I was reading one of my baby magazines and it mentioned an "exercise" PG women can do to stretch the perineum to reduce the likelihood of needing an episiotome. It said to wash your hands really well and apply some KY Jelly/cocoa butter/or oil to the perineum. Then insert your thumbs (or have your partner do it if you can't reach) about an inch into your vagina and push downwards until you feel a slight burning sensation. Hold it there for about two minutes, it will become numb. Then push down and to the left for two minutes, then repeat to the right. It says to do this several times a week starting at about week 34.
Not sure if it works or not, but just thought I'd share. Obviously check with your doctor first
TTC since April '02
"You must have mistaken me for someone who's HAD THEIR COFFEE!"