Worldwide, the majority of maternal and newborn deaths occur around the time of birth, typically within the first 24 hours after childbirth. Most of these deaths are preventable.

A newly-released guide from the World Health Organization describes the major causes of maternal and newborn complications and deaths, including post-partum hemorrhage, infection, obstructed labor, preeclampsia and birth asphyxia and offers suggestions on how to prevent these complications. 

The “Safe Childbirth Checklist and Implementation Guide,” developed and tested in partnership with Ariadne Labs, a joint center of Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health and supported by the Bill & Melinda Gates Foundation, synthesizes existing evidence-based World Health Organization (WHO) guidelines and recommendations into a single and practical bedside tool targeted at improving adherence to best practices, including adequate communication around the time of delivery.

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The checklist identifies four pause points each corresponding to a specific period in a health worker’s normal flow of work: when the mother is admitted, just before pushing (or before Caesarean section), within 1 hour after birth and before the mother and newborn are discharged. These pause points allow birth attendants to make their “checks” at times when they can not only protect the mother and newborn against dangerous complications, but also at the most convenient times in their work flow.

Of the more than 130 million births occurring each year, an estimated 303,000 result in the mother’s death, 2.6 million in stillbirth, and another 2.7 million in a newborn death within the first 28 days of birth. The majority of these deaths occur in low-resource settings, often lacking skilled birth attendants.

“Far too many women and children are still dying in childbirth from preventable causes often linked to poor quality of care,” Marie-Paule Kieny, WHO Assistant Director-General, Health Systems and Innovation said in a press release. “The WHO Safe Childbirth Checklist will help health care workers follow the essential care standards for every birth.”

A randomized controlled trial called BetterBirth is currently being conducted in more than 100 hospitals in Uttar Pradesh, India, by Ariadne Labs, Harvard T.H. Chan School of Public Health and the Bill & Melinda Gates Foundation. The objectives of the trial are to measure the impact of the checklist-based intervention on maternal, fetal, and newborn survival; and severe maternal harm. The trial will be completed in 2017.


WHO. Safe Childbirth Checklist and Implementation Guide. Accessed: Dec. 4, 2015.