Background: In Ghana, midwives are the primary maternity care providers. Their knowledge of postpartum care is critical for preventing and reducing maternal deaths because it affects the quality of care provided to women. Also, midwives’ knowledge of post-birth warning signs is important for early identification and management of complications. This study assessed midwives’ knowledge of postpartum care and post-birth warning signs in order to develop interventions to improve patient care.

Methods: A cross-sectional survey of 246 midwives was conducted in the four main hospitals of Tamale, Ghana. Data were collected using a postpartum care knowledge questionnaire developed by JHPIEGO. Data were analyzed in SAS version 9.4 using descriptive, bivariate, and multivariate statistics.

Results: Mean age of midwives was 31.87 years. The percentage of midwives who responded correctly to each postpartum care question ranged from 41.6% to 84.9%. Most midwives were knowledgeable about breastfeeding—however, knowledge about fundus location, postpartum examination, and care during first two hours postpartum were low. Hospital was associated with knowledge of postpartum care (p<0.0001). Only 28.1% of midwives identified all nine warning signs of complications. Most midwives could identify severe bleeding, severe headaches, and high temperature as warning signs—however, knowledge of warning signs of life-threatening complications such as pain in chest, obstructed breathing, and thoughts of hurting oneself were low. More years of experience was associated with knowledge of post-birth warning signs (p=0.03).

Discussion: Findings suggest a need for additional training of midwives in how to care for postpartum patients as well as in warning signs for life-threatening complications.