A previous Concerted Action EU grant ( " Tropical Medicine on Trial", contract ICI8CT96-0086) included action research projects around evidence-based medicine. One topic area that was developed concerned obstetric practice, particularly in relation to painful and unnecessary procedures for which no good evidence of benefit existed. Collectively, we conducted action-research projects in China, Zimbabwe, and South Africa, with a project in Chile currently underway. At the same time, we have drafted the "Better Births Initiative", to help draw this work together. We are applying now for funds to allow researchers to exchange result sat a meeting in South Africa, and to allow dissemination, feedback and intervention research planning in China.