Acupressure in perinatal care: Results of a cross-sectional study in Malta

Acupressure, the application of firm pressure to specific acupoints, has been associated with benefits during the perinatal period, including reducing nausea, alleviating pain, inducing labor, supporting lactation and decreasing anxiety. While research has explored its effectiveness, little is known about midwives' knowledge and views regarding acupressure and its integration into practice. This study aimed to explore midwives' knowledge, perspectives and factors influencing their use of acupressure during the perinatal period.

A quantitative, cross-sectional survey design was employed using a self-administered online and paper-based questionnaire. This was a total population study utilizing a non-probability sampling technique where the entire population of 240 midwife members of the Malta Midwives Association (MMA) was included. Eligible participants included practicing members in any maternity care setting across the Maltese Islands and these were invited to complete the survey. After conducting a pilot study, data collection took place between July and September 2024, where a total of 94 responses were received. Quantitative data were analyzed using descriptive and inferential statistics, while open-ended responses underwent thematic analysis.

While midwives demonstrated a strong interest in acupressure, their hesitation to practice stemmed primarily from insufficient training (20.7%; n=87), education (19.5%; n=82) and a lack of evidence-based guidelines (16.7%; n=70). Less than half of the respondents reported practicing acupressure (12.8%; n=12), with most expressing uncertainty about the location of various acupoints and acupoints contraindicated before 37 weeks of gestation (61.7% to 87.2% across all acupoints). Findings from thematic analysis highlighted that increased maternal interest in natural approaches, creates a corresponding need for enhanced midwifery expertise in acupressure.

The findings revealed midwives' lack of adequate knowledge, education and training in using acupressure during the perinatal period. These themes mirrored the quantitative findings, reinforcing that interest in acupressure is present among Maltese midwives but is constrained by gaps in knowledge, training and policy support.