What Midwives in Ghana and the US Are Teaching Me About Care and Community
By Liz Friedman, Co-Founder and CEO of GPS Group Peer Support
I recently had the opportunity to join a conversation with midwives and health workers from Midwifery Exchange in Ghana, a group of midwives, doctors, and physician assistants based in Ghana and the US, who are beginning to explore what it might look like to bring peer support more intentionally into their maternal and community health settings. To help jumpstart this journey, GPS provided free facilitator training to the healthcare team in Ghana.
As our conversation unfolded, it became increasingly clear that the core ideas behind peer support are not new to the communities we were speaking with. In many ways, they are already deeply embedded in how care is practiced and shared.
The folks from Midwifery Exchange described how they organize groups within their communities—mother-to-mother groups, father-to-father groups, and adolescent support groups—where people come together to share experiences and support one another. They explained that someone who has lived through a particular experience is often best positioned to support another person going through something similar, because that shared understanding builds trust in a way that formal structures sometimes cannot.
What struck me is that this is, at its core, the same principle that underlies the GPS model. The difference is not in the existence of peer support, but in how it is articulated and structured. What GPS offers is not a replacement for what already exists, but rather a framework. We provide a way of naming, organizing, and strengthening practices that are already present in the community.
That sense of recognition came through for the participants from Midwifery Exchange. One of the midwives described the GPS training experience as feeling like a “warm hug,” not because it was simple, but because it affirmed something she had already been doing intuitively and gave her language and structure to deepen it.
One of the most powerful insights from the conversation was the way knowledge travels within these communities. Rather than remaining centralized, it moves outward through relationships and shared experience. In Ghana, when facilitators receive training, they do not hold that knowledge in isolation. Instead, they bring it back to their respective groups and share it with others, who in turn pass it along within their own networks. In this way, the community itself becomes the primary vehicle for dissemination, with knowledge flowing through trusted relationships rather than formal hierarchies.
This raises an important question for those of us working with structured models: If knowledge is already moving in this way, what does it mean to support that process without disrupting it? How do we contribute in a way that strengthens what is already working, rather than inadvertently replacing or reshaping it?
Caring for the Caregivers
Another important thread in the conversation centered on the well-being of the health workers themselves. There was a shared recognition that while much of the focus is often on patients and communities, the providers delivering care also need spaces for support. One participant noted that “…sometimes we are the ones carrying everything… and we don’t have a space to talk about it.”
The midwives based in Ghana shared powerful testimony about the continuous exposure to high-stress, life or death situations, and the lasting impact that has on them. They described working in environments where they are regularly exposed to complicated births, emergencies, and maternal risk. This creates an ongoing sense of pressure, where the stakes are consistently high and outcomes are not always within their control.
There was also discussion about how the midwives absorb emotional experiences without having structured spaces to process them. In Ghana, there is a normalization of “carrying” emotional experience, which is compacted by a lack of formal or informal support systems. The idea of creating peer support groups for midwives and health workers, not just for the populations they serve, emerged as both a practical and necessary step.
This support is not simply an added benefit; it is foundational. Sustainable systems of care depend on the resilience and well-being of those within them, and creating spaces where providers can process their own experiences is an essential part of that equation.
Moving Forward
Midwifery Exchange in Ghana is already planning on implementing a pilot GPS support group for mothers in the town of Dorimon, and we’re discussing how best to start a support group for the midwives themselves.
The team from Midwifery Exchange are reminding us of something significant: The people holding these systems together are carrying more than we often see. They are navigating life-and-death moments, absorbing emotional weight, and continuing to show up for others, often without a place to be held themselves.
If we are serious about building sustainable systems of care, we cannot overlook this. Supporting caregivers is not secondary to the work. It is the work.
