 | This article needs more reliable medical references for verification or relies too heavily on primary sources. (June 2016) |  |
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 (or 'birth canal' – when a baby is in this passage), performed in the 4 to 6 weeks before childbirth, i.e., 34 weeks or sooner (Reference 7, as more births are occurring at around 28 weeks) 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) prior to birth, so works with nature, to achieve the 10 cm diameter opening without using the back of baby's head, i.e., doing some of the hard work of labour (birth) 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 and in this way avoid infection (cellulitis and necrotising fasciitis of the pelvic floor muscles), helping to keep antibiotics working into the future. This technique uses Plastic Surgeons 'skin tissue expansion' principle, to aid a natural birth.
