Preventing an Episiotomy
To prevent an episiotomy of tearing the most important thing you can do is kegel exercises. Do kegel exercises throughout your entire pregnancy, many times a day. Do the quick tighten and release kegels and do "elevator kegels". To do elevator kegels you tighten your muscles hold to the count of 5 and then tighten them even more, do this 5 time as if you are going up floors in the elevator and then do the same thing on the way down, slowly release the muscles on floor at a time.
Talk to your healthcare provider about their beliefs regarding episiotomies. Ask them how often they feel they are needed and what they do to prevent them. Some healthcare providers will do perineal massage with oil while you are pushing to help you slowly stretch.