ACNM has supported international maternal-child health projects for more than 20 years. The Department of Global Outreach (formerly Special Projects) started in 1982 with the development of training programs for traditional birth attendants under the leadership of Bonnie Pederson, CNM, MPH. These initial efforts led to the development of training curricula for midwives and other providers of obstetrical and reproductive health care. The Life Saving Skills (LSS) curriculum has been incorporated into many large-scale efforts to reduce maternal and neonatal mortality. The LSS manual is available in several languages, including English, Spanish, French, Russian, and Vietnamese, and is used in over 30 countries. The Department of Global Outreach has received numerous contracts, grants, and cooperative agreements through the United States Agency for International Development, The US Department of Health and Human Services, private voluntary organizations, nongovernmental organizations, and private foundations to provide technical support to safe motherhood programs around the world. The Home Based Life Saving Skills manual, launched in 2004, moves beyond a focus on education for providers to a focus on educating women and their families in the identification and management of childbirth complications. Nurse-midwives, midwives, and families in developing countries have an expanded capacity to provide safe and satisfying care and to reduce maternal and neonatal deaths in Africa, Asia, Latin America, and Eurasia as a direct result of the work of the Department of Global Outreach.