Women’s knowledge, attitudes and interest in antenatal perineal massage – a cross-sectional survey

Antenatal perineal massage (APM) is an established technique for preventing severe perineal trauma, but it is uncommonly practised in Hong Kong. This study aimed to investigate pregnant women's knowledge, attitudes and interest in APM, and to identify factors that influence their interest in the technique. A prospective cross-sectional study was conducted over 7 months at Princess Margaret Hospital. Pregnant women aged 18 years or above and under 37 weeks of gestation were invited to participate via a bilingual questionnaire distributed during antenatal clinic visits. Descriptive and regression analyses were used. Out of 385 respondents, only 31.4% were aware of APM with social media (61.2%) as their main source of knowledge. Only 44.8% of the questions were answered correctly, with a median knowledge score of 3.0 out of 7. A majority were unaware of the long-term impacts of severe perineal injury (57.7%) and potential benefits of perineal massage (54.5%), highlighting a deficiency of knowledge. Interest in APM was high (66.2%). Non-Chinese, higher education, planned vaginal delivery and knowledge of the technique's benefit are positive predictors of expressed interest. However, concerns about discomfort (38.5%) and embarrassment (38.5%) were notable barriers to participation. Among those who practised APM, the median Likert score was 4 out of 5, indicating a generally positive perception of its benefits. This study reveals important areas where knowledge regarding obstetric anal sphincter injuries (OASIS) and APM is lacking among some pregnant women in Hong Kong. There is a need to enhance education and resources regarding these topics in antenatal classes.