Promoting respectful maternity care: challenges and prospects from the perspectives of midwives at a tertiary health facility in Ghana

Veronica Millicent DZOMEKU*, Adwoa Bemah BOAMAH MENSAH, Emmanuel Kweku NAKUA, Pascal AGBADI, Joshua OKYERE, Peter DONKOR, Jody R. LORI

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

4 Citations (Scopus)


Evidence shows that women in Ghana experience disrespectful care (slapping, pinching, being shouted at, etc.) from midwives during childbirth. Hence, evidence-based research is needed to advance the adoption of respectful maternity care (RMC) by midwives. We therefore sought to explore and document midwives’ perspectives concerning challenges faced and prospects available for promoting RMC in a tertiary health facility.

We employed an exploratory descriptive qualitative study design. In total, we conducted 12 interviews with midwives educated on RMC. All audio data were transcribed verbatim and exported to NVivo-12 for data management and analyses. We relied on the Consolidated Criteria for Reporting Qualitative Research guideline in reporting this study.

The findings were broadly categorised into three themes: emotional support, dignified care and respectful communication which is consistent with the WHO’s quality of care framework. For each theme, the current actions that were undertaken to promote RMC, the challenges and recommendations to improve RMC promotion were captured. Overall, the current actions that promoted RMC included provision of sacral massages and reassurance, ensuring confidentiality and consented care, and referring clients who cannot pay to the social welfare unit. The challenges to providing RMC were logistical constraints for ensuring privacy, free movement of clients, and alternative birthing positions. Poor attitudes from some midwives, workload and language barrier were other challenges that emerged. The midwives recommended the appointment of more midwives, as well as the provision of logistics to support alternative birthing positions and privacy. Also, they recommended the implementation of continuous training and capacity building.

We conclude that in order for midwives to deliver RMC services that include emotional support, dignified care, and respectful communication, the government and hospital administration must make the required adjustments to resolve existing challenges while improving the current supporting activities.
Original languageEnglish
Article number451
Number of pages15
JournalBMC Pregnancy and Childbirth
Issue number1
Early online date31 May 2022
Publication statusPublished - Dec 2022

Bibliographical note

We acknowledge the midwives who participated in this study and shared their perspectives about challenges faced and prospects available for promoting RMC.

The research reported in this publication was supported by a grant awarded by the National Institutes of Health through the Fogarty International Center under Award Number K43TW011022 to VMD. The content is solely the responsibility of the authors and does not represent the official view of the funder. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

© 2022. The Author(s).


  • Female
  • Ghana
  • Health Facilities
  • Humans
  • Maternal Health Services
  • Midwifery
  • Parturition/psychology
  • Pregnancy
  • Midwives
  • Dignified care
  • Respectful maternity care
  • Respectful communication


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