“WHO Safe Childbirth Checklist” has been developed to support the delivery of essential maternal and perinatal care practices. The Checklist addresses the major causes of maternal death (haemorrhage, infection, obstructed labour and hypertensive disorders), intrapartum-related stillbirths (inadequate intrapartum care), and neonatal deaths (birth asphyxia, infection and complications related to prematurity). It was developed following a rigorous methodology and tested for usability in ten countries across Africa and Asia.
An implementation guide for health facilities has been developed to help birth attendants and health-care leaders successfully launch and sustain use of the WHO Safe Childbirth Checklist. The simple document lists basic interventions. Amongst the six instructions: “Encourage birth companion to be present at birth”.
Birth companions provide support to the mother during birthing and in the postpartum period. They can also recognise danger signs, alert health care workers in case of emergency and care for the baby. Possible birth companions are the spouse, a family member, friend, health worker or doula.
Evidence shows that birth companions can help to improve health outcomes. The emotional and psychological benefit cannot be emphasised enough. The presence of birth companions increases the likelihood that the mother will have a spontaneous vaginal delivery instead of caesarian, vacuum or forceps birth. Mothers with birth companions have also been shown to need fewer pain medication, to have shorter birthing process and be better satisfied with their delivery experience.
This is great news for doulas as they receive validation from the most influential health organisation in the world.
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 and most could be prevented.
Since 2012, WHO has been supporting a multi-centred randomized controlled trial in more than 100 hospitals in Uttar Pradesh, India, to test whether adoption of the Checklist improves health outcomes for mothers and newborns.
The trial is being conducted by the Ariadne Labs, a joint centre of Boston’s Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, with support from the Bill & Melinda Gates Foundation.