Episiotomy

An episiotomy is a surgical incision made in the perineum (the area between the vagina and the rectum) to enlarge the vaginal opening. An episiotomy may or may not be needed. Techniques such as perineal massage or warm compresses may assist in softening and stretching the skin of the perineum. However, if the delivery is imminent, the numbing effect of the baby’s head pressing against the perineum may enable the incision to be performed without discomfort and the use of local anesthesia.

Discuss management of pushing with your physician or midwife prior to delivery.

Activities to try in the prenatal period that may assist relaxation of the perineum are:

• Kegels/Pelvic-Floor Bulging
• Education - Know what to expect during the pushing stage and effective pushing techniques

Activities to try during the pushing stage to help relax the perineum:

• Release the perineum by doing a Kegel squeeze and relax.
• Use various positions. Gravity assisted positions are the most advantageous.
• Cooperate with your physician, midwife and labor nurse(s) during the birth (i.e. lie back and blow if instructed not to push to allow your baby to come out slowly, and stretch the perineum gradually).
• Warm compression on perineum by your coach.