Accra: '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.
According to Ghana News Agency, one mother recalled repeatedly reporting severe vomiting, only to be reassured that it was 'normal during pregnancy.' 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.
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. Her reflection resonated strongly with participants and reinforced an important message: every pregnancy is unique, and every mother's concerns deserve careful attention.
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.
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.
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. 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 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. 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.
The Women's Health Discourse Roundtable 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.