Maternal and child health is fundamental to national development and remains a major priority in healthcare systems worldwide. Despite global initiatives and interventions, including the Sustainable Development Goals (SDGs), maternal and neonatal mortality and morbidity continue to pose significant challenges, particularly in developing countries. Annually, approximately 130 million births occur globally, with an estimated 303,000 women dying from pregnancy- or childbirth-related causes, 2.6 million stillbirths, and 2.7 million neonatal deaths—nearly 45% of all under-five child deaths. Many of these outcomes are preventable through the implementation of safe and effective childbirth practices. Understanding the utilization patterns of evidence-based tools, such as the WHO Safe Childbirth Checklist, among healthcare providers is essential to improving maternal and newborn outcomes. This study examines the usage patterns of the WHO Safe Childbirth Checklist among midwives in Imo State, highlighting areas for improvement in adherence and identifying potential strategies to enhance safe childbirth practices