Maternal and child health is fundamental to the growth and development of any nation, ensuring safe childbirth practices for the well-being of both mothers and newborns. Despite global, national, and subnational interventions, maternal and neonatal morbidity and mortality remain high, particularly in developing countries. Each year, approximately 303,000 women die due to pregnancy-related complications, 2.6 million stillbirths occur, and 2.7 million newborns die within the first month of life, many of which could be prevented with effective interventions. In response to these challenges, the World Health Organization (WHO) developed the Safe Childbirth Checklist (SCC), designed to guide birth attendants through essential childbirth practices and the management of complications. The SCC builds upon the success of the WHO Safe Surgical Checklist and aims to improve the quality of maternal and newborn care globally. This study assesses the utilization of the WHO Safe Childbirth Checklist among midwives in health institutions in Imo State, Nigeria, to determine adherence levels, identify factors influencing its use, and provide insights for improving maternal and neonatal outcomes. Understanding the patterns and barriers to SCC adoption is critical for informing policy, enhancing training, and ultimately reducing preventable maternal and neonatal deaths.