USAID, the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, DFID, and KOICA have joined together to launchSaving Lives at Birth: AGrand Challenge for Development,to find the tools and approaches to help the mothers and newborns during their most vulnerable hours. We seek groundbreaking prevention and treatment approaches for pregnant women and newborns in poor, hard-to-reach communities around the time of delivery. This is the period when the majority of maternal and newborn deaths occur and the population that has been the most difficult to reach. We seek innovative ideas that can leapfrog conventional approaches in three main domains: (1) technology; (2) service delivery; and (3) “demand side” innovation thatempowers pregnant women and their families to practice healthy behaviors and be aware of and access health care during pregnancy, childbirth and the early postnatal period, especially the first two days after birth.