How to Avoid an Episiotomy

Performing some simple exercises can prepare your perineum for the crowning and delivery of your child and lessen your chances of having an unnecessary episiotomy.

Instructions

Difficulty: Moderate

Things You’ll Need:

• Pure Vegetable Oils
• Personal Lubricants

1. Wash your hands thoroughly and trim your nails.
2. Sit in a warm room, spreading your legs in a relaxed sitting position. Use a mirror to locate your perineum, the area of skin between your vaginal opening and rectum. This is the area of skin that may tear or be cut during the crowning and delivery of your child.
3. Lubricate your thumbs, vaginal opening and perineum with a pure vegetable oil or a water soluble lubricant. Ask your doctor or a pharmacist for acceptable lubricants.
4. Insert your thumbs as deeply as possible into the vaginal opening. Gently stretch the perineum down toward the rectum and to the sides. Continue with a slow steady stretch until you feel a slight burning or tingling sensation.
5. Hold the stretch until the tingling subsides and then slowly massage the vaginal canal back and forth for about 10 minutes. While massaging, hook your thumbs into the sides of the vaginal canal and gently pull the tissue forward, as the baby will when being delivered.
6. Massage the tissue between your thumbs and forefingers for about a minute before removing your thumbs from the vaginal opening.
7. Remove your thumbs from the vaginal opening and relax your body while still in a sitting position.
8. Clench and release your perineum muscles 25 times, also known as Kegel exercises. Pretend you are stopping a stream of urine: Hold and release.

Tips & Warnings

• Ask your obstetrician (OB) or midwife when, how and why episiotomies are performed. Be direct in your questioning and expect serious and factual answers to your questions.
• Consult with your OB or midwife before performing any exercises while you are pregnant.
• Using a full-length mirror for the first few days will help you become familiar with the perineal area.
• Perform Kegel exercises often to help you learn to focus on the vaginal and pelvic muscles.
• Teach your partner to perform the massage so you can relax and focus on the sensations you feel. It is great practice for the big day!
• Do not use petroleum jelly as a lubricant as it is oil-based and may cause infection.
• Stop exercises and consult your doctor if you experience any unusual discomfort.