• introductions using a ‘talking circle’ with each person sharing their name where they were from and why they had come, i.e. what their expectations were
  • handing out of manuals
  • hand washing demonstration followed by everyone washing their hands
  • anatomy and basic physiology lesson
  • probable and definite signs of pregnancy
  • calculating a probable due date for a specific pregnancy
  • risk factors in pregnancy and how to identify them
  • demonstration of prenatal interviews- what questions to ask to identify women at risk as well as making use of this time to teach the pregnant woman
  • role-playing of prenatal interviews

Traditional Birth Attendants (midwives, or TBAs ) were asked to bring an item of food that she felt would be important for a pregnant woman to eat for the following day as we would be discussing nutrition.


  • washing of hands
  • review of day 1
  • any questions or concerns
  • nutrition, with each person sharing why they brought what they had and then further discussion about what nutritional needs a pregnant woman has
  • practise of prenatal interviews through role playing
  • demonstration of a complete prenatal exam: identification of potential risks, determining the position of the fetus in the uterus, signs of anemia, pre-eclampsia, etc.
  • demonstation of a normal birth
  • DVD of birthing and discussion of same

TBAs were asked to think about complications during birth that they would like to talk about the following day
We also ask for 4 volunteers to do a birth demonstration of a typical birth in their area for the following day.


  • washing of hands
  • watching of birthing DVD
  • dramatization done by volunteers showing a typical birth in their community
  • demonstrations and discussion about complications at birth such as hemorrhage, malpresentation of fetus, twins, pre-eclampsia, prolonged labor, premature rupture of membranes, a baby that doesn’t breathe, retained placenta, etc.
  • many dramatizations of normal and complicated births


  • washing of hands
  • discussion re:
    -family planning
    -vaccinations of pregnant women and babies
    -breastfeeding and watching of a DVD on breastfeeding
    -local resources and a community emergency plan
    -questions that anyone may have that haven’t been answered during the week
  • Final ‘talking circle’ for everyone to share their experience of the course

In the afternoon of the 4th day we hold a ‘graduation ceremony’.  Each TBA receives a certificate and a birthing kit.

Each kit contains:

  • nailbrush, nailclippers, soap and a soap container
  • an apron and a plastic sheet
  • stainless steel scissors, umbilical cord ties, Q-tips and a small bottle of alcohol
  • guaze, gloves erythromycin eye ointment,
  • a headlamp (as there is often no electricity where these women birth)

Each day of the course a midmorning snack and lunch is provided.