Avoiding an episiotomy and or tearing during birth is partially genetics, partially your prenatal and birth attendants issue, and somewhat...
Avoiding an episiotomy and or tearing during birth is partially genetics, partially your prenatal and birth attendants issue, and somewhat the luck of the draw. An episiotomy is when a cut is made into your perineum wall that helps to deliver your baby. This procedure has been very over-done in the past. Currently more care providers are becoming cautious about the routine use of episiotomy but it's still performed in about 60% or more of births even though a recent JAMA report notes that, "The U.S. could immediately achieve an episiotomy rate below 15%." Note also that it's your right to refuse an episiotomy, but be sure to talk with your care provider about the benefits and risks. Tearing is just like it sounds, but in many cases a tear may heal quicker than an episiotomy. That said there's been a debate for years about which is better - tearing naturally or having an episiotomy. Read: an argument against episotomy and a debate about tearing vs. episiotomy. Of course the best thing of all is not to tear at all. You can try the following which may help you avoid tearing or a cut.
- Choose your maternity caregiver and birth setting carefully. Childbirth Connection notes that midwives generally have the lowest rates, followed by family physicians and obstetricians.
- Make sure your care providers know about your choice - i.e. you'd rather tear than be cut or vice vs.
- Prepare your perineum by doing Kegels.
- Try some perineum massage in the weeks before labor - although if this works or not is also a debate among birth professionals. In any case, check with your care provider before trying it, because there are times you should not do this, if you have active herpes for example.
- During labor (during the pushing stage) go slow and steady. Push only when you feel you need to and aim for 5 second pushes. When you start to feel a burning sensation, stop pushing for one or two contractions.