Requesting an episiotomy for DS2 after having one for DS1

[BeyondTheLimitsOfAcceptability]

I've read today that you are more likely to tear on your scar if you have had a previous episiotomy, so I'm thinking I might put it in my birth plan that I'd rather have a second episiotomy than tear naturally?
Which is surely rare as I know that generally its better to tear than be cut...?

Are there any experts around to talk this through with? Or anyone with similar experience?
(DS2's birth will be only 18m after DS's by the way)

I can only tell you my experience.

2 DCs, 24 months apart.

1st = episiotomy & forceps

2nd = requested episiotomy in writing, all staff too busy to even read maternity notes, they had admitted me so late that I was unable to speak with the pain so couldn't request it. Baby born ripping previous episiotomy fully, plus another 2 stitches worth. All healed fine.

So:

1. Hopefully someone will read your birth plan
2. If not, make sure birth partner is equipped to make appropriate requests (my DH was not, he was confused and frightened).

Notable that I was in on a bank holiday weekend though!

My birth plan is basically the same as for DS which was "go with the flow"
Hopefully DH will be up to pointing out my one actual request! Though the episiotomy was the one thing he went a bit pale at last time...
Or I might write it on my forehead?

Maybe on my inner thigh, with an arror?

Hmm, well I had an episiotomy for DD1 (forceps) and then a tear for DD2 (water birth, but shot out like a speeding bullet so no time to protect the perineum).

I have to say that the tear healed miles quicker and more easily than the epi. I was always a bit about tears healing better - I mean, surely there is a reason than they don't tear you open for surgery! But it does seem to be true and the, ahem, area, is probably in a better condition now than it was between the two children. Personally I would always risk another tear rather than a pre-emptive episiotomy.

However, I can imagine it would depend on your situation, could you discuss this at your next midwife appointment?

i had an episiotomy for ds1 and then tore for ds2, like the above poster, depsite my tear being 'unusual' i tore upwards rather than down! it healed much better than my episiotomy did.

ds3, ds4 and dd i didnt tear at all :)

is it not worht seeing if you dont tear at all, also the midwives should be able to tell if its likely you will tear and then they can offer you the choice of an episiotomy or a tear, i would choose a tear every time as it healed much better :)

I had an episiotomy with DS (1st baby) and then got a 2nd degree tear with DD. The recovery was completely different. Chalk and cheese different. With the episiotomy, I couldn't feel my pelvic floor for days, standing and sitting was incredibly painful, I had a 'baggy' feeling for weeks and couldn't use tampons for a whole year. With the tear, there was much less pain, and I felt virtually normal within a week.

I'd choose a tear every time. DD was bigger than DS too.

I had an episiotomy with my first that was incorrectly stitched afterwards (too tight). Only got a slight graze with my 2nd which I didn't feel at all so I would argue it's by no means a certainty that you will tear the 2nd time.

Birthing my 2nd naturally on all fours with no coached pushing helped enormously I think (well the paramedic tried but DH and I told him to shut up!). Plus I got DH to do lots of perennial massage, concentrating on the scar area in the months leading up to the birth, using almond oil mixed with a few drops of maroc rose oil to soften and stretch the scar area.

I really didn't want an episiotomy again ended up with 2nd degree tear along the scar the second time much nicer and healed much quicker but that was just me. Episiotomy was much more painful and got infected.

You might not need an episiotomy and you might not tear. Make sure the midwives know you've had an episiotomy before and get them to keep a close eye on things at the pushing stage. I had 2 hours pushing with DS and had an episiotomy as he just wouldn't come out. It was pretty uncomfortable afterwards.

With DD 2 years later, I had a 10 minute pushing stage and just a small graze. If she hadn't come out with her hand by her face, there would have been no damage.

i'd be interested to know why you want an episiotomy again. Like many of the above I had episiotomy with 1st, 2nd degree tear with 2nd (20 months apart) and the tear healed much better and much more quickly

howlong was the tear on your scar? I'd heard you were more likely to tear on your scar, and reopening scar tissue is A Bad Thing?
I think the fact that I had no trouble at all with my episiotomy may be colouring my view a little though, if I'd had any bad experiences I'm sure I'd want to avoid it like the plague...
Think I will discuss it with my midwife at my next appt, see what she thinks :)

I had and an episiotomy with DD1 for a forceps delivery. I had DD2 2 years later, i tore very slightly but not on the episiotomy scar it was the opposite side, interestingly i also tore in the same place again when i had DS 4 years after DD2 .

You're more likely to tear with an episiotomy - get a piece of paper, hold each side and try to pull it apart. Then cut (or tear) the paper about 1cm on one edge, and then try pulling the sheet apart again.

I had an episiotomy with DD1 (forceps delivery) and it extended into a 3a tear. This time I won't be requesting an episiotomy and will only consent to one if it's absolutely necessary. I'd rather not have a cut 'just in case' because I could end up not needing one at all - there is a chance I will have another 3rd degree tear, but there is an even bigger chance that I won't.

Have you considered perineal massage?

Had to have a ventouse last time, so that's what the ep was for btw, just realised I havent mentioned that

Have had another thread about it before, but basically DS got distressed, coincidentally just after the midwife told me I wasnt ready to push (no examination at that time and my body started pushing on its own...), and they had to get him out straight away. This time, if my body pushes, I wont fight it (as I was made to last time)!

I did perineal massage with DS, and will again this time, so fingers crossed for not needing anything done and DS2 will just pop out. (Probably unlikely though, as have a rectocele too now from very quick first labour...)