Updated: Aug 2, 2019
1. Good nutrition: This is the first line of defense. Strong, elastic tissue will usually tear less and heal better with a high protein whole food diet, rich in salt and calories. Vitamin C have been known to improve skin integrity.
2. Pelvic floor (Kegel) exercises: A healthy pelvic floor has both tone and elasticity, both essential for the descent of baby and protection of the pelvic muscles. Rhythmic tightening, or elevator kegels daily will allow you to be intune with your pelvic floor, while improving its resilience! Don't over kegel! Too tight of a pelvic floor can cause its own problems.
3. Perineal stretching: 5 minutes of perineal massage daily, done yourself or by your partner, starting at 37 weeks. This is a controversial recommendation. Some Midwives swear by it, while others state it increases perineal trauma. Those who have had an episiotomy, or extensive tear may benefit from massaging EPO into the scars, to increase flexibility. I would recommend speaking with your midwife and discussing whether this would be a good option for you.
4.Warm compresses applied during the second stage of labor increase the incidence of an intact perineum and lower the risk of episiotomy and severe perineal trauma.