Business Category: Quality / Industrial Category: Health Care

WHO Safe Childbirth Checklist

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The WHO Safe Childbirth Checklist is a structured clinical quality-improvement tool designed to standardize and enhance the quality of maternal and neonatal care throughout labor, delivery, and the immediate postpartum period. It consolidates evidence-based essential birth practices into a systematic framework, directly targeting the leading causes of maternal mortality, intrapartum-related stillbirths, and neonatal deaths occurring in healthcare facilities worldwide. This checklist is intended to be implemented in conjunction with its companion implementation guide to support sustainable and effective adoption across clinical settings.

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WHO Safe Childbirth Checklist
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How to Use This Checklist

  • **Before birth:** Assess the mother, identify whether she requires antibiotic therapy, magnesium sulfate, or antihypertensive treatment, prepare medications, and verify that all maternal and newborn supplies are available and ready.
  • **Just before pushing or caesarean delivery:** Confirm that a birth assistant is ready, conduct a final team briefing, and ensure essential supplies for both mother and newborn are in place.
  • **After birth:** Monitor the mother for abnormal postpartum bleeding and respond to postpartum hemorrhage. Continue maternal monitoring, document interventions, and assess whether the mother needs antibiotics or treatment for elevated blood pressure. For the newborn, check whether referral, antibiotics, or special care is required, record the APGAR score at five minutes, and confirm that skin-to-skin contact and breastfeeding have been initiated if both are stable.
  • **Before discharge:** Review whether the mother requires antibiotics or treatment for elevated blood pressure, and whether she is experiencing abnormal bleeding. Check whether the newborn requires antibiotics and whether feeding is adequate. Discuss family planning options, arrange follow-up care, and confirm the mother or companion understands when to seek help for danger signs after discharge.
  • **Danger signs:** Provide counselling on maternal and neonatal danger signs and confirm understanding.
  • **Documentation:** Record additional clinical observations, estimated blood loss, APGAR score, signature, and start and end times as required.

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What the WHO Safe Childbirth Checklist is

The WHO Safe Childbirth Checklist is a structured clinical quality-improvement tool designed to standardize and enhance the quality of maternal and neonatal care throughout labor, delivery, and the immediate postpartum period. It consolidates evidence-based essential birth practices into a systematic framework, directly targeting the leading causes of maternal mortality, intrapartum-related stillbirths, and neonatal deaths occurring in healthcare facilities worldwide. The checklist is intended to be implemented in conjunction with its companion implementation guide to support sustainable and effective adoption across clinical settings.

Why it matters

The checklist addresses the leading causes of maternal mortality, intrapartum-related stillbirths, and neonatal deaths in healthcare facilities. By following its structured sequence, you help ensure that essential, evidence-based practices are consistently performed for every mother and newborn.

What a good checklist covers

The WHO Safe Childbirth Checklist covers eight areas of care: - **Before Birth**: Clinical assessment and preparation before delivery. - **Just Before Pushing or Caesarean Delivery**: Final checks and team briefing. - **Essential Supplies for Maternal Care**: Verification of items such as sterile gloves, hand hygiene supplies, and pre-drawn oxytocin. - **Essential Supplies for Newborn Care**: Verification of items such as clean towels, cord ties or clamps, sterile blades or scissors, neonatal suction devices, and neonatal bag-and-mask for resuscitation. - **After Birth**: Monitoring, management of postpartum hemorrhage, documentation, and newborn assessment. - **Soon After Birth (Within 1 Hour)**: Immediate newborn care and initiation of breastfeeding. - **Before Discharge**: Discharge assessment, counselling, and follow-up planning. - **Danger Signs — Maternal and Neonatal**: Counselling on when to seek help.

How to carry it out

You carry out the checklist by working through each section in sequence during labor, delivery, and the postpartum period. At each step, you assess the mother and newborn, take required actions, and document findings. The checklist includes spaces for recording estimated blood loss, APGAR score at five minutes, additional clinical observations, signature, and start and end times. Use it together with its companion implementation guide to support sustainable and effective adoption in your clinical setting.

Frequently Asked Questions

The checklist organizes the care of a mother and her newborn around four moments: before birth, just before pushing or caesarean delivery, after birth, and before discharge. Within each moment you verify clinical assessment and treatment decisions, confirm the essential supplies and medications are prepared, carry out the required monitoring and documentation, and counsel the mother on danger signs and follow-up before she leaves the facility.

It addresses the leading causes of maternal mortality, intrapartum-related stillbirths, and neonatal deaths that occur in healthcare facilities. By consolidating evidence-based essential birth practices into a single sequence, it helps you ensure nothing is missed during labor, delivery, and the immediate postpartum period.

The tool is intended to be used together with its companion implementation guide, which supports sustainable and effective adoption across clinical settings. Practitioners should review the guide alongside the checklist to align local workflows.

Before delivery you assess the mother, check whether she needs antibiotics, magnesium sulfate, or antihypertensive treatment, prepare medications, and verify that maternal and newborn supplies are ready. You also confirm that a birth assistant is ready and hold a final team briefing before delivery.

You prepare and verify essential supplies for both the mother and the newborn, including sterile examination gloves, hand hygiene supplies, pre-drawn oxytocin, clean towels, cord ties or clamps, sterile blades or scissors, neonatal suction devices, and a neonatal bag-and-mask for resuscitation. You also confirm the birth assistant is ready and conduct a final team briefing.

After birth you monitor the mother for abnormal postpartum bleeding and respond to postpartum hemorrhage, continue maternal monitoring, document maternal interventions, and assess whether the mother needs antibiotics or treatment for elevated blood pressure. You record estimated blood loss and the newborn's APGAR score at five minutes, check for newborn referral, antibiotic treatment, or special care needs, and confirm that skin-to-skin contact and breastfeeding have been initiated if both are stable. You also counsel the mother or her companion on when to call for help if danger signs appear and confirm a minimum 24-hour postpartum stay.

Before discharge you review whether the mother requires antibiotics or treatment for elevated blood pressure, and whether she is experiencing abnormal bleeding. You check whether the newborn requires antibiotics and whether feeding is adequate. You discuss and offer family planning options, confirm follow-up care is arranged and that the mother or companion will seek help if danger signs appear after discharge, and provide counselling on maternal and neonatal danger signs. The checklist also includes fields for additional clinical observations and notes, signature, and start and end times.

The checklist includes dedicated sections for maternal and neonatal danger signs counselling, ensuring the mother or her companion understands when to call for help. You confirm this understanding before discharge and again verify that they will seek help if danger signs appear after discharge.

The checklist includes recording of estimated blood loss in milliliters and the newborn's APGAR score at five minutes, along with fields for additional clinical observations and notes, signature, and start and end times. These support documentation of the care provided.

The checklist references evidence-based essential birth practices and is designed to be used with its companion implementation guide. If you work in a setting where OSHA, ISO, HACCP, or other standards apply, name them plainly in your local protocol without paraphrasing their requirements into something more specific than you can support.
Arne Reis
Written by
Arne Reis
Founder

Process optimizer with 25 years of expertise, focused on operational excellence in quality, maintenance, EHS, and commissioning. Emphasizes innovative solutions and top-quality standards.

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