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Cutting Down On Episiotomies

If you think an episiotomy—a small cut to the area between the vagina and anus—is inevitable during delivery, think again. There are a few things you can do to try to avoid this procedure:

SPEAK UP
Talk to your ob-gyn about your reservations. "Have the initial discussion during your pregnancy," says Bruce Shephard, M.D., an obstetrician in Tampa. "And when you're in labor, remind him of your conversation." If you're too tired, enlist your partner as your advocate.

LEARN PERINEAL MASSAGE
In your last month, practicing this technique once a day for five minutes may stretch out the perineum. Lubricate your index and middle fingers with K-Y jelly and insert them into your vagina. Stretch your fingers apart and slide them along the bottom and up the sides. (It is normal to have some discomfort or burning, but stop if you feel a sharp pain.)

PUSH GENTLY
Pant while you push instead of holding your breath and straining. "If you push slowly, you may avoid both an episiotomy and lacerations," says Daniel Schrinsky, M.D., an obstetrician in Portland, OR. "Women who push explosively may be in danger of a major tear."

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