More than 60 million women give birth at home without skilled care every year, attended by family members, neighbors, traditional birth attendants or no one. More than 500,000 women die from pregnancy-related complications, mostly within the first 24 hours of birth. Many more women suffer poor health and long-term disability at the height of their family responsibility and productivity. In addition, almost 11 million children die before the age of 5 years, of which 38% die within the first month of life. Among those who die within the first month of life, 75% die within the first week, mostly within the first 24 hours of birth. Moreover, there are about 4 million stillbirths. The most vulnerable time period for both women and newborns is clearly in and around the time of birth. The social and economic consequences of maternal, newborn and child mortality is significant and the burden of mortality falls disproportionately on the world's poorest countries and on the poorest populations within countries.