WHO and Ariadne Labs Release Safe Childbirth Checklist

The simple list of questions and reminders is meant to improve maternal health.

Years ago, local surgeon and researcher Atul Gawande proved how much of a difference a simple checklist can make in medicine. Now, the World Health Organization (WHO) and Boston’s Ariadne Labs are applying the decidedly low-tech solution to childbirth.

Pregnancy may seem routine in the United States, but childbirth and related complications kill roughly 300,000 women and 2.7 million newborns each year worldwide. As such, Ariadne Labs—a joint venture between Brigham and Women’s Hospital and the Harvard School of Public Health, which counts Gawande as executive director—launched the BetterBirth program, an initiative dedicated to improving maternal health.

As part of that goal, Ariadne Labs and the WHO teamed up to develop the Safe Childbirth Checklist, a simple, four-page procedural guideline that makes it easier for doctors to monitor and assess patients’ health. The list pertains to four stages of birth (admission, just before pushing, soon after birth, and before discharge) and are meant to catch human errors that could lead to common conditions like infection, bleeding, and obstructed labor. It includes both simple questions—like whether the mother is bleeding abnormally—and reminders for health professionals, like when to discuss family planning options with the new mother.

In a statement, Gawande noted how successful intuitive measures like checklists can be in medicine:

“We know from other health disciplines such as surgery that a properly implemented checklist of best practices encourages a culture of teamwork, problem solving and discipline that leads to better care. We believe this simple and low-cost tool can make a difference for women and infants in settings around the world.”

The checklist was first piloted in hospitals in nine African and Asian countries. Now BetterBirths, led by director Katherine Semaru, is heading up the largest-ever clinical trial of the Safe Childbirth Checklist, measuring its impact in 100 hospitals in India and Namibia. The study will be complete in 2017.