Moral distress among midwives working in the labour ward of a hospital in Ghana

INTRODUCTION: The existing literature on moral distress is replete with studies conducted among nurses. That on midwives is however lacking. The aim of this study was to explore and understand moral distress from the perspective of and as experienced by midwives. METHODS: This study involved an exploratory and qualitative case study design and adopted the interpretative phenomenological approach to collect data from 8 Ghanaian female midwives working in the labour ward of a public Hospital in Sunyani, Ghana, using individual in-depth interviews. The data obtained through audio-taped recordings were transcribed verbatim and analysed, adopting Colaizzi’s qualitative analysis procedure. RESULTS: Three major themes were generated: perceived knowledge about moral distress, perceived causes of moral distress, and perceived effects of moral distress. The midwives perceived moral distress as stress arising from situations where they knew the right thing to be done or how to save a life but due to reasons such as resource constraints and disrespect from their colleagues and superiors, they were unable to do so. Moral distress often impacted negatively on midwives work performance and psycho-emotional wellbeing. Effects that manifested in the form of problems such as stomach sickness, sleepless nights, frustration, and anger, were mentioned. CONCLUSIONS: Efforts aimed at providing adequate logistics and resources, as well as improving communication, healthy interactions and interpersonal relationships among midwives and their colleagues should be intensified.