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You have no Choice but to go on: How Physicians and Midwives in Ghana Cope with High Rates of Perinatal Death

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Abstract

Objectives Healthcare providers in low-resource settings confront high rates of perinatal mortality. How providers cope with such challenges can affect their well-being and patient care; we therefore sought to understand how physicians and midwives make sense of and cope with these deaths. Methods We conducted semi-structured interviews with midwives, obstetrician-gynecologists, pediatricians and trainee physicians at a large teaching hospital in Kumasi, Ghana. Interviews focused on participants’ coping strategies surrounding perinatal death. We identified themes from interview transcripts using qualitative content analysis. Results Thirty-six participants completed the study. Themes from the transcripts revealed a continuum of control/self-efficacy and engagement with the deaths. Providers demonstrated a commitment to push on with their work and provide the best care possible. In select cases, they described the transformative power of attitude and sought to be agents of change. Conclusions Physicians and midwives in a low-resource country in sub-Saharan Africa showed remarkable resiliency in coping with perinatal death. Still, future work should focus on training clinicians in coping and strengthening their self-efficacy and engagement.

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Acknowledgments

Travel and study support were provided by GlobalREACH and the Student Biomedical Research Program of the University of Michigan. Dr. Gold received salary support from a K-23 from the National Institute of Mental Health. No funder had any role in project development, data collection, or review of the manuscript.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA

    Alissa D. Petrites

  2. Department of Medical Education, University of Michigan, Ann Arbor, MI, USA

    Patricia Mullan

  3. Family Medicine, Polyclinic Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Kathryn Spangenberg

  4. Department of Family Medicine and, Department of Obstetrics and Gynecology, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104-1218, USA

    Katherine J. Gold

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  1. Alissa D. Petrites
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  2. Patricia Mullan
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  3. Kathryn Spangenberg
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  4. Katherine J. Gold
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Correspondence to Katherine J. Gold.

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Petrites, A.D., Mullan, P., Spangenberg, K. et al. You have no Choice but to go on: How Physicians and Midwives in Ghana Cope with High Rates of Perinatal Death. Matern Child Health J 20, 1448–1455 (2016). https://doi.org/10.1007/s10995-016-1943-y

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  • DOI: https://doi.org/10.1007/s10995-016-1943-y

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