Despite global attention, high levels of maternal mortality continue to plague many low- and
middle-income settings. One important way to improve the care of women in labour is to increase
the proportion of women who deliver in a health facility. However, due to poor quality of care,
including being disrespected and abused, women are reluctant to come to facilities for delivery
care. The current study sought to examine disrespectful and abusive treatment towards labouring
women from the perspective of midwifery students who were within months of graduation.
For this study, we conducted focus groups with final year midwifery students at 15 public midwifery
training colleges in all 10 of Ghana’s regions. Focus group discussions were recorded and transcribed.
A multi-disciplinary team of researchers from the US and Ghana analysed the qualitative
data.
While students were able to talk at length as to why respectful care is important, they were also
able to recount times when they both witnessed and participated in disrespectful and abusive
treatment of labouring women. The themes which emerged from these data are: 1) rationalization
of disrespectful and abusive care; 2) the culture of blame and; 3) no alternative to disrespect
and abuse.
Although midwifery students in Ghana’s public midwifery schools highlight the importance of providing
high-quality, patient-centred respectful care, they also report many forms of disrespect and
abuse during childbirth. Without better quality care, including making care more humane, the use
of facility-based maternity services in Ghana is likely not to improve. This study provides an important
starting point for educators, researchers, and policy makers to re-think how the next generation
of healthcare providers needs to be prepared to provide high-quality, respectful care to
women during labour and delivery in low-resource settings.