Over the past decade, Norwegian cities have experienced an influx of immigrants, many from third world countries. Women from these societies have brought with them cultural traditions and mores regarding birth, prevention and their own bodies which can present many problems and challenges to public health personnel. This study specifically deals with the experiences of midwives and clinicians working with immigrant women in Oslo, and offers some recommendations to health care staffs in their counseling and treating such women. Many things which seem obvious to Western-trained clinicians may not seem so to their patients, and when staff are not understood or are questioned they may interpret this as a challenge of their authority and competence. For example, Norwegian health workers, having been reared in a society concerned about the "population explosion" and often having been trained to readily equate large families with poverty and/or ignorance of birth control, must attempt to try and understand that this is not necessarily true, and that such attitudes can limit the effectiveness of counseling in sensitive areas. Most Asian and African societies see children as an economic resource. The author accordingly urges health care workers to approach their patients in this area, as in others, with empathy and to try and be aware of their assumptions. Cultural traditions should also be taken into account when recommending a particular form of birth control to a woman or couple requesting such advice. Some methods will be more or less acceptable to different nationalities. For instance, many Asian cultures view menstruation as a necessary part of nature's plan to maintain balance between the "hot" and "cold" forces of the body, and since oral contraceptives often reduce flow, they might be considered as harmful. Condoms, on the other hand, may be more readily acceptable since they do not affect body rhythms. Coitus interruptus is the most widely practices form of birth control in the world, and is probably more reliable than the West believes. Despite stereotype thinking that women fail to reach orgasm with this method, most couples who practice it seem to experience no problems. The rhythm method usually will be less attractive to women of many societies, since examining one's own cervix secretion and touching one's body will be unacceptable to many. In counseling or parental care and birthing, workers are urged to realize the role ritual plays, and to accept such practices as Pakistani mothers massaging their young infants and themselves. Unless harmful medically, we should be careful not to criticize such practices, but to learn from them in creating a good relationship with patients. Giving birth in a large Norwegian hospital may itself seem frightening to many immigrant women, and if a Moslem woman there is criticized for keeping still after giving birth (for 40 days in the Islamic faith), this may only create more anxiety. Guidelines are provided for promoting physician-patient communication, such as talking to and looking at the patient--not the interpreter--and to avoid using difficult sentences or concepts.

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