Direct maternal infections around the time of childbirth account for about one tenth of the global burden of maternal death. Women who experience peripartum infections are also prone to severe morbidity and long-term disabilities such as chronic pelvic pain, fallopian tube blockage and secondary infertility. Maternal infections before or during childbirth are also associated with an estimated 1 million newborn deaths annually. Several factors increase the risk of maternal peripartum infections, including pre-existing maternal conditions (e.g. malnutrition, diabetes, obesity, severe anaemia, bacterial vaginosis and group B streptococcus infections), as well as prelabour rupture of membranes, multiple vaginal examinations, manual removal of the placenta, operative vaginal birth and caesarean section. As such, the strategies to reduce maternal peripartum infections and their shortand long-term complications have been directed at improving infection prevention and control practices. Globally, an effective intervention for preventing morbidity and mortality related to maternal infection is the use of antibiotics for prophylaxis and treatment. However, the misuse of antibiotics for obstetric conditions and procedures is common in many settings. Inappropriate antibiotic use has implications for the global effort to prevent and reduce antimicrobial resistance. The WHO global strategy for containment of antimicrobial resistance underscores the importance of appropriate use of antimicrobials at different levels of the health system to reduce the impact of antimicrobial resistance, while ensuring access to the best treatment available. WHO guidelines for health professionals and policy-makers on the need for antibiotics – and the type of antibiotics – for the prevention and treatment of maternal peripartum infections align with the WHO strategy and, if implemented, will improve maternal and newborn outcomes. In 2019, the Executive Guideline Steering Group (GSG) for World Health Organization (WHO) maternal and perinatal health recommendations prioritized updating of the existing WHO recommendation for routine antibiotic prophylaxis for women undergoing operative vaginal birth in response to the availability of new evidence. The recommendation in this document thus supersedes the previous WHO recommendation on routine antibiotic prophylaxis for women undergoing operative vaginal birth as published in the 2015 guideline WHO recommendations for prevention and treatment of maternal peripartum infections.