Background: Maternal and neonatal mortality remain major public health concerns, particularly in low-resource settings where maternity care quality is inconsistent. The World Health Organization Safe Childbirth Checklist (WHO SCC) was developed to improve adherence to essential childbirth practices and reduce preventable maternal and neonatal morbidity and mortality. However, evidence of its effectiveness remains mixed. This systematic review and meta-analysis evaluated the impact of the WHO SCC on the timely management of eclampsia/preeclampsia, maternal mortality, and stillbirth rates.

Materials and Methods: A systematic search was conducted in PubMed, EBSCO, and Scopus for English-language studies published between 2004 and 2024. Eligible studies included randomized controlled trials, pre-post studies, and quasi-experimental designs. Data were extracted using a standardized form. Pooled estimates were calculated using a random-effects model and the Mantel-Haenszel method. Only studies reporting appropriate ethical approval or clearance were included.

Results: Of 1,147 identified records, 11 studies involving 174,994 births met the inclusion criteria. WHO SCC implementation significantly improved the timely management of eclampsia/preeclampsia (RR: 3.09, 95% CI: 1.23–7.74, p = 0.020). However, no statistically significant effects were observed on maternal mortality (RR: 1.13, 95% CI: 0.83–1.54, p = 0.42) or stillbirth rates (RR: 1.18, 95% CI: 0.77–1.83, p = 0.45).

Conclusion: The WHO SCC significantly improves the timely management of eclampsia/preeclampsia but does not significantly reduce maternal mortality or stillbirth rates. Its integration into routine maternity care should therefore be accompanied by complementary interventions addressing broader determinants of maternal and neonatal survival. Further high-quality research is needed to identify strategies that can maximize the checklist’s effectiveness and improve overall maternity outcomes.

Keywords: Maternal health, Meta-analysis, Neonatal mortality, Quality improvement, Stillbirth, WHO Safe Childbirth Checklist.