Perineal massage

Antenatal perineal massage (APM) or Birth Canal Widening (BCW) is the massage of a pregnant woman's perineum (the skin and deep tissues around the opening to the vagina) performed in the 4 to 6 weeks before childbirth, i.e., 34 weeks or sooner and continued weekly until birth. The practice aims to gently mimic the 'massaging' action of a baby's head on the opening to the birth canal (vagina) before birth to achieve the 10 cm diameter opening without using the back of baby's head, i.e., doing some of the hard work before the start of labour, making birth less stressful on the baby and mother. The intention is also to attempt to: eliminate the need for an episiotomy during an instrument (forceps and vacuum extraction) delivery; to prevent blood loss (risk of Sheehan's syndrome) and tearing of the perineum during birth, helping to avoid infection (cellulitis and necrotising fasciitis of the pelvic floor muscles) This technique uses plastic surgeons’ tissue expansion principle to aid a natural birth.

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