This study assessed the knowledge, awareness, and acceptability of antenatal perineal massage (APM) among pregnant women in Saudi Arabia. This cross-sectional study included 240 pregnant women who met the predefined inclusion criteria and attended the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia, from 1 October to 31 December 2023. Participants answered seven knowledge questions, classified as having good knowledge if they answered ≥4 correctly and poor knowledge if <4 were correct. Most women (46.25%) reported it was their first encounter with APM. Common sources of information included the internet (39.58%), physicians/midwives (7.92%), and friends/family (3.75%). Nearly half (47.5%) had heard of APM, but only 8.75% had practiced it, and 3.75% attended related classes. Only 17.5% knew that APM could be performed by the woman or her partner, while 25.83% knew it should start at 34 weeks, and 17.92% recognized the recommended duration of 5 to 10 minutes daily. Additionally, 22.5%, 15.83%, and 35.42% acknowledged APM's benefits for labor duration, anal sphincter dysfunction, and perineal injuries, respectively. The average knowledge score was 1.39±1.84, with 84.17% classified as having poor knowledge. No significant differences were found between knowledge levels (p>0.05). Low acceptability was noted, with only 58% of patients and 37% of their partners willing to engage in APM. No significant differences in acceptability were found between poor and good knowledge groups (p>0.05). The study revealed low awareness, poor knowledge, and weak acceptability of APM among pregnant patients. Targeted education for patients and healthcare providers could enhance knowledge and improve maternal-fetal health outcomes.
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