Help! Advice needed re. elective episiotomies..

[laa]

I had an episiotomy with my 1st baby, after a 2.5hr. 2nd stage 3 yrs ago (May 2001). He was pretty large at 9lbs 11. I tore really badly with no. 2. who was born March 2003. She was 9lbs 10. Now I'm expecting no. 3 in 5 wks. and I'm finding myself really anxious about labour and I think that this is largely to do with a fear of tearing again. My midwife suggested that I consider an elective episiotomy because of the high likelihood of another tear, but I'm wondering if this is a bit drastic, because maybe I won't. Does anyone have any experience of elective episiotomies? Or tearing in each pregnancy. Does the fact I've had a tear and an episiotomy make me more likely to tear again. I'm about to embark on my birth plan and could really do with some advice. This baby is likely to be large too.. Thanks for any help!

Is this really something you need to decide right now? Surely as the baby is crowning yor doctor will be able to tell if an episiotomy is necessary.

It was my midwife who recommended that I ask for one before it gets that far, due to the fact that she thinks it inevitable that I will tear and that an episiotomy may be preferable to a bad tear.

My birth plan stated that I would prefer no episiotomy but should the previous tear look at all vulnerable then I wanted one.

I had a 3rd deg tear with DS1 (10lb 1oz) and an elective episiotomy when the tear looked weak with DS2 (8lb 4oz bless him)

Maybe you should just write in your birthplan that you want one if it seems like you are going to tear?
Tears actually heal better than if you are cut, but a cut can be strategically placed to cause least harm...
I wouldn't rush into saying yes to an episiotomy

I hate to be negative about this - I ended up with an episiotomy with DS2 as he was a forceps delivery - unfortunately I had a really bad 3rd degree tear AS WELL (some apparently class it as a 4th degree) so I think you 'could' still tear with or without the episiotomy

Decide at the time, but suggest you make sure your midwife's quite a master with the scissors and needle and thread cos sometimes, you'll get someone who needs the experience...

I had both 1st time round, Gwenick, but the episiotomy did prevent the tear re-tearing 2nd time round.

Also, whilst my tear did heal quicker than the episiotmoy, it carried more risk of permanent damage. Lesser of two evils I guess!!

Even though I'm only very newly pregnant I'm also worried about tearing this time too - TBH it is the only thing that puts me off a home birth because if I do need stitches I want to be assured that they're done properly this time and don't need redoing 8 months later as happened last time. Think would rather have a straight cut that is easily stitched but am sure will change my mind over the next 9 months!

pooka - as I mentioned below I had an episiotomy and a tear, obviously the tear was further 'round the back' (srry if TMI LOL) but I think I really need 're-stitching' where they stiched the episitomy as doing the business with DH (TMI I know LOL) is nigh on impossible - I'm terrified of needles and am putting it off.

can I also add that pelvic floor exercises will help strengthen your perineum. currently, 85% of women experience perineal tears...

if you want a routine, let me know. I've just written an essay on the pelvic floor...

h gosh Gwenick. Sex was impossible for me too. I suppose it really does depend who does the stitching/how well you heal. I had mine redone when dd was about 8 months old. Hope all goes well for you

ok oatcake - i'd love to hear your advice and exercises!
thanks