Background: Khon Kaen Hospital (KKH) is a regional hospital in northeast Thailand with approximately 4000 births per year. Some common practices related to pregnancy and childbirth are done without evidence of their effectiveness. KKH is part of the SEA-ORCHID Project that aims to improve clinical practice relating to pregnancy and childbirth and enhance health outcomes by promoting evidence-based practice (EBP) and increasing the capacity for preparing guidelines and systematic reviews. We report on our experiences of implementing evidence-based practice in the hospital and the impact of our activities on reviews and guidelines. Methods: Two obstetricians from KKH spent one month at the Australian SEA-ORCHID sites to gain experience as a clinical educator and research fellow. The aim of the educator position was to promote and increase capacity for EBP among clinical staff. The aim of the fellowship was to develop skills in research synthesis and guideline development. Over the last two years a range of intervention activities directed at improving EBP (e.g., workshops, journal clubs, audit and feedback) have been implemented. Results: During 2006 and 2007, there were 15 workshops, 2 lectures and 5 journal clubs on the topics related to pregnancy and childbirth care, such as EBP and episiotomies, etc., for obstetricians, physicians, interns and nurses. Participants varied from 10 to 35 for each activity. Other achievements include updating clinical protocols, publishing a systematic review in The Cochrane Library, and developing two Cochrane protocols. The barriers were English language (especially for the research synthesis activity), time, limited experience with some interventions and inadequate support from policy makers. Conclusions: Achieving EBP is a challenging process that has involved several steps: (1) promoting EBP, (2) facilitating team building, (3) integrating EBP into routine activities, (4) data monitoring & feedback, and (5) building activities to sustain EBP. The clinical educator and fellowship training have helped to build capacity in EBP, guideline development and research synthesis at KKH.