Women in West and Central Africa have the highest lifetime risk of maternal death of 1 in 27, compared to a ratio of 1 in 180 globally, and 1 in 2,000 in Central and Eastern Europe. Like many West African countries, Ghana made insufficient progress in efforts to meet the Millennium Development Goals. In 2015, Ghana’s maternal mortality ratio was 319 per 100,000 live births with a lifetime risk of maternal death of 1 in 74. This PhD study examined the management and referral of obstetric complications in the Upper East Region of Ghana.