Episiotomy

Your body goes through amazing changes to bring your baby into the world. Sometimes, a small surgical cut called an episiotomy is needed to help with delivery. This incision is made in the perineum — the area between the vagina and rectum — to create more space for your baby. Episiotomies are not routine in vaginal births. They’re only done if it’s urgently needed for your or your baby’s safety, such as if there are changes in the baby’s heart rate or if extra room is necessary to help your baby be born quickly.

The good news is there are gentle ways to prepare your body and reduce the chances of needing one. Techniques like perineal massage or warm compresses can help soften and stretch the skin during labor. Talking with your doctor or midwife ahead of time about pushing strategies can also make a big difference.

Before labor:

• Practice Kegels and pelvic-floor “bulging” to help with muscle control and relaxation
• Learn what to expect during the pushing stage and review effective pushing techniques

During pushing stage: 

• Try a Kegel squeeze, then relax, to release tension in the perineum.
• Experiment with different positions — gravity-assisted ones can be especially helpful.
• Follow your care team’s guidance. For example, if asked to pause pushing and blow instead, it allows your baby to ease out slowly and gives your perineum more time to stretch.
• Ask your coach to apply a warm compress to your perineum for comfort and relaxation.

Each birth is different, and your care team will be by your side through it all. Preparing ahead of time and practicing these techniques can help you feel more confident and in control. Most importantly, trust your body — it’s built for this — and know that your doctor or midwife will guide you safely through the process.