https://www.um.edu.mt/library/oar/handle/123456789/87496 2026-04-28T02:45:37Z https://www.um.edu.mt/library/oar/handle/123456789/87594 Title: The effects of opioids during labour on breastfeeding : midwives' views and experiences Abstract: Opioid use during labour and the early postpartum period may affect the initiation and establishment of breastfeeding due to opioids’ side effects (Lim et al., 2018). The aim of this study is to explore the views and experiences of midwives on the effects of opioids on breastfeeding following their use during labour and the early postpartum period. The objectives of this study are to explore midwives' views on the effects of opioids on breastfeeding in the early postpartum; to seek midwives' experiences of breastfeeding when the mother has received opioids during labour and in the early postpartum; and to identify midwives' management of breastfeeding in the presence of opioid side effects. A qualitative approach was adopted for the study, using faceto-face, semi-structured interviews. A target population of eight midwives, working at the obstetric wards in the local general hospital, were chosen by convenience sampling. A response rate of 100% was achieved. The interview recordings were transcribed via verbatim transcription and data was analysed using the Braun and Clarke (2006) thematic content analysis framework. The findings in this study demonstrated that midwives are faced with several maternal and neonatal problems due to opioid use during labour and the early postpartum period; such as maternal fatigue and sleepy babies. The type of opioid used and the time when the opioids were administered, played an important part in the severity of problems with breastfeeding, but were usually resolved within 24 hours. However, participants claimed that the mother’s sheer will to breastfeed supersedes the ill effects of opioids. Participants identified skin-to-skin contact, providing the mother with adequate support, assisting with different breastfeeding positions, and finger feeding, as methods that help in initiating breastfeeding. In comprised situations, a gastric washout and an opioid antidote are strategies used to initiate and establish breastfeeding. Ongoing care for the breastfeeding mother may also be needed through referral to the paediatrician and the breastfeeding clinic. Several recommendations for practice, education, and further research were presented, namely; educating mothers on opioid effects on breastfeeding, and further education for midwives on the challenges and strategies to establish breastfeeding. More in-depth larger scale research is also recommended. Description: B.Sc. (Hons)(Melit.) 2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/87593 Title: Midwives’ views and attitudes of amniotomy to accelerate spontaneous onset of labour Abstract: Amniotomy, through which the amniotic membranes are intentionally ruptured, is an obstetric intervention performed during labour. The aim of this study was to explore midwives’ views and attitudes of amniotomy to accelerate spontaneous onset of labour. The objectives sought to explore midwives’ attitudes regarding amniotomy performed to accelerate spontaneous onset of labour, to identify the midwives’ views on the advantages and disadvantages of this procedure, and to outline the midwives’ views on the ethical implications when performing amniotomy to accelerate spontaneous onset of labour. A descriptive survey design was chosen for the study. Data was collected through a self-designed questionnaire using open- and closed-ended questions. The sample consisted of 30 midwives (N=40, 75%) working at the Delivery-Suite of the local State hospital, selected through convenience sampling. The data was analysed via Microsoft Excel, using both descriptive statistics and content analysis, and was presented in diagrammatic graphs and tables. The findings suggested that, even though amniotomy is a commonly performed procedure, most midwives do not perform this intervention during spontaneous labour when not indicated. Furthermore, the risks of complications following amniotomy were considered to be minimal. All the participants emphasised informed choice and gaining consent prior to performing the procedure. However, information giving was not always consistent among the midwives. The midwives also believed that women do not always have adequate knowledge of amniotomy prior to the procedure. Similar to other studies, the participants agreed that amniotomy is performed in situations as prolonged labour, compromised fetal condition, and locally, prior to administering pharmacological pain relief. Strengths and limitations were outlined. Several recommendations for practice, education, and further research were proposed, including information about amniotomy during antenatal education, and continuous professional development of midwives with regards to the latest literature on amniotomy. In conclusion, recommendations were put forward for further research using a qualitative approach to study the experiences and perspectives of both midwives and mothers concerning amniotomy. Description: B.Sc. (Hons)(Melit.) 2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/87587 Title: Midwives’ experiences of assessing and managing neonatal pain Abstract: The assessment and management of pain in neonates cared for at the Neonatal and Paediatric Intensive Care Unit (NPICU) are very crucial aspects of care provided on a daily basis in order to safeguard their wellbeing. The aim of this study was to explore midwives’ experiences of assessing and managing neonatal pain at the local NPICU. The objectives were to explore how midwives identify and assess neonatal pain and to explore how midwives manage neonatal pain. The study adopted a qualitative research approach. Data was collected via a one-time, face-to-face, semi-structured interview using a self-designed interview schedule. Participants were selected by purposive sampling from a target population of qualified midwives who have a minimum of two years working experience at the NPICU. Seven midwives who satisfied the inclusion criteria participated in this small-scale study. Data collected was transcribed verbatim and analysed by means of thematic analysis. Findings revealed that midwives assess behavioural and physiological indicators of neonatal pain. However, neonates’ inability to self-report their pain, time and work constraints, and the lack of use of established neonatal pain assessment tools seem to hinder midwives from carrying out a thorough pain assessment. Most midwives agreed that their assessment would improve by using objective guidelines. While participants reported using both non-pharmacological and pharmacological pain management strategies, some barriers are also encountered, such as parents’ fears, Covid-19 restrictions, neonates requiring intensive care and the desensitization to pain. In conclusion, midwives agreed that their neonatal pain assessment and management practices can be improved. Therefore, the implementation of educational and practice interventions, together with the introduction of pain assessment guidelines are being recommended. Description: B.Sc. (Hons)(Melit.) 2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/87581 Title: Exploring maternal expectations of first-time childbirth Abstract: The aim of this study was to explore first-time mothers’ expectations of childbirth. To meet this aim, the study enquired into women’s expectations for their emotional and behavioural responses to the childbirth process, assessed women’s expectations for care during labour and childbirth and identified sources of influence on maternal expectations for childbirth. A quantitative approach was adopted. A convenience sample of 48 expectant mothers, representing a response rate of 96%, completed a questionnaire which had been designed specifically for the purposes of the study. Data was manually analysed and is presented using descriptive statistics, bar graphs and pie charts. The majority of expectant mothers expected childbirth to be an overall positive experience, although many were frightened by the prospect of the event. They largely anticipated that they would be able to cope with the labour pain with the use of pharmacological measures. The presence of their partner during labour and delivery was expected to be of great comfort. In relation to care, the participants had confidence that midwives would spend significant amount of time with them during labour and involve them in decision-making. Information gained from prenatal classes were said to have had the greatest impact in their expectations, followed by information obtained from online sources. Results suggest that expectant mothers expect their childbirth experience to be positive overall. Several recommendations for practice, education and further research are proposed. These include further research on the topic using a qualitative approach. Description: B.Sc. (Hons)(Melit.) 2021-01-01T00:00:00Z