Midwives’ perceptions of enablers and barriers of quality maternal healthcare in a rural public hospital in the Northern Cape Province

Background Midwives who practice in rural public hospitals mostly depend on each other during work. Continuous clinical development improves their skills when managing pregnant women from antenatal to postnatal care. This study aimed to explore and describe the midwives’ adjustment to enablers and barriers of quality maternal healthcare in a selected rural public hospital in the Northern Cape Province, South Africa, and how quality assurance can be maintained throughout. Methods A qualitative, exploratory, descriptive, and contextual approach was used. Data was collected through focused group discussions, using a semi-structured interview guide, adopting a non-probability purposive sampling technique of 23 participants (midwives and accoucheurs) with at least one year of working in the maternity ward at a selected rural public hospital in Northern Cape Province, South Africa. A thematic data analysis was used, with trustworthiness ensured through dependability, confirmability, credibility, transferability, and authenticity. Ethical considerations were maintained. Findings: Two main themes were identified, namely Theme 1: midwives’ adjustment to enablers of quality maternal healthcare, with two sub-themes: passion for midwifery and continuous teamwork, including consistent learning and clinical development in midwifery. Theme 2, midwives’ barrier to quality maternal healthcare, identified four sub-themes: lack of human resources, lack of material resources, inadequate and outdated hospital infrastructure and delayed emergency medical response for maternity care. Conclusion Midwives mostly rely on their passion and teamwork for maternal health services. Cooperative efforts contribute to providing quality healthcare to the mother and child, regardless of the negative experiences. Challenges such as lack of equipment, inadequate midwives, outdated hospital infrastructure and delayed emergency medical response for maternal healthcare form part of the barriers to quality maternal health care. Even though midwives are equipped with skills in caring for the mother and child through antenatal, intrapartum and postnatal care, many barriers still limit them from providing holistic quality nursing care. Therefore, fundamental support is still needed to improve the midwives at the selected rural public hospital.