During delivery, some doctors cut the skin between the vagina and the rectum to enlarge the opening. This procedure is called an episiotomy. As late as the 1980s, many doctors believed that doing a routine episiotomy during vaginal delivery would help to prevent a woman from developing a rectocele later in life. Now, however, there is some evidence that rectoceles may develop near healed episiotomies. Episiotomy is no longer done for every vaginal delivery and many doctors and midwives go to great lengths to avoid doing the procedure unless absolutely necessary. Doctors usually discuss the risks and benefits of this procedure with their pregnant patients in the weeks before delivery.
Some health experts believe that Kegel exercises can either help to prevent a rectocele or relieve some of its symptoms. Kegel exercises are muscle-strengthening maneuvers that help to tighten the tissues around the vagina, but they have not been proven to prevent rectoceles.