Once you've had an episiotomy, would you need one next time?

[KHR1]

Basically, I had an episiotomy when j gave birth to my DD and wondered, if I was to have another child, what are the chances of me needing an episiotomy again? The episiotomy itself didn't bother me, however the blood loss was quite high and left me feeling really unwell and unable to get out of bed without fainting, for 24 hours.

I didn't, I had an episiotomy and forceps with my first, but not with my 2nd or 3rd (had them both at home actually). I did tear with them both, but the healing was easier than with an episiotomy.

No, I had one with DC 1 but not DC2 and 3

Not necessarily, I had one with my first, but not the second. I did tear but only needed a few stitches.

Same. I had ventouse with dc1 and needed an episiotomy but dc2 was a natural delivery and I tore slightly. Not on the episiotomy scar though. Didn’t need stitches but it was borderline.

Had one with my first & second but not 3rd. The 3rd baby was a bit smaller than the huge first 2

It's fairly likely, because your perineum won't stretch very well this time around. The area where you had the episiotomy is now scar tissue , which isn't as flexible as undamaged tissue. If you try to avoid an epi you could tear, which is just as traumatic and more fiddle to repair. I'm surprised that you bled so much last time - that really isn't a normal outcome. They normally only bleed a little.

Had one with my first, a forceps delivery, but not the next two. One small tear with DC2 & a graze with DC3.

No, my next child was bigger and I naturally tore and healed so much better than episiotomy!! I should have never been cut!

Unlikely, unless there was the need for an instrumental delivery second time around (less common after first vaginal birth) as the cut is usually made to allow space for the instruments.

I had episiotomy and forceps with first and a ton of blood loss; it was a nightmare labour, and with second neither - a tiny tear. Way easier the second time around!

I had an episiotomy with my first but not with my second. Second was a bigger baby but I didn't tear or anything.

My episiotomy was nothing to do with instruments btw, he just needed to come out!

Episiotomy with my first, bad tear with the second, just missed being 3rd degree.

I had one with first and then tore a bit with second - it healed much better after the tear though, having never been quite right after episiotomy it was back to normal so I was kind of glad (after a bit!).

No depends on your birth, labour and baby's position. Tell him or her to face your baby and curl curl up on the way out.

Face your back , sorry !

I'm in the same situation, expecting dc2. Was told by a consultant at my birth review that chances of needing one again are 5%.

Impossible to predict, OP. Your midwife or obstetrician will make a judgment call on whether you need one or not at the time, to prevent significant tearing and possible permanent damage.
Judging by the numbers of women on MN who have suffered third degree tears, and in some cases permanent issues with incontinence or chronic pain, we’re not doing enough episiotomies.
Labouring women nowadays tend to be older (30’s and 40’s, rather than teens and 20’s) with a less elastic perineum, and also more obese/diabetic with resulting larger babies - so tearing badly is more likely.
I used to be very anti episiotomy, until I had one with my first and a tear with my second. The epis was much more comfortable and healed quicker. It’s positioned away from vital structures and is a neat straight cut, easy to repair. If you tear near the urethral meatus, it’s agony every time you pee for a week, and if you tear into your anus... let’s just not go there!

Generally are you told before or after the birth that they’ve cut you?? I was told afterwards and I wouldn’t have agreed to it, but I suppose they needed to get dc out. Healing was awful, it was so painful. DM kept saying oh at least you aren’t recovering from a c section, then you’d know what pain is...

Reading Babdoc post, makes me glad I had one....even though it is still painful 8 years later.

I had one with my first, but the following three I didn't need one!

I needed to give (verbal) consent for them to cut me, although at that point I was so off my head on gas and air I'd have probably consented to anything! I'm sure they have to ask you.

The first time I had one was with my 4th didn't have one with my 5th

I had one with my first but not my next two, it healed well with no problems. Babies 2 and 3 were much bigger but thankfully I had no tears or stitches with them.

@mistermagpie neither was mine, that's why I wondered if I would need one again next time!