Obstetric violence informed by theories of intersectionality, oppression, and power dynamics—a Ghanaian’s perspectives

Abstract

This essay explores obstetric violence (OV) from a Ghanaian perspective, applying theories of intersectionality, oppression, and power dynamics to critically analyze its causes and manifestations. OV, defined as mistreatment during childbirth, includes acts of physical abuse, nonconsensual care, discrimination, and breaches of privacy. Despite efforts to reduce maternal mortality in Ghana, systemic challenges persist, contributing to a high prevalence of OV, particularly among vulnerable groups such as adolescents, the socioeconomically disadvantaged, and ethnic minorities. The essay highlights that midwives, while essential to maternal care, often operate within oppressive healthcare systems characterized by poor resourcing, rigid hierarchies, and systemic gender bias. Through the lens of intersectionality, the study reveals how overlapping social identities—such as age, ethnicity, and socioeconomic status—influence women’s vulnerability to mistreatment. Oppressed group theory explains how midwives, themselves marginalized within patriarchal and medically dominated structures, may internalize oppression and perpetuate violence toward patients. Foucault’s theory of power and knowledge is used to illustrate how institutional norms and knowledge hierarchies empower midwives to exercise control over birthing women, often compromising women’s autonomy and dignity. The essay further discusses how systemic issues, including underinvestment in healthcare infrastructure, inadequate training on respectful maternity care, and normalization of abusive practices, contribute to the persistence of OV. It calls for comprehensive reforms such as empowering midwives through education and leadership training, decentralizing healthcare authority, promoting respectful maternity care practices, and addressing systemic inequities. Raising awareness, fostering accountability, and embedding patient-centered care principles into healthcare institutions are critical steps toward eliminating OV. Ultimately, the essay argues that addressing OV in Ghana requires not only confronting individual behaviors but dismantling the deeper structural and institutional forces that sustain power imbalances and systemic oppression. Empowering both midwives and birthing women is essential for transforming maternity care and advancing equitable, respectful maternal health outcomes in Ghana.