Birthrights photo pack Selina Accra The captions are in the notes section

Selina Fletcher, 30, prepares to go to the labour ward of Korle Bu Teaching Hospital, Accra, Ghana’s premier health care facility. In Ghana, Selina is one of the lucky ones – many pregnant women here still do not get the quality, free health care they are entitled to.

Selina’s overnight bag Selina’s overnight bag. In Ghana, many patients are required to bring their own disinfectant, bed sheet, hair net and cloths. Selina didn’t bring these items with her, and was told to buy them as soon as she arrived. The policy of free health care for pregnant women in Ghana was a big step forward, but these extra costs are still unaffordable for many.

Selina is taken to the labour ward through the busy waiting area of Korle Bu Hospital, Accra.

As Selina’s contractions intensify, the midwife examines her using the basic equipment available. Further investment is needed to train more health workers and provide modern equipment and medicines, so more women can survive childbirth.

After five hours in labour, Selina gives birth to a girl After five hours in labour, Selina gives birth to a girl. A midwife is there throughout delivery and helps to clean the baby. Across Ghana, nearly half of all women give birth without assistance from a qualified health worker.

Savina, named after her Grandmother, opens her eyes for the first time.

Selina and her baby girl Savina take rest in a ‘lying-in’ ward.

Around 35 hours after giving birth, Selina (far right) leaves the hospital with her friends and family.

Selina’s friend Sarah (left) helps her to settle in at home after the taxi ride from the city.

Selina’s two sons meet their baby sister for the first time Selina’s two sons meet their baby sister for the first time. Selina is fortunate to have benefited from Ghana’s free health care policy, but not all women are as lucky. Not all women here are aware of their right to free care, a situation made worse by low levels of literacy and limited education on health-related issues.

Birthrights photo pack Adumporka Bolgatanga The captions are in the notes section

Adumporka Abotiyure gives birth in Sumbrungu Health Centre in Bolgatanga, north east Ghana. In rural areas like this, access to skilled, free health care is much lower than the national average, due to a critical shortage of trained health workers and clinics. Some health centres even lack electricity and clean water.

Adumporka has brought her own soap, mug, disinfectant, bed sheet and cloths, as required by many health centres in Ghana. The extra cost of these items means some women are not able to take advantage of free health care.

Adumporka’s new-born baby boy.

Adumporka (right) was brought to the health centre by a traditional birthing attendant, 72-year-old Atulepoka (left), who remains by her side throughout. In rural areas like this, many women don’t seek hospital care because they prefer to use these traditional birthing attendants. But these health workers are often unqualified, and don’t have the skills to save lives when complications arise.

Baby and mother take a moment’s rest Baby and mother take a moment’s rest. After just a couple of hours, they are asked to leave as there is limited space. It’s a reminder that more investment is needed in health centres, medicines and equipment, so more pregnant women can receive free health care.

Adumporka and her baby boy prepare for the trip home Adumporka and her baby boy prepare for the trip home. This is another example of free health care protecting new mums and their babies – but much more needs to be done. Many women in remote, northern areas of Ghana are still not getting the health care they desperately need.

Adumporka travels the 4km journey home on the back of her husband’s motorbike, carrying her new-born son in her arms. In northern Ghana, less than half the population live within an hour’s travel of a hospital or health clinic. This is preventing many women getting the free health care they deserve.

Adumporka’s mother-in-law holds her new grandson Adumporka’s mother-in-law holds her new grandson. He will be named as part of a traditional ceremony, where family members decide if he is a reincarnated relative.

Adumporka’s relatives and the traditional birthing attendant bury the placenta and umbilical cord. Tradition requires a burial so that the woman remains fertile.

Adumporka stays indoors for three days after the birth, according to the local tradition. During this time, her mother-in-law washes her regularly in shea butter.