Perspectives on midwife-led care as a solution to reduce obstetric violence in health facilities in Ghana

Abstract

Background: Ghana's maternal mortality rate is substantially higher, well above the global target of 70 per 100,000 births. Despite high antenatal care attendance, less than seventy per cent of births are attended by skilled personnel, with some women opting for home births with unskilled attendants due to obstetric violence. Obstetric violence and the abuse inflicted by healthcare workers on pregnant women during childbirth deter women from facility-based births and exacerbate maternal mortality. Objective: To explore how implementing midwife-led care can mitigate obstetric violence and enhance maternal health outcomes in Ghana through a literature-informed perspective. Approach: Existing evidence was drawn from primary and secondary sources, including the World Health Organisation and the International Confederation of Midwives. Literature was synthesised to identify common patterns across studies. Results: Implementing midwife-led care, which emphasises a bio-psycho-social approach and supports women's autonomy and comfort, can mitigate obstetric violence and enhance maternal health outcomes. Scaling up midwife-led primary care and providing training in humanised care at health facility levels are essential steps toward this goal. Conclusion: Midwife-led care is a valid and evidence-based approach, proven effective in multiple countries. Implementation is feasible in Ghana but requires system readiness and stakeholder engagement.