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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

tear or episiotomy??

22 replies

kiwibella · 14/01/2007 18:53

I have given birth once before, luckily with absolutely no complications, but I am wondering whether to avoid perineal damage when giving birth would you rather tear naturally or have an episiotomy?

Tx for your advice.

OP posts:

hunkermunker · 14/01/2007 18:56

To avoid perineal damage, I'd rather do neither, thanks.

Have torn twice though - once badly, once not so. Neither's something that's top of my list of fun things to do, but I healed OK. I don't like the idea of being cut. I think that tears are meant to heal better, and you can still tear with an episiotomy.

foundintranslation · 14/01/2007 18:58

I had an episiotomy - apart from minor discomfort the first couple of days, it was absolutely fine and healed really well. I think I would have torn pretty badly without.

Skyler · 14/01/2007 19:00

I am very lucky to be a stretchy lady but I think I would always go for a tear rather than episiotomy as you never know i.e I wouldn't have needed one.
HTH

kittylette · 14/01/2007 19:01

i tore first time, and 2nd time round i put it in my birthplan that i wanted to tear again rather than be cut,

not sure why, the ideaof being cut makes me nauseous,btw, i didnt tear 2nd time

Skyler · 14/01/2007 19:02

Well actually if an episiotomy had been suggested during the event I don't think I would have been fussed and perhaps preferred it at that point rather than tearing??
Why do you ask? Will you request one if you have another child?

Mercy · 14/01/2007 19:03

Tear.

Had an episiotomy with dd, couldn't sit comfortably for nearly a month. Had a 2nd degree tear with ds, no problems with sitting but did take longer to heal

ledodgy · 14/01/2007 19:08

If I had to do either I would tear. I was given an episiotomy with dd and it hurt like hell afterwards with ds I tore naturally and it didn't even hurt when I went to the loo!

Original poster

kiwibella · 14/01/2007 19:08

sorry, I didn't explain myself well - I am 34 weeks pg and anxiouxly writing a birth plan for my home birth. All was fine last time, in fact it was the only time mw raised her voice when she told me to stop pushing or I would tear!!

OP posts:

TheBlonde · 14/01/2007 19:10

I'd go for a tear thanks

I think they are unlikely to cut you in the UK unless they need to for forceps etc

Original poster

kiwibella · 14/01/2007 19:10

btw... tx for so many quick responses

OP posts:

belgo · 14/01/2007 19:15

I tore both times, not very badly. Some midwives would choose not to stitch up a minor tear, but my midwife had worked for years in Africa, and said that from what's she's seen, it's always better to sew up a tear.

I was very fortunate not to have an episiotomy as the episiotomy rate in Belgium is very high for first time mums. ( I think it was due to the fact that I refused to use the stirrups.)

Skyler · 14/01/2007 19:17

Oh in that case def a tear and listen to your midwife again. I am glad I was able to.
Good Luck. I am jealous of your home birth.

kiskidee · 14/01/2007 19:21

read a book called 'Active Birth'. there are also antenatal classes following the principles. it gives info about avoiding tears.

can't say i had the chance to test its theories as i ended up in lots of probs with oedema & pre-eclampsia and a horrible labour despite avoiding tears. I still think one of the breathing techniques the book described avoided tears tho.

MamazonAKAfatty · 14/01/2007 19:21

I had an episiotomy with Ds. she cut me whilst thinking i had had the epidural going but it had completly worn off and i felt it all.
She then only gave me a local whilst she put the sticthes in and i felt each and every single one of those 32 stitches.

With DD i tore. i was very sore afterwards but i didn't feel it at the time amongst all the other fanjo pain i was in from pushing out a large turkey.

i would much rather tear if i have to.

rarrie · 14/01/2007 20:04

First time I had a second degree tear and an episiotomy. Second time I had a third degree tear. From my experience, I'd do gor the tear. Firstly, because I felt the cut being done (I did have a local, but they didn't leave it enough time to work, so I felt the cut) but secondly, I have felt that I have healed better from the tear (even though it is much worse) than I did from the episiotomy. So I'd vote for the tear as being the better option

mamijacacalys · 14/01/2007 20:06

I had an episiotomy both times due to forceps with DS and DD being rather large (8lb 12). Unfortunately, as well as the episiotomy I also tore badly with DD as she was face-to-pubis, almost 3rd degree, and had to go to theatre to be stitched.
But although have had stitches both times, I healed well and did the kegel exercises and now I don't have any probs, whereas friends who had tears that weren't stitched still have various degrees of incontinence years on from giving birth.
So I would definitely go for the episiotomy as it seems to mean that at least you have a chance of healing properly although there is greater short-term discomfort from stitches, whereas a tear may be left and there is potential for greater long-term problems IMO.

lulumama · 16/01/2007 12:33

tear is better IMHO

if you cut a piece of paper at the top,and then pull sideways it is much easier to rip, where as it is stronger without the cut....

i had a labial graze with DD, intact perineum.......nice controlled delivery and she was also face to pubes..so i think it also depends on the stretchiness and the speed of delivery, position you are in

just googles it and there is a website here with a similar analogy to the cut piece of paper

\link{http://www.birthpsychology.com/messages/episiotomy/episiotomy.htmtear or cut?}

lulumama · 16/01/2007 12:34

tear or cut?

happyatlast · 16/01/2007 15:15

I had an episiotomy with both my kids cos they used a ventouse both times and after being stitched up I had no problems afterwards at all.

Sakura · 19/01/2007 09:17

When I told my (79 year old) midwife that I really did not want an episiotomy, she told me that if we do tear, we are designed to tear in all the right places to let the baby out. Also, a jagged tear heals better than a straight slice too. She was brilliant at the birth

LemonTart · 19/01/2007 09:23

I have always heard the tear is better than an episiotomy. Maybe I am the odd one out, but after an episiotomy with DD1 and a tear with DD2, the episiotomy was quicker to heal. I am not sure it is black and white. An episiotomy can stop a really bad tear from happening and is "controlled" in direction and size. A tear can be unpredictable, esp if the baby is in an awkward position and large (liek DD2!)
If you trust the professionals on hand, I would let them assess the situation and make than decision for you based on your own unique situation rather than force their hand by insisting on one or the other.
hth (I did heal with both but the large tear in a more awkward place was more painful and took longer to heal - despite better stitching IMHO than the episiotomy)

pulapula · 20/01/2007 08:04

I wouldn't rule out an episiotomy, and go with what the mw/dr advises. I don't think you can choose one or the other. I had an episiotomy but still tore in 2 places, so not sure which hurt most/healed better. The only negative thing was the local anaesthetic before the cut- it was really painful.

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