Maternity care is one of the things Ghana does comparatively well. Antenatal care is free under the NHIS, delivery is covered, and the network of midwives reaches further than almost any other service.
Antenatal care
Register early, at a hospital, polyclinic or health centre. First trimester if you can.
NHIS covers antenatal care and delivery, and pregnant women are exempt from NHIS premiums — so registering for NHIS while pregnant is both free and immediately useful.
You will be given a maternal health record book. Keep it. Bring it to every appointment, and bring it when you deliver.
Expect: monthly visits becoming fortnightly then weekly, blood and urine tests, ultrasound scans, blood pressure monitoring, tetanus vaccination, and intermittent preventive treatment for malaria, which matters a great deal in pregnancy.
Where to give birth
Public hospitals. Korle Bu, Ridge, 37 Military, UGMC and the district hospitals. Covered by NHIS. Busy, experienced, and the right place if anything is complicated.
Polyclinics and health centres handle uncomplicated deliveries with midwives, and refer upward when needed.
Private hospitals. Nyaho, the Bank Hospital, Lister, Trust and others. Short waits, private rooms, and you pay for it.
Maternity homes run by licensed midwives are common and well used, particularly outside the wealthier suburbs.
Home birth happens but is not the norm in Accra and is not recommended where a facility is reachable.
Decide early, and have a second option. Traffic decides more Accra birth stories than anyone would like.
What it costs
Under NHIS at a public facility, delivery is covered. You will still be given a list of items to bring, and you should expect to buy them.
The list. Every Ghanaian mother knows this list. Roughly: cotton wool, sanitary pads, disinfectant, gloves, a bucket, wrappers or old cloth, baby clothes, blankets, nappies, soap, a flask. The facility will give you its own version at booking. Assemble the bag by month seven.
Private delivery is a different order of cost entirely and varies by hospital and by whether it is a caesarean. Ask for the full package price in writing, and ask specifically what is excluded if there are complications.
Your rights at work
Under the Labour Act 2003 (Act 651):
- 12 weeks paid maternity leave, extended to 14 weeks after a caesarean or the birth of two or more children
- An hour a day for nursing, counted as working time
- You cannot be dismissed because you are pregnant, on maternity leave, or absent with a related illness
There is no statutory paternity leave in Ghana. Some employers offer it.
Registering the birth
Register with the Births and Deaths Registry — ideally before you leave the hospital, since most facilities can start it for you.
The birth certificate is needed for school admission, a passport and eventually a Ghana Card. Registration within twelve months is straightforward; afterwards it becomes an ordeal. Do it immediately.
You will need the hospital’s notification of birth, both parents’ identification, and the details you want on the certificate. Check the spelling of every name before you sign.
Citizenship
A child born in Ghana is a Ghanaian citizen if at least one parent or grandparent is or was a citizen. Birth in Ghana alone does not confer citizenship.
If you are a foreign national, register the birth with your own embassy as well — usually a consular report of birth abroad, which is what gets your child their other passport.
The customs
Outdooring. The naming ceremony, traditionally on the eighth day. The child is brought outside and formally named, family gather, and contributions are given. Among Akan people the child also receives a day name for the day of the week they were born.
Confinement. In many families the mother and baby stay in for the first days or weeks, with family taking over the household. Accept the help.
Everyone will have advice. Grandmothers especially, and much of it is good. Some of it conflicts with what the midwife said. The midwife wins on clinical matters.
Funerals and social obligations — the same machinery of obligation, in a happier direction. Creches and daycare