MIDIRS Digest Hot Topic: Midwives’ experiences of assessing and managing neonatal pain

By Lynn Scicluna and Rita Pace Parascandalo


The assessment and management of pain in neonates cared for in a neonatal intensive care unit (NICU) are crucial aspects of care provided daily to safeguard their wellbeing. However, there is a dearth of research exploring midwives’ experiences of the management of neonatal pain.


To explore midwives’ experiences of assessing and managing neonatal pain.


The study adopted a qualitative research approach. Data were collected via a face-to-face, semi-structured interview using an interview schedule self-designed by the researchers. Seven midwives with a minimum of two years’ working experience at the sole NICU in Malta were included. The data were transcribed verbatim and thematic analysis was carried out.


Midwives assess neonatal pain by using behavioural and physiological indicators. However, neonates’ inability to self-report pain, time and work constraints, and the lack of use of established neonatal pain assessment tools, hinder midwives from carrying out a thorough pain assessment. While participants reported using both non-pharmacological and pharmacological pain management strategies, barriers are also encountered. These barriers include parents’ fears, the recent COVID-19 restrictions, neonates requiring critical care and the midwives’ desensitisation to pain.


Neonatal pain assessment and management by midwives requires improvement. Recommendations include the implementation of educational and practice interventions, together with the introduction of pain assessment guidelines.

Keywords: midwives, assessment, management, neonatal pain, neonatal intensive care

unit (NICU)

Read the full MIDIRS Digest December Hot Topic

Scicluna L, Pace Parascandalo R. MIDIRS Midwifery Digest, vol 31, no 4, December 2021, pp 414-418.

Original article © MIDIRS 2021

Would you like to read more articles like this? Subscribe to MIDIRS today to receive MIDIRS Midwifery Digest every quarter here.