Motherhood is not easy.

In fact, I have frequently heard and seen it described as a form of physical trauma. So much so that one American TikToker created an ongoing list of horrifying things that can happen during pregnancy. People often describe this ‘List’ as a form of contraception. 

In Ghana, apart from all the terrors that ‘The List’ holds, women must also face a maternal mortality rate of 264 out of every 100,000 births (2020). Even if these women survive, they must face the odds that their children will not. Per Dr Alexander Manu, in 2020, 39,000 babies died in their first month of life, and of these, 75% died during the first week. I cannot imagine a more painful experience than enduring nine months of physical trauma, which inflicts lifelong changes on your body, only for it to be futile.

While some might argue that Ghana has done well to reduce its maternity mortality rate from 499 per 100,000 births in 2000, Dr Manu pointed out that the rate of decrease has slowed down significantly since 2010 and is in danger of plateauing if more is not done. Moreover, the women who fall victim to these issues the most are poorer women. These women are less likely to have access to medical support due to transportation issues, reduced subscriptions to NHIS and increased distance from healthcare providers. He outlined the Inverse Equity Hypothesis which suggests that poorer women only experienced improvements in their medical care when they “trickled down” from the rich, who tend to benefit from medical improvements most, albeit needing them least.

However, Dr. Manu was also generous enough to provide solutions. He used the results of his own research to demonstrate that interventions which targeted the needs of the poorer women in certain villages were able to decrease their fatalities to rates that were even below those of higher socio-economic status. Using this method of intervention which restores equitable balance, as far as I’m concerned, is essential not just in healthcare and childcare, but across the board.

Another aspect of maternity protection that sharply impacted me was the lack of job security and maternity leave that is awarded to Ghanaian women. One speaker at the conference shared how she was forced to go back to work two weeks after giving birth for fear of losing her job, while another said that she was denied a promotion due to having given birth that year. People also pointed out that the government recommends that mothers breastfeed for six months, but women are only given twelve weeks of maternity leave. Idiosyncrasies like this demonstrate how much is expected of women and how few allowances are made to help us meet these expectations. 

Near the end of the conference, it was pointed out that while increasing maternity leave and advocating for more laws to protect mothers is important, we should first aim to ensure that all women benefit from the existing laws. I thought this was immensely astute - a society is only as strong as its weakest member and, as highlighted by the Inverse Equity Hypothesis, improvements tend to favour first those who need them least. 

Another issue that was raised at the end of the conference had been on my mind throughout. All of this legislation for maternity protection could only ever protect women working in the formal economy. However, the Ghanaian economy is fundamentally propped up by the informal economy, and more specifically the women who contribute to it. These include food sellers, farmers, market women etc. who would never even be able to dream of maternity leave, a nursing area or childcare. One woman even mentioned how the children of farmers had been playing with pesticides because their mothers had no choice but to bring them to work. While it is potentially difficult to think of a solution that would benefit these workers, I believe it’s important to keep them in mind as an essential part of Ghana’s labour force.

While I was sitting in this workshop, I began to feel a deep sense of dread at the thought of having children. I might be discriminated against at work. I might lose my job. I might be forced to work after just having given birth. Worst of all, I or my child might die. Although I don’t live in Ghana, attending the conference made these outcomes feel imminent and predetermined. I started to ask myself whether it was worth it. I’m sure the average Ghanaian woman doesn’t have access to the information shared at this event, or they might feel the same. If we as a people don’t do something to protect the women who ensure the future of our nation, we cannot expect them to keep sacrificing their bodies, careers and well-being for us.

Thankfully, the aim of this conference was for the CSJ to develop a position paper from the various deliberations. This position paper will then be an advocacy tool with government, health authorities, labour and employer’s associations including the Trades Union Congress and political parties developing their manifestos for the 2024 Presidential and Parliamentary elections in Ghana. It will be interesting to see what is recommended in this position paper and the extent to which the varied groups adopt and enforce the given suggestions.

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The writer, Emerald Effe Ace-Acquah is a graduate of Oxford University and currently works with the Centre for Social Justice in Accra as an intern. CSJ is a think tank advocating for progressive social transformation and people-centred development. She can be reached at emeraldacecquah@icloud.com.