Nursing and Midwifery organizations have been building capacity to utilize virtual electronic communications systems to support collaborative projects since 2005 when the Global Alliance for Nursing and Midwifery became a reality. The Nursing and Midwifery Community of Practice for Making Pregnancy Safer has grown from 55 members in 18 countries at the end of the first year to 382 members from 79 countries by the end of 2009. The Spanish-language community created in 2007 has 187 members from 32 countries. We will present background information on developing communities of practice, strategies for building capacity and lessons learned over the past four years. We will present our findings from a simultaneous discussion held in Spanish and English on traditional midwifery and active management of the third stage of labor-applying the evidence, discussing the challenges and rewards of a bilingual discussion. Additionally, findings from an on-line survey to elicit feedback on the discussions and recommendations for future direction will be discussed.