While Japanese people represent a significant and growing cultural group within the United States, little is known about the culture-specific needs of Japanese women who experience pregnancy and childbirth in this country. Five women participated in a study of Japanese women's experience of pregnancy and childbirth in the United States. The following thematic clusters emerged from the interview data: issues related to the maintenance of Japanese birth-related practices and traditions; comparison of the Japanese and U.S. health systems; language difficulties; and the need for support systems. This group of well-educated, medically sophisticated women regarded their experiences overall to be positive. Still, they identified areas of uncertainty and unfamiliarity of which health professionals should be aware in order to facilitate the negotiation of culturally congruent care.