How to Avoid an Episiotomy During Childbirth

When a woman gives birth, her baby's head puts a great deal of pressure on her perineum, the area between the vagina and anus. Birth attendants sometimes perform a procedure called an episiotomy in which they make a small cut to enlarge the vagina's opening to give the baby's head more room. This might prevent the perineum from tearing and hasten delivery. However, many perineal tears are very minor, and they might not even require any sutures, but episiotomies always require stitches. An episiotomy might increase a woman's pain after delivery and prolong the healing process after childbirth.

Instructions

• 1

  Select a midwife as a birth attendant rather than a physician if your pregnancy is considered low-risk and you do not expect any complications during childbirth. Midwives perform episiotomies less often than physicians, according to the Brigham and Women's Hospital website.

• 2

  Discuss your desire to avoid an episiotomy with your birth attendant. Ask her what you might do to reduce the likelihood of requiring an episiotomy, and ask what she will do during the birthing process to reduce the need for one.

• 3

  Practice perineal massage beginning about six weeks before your due date. Sit in a comfortable semi-reclining position with your legs spread. Use a personal lubricant, vitamin E oil or olive oil (open a new bottle of olive oil for this purpose; don't use the half-empty bottle in your kitchen cupboard). Insert both thumbs into your vagina, and push firmly down and to the sides. Stretch until you feel a slight burning sensation, but stop if you begin to feel pain. Next, massage the bottom of your vagina back and forth. Finally, massage the skin between your vagina and anus.

• 4

  Avoid the use of epidural anesthesia during childbirth if you can. Epidurals make it difficult to control how hard you push when giving birth and prevent you from using positions that reduce the need for episiotomies during delivery.

• 5

  Give birth in a kneeling or hands-and-knees position if you can. Other positions that might reduce the need for an episiotomy and the risk of tearing include a semi-reclining position, squatting position or side-lying position. These positions put less strain on the perineum than lying on your back with your feet up.

• 6

  Push in a gentle, controlled way during childbirth. Instead of holding your breath and pushing as long and hard as you can, keep breathing and push gently when you feel the need to push.