20% of pregnancies are at risk. In low-resource settings, the challenge is to identify these 20% earliest, to reduce maternal and infant mortality. This checklist empowers lay and professional healthcare workers to recognize signs of high risk pregnancies, and encourages early referral to the closest healthcare centers for safe deliveries. It is also designed to raise awareness on healthy habits and to encourage antenatal check-ups. The checklist comes in different forms. There are a pocket-sized, waterproof and non-tearable booklet and a dual-function bag that, when open, becomes a poster to facilitate training and group communication to reaching out pregnant women & their families. The checklist booklets are tested and deployed in fragile environments through a pilot study led by the International Committee of Red Cross. Since January 2017, the checklists are being used by Traditional Birth Attendants and healthcare workers in selected sites in South Sudan and northern Nigeria.