1. Good Nutrition to ensure healthy tissue elasticity.
2. Squatting Exercises to stretch the tissues before birth.
3. Exposure to Air to keep the tissues healthy.
4. Daily Kegel Exercises (see Lifelong Pregnancy Exercise)
5. Avoid Soap as it dries tissues (cleanse with plain water instead).
6. Lotion and Massage to soften tissues and help mother become comfortable with her own anatomy.
7. Talk to Your Doctor in Advance about your desires and preparations to avoid episiotomy.
8. Be Patient during birth. An episiotomy can speed up the delivery by a few contractions, but it isn’t worth the resulting pain and recovery trauma.
9. Pull Your Knees Back (or Squat) during birth. Do not spread your legs wide open (which also means stay out of stirrups!).
10. Push With Self Control at the moment of birth to ensure you gently ease the baby’s head out and stop for the shoulders to naturally rotate during the subsequent contraction.
11. Remind Your Doctor at the Time of Birth; don’t assume they recall your wishes in this regards (also have your companion watch and advocate for no cuts during the birth).
12. Don’t Take Medicinal Pain Relief, as it prevents you from being able to push with self control.