Midwives’ rural health experiences of ‘being-with’ women and newborns in labour and delivery settings, Ghana: Implications for policy and planning 

Abstract Introduction: The global shortage of midwives and skilled birth attendants is a major risk factor for quality health service delivery in resource limited settings. This gap in skilled health workforce impacts quality labour and delivery services and the survival of pregnant women and their newborns, as well as midwives’ emotional and physical wellbeing. In resource-constrained contexts where midwives practice as fontline health workers, respectful maternal and newborn care delivery is compromised as midwives encounter continual distress with health system gaps. In Ghana, midwives in rural practice work as frontline health staff but their lifesaving efforts in maternal and newborn health have least been researched. We therefore aimed to explore, gain insight, and offer in-depth descriptions of the meanings embedded in midwives’ contextual experiences of being-with women and newborns in birth settings of southern rural Ghana. Methods: Thirteen (13) midwives were purposively and conveniently sampled, and data were collected through face-to-face in-depth interviews. Data were content analysed and three major themes emerged. Results: The study findings revealed that midwives in rural practice face complex distress circumstances that require resilience and capacity to embrace peculiarities, typically in emergency situations within resource-constrained settings where families are engaged as lifesaving companions to save maternal and newborn lives. Conclusions: Reviewing policies on rural health care delivery focused on primary health care, planning on rural midwifery postings and creating support network for midwives are critical for saving maternal and newborn lives and improving retention of rural midwives at post. Future research is required to examine midwives’ resilience in rural practice and intention to stay for delivering quality maternal and newborn community health care service.