Antenatal Perineal Massage Improves Women’s Experience of Childbirth and Postpartum Recovery: A Review to Facilitate Provider and Patient Education on the Technique

Abstract

Vaginal delivery during childbirth is associated with perineal trauma and damage in most women. Perineal damage during delivery can have significant long-term consequences for women, including decreased quality of birthing experience, persistent postpartum perineal pain and sexual dysfunction, as well as pelvic floor pathology. Many women fear such perineal trauma. In fact, obstetrical perineal damage and its long term consequences are some of the greatest concerns of patients. Even though evidencebased outcomes show antenatal perineal massage (APM) is an effective tool to reduce perineal trauma at childbirth, education of pregnant women about and subsequent application of the intervention remains low. This review details the potential physicaland psychological benefits of APM for most women, with a focus on helping the providers educate women and staff on the technique. Additionally, the impact of partner involvement in APM is discussed. Potential discussion topics are provided, to help care providers explain the benefits of APM to their patients. Revised, more flexible patient instructions for APM are also proposed. A discussion of vaginal physiology with regard to product choice during APM is reviewed. In spite of the mention of APM in many modern medical practice guidelines, detailed information to help providers teach the techniqueand to encourage patient adoption is lacking. This review provides information to make APM a more accessible choice for providers and women in order to decrease chances of perineal damage during childbirth, along with related long-term morbidities, which can deleteriously impact the patients’ quality of life.