||This investigation is a study of the childbearing beliefs, practices, and perceptions of immigrant Tongans with health care considerations. Tongans are an Oceanic culture who has been living in the United States in increasing numbers for several decades. Between October 1979 and March 1980, four English-speaking immigrant Tongan women were selected from a sample of convenience to participate in this study. The women had all experienced pregnancy and childbirth both in their home country and then subsequently in and urban American city. A series of five to eight in-depth interviews were held in each of the informant's homes. During the interview, open-ended questions were asked by the investigator to elicit their perceptions and beliefs of their childbirth experiences and to gain information about Tongan lifeways. Transcription of the tape recorded interviews were made and data analyzed by the investigator. The data are presented in a descriptive and narrative style with direct supporting statement may by the informants. Two research questions guided the investigation: 1. Will Tongan immigrants' perceptions of their traditional cultural beliefs and practices of childbirth be different from their perceptions of urban American birthing practices? 2. Would Tongan immigrants' desire the American childbirth health care provides modify their care-giving practices to incorporate beliefs and practices of the traditional Tongan culture? With respect to the first question, the investigator would answer in the affirmative. The major differences between the Tongan and the urban American childbirth care systems were reflective of the overall differences between the two cultures. Extensive kinship ties provided support and caring for the parturient in Tonga whereas the parturient's husband and professional health care providers were more greatly relied on in the United States. Socialization practices in Tonga separate male and females and unmarried females from married ones regarding sexual matters. Structured classes on childbirth and parenting were available in Tonga although none of the informants had attended these classes. Informal exchanges between the parturient and her mother or other female kinfolk prepared the parturient for childbirth. Differences between Tonga and the United States in the use of technology were evident. Medical intervention in childbirth was minimal in Tonga. In the United States, the Tongan informants encountered technological interventions during childbirth. A sense of anxiety about the equipment was reported, but also a sense of safety and satisfaction regarding its availability was related. Economically, the cost of childbirth care in Tonga was minimal compared to the cost for care in the United States. With respect to the second research question, the investigator would answer negatively on a superficial level. The Tongan informants replied that American health care professional did not need to change their practices to accommodate to Tongan lifeways. However, conflict and ambivalence were noted as the informants related their childbirth experiences. Attitudes towards positive and negative aspects of childbirth care, "choice" within the system, and compliance with medical regimes were explored. At a deeper level, the need emerged for American childbirth care providers to reassess their actions when caring for Tongan women. Suggestions emphasized kindness, patience, encouragement, giving careful explanations, and treating the clients with respect. The study generates implications for health care professionals working with peoples of different cultural groups. Knowledge of culture's beliefs and values will be gained by careful observations, attentive listening, and nonjudgmental attitude. The health care profession can thus provide meaningful care, linking the client's indigenous health care system with the American one.