Episiotomies  -- the surgical cuts doctors make during delivery to widen the birth canal  -- have been thought to reduce the chance of tearing. But routine episiotomies have no benefits at all, says a study in The Journal of the American Medical Association.

"Two-thirds of women will tear anyway, and an episiotomy may make tearing worse," says Katherine Hartmann, M.D., coauthor of the study. Although there are emergency situations when one is necessary to help speed delivery  -- for example, when your baby's heart rate slows down and doesn't pick up again  -- this type of situation is fairly rare.

So to reduce your chances of needing an unnecessary episiotomy:

Talk to your doctor. Ask how frequently she does them. If her numbers are much higher than average (currently 30 to 35 percent and falling), consider finding a new ob.

Do your Kegels. Stronger pelvic muscles can give you greater pushing control, which may help avoid even a natural tear. To do them, flex your muscles as though you were trying to stop the flow of urine; do five sets of five every day.

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