When a pregnancy failed, a woman could consult a ritual specialist. In many cases, she and her mother, aunt or sister would then visit the shrine of a local priest. After a donation of money or food, she was let into the shrine and could present her problem with the priest acting as a mediator between her and the spiritual world. If no insurmountable obstacles were found the woman would be advised at the end of the consultation to return on a certain day with an akua'ba which she could order herself from a local carver, some priests also carved the sculptures themselves. The akua 'ba would be handed over to the priest on the appointed day, placed on the altar for a specified time and then consecrated and returned to the woman loaded with powers.
From then on, she would carry the akua'ba with her continuously and care for it as if it were already her own child. She would probably also be given a medicine to drink or bathe in and would be instructed in certain prohibitions to which she was to adhere until she had given birth to a healthy child. Mother and child would then return with the akua'ba to the priest to offer a sacrifice of thanksgiving. Then the akua' ba could be left in the shrine, or it could be taken home to put in the personal home shrine or stored wrapped in cloth with the woman's other valuables. Sometimes, too, the figure was given as a toy to the child herself. In later years, selling to an art dealer was added as an option.