- Position. Not being on your back, or in a position that requires an assisted delivery can help.
- Water. Being in warm water can help. If you birth on land, having the midwife hold a warm, wet facecloth on your perenium can help.
- Slow birthing. Don't push, but breathe between contractions. Allow baby's head to crown slowly.

Ive heard mixed reviews on whether massage and epi-nos actually help. The stretching you'll do in late pregnancy is very different to the stretching that happens in labour with other hormones in play.

I tore in both my labours. First appeared to be caused by sitting on a birth stool, pushing with ALL my might for about an hour. All the blood would have been pooled down there and it would have been fit to burst once babys head came out. The MW supported the perenium with her hand but I still tore.

Second labour was in a birth pool, breathing baby out. The tear was second degree again but only fairly shallow intothe muscle. Best decision I made then was not to get stitched. Tearing didnt bother me a whole lot. Stitching did.