Recently the World Health Organization (WHO) released a ‘Safe Childbirth Checklist’.
The checklist (and accompanying implementation guide) targets the major causes of maternal and newborn complications and deaths, including post-partum haemorrhage, infection, obstructed labour, preeclampsia and birth asphyxia.
More than 130 million births occur each year. Of these, an estimated
- 303 000 result in the mother’s death,
- 2.6 million result in stillbirth, and
- 2.7 million result 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.
The use of the checklist is hoped to improve the quality of care during childbirth, substantially reducing maternal and neonatal morbidity and mortality.
The checklist identifies 4 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.
The checklist was first piloted for usability in 9 countries in Africa and Asia. Subsequently it was field-tested in Karnataka State, India, where adherence to recommended practices at each birth increased from an average of 10 out of 29 practices prior to introduction of the checklist to an average of 25 out of 29 practices after the checklist had been introduced.
A Randomized Controlled Trial called BetterBirth is currently underway in more than 100 hospitals of Uttar Pradesh, India. The trial aims 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 is currently developing the French and Spanish editions of the checklist and the implementation guide, which will be followed by other language editions.
Link to the WHO news release:
Link to the WHO Safe Childbirth Checklist home page:
Link to the WHO Safe Childbirth Checklist:
Link to the WHO page describing how to implement the checklist:
Link to description of items in the checklist:
Link to description of safe birth supplies:
Link to WHO Safe Childbirth Checklist Implementation Guide:
Link to ‘Guide to holding a launch event’:
Link to document on effective coaching:
Link to coaching tool:
Link to observation tool: