A feature by Jemima Nontaa Dery and Vera Bonku Turkson
Accra, Aug. 3, GNA – “Please listen to me. Something doesn’t feel right!”
No expectant mother should have to repeat those words. Yet, during a recent Women’s Health Discourse virtual roundtable on maternal healthcare in Ghana, several mothers recounted experiences of feeling unheard while seeking care during pregnancy.
One mother recalled repeatedly reporting severe vomiting, only to be reassured that it was “normal during pregnancy.”
“My severe vomiting was repeatedly dismissed as ‘normal during pregnancy’, even after I explained that I had not experienced vomiting from the beginning of the pregnancy. I only received treatment after insisting that something was wrong,” she recounted.
Her experience was not presented as an isolated incident or an indictment of healthcare professionals. Rather, it served as the starting point for a broader discussion on one of the least recognised, yet most critical, components of quality maternal healthcare—effective communication.
To explore the issue, health communication researchers Jemima Nontaa Dery and Vera Bonku Turkson of the University of Kentucky convened the first in a series of Women’s Health Discourse Roundtables. The virtual dialogue brought together six experienced nurses and midwives and six mothers to examine communication between healthcare providers and women during pregnancy, labour and childbirth.
The participants discussed trust, respectful maternity care, information sharing and practical ways of improving maternal healthcare delivery in Ghana.
The discussion comes at a crucial time. Ghana’s maternal mortality ratio remains about 310 deaths per 100,000 live births, more than four times the Sustainable Development Goal target of 70 deaths per 100,000 live births by 2030.
While continued investment in skilled personnel, emergency obstetric services and healthcare infrastructure remains essential, participants agreed that communication deserves equal attention.
Every well-informed decision begins with a conversation.
Research in health communication shows that patient-centred communication strengthens trust, improves patient satisfaction, promotes shared decision-making, encourages treatment adherence and contributes to better health outcomes. During pregnancy, effective communication also helps reduce anxiety, enables women to recognise danger signs early and empowers them to make informed decisions about their care.
The experiences shared by the mothers reflected these findings. Many said what troubled them most was not merely experiencing pregnancy-related symptoms, but feeling that their concerns had been dismissed before they were fully understood.
Several first-time mothers said they had been told their symptoms were “normal” without receiving adequate explanations as to why they were considered normal or when they should seek urgent medical attention.
For the mother whose persistent vomiting was repeatedly dismissed, patient-centred communication would have gone beyond kindness. It would have meant taking her concerns seriously enough to conduct a proper assessment, explain possible causes and provide reassurance based on clinical evaluation rather than assumption.
Persistent vomiting during pregnancy may require further assessment to rule out conditions such as hyperemesis gravidarum, dehydration or other pregnancy-related complications.
Significantly, the nurses and midwives participating in the discussion did not dismiss the concerns raised by the mothers. Instead, they acknowledged that effective communication is often constrained by the realities of the healthcare system.
Heavy patient loads, staff shortages and professional burnout, they noted, frequently leave healthcare providers with little time to explain procedures, answer questions or build trusting relationships with mothers.
Doreen Araba Korsah, a nurse at Sekyere Kumawu District Hospital, acknowledged the challenge.
“Experience and workload can sometimes result in routine approaches to maternity care that overlook each woman’s unique experience,” she observed.
Her reflection resonated strongly with participants and reinforced an important message: every pregnancy is unique, and every mother’s concerns deserve careful attention.
Communication vital to safer maternal healthcare
Part II
Recognising these challenges, the nurses and midwives proposed one of the dialogue’s strongest recommendations: continuous professional development in patient-centred communication, Respectful Maternity Care and emotional intelligence.
Communication is often regarded as a soft skill. In maternity care, however, participants argued that it is an essential clinical competence.
Patient-centred communication enables healthcare providers to listen actively, acknowledge patients’ concerns, explain diagnoses and procedures in language they can understand, involve women in decisions about their care and create opportunities for questions. Emotional intelligence complements these skills by equipping healthcare professionals to respond to fear, anxiety and vulnerability with empathy and professionalism.
Participants agreed that regular training in these areas would strengthen therapeutic relationships between mothers and healthcare providers, reduce dismissive communication and foster greater trust throughout pregnancy and childbirth.
Beyond interpersonal communication, the dialogue identified broader systemic challenges that also affect the quality of maternal healthcare.
Although some health facilities have introduced WhatsApp platforms to remind expectant mothers of antenatal appointments and provide follow-up support, participants observed that such initiatives remain limited to a relatively small number of facilities.
Emmanuella Abdullai, a midwife at Holy Family Hospital in Techiman, noted that many women remain excluded because they lack smartphones, internet access or the digital literacy needed to participate in such platforms.
She called for more inclusive communication strategies to ensure that no woman is denied access to vital maternal health information because of the digital divide.
Language barriers also emerged as a significant concern.
Nurses working in communities where they do not speak the local language often rely on relatives or informal interpreters to communicate with patients. While this practice may facilitate understanding, participants observed that it could compromise patient confidentiality and discourage mothers from discussing sensitive health concerns openly.
They therefore advocated greater investment in culturally and linguistically responsive healthcare to strengthen trust and improve communication between healthcare providers and patients.
The discussion also highlighted the importance of birth companionship.
Felicity Angabey, a midwife, advocated allowing trusted family members to accompany women during labour and childbirth wherever facility conditions permit.
“Trusted family members can strengthen communication during childbirth, reduce anxiety and help build confidence between mothers and healthcare providers,” she said.
Although infrastructure constraints make this difficult in some health facilities, participants believed that expanding opportunities for birth companionship would enhance women’s childbirth experiences while improving communication throughout the delivery process.
Another important concern raised during the dialogue was the limited education provided on Caesarean sections during antenatal care.
Several mothers said they received little information about Caesarean births before labour, leaving many frightened and unprepared when emergency surgery became necessary.
Participants observed that persistent cultural and religious misconceptions continue to reinforce stigma surrounding Caesarean births.
They recommended broader public education involving healthcare professionals, religious leaders, men, community organisations and the media to improve understanding and dispel misconceptions surrounding the procedure.
The dialogue also acknowledged ongoing efforts within nursing and midwifery education to strengthen Respectful Maternity Care and therapeutic communication.
Participants noted that accountability mechanisms increasingly provide mothers with opportunities to report disrespectful treatment and seek appropriate redress.
They described these initiatives as important steps towards improving the quality of maternal healthcare in Ghana, while emphasising that sustained commitment to professional development and supportive health systems remains essential.
Despite these encouraging developments, participants agreed that learning should not end with formal nursing and midwifery education.
Healthcare communication continues to evolve in response to changing technologies, patient expectations and community needs. They therefore advocated making regular in-service training in patient-centred communication, emotional intelligence and Respectful Maternity Care an integral part of professional development across Ghana’s health system.
Such continuous learning, they argued, would equip healthcare providers with the skills needed to communicate more effectively, build stronger therapeutic relationships and respond more compassionately to the needs of women during pregnancy and childbirth.
Participants were unanimous that communication alone will not eliminate maternal mortality. Ghana must continue investing in skilled healthcare professionals, district hospitals, referral systems and emergency obstetric services to improve maternal and newborn outcomes.
However, they stressed that communication shapes how women experience the care they receive.
When mothers feel heard, respected and involved in decisions affecting their health, they are more likely to seek medical care promptly, ask questions, adhere to treatment and return for future maternal health services.
For healthcare professionals, effective communication can reduce misunderstandings, minimise conflict, strengthen trust and enhance professional satisfaction.
The Women’s Health Discourse Roundtable therefore concluded with a simple but compelling message: improving maternal health requires stronger collaboration among healthcare providers, researchers, policymakers, communities and families.
Participants maintained that while investments in medical technology, infrastructure and policy reforms remain indispensable, meaningful improvements in maternal healthcare often begin with something far less expensive but equally transformative – listening.
Sometimes the most important intervention is not a new medicine, a sophisticated technology or another policy directive. Sometimes it begins with a conversation that assures a woman her voice matters and her concerns will be taken seriously.
Every mother deserves not only safe, skilled and timely clinical care but also the confidence that when she says, “Something doesn’t feel right,” someone will truly listen.
GNA
Edited by Beatrice Asamani Savage
Jemima Nontaa Dery and Vera Bonku Turkson are health communication researchers at the University of Central Florida and University of Kentucky, respectively