https://www.um.edu.mt/library/oar/handle/123456789/2289 2026-10-11T14:01:53Z https://www.um.edu.mt/library/oar/handle/123456789/149602 Title: Women’s knowledge and attitudes towards non-pharmacological pain relief methods during labour Abstract: Pain during labour is a complex and subjective experience shaped by physiological, psychological, and social factors. Non-pharmacological approaches to pain have been widely recognised as safe and supportive of physiological birth. Despite this, their utilisation in clinical practice remains inconsistent, suggesting a gap between evidence, policy, and practice. Hence this critical literature review aims to explore women’s knowledge and attitudes towards non-pharmacological pain relief methods during labour. The research question for this review is; What are women’s knowledge and attitudes towards non-pharmacological pain relief methods during labour? A systematic search of the literature was conducted using CINAHL, PubMed, MEDLINE, and Scopus to identify peer-reviewed studies published in the English language between 2020 and 2025. The main key words included ‘women’, ‘labour’, ‘pain relief’, ‘non-pharmacological’, ‘knowledge’, and ‘attitudes. Inclusion criteria focused on primary research examining women’s understanding and perceptions of non-pharmacological pain relief during labour. Following a structured screening process, six studies with various methodologies were selected to address the research question. Methodological quality was critically appraised using Joanna Briggs Institute tools, ensuring a consistent evaluation of study rigour and potential bias. The review identified three main findings: (1) inconsistent and limited knowledge, with women relying on informal information sources (2) positive attitudes towards non-pharmacological methods, in relation to control, autonomy, and a natural birth experience; and (3) the significant influence of healthcare professionals, cultural context, and the birth setting. Despite favourable attitudes, limited knowledge and health system barriers, including a predominance of medicalised care, were found to restrict implementation in practice. This review highlights a clear disparity between the recognised benefits of non-pharmacological pain relief and their underutilisation in maternity care. It recommends the need for improved antenatal education, strengthened midwifery support, and organisational changes to promote woman-centred care. Further research is recommended to generate more robust and generalisable evidence to inform practice and policy. Description: B.Sc. (Hons)(Melit.) 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/149601 Title: Fathers’ experiences of witnessing a traumatic birth : critical literature review Abstract: This critical literature review aimed to explore and critically synthesis the current evidence on fathers’ experiences of witnessing a traumatic birth. While traumatic birth is an increasingly recognised area of research in maternity care, existing literature has predominantly focused on maternal physical and psychological outcomes. This review addressed this notable knowledge gap by synthesising the findings related to how fathers navigate their experiences when witnessing births, they perceive as traumatic. A systemic literature search was conducted using relevant databases including Scopus, CINAL Complete, Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO to identify peer-reviewed studies published between 2015 and 2026 in English. The PEO (Population, Exposure and Outcomes) framework was used to search the literature using relevant keywords. The inclusion criteria focused on studies involving fathers who physically witnessed the birth of their child, which they perceived as traumatic, using qualitative, quantitative, or mixed-methods design. Five studies met the inclusion criteria and were assessed for their methodological rigour using the CASP critical appraisal tools. Collectively, the three themes that emerged from the literature highlight that fathers’ experiences are characterised by a sense of exclusion and loss of control, compounded by witnessing distressing clinical events, while simultaneously negotiating internal conflict driven by traditional ideals of masculinity and their perceived paternal role. The review findings highlight the need for clinical practice to evolve beyond a focus on medical outcomes to formally recognise and support the father’s unique psychological burden as a witness of the birth perceived as traumatic. Future research should focus on how cultural, ethnic, and socioeconomic factors shape fathers’ experiences of birth trauma, as existing literature is largely limited to Western, middle- to high-income populations. Description: B.Sc. (Hons)(Melit.) 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/149600 Title: Fathers’ experiences of having an infant in the neonatal intensive care unit Abstract: The admission of an infant to the Neonatal Intensive Care Unit is a transformative, often traumatic event for families. Within this highly medicalised environment, paternal perspectives frequently remain marginalised. Addressing this gap, this critical literature review synthesises contemporary qualitative research exploring fathers’ experiences of having an infant admitted to the Neonatal Intensive Care Unit. A systematic search across five electronic databases (MEDLINE, Cochrane, PsycINFO, CINAHL, and Web of Science) identified primary qualitative research, published in English between 2020 and 2025. Following SPIDER-guided screening, seven high-quality studies were included. Data were analysed using thematic synthesis, and methodological quality was assessed using the CASP Qualitative Research Checklist. The included studies were found to be of good to high quality, demonstrating strong methodological rigor and clear research objectives, although some lacked detail regarding researcher reflexivity. Three overarching themes emerged: (1) ‘psychological and emotional impact’, characterised by feelings of powerlessness and emotional suppression; (2) ‘disruption of paternal role and identity’, with fathers often frequently positioned as visitors or secondary caregivers; and (3) ‘support and guidance’, highlighting a disconnection between technical information provision and the need for personalised emotional validation. Results suggest that although fathers’ desire involvement in infant care, engagement is often shaped by staff attitudes and gatekeeping. This review underscores the need for father-inclusive approaches in neonatal care, advocating a shift from maternal-centric paradigms toward collaborative partnerships that recognise fathers as integral members of the caregiving team. Description: B.Sc. (Hons)(Melit.) 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/149599 Title: Aromatherapy for postpartum pain relief : a review of evidence from intervention studies Abstract: Postpartum pain management is a critical component of maternal recovery from childbirth. While pharmacological analgesia remains the standard of care, concerns regarding maternal side effects and infant drug transfer through breastmilk highlight a significant need for safe, evidence-based adjuncts. Despite growing interest, integrating aromatherapy into midwifery remains limited by a lack of consolidated evidence. This critical literature review synthesises existing evidence on the efficacy of aromatherapy as a non-pharmacological intervention for managing acute postpartum pain following vaginal or surgical birth. A systematic search was conducted across five health science databases- CINAHL, Cochrane Central Register of Controlled Trials, PubMed, PsycINFO and Scopus- to identify peer reviewed primary intervention studies published in English between 2020 and 2025. Eight papers, comprising six randomised controlled trials and two quasi-experimental studies, met the inclusion criteria. Methodological rigour was assessed using the Joanna Briggs Institute critical appraisal tools. Three themes were identified through narrative synthesis: (1) the overall efficacy of aromatherapy, with most trials reporting statistically significant reductions in pain scores, (2) the diversity of administration routes, where inhalation was most common, while topical applications demonstrated additional benefits; and (3) a reduction in pharmacological requirements, where aromatherapy served as an adjunct that decreased the demand for rescue analgesia. While the literature demonstrated generally high methodological quality, limitations such as unfeasible participant blinding, small sample sizes and the potential for ‘passage of time’ bias necessitate a cautious interpretation. Aromatherapy appears to be an effective, non-invasive adjunct for postpartum pain relief. Implementing standardised aromatherapy protocols- accounting for oil concentration and inhalation duration- is recommended to support clinical safety. Further research within Western healthcare contexts is warranted, alongside structured midwifery training, to support integrating holistic approaches into clinical practice. Description: B.Sc. (Hons)(Melit.) 2026-01-01T00:00:00Z