."

Then she had my older sister, and then she had four girls in a row after that. So it was just crazy.

When she got to America and the advent of freaking ultrasound to let you know what's going on inside of there, she was like, "Thank God. This is freaking nerve wracking."

Leen: Actually that reminds me of a funny story that happened when I was born. My aunt, she has three boys and they were driving her up the wall, I guess. And she really wants a girl. She never had a girl, but when my mom had me, the first day she came to my hospital room, she had already bought me bras and underwear. And she's like, "I have a daughter." Yeah, I still have them.

Harjit: So I really like hearing y'all's stories about how happy your family was when you were born. I don't want to get emotional, but I think the thing that's been the hardest for me, and this is . . . I don't really like talking about this, but the reason I celebrate my birthday so much is because no one was happy that I was born. I can't talk about this.

Margaux: Do you want to talk about it off air?

Harjit: No. Actually I was like, "I'll share it," but then I didn't want to.

°ä³ó±ô´Çé: Then you don't have to. It's all right.

Harjit: I just need a break.

°ä³ó±ô´Çé: That's fine.

Margaux:Let's take a break.

Harjit: I think I will mention . . . let me just . . . I think it's me, so I have to kind of. I mean, my family all knows about it. We always talk about it.

Bushra: Do you want to?

Harjit: Yeah, I do.

Leen: Tell them how great of a person you've become.

Harjit: I think a huge part of my birth story that I kind of was hesitant about telling is the reason that the mother gets nurtured so much before her pregnancy is because the thought is that she'll have a son. So usually they do all that work for her so that she'll give birth to a son and she kind of will fulfill her duty.

Actually, I'm the youngest and I'm the third daughter in my family. So the reason I love celebrating my birthday is because at that time in those circumstances, I don't think my mother was allowed to be happy that she had me. So because of that, the mood was very somber after I was born. Not only was I the first, not only the second, but the third time there was also a daughter.

And I think that the reason why revealing gender and revealing sex really bothers me personally is it's from my experiences. My whole life, I think I was fighting my birth. I was fighting being a woman.

I remember when I was younger, I would always do things so I wasn't. No one would be like, "Oh, she's a girl." I was like, "I'm going to prove to everyone that I can do everything that a boy can." And that's literally the first thought I had.

And now that I think of it, I was maybe 3 or 4. Those are the things I shouldn't have been thinking of at that time, and I did that. So I did things and I pushed all the feminine parts of me away from me, right?

In that same breath, I want to say that as a people, we both have what's perceived as feminine in society and what's perceived as masculine in society. We have both of those qualities, and that's why I think that it really bothers me because once ultrasounds started occurring in my state, in Punjab, a lot of daughters were killed before they were born.

And so in a way I'm really happy they didn't have it at my time, because I don't know what my mother would've had to do. But also, I think that burden is something that's huge in my community when women are pregnant. It's such a big thing. "What if we don't have a son? Is our first child going to be a son? And if I have a daughter, is my next child going to be a son?"

I think that basically my birth story has really dictated the choices I make in my life, and so that's kind of my thoughts, Margaux, on revealing a gender, revealing a sex, because I don't think anyone should have the right to tell you if you're having a boy or girl. Yeah, you can say their sex is female or male, but I feel like no one has a right to tell someone that you're having a boy or girl until that person or that individual can formulate their own identity.

Margaux: Thank you so much for sharing that, Harjit. I think it's so important to hear these stories of the psychological impact of the emphasis that our society puts on gender, right? And not even the U.S. culture, but all cultures. If you have a preference for one gender or the other, there's a lot of impact for the opposite gender that's not favored.

So I think that as future physicians, we should be aware of the rhetoric that we use surrounding gender and how deep that it can affect somebody. And so thank you for sharing.

Harjit: Thank you. Thank you for listening. And also, I do want to add that, again, this is my story and I don't think it should be used to generalize about my culture and my community.

There are ingrained things that are passed on generation to generation, and I think that's literally . . . A lot of the women, the pressure they feel to have a son is something that's been going on for years and years and years, right?

I've heard people be like, "Oh my god, I can't believe that. I can't believe your family thought like that." That really hurts my feelings too, because I want to say that you also don't understand what my mother and father had to go through as well. And yeah, I just wanted kind of to add that to the side.

Bushra: To just add on to what you just said, Harjit, I think it's important to realize that we're all a product of our environment and the way that we grew up. It's not always black and white. So our experiences, what we had to endure growing up, what we had to experience kind of drives who we are and our struggles. And so that was really strong of you to share that.

And just from my own past, I think that sentiment in my culture is also very rampant. But I feel hopeful when I look at this room of people, of women who are pushing the boundaries, who are trying to change the labels that are put on us and trying to be who we are, who we want to be as people every day, and just kind of setting our own examples is very important.

Yeah, I just want to thank you guys for being strong, independent, badass women. And I just want to thank the audience for listening to the "Bundle of Hers." Make sure to subscribe, and please go ahead and leave us a review. Let us know what you think, any thoughts of what we should talk about next.

Until next time, people, bye.

°ä³ó±ô´Çé: That was a good one.

Margaux: That was good. Good job, Harjit.