Maternal mortality remains a significant public health concern, particularly in developing countries, where it is driven by a complex interplay of socio-economic, healthcare-related, professional, and socio-cultural factors. Globally, an estimated 295,000 maternal deaths were recorded in 2017, with a maternal mortality ratio (MMR) of 211 deaths per 100,000 live births across 185 countries (WHO et al., 2019). In Lesotho, the MMR was estimated at 566 deaths per 100,000 live births in 2020 (WHO, 2023). Despite the gravity of this issue, limited attention has been paid to the psychological experiences of midwives who are directly involved in maternal care. This study investigates the emotional and psychological impact of maternal deaths on midwives working in two public hospitals in Lesotho—St James Mission Hospital and Paray Mission Hospital. Using a qualitative, phenomenological approach, data were collected through in-depth, face-to-face interviews with a purposively selected sample of ten midwives. Interviews were recorded with audiotapes, transcribed verbatim and analyzed using qualitative content analysis. Midwives included in the study were of any age and gender, held either a diploma or degree in midwifery, had a minimum of one year’s experience, and had directly encountered maternal death in their practice. Ethical approval was obtained from the Lesotho Ministry of Health (ID58-2022), and all ethical protocols were followed. Findings revealed that midwives experienced various psychological responses, including trauma, shock, stress, depression, insomnia, helplessness, loss of trust, and recurring nightmares. These emotional burdens were associated with increased absenteeism, demotivation, and demoralization. Participants reported relying on personal coping mechanisms such as crying, alcohol and substance use, and recreational activities— though these methods were unguided and potentially harmful. The study highlights the urgent need for structured support systems and healthier coping strategies to assist midwives in managing the emotional consequences of maternal deaths

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