7) How Can Prenatal Training Help Avoid Episiotomy? Episiotomy is the cutting of the tissues of the perineum and the vaginal canal during birth, right before the baby crowns, in order to widen the opening. A few obstetrical circumstances may necessitate episiotomy and these occur in less than five percent of deliveries. Otherwise, episiotomy is often unnecessary and in fact quite painful. To avoid this, we strengthen the muscles of the pelvic floor. As mentioned above, the stronger these muscles are, the greater they can relax and lengthen during labor. Their ability to relax and lengthen means less chance of the doctor performing an episiotomy. Prenatal training can also help avoid episiotomy by providing mothers with the necessary strength to maintain more favorable birthing positions such as squatting or side-lying. The back-lying, feet- in- stirrups position is the least efficient position, as it narrows the pelvic outlet and tenses the perineal muscles, thereby inviting episiotomy where it could otherwise be avoided. It makes sense to take preventive action to avoid episiotomy. Recovery is painful and lengthy, and incisions are susceptible to infection and long term problems. Women can take steps through simple yet effective preventive measures by adhering to a regular prenatal exercise regimen. There are some exceptions, however, which exclude certain women from exercising during pregnancy. For this reason, a doctor¹s clearance is required for all women before beginning any exercise program to determine whether or not exercise is contraindicated. Once clearance is obtained, however, all training sessions are conducted within the safety guidelines outlined by ACOG.

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