Delivering Dignity Under Constraints: Midwives’ Perspectives on Respectful Maternity Care and Labour Pain Management: A Qualitative Study in Ghana

Abstract

Respectful Maternity Care (RMC) is vital for positive childbirth experiences and effective Labour Pain Management (LPM). This study examined midwives’ knowledge, practices, and the barriers to implementing RMC during LPM at the Shai Osudoku District Hospital (SODH) in Ghana. Using an exploratory qualitative design, data were collected between July and November 2023 through purposive interviews with 20 midwives. Thematic analysis revealed two main themes and six subthemes. Midwives demonstrated sound knowledge of RMC principles, acknowledging its role in alleviating pain and improving birth outcomes. Core practices included effective communication, dignity, respect, privacy, and informed consent. However, implementation was constrained by the absence of protocols, limited resources, staff shortages, heavy workloads, language barriers, low motivation, and negative client attitudes. While midwives value and strive to practice RMC, their efforts are hindered by institutional, provider, and client-related challenges. Strengthening RMC requires continuous training, clear protocols, adequate resources, incentives, and strategies to foster client cooperation, thereby promoting respectful care and positive maternal experiences.