This is a descriptive study of the beliefs and practices of the traditional midwives in a rural Guatemalan village. During pregnancy and birth, traditional midwives who have received minimal or no training attend more than 80% of the indigenous Mayan women. Data were obtained from interviews with the midwives and from direct observation of midwives attending births. The midwives had few skills with which to handle complications. They failed to use basic aseptic technique and were unfamiliar with lifesaving skills such as fundal massage and proper infant stimulation. Even though most of the midwives interviewed had attended a Ministry of Health training course, they lacked basic knowledge of safe obstetric practices. To reduce infant and maternal mortality rates, traditional midwives must be adequately trained. The teaching methods used by an indigenous Guatemalan group training elderly, illiterate midwives are described as an example of an effective training program.