The thought of having a cut down there fills me with fear beyond belief – is there anything I can do to not have one?

Episiotomy or cutting down along the muscle felt between the vagina and anus known as the (perineum in order to widen the area where the baby will be delivered and is only done when absolutely necessary. It will only be done with your consent and may prevent you tearing very badly. It may also be done if the baby is in distress to speed up the delivery of the head or in the case of forceps or ventouse deliveries. Usually, local anaesthetic is injected in to the muscular area first and the procedure is performed at the strongest part of the contraction, as this distracts you from what is being done and assists with a quick delivery. Some studies have shown that massaging the perineum regularly during pregnancy, using a suitable oil or cream, can reduce the risk of tearing as it helps to stretch the area as the head is being born.

See: McCandlish et al (1998) A randomised controlled trial of care of the perineum during the second stage of normal labour. British Journal of Obstetrics and Gynaecology. 105(12) pp1262-72.