There are several ways to avoid the need for an episiotomy. First of all you need to make sure that your practitioner realizes your concern and that they will work with you to help avoid one. Prenatal perineal massage is helpful in stretching the tissues and muscles in the perineum, making them more flexible for birth. More suggestions:

• Slow, controlled pushing
• A gentle pushing effort when head and shoulders are born
• Massage and lubrication
• Warm compresses
• Manual support of the perineum (done by birth attendant)

Cervical dilation is the actually opening of the cervix. A women must get to ten centimeters to be completely dilated.

Effacement is the thinning of the cervix. Normally the cervix is about 2 inches long, so a cervix that is 70% effaced is less than 3/4 of an inch.

Effacement and dilation go together, not on over the other. However, just becaues she is dilating and effacing doesn't mean that labor will begin within the hour, or the day, or even the week. Nor does it mean that the woman who is not effaced or dilated will be pregnant for another week as some would have you believe. I've even had students walk around at five cetimeters for about 2 weeks.

The APGAR score is used to asses the health of a baby straight after childbirth. The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria (Appearance, Pulse, Grimace, Activity, Respiration) are used as a mnemonic learning aid.

This is referring  to when the fetal head is seen to 'crown' as the labia part. At this point the woman may feel a burning or stinging sensation.

Fetal monitoring is defined as watching the baby's heart rate for indicators of stress, usually during labor and birth.