Tearing Vs Episiotomy

[RIBS]

What are your thoughts?

would rather not have either! Lots of women don't tear, or tear very slightly. I've had 3 with no stitches. A lot to do with the midwife and not pushing when you shouldn't

I had a very bad experience with an episiotomy which left me determined never to have one ever again! The stitches healed so badly and were so painful that could not have sex without being in considerable pain for at least 3 years - at one point I felt I would never be able to again.

With dd2 I tore a little and it healed up fine.

Had an episiotomy then tore on the other side - fat lot of good the episiotomy did.
Mind you I don't think they could have done the forceps delivery without it

Supposedly a tear heals better. Ouch ouch ouch.

Definately do the perineal massage.

I think it depends, tbh. I had an episiotomy with DD. Her heart rate was dropping and the midwives suggested an episiotomy to see if I could push her out quickly and thus avoid forceps, ventouse or a c-section, which I did. I recovered extremely quickly, and had no pain at all after a couple of days (and I'm guessing I might have felt a bit sore in that area episiotomy or not!).

I had an episiotomy with dd, it took a month before I could sit down comfortably.

Had a 2nd degree tear with ds, recovered much more quickly but have been left with a lumpy bit due to the number of stiches/location of tear

I had both, DS tore me before they cut me basically.

I was v v sore for a few days after, (but that might have been the internal a silly dr gave me not 24 hours after having DS - and then claiming I was 'sore' down there - well duhh! just had a baby and episotimy/vontose delivery!!) was given pain killers, could sit down ok thou after about a week was fine tbh - still a little achy but nothing I wouldn't imagine was unusual to normally having a baby.

they took an hour to stitch it all back up thou so not sure if that effects anything the fact the dr was so precise on her stitching?

Only had 2nd degree tear, no episiotomy but it wasn't that bad. Bit sore, and being stitched wasn't that nice, but completely back to normal and healed after three weeks, and it didn't affect sex afterwards. Didn't feel it tear either.

I asked not to be cut unless absolutely necessary, in my birth plan.

I had an episiotomy last time (without my consent - , but this is very rare, so please don't think this will happen to you). I did not want an epi and would have preferred to tear. It has taken a long time to heal, in fact it still hasn't healed properly, and it is really big. I have spoken to midwives since who have told me that the advantage of a tear is that you only tear as far as your body needs to to get the baby out, whereas an epi could be much bigger because the doctor/MW is guessing how big.
I will have an episiotomy this time around if the baby is in distress, or if I have a very unusual tear that would be likely to extend to the spincter, otherwise I would rather tear.

It took an hour and a half to stitch me up afterwards, which at the time I found quite disturbing, but looking back the fact the midwife took such care was probably a factor in the healing process.

Looks like Tearing is the better plan out of the two then. Whats the best thing to put on birth plan? Prefer to tear, episiotomy if really necessary.

I recovered much quicker from a 3rd degree tear than I did from my episiotomy which took months and months

i had epi which resulted in a 3rd defree tear with ds1, which i found really painful for a few weeks after, and of course they whisk you away to stitch you up so you can't be wiht your baby.... With ds2 i screamed no epi at them when they kept asking if I wanted one! In the end I only got a 2nd degree tear with him, and it was all so much less painful.
I put in my notes with ds2 no epi unless the baby is in distress........

My notes say "no episiotomy unless foetal distress or buttonholing". They were written by a senior midwife, so I would bet that that's the right terminology.

What is buttonholing?

i ended up with both having dd1

she was delivered unexpectedly at home, and they couldnt hear her heartbeat, so i was given an episiotomy, but because she came out brow first, i also ended up with a 3rd degree tear

I had an epi as had been pushing for an hour and Ds's heart rate started dropping. Took about 20 minutes for lovely doc to stitch me up and to be honest by the next week I was fine. Would do it again (provided it's the same doctor though)

Buttonholing is a very, very, very rare kind of tear that starts in the middle of the perineum (not at the vagina). Because it's in the middle, it's more likely that you will tear closer to the spincter, so in that case I would rather an episiotomy.
I only know about it because it happened to someone on MN - it was the reason that her MW did an episiotomy - and she was asking what is was. I've never heard about it in real life.

Wow, well you learn something new every day. Sounds nasty.

I had a 3rd degree tear with my dd, and had bowel troubles for sometime afterwards.

My mum asked the MWs why didn't they cut me if they knew i was going to tear and their answer was they do not routinely cut now as a tear heals better, which i did understand the reasoning about that, imagine if you ripped a piece of paper or cut it, the rip would bond together quicker as it isn't a clean cut.

Strangely enough my biggest fear was and episiotomy, but honestly at the time i just didn't care really.

My tear, i am fairly certain is down to 2 factors.

1. i did NO pelvic floor exercises.
2. The MW didn't tell me to pant the head out, therefore i pushed extremely hard as the head was crowning, taking my pelvic floor with it.

BTW my 3rd degree tear was not that bad at all, once the spinal had worn off after being repaired i was up and about, it was sore don't get me wrong but not as bad as you would think, the worse thing for me was having a poo, which in itself wasn't that bad but the thought of it made me cringe. Also the only other thing was the ichiness due to the healing and the stitches disolving.

I had a elective section with ds, which was recommended due to bowel trouble following my tear and that was MUCH MUCH worse believe me! if i had a 3rd i think i would prob push for a natural delivery again as recovery was alot quicker.

The poster who had buttonholing was fine, because the midwife gave her an episiotomy and the tear didn't spread. I would imagine that it would be nasty otherwise, but it's so rare that it's not on my list of worries for this pregnancy, it just warrants a short note that even though I want to tear, I'm not going to be so militant that I cut off my nose to spite my face!

My biggest concern this time around is that things will go so fast that my perineum won't have time to thin out properly. I've been told that some women have such a strong urge to push that they can't resist. With DD1 I never had any urge at all, as she was so badly positioned that she didn't really engage. So it's a bit of an unknown for me.

I tore with my 1st, his head was born rather fast, was sore after, but not unbearable.

With 2nd, midwife told me to pant the head out and sort of held it there to come out slowly, iykwim, no tear!

And it was 11 years later so can assume everything was back to normal down there!

I tore with my first too - apparently a 2nd degree... had to sign millions of bits of paper as I insisted on no stitches... the MWs were very insistant that i needed stitches and spiteful about it but consultant next day said it was fine... healed quickly and without itching or pain

with 2nd I don't recall having a tear at all 13 yrs later so like izzybiz, kind of think things were 'back to normal' too

I'm in the 'would really dread an episiotomy' camp!