Midwives’ knowledge and views of acupressure during the perinatal period

Abstract

Purpose: Acupressure involves the application of firm pressure on specific acupoints of the body using thumb or finger pressure. Acupressure is associated with numerous benefits when used during the perinatal period, such as preventing nausea and vomiting, reducing pain, inducing labour, aiding in breastmilk production, and decreasing anxiety throughout pregnancy, labour, and the postpartum period. This study sought to address a global gap in the literature regarding midwives' knowledge and views on acupressure during the perinatal period. While previous literature has investigated acupressure’s effectiveness, there is limited understanding of midwives’ knowledge, specifically on acupressure and how they view and use this intervention in their midwifery practice. Aim and Objectives: The study’s aim is to explore midwives' views and knowledge of acupressure during the perinatal period. The study also addresses three specific objectives: to identify midwives' views on acupressure during the perinatal period, to determine midwives' knowledge of acupressure during the perinatal period and to elicit what influences midwives' decision to practice acupressure during the perinatal period. Methodology: A quantitative, non-experimental, and cross-sectional approach was adopted using a self-designed, one-time, self-administered online questionnaire distributed via email. This was a total population study utilising non-probability sampling technique where the entire population of 240 midwives members of the Malta Midwives Association (MMA) were included. However, not all of these midwives fulfilled the eligibility criteria to participate in the study, and the number of eligible midwives was unknown. As data collection progressed, questionnaires in paper format were distributed to eligible participants, midwives members of the MMA, through an intermediary to improve the response rate. A total of 94 answered questionnaires were returned, yielding a response rate of 39.2%. Descriptive and inferential statistics were used to analyse the quantitative data, while qualitative data was analysed using thematic analysis. Results: The study revealed knowledge gaps among midwives regarding acupressure, particularly concerning safety considerations and contraindicated acupoints during pregnancy. While midwives demonstrated a strong interest in acupressure, their hesitation to practice stemmed primarily from insufficient training, education and a lack of evidence-based guidelines. Less than half of the respondents reported practising acupressure, with most expressing uncertainty about the location of various acupoints and acupoints contraindicated before 37 weeks gestation. Findings highlighted that increased maternal interest in natural approaches creates a corresponding need for enhanced midwifery expertise in acupressure. Through a constructivist theoretical lens, the results emphasised the importance of developing experience from formal education and training to ensure the safe integration of acupressure into midwifery practice. Conclusion: The findings highlighted the midwives’ lack of adequate knowledge, education, and training in using acupressure during the perinatal period. The main recommendations include improving acupressure practice in midwifery through accessible training, preceptorship, and standardised guidelines. This study provides a foundation for further research especially focusing on acupressure during pregnancy and postpartum which are areas less studied than the practice of acupressure during labour.