Background: To study sexual and reproductive health issues, an understanding of cultural and language bound concepts is needed. Scandinavian studies of native speaking women show a relation between history of partner violence, sexual abuse and fear of delivery. In Malmo the third largest city of Sweden, 36% of the population has a foreign background. The proportion of Arabic speaking women within maternity care is increasing in Sweden. Islamic concepts are often based in the Arabic language and are of importance for non-Arabic speaking Muslim women as well. To enable participation in a prospective study on history of abuse and fear and delivery outcome, the validated instruments needed translation into Arabic language. Aim: To describe challenges in translating instruments, on fear and abuse, developed for westernized societies into an Arabic questionnaire. Method: Interviews and face validity testing of translated instruments from Western language to develop an Arabic questionnaire were conducted. Results: In order to validate translated instruments of concepts related to sexual and reproductive health, an understanding of cultural and religious ideas, meaning of words for sexuality, violence, abuse, fear and “destiny” needs to be addressed and considered. Examples of international approaches to these issues will be presented. Conclusion: Translation of cultural concepts for questionnaire development requires more than understanding and interpretation. Ethical approval 2006/354-31; 2007/1360-32. PhD-studies by faculty funding