Evidence links adequate prenatal care to improved birth outcomes. Research, however, indicates that First Nations women do not attend regularly for prenatal care. In the current study, seven informants, representing three First Nations tribes, were extensively interviewed to examine their beliefs about pregnancy and participation in prenatal care. First Nations women conceptualized pregnancy in a spiritual context and believed it to be a healthy, natural process requiring no intervention. Since they believed they were responsible for "taking care of themselves" during pregnancy, cultural practices that were thought to promote a healthy pregnancy were espoused. First Nations women were reportedly often dissatisfied with health-care providers in prenatal clinics. Their expectations of freely offered explanations and a friendly non-authoritarian approach were often not realized and their beliefs about pregnancy were in conflict with those of health-care providers. Barriers to prenatal care might be reduced by improving communication and providing holistic culture-specific care.