Safe childbirth checklist: A simple tool to encourage best practices by skilled attendants

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Safe childbirth checklist: A simple tool to encourage best practices by skilled attendants. Ann Trop Med Public Health 2016;9:290-1


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Shrivastava SR, Shrivastava PS, Ramasamy J. Safe childbirth checklist: A simple tool to encourage best practices by skilled attendants. Ann Trop Med Public Health [serial online] 2016 [cited 2020 Nov 26];9:290-1. Available from:

Dear Sir,

Globally, a major proportion of maternal and newborn deaths have been reported around the time of birth, especially within the first 24 h after the childbirth.[1] In fact, out of the estimated 130 million births that have been observed throughout each year, 0.3 million, 2.6 million, and 2.7 million precipitates death of the mother, as stillbirth, and neonatal deaths, respectively.[1] However, the worrisome concern is that most of these adverse pregnancy or childbirth related outcomes can be significantly improved or prevented through discharge of quality care at the time of delivery.[1],[2]

Furthermore, most of these maternal and newborn related deaths have been reported in low-resource settings, which are often devoid of skilled birth attendants.[2] In fact, ensuring the presence of a skilled attendant has been recognized as a priority in most of the high-risk areas, and thus, all pregnant women should be motivated to deliver in health-care establishments.[1],[2] In addition, under the newly proposed Sustainable Development Goals, which has aimed to significantly minimize the incidence of maternal and newborn deaths, a lot needs to be done to end the preventable causes of deaths of women and newborns.[1]

Acknowledging the magnitude of the problem, and considering the need to translate policies into practical actions that can eventually improve the different aspects of the quality of care of mothers and newborns, the World Health Organization in collaboration with international partners has developed a Safe Childbirth Checklist.[3] The checklist aims to not only support the health professionals in low-resource settings, by guiding them about the essential standards of care desired for every birth, but also addresses the major causes of maternal and newborn complications and deaths.[3]

In general, the checklist comprises 29 practices distributed across four phases, each referring to a defined time-frame in a health worker’s routine work such as when the mother is admitted (viz., necessity of referral or antibiotics, logistics, presence of birth companion), just before pushing or before caesarean section (like starting antibiotic, adequate resources for mother/baby), within 1 h after birth (such as no abnormal bleeding, presence of any infection, and initiation of breastfeeding), and before the mother and newborn are discharged (viz., minimum stay of mother for 24 h postdelivery, normal blood pressure of postnatal mother, the baby is feeding well).[1],[3] These four phases of concept will not only enable birth attendants to protect mother/children from dangerous complications but also be a convenient bedside tool to ensure adherence to the best practices.[1],[3] Altogether, the checklist is a compilation of essential birth practices, which also gives due attention to the necessity of adequate communication around the time of delivery.[1]

Moreover, in an attempt to test its utility in various settings, the checklist has been piloted in different developing nations across the African and Asian regions.[1] In fact, the results of the trial have been quite encouraging and significant improvement in the safety and quality of care has been achieved.[4] However, it is very necessary to assess the opinion and knowledge status of the health workers before implementing the checklist in a specific health-care establishment.[5]

To conclude, the Safe Childbirth Checklist is a simple and cost-effective tool for improving the quality of care for pregnant mothers and newborns in heterogeneous settings across the world.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.



World Health Organization. WHO checklist targets major causes of maternal and newborn deaths in health facilities; 2015. Available from: . [Last accessed on 2015 Dec 8].
Spector JM, Lashoher A, Agrawal P, Lemer C, Dziekan G, Bahl R, et al. Designing the WHO safe childbirth checklist program to improve quality of care at childbirth. Int J Gynaecol Obstet 2013;122:164-8.
World Health Organization. WHO Safe Childbirth Checklist. Geneva: WHO Press; 2015. p. 1-4.
World Health Organization. Colombian nurses improve the quality of care at birth; 2015. Available from: . [Last accessed on 2015 Dec 5].
Patabendige M, Senanayake H. Implementation of the WHO safe childbirth checklist program at a tertiary care setting in Sri Lanka: A developing country experience. BMC Pregnancy Childbirth 2015;15:12.

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.184796

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