Almost half of the under-5 mortality in resource-limited settings occurs within the neonatal period (birth to 28 days of life). Despite improvements to under-5 mortality globally, the rate of improvement in the neonatal population is much slower. The vast majority of neonatal deaths are attributed to prematurity, intrapartum complications, congenital anomalies, and infection. Recognizing the sick infant at birth and effective resuscitation of the newborn is critical, and many low-cost interventions have the greatest impact in improving outcomes. This chapter focuses on actions that can be taken during delivery and the immediate postpartum period to improve the immediate care of the newborn after birth by following the clinical guidance described in the World Health Organization Essential Newborn Care 1.