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Globally, almost 515,000 women die every year from maternal causes related to pregnancy or childbirth. Most research focuses on identifying high-risk cases or managing obstetric emergencies, in an attempt to reduce women’s risk of dying of maternal causes. While facility practices for normal labor were extensively examined and revised in Europe and North America in the 1970s and 1980s, little is known about facility practices for normal labor in many parts of the developing world. It is important for practitioners and policymakers to know the nature and frequency of common facility practices for normal labor. Substandard care has been identified by the Egyptian Ministry of Health and Population as the leading avoidable factor contributing to maternal deaths in Egypt. Much progress has been achieved regarding management of obstetric emergencies, however facility practices for normal labor are unexplored and undocumented in Egypt. With the support and collaboration of El Galaa hospital staff, a study was conducted in 2001 and yielded comprehensive data. This monograph presents one of the data collection tools—the observation checklist—and describes the process of developing the checklist and a critical analysis of its performance.