Tear or Episiotomy- MWs or ladies with experience??

[Leilababyno1]

I have just finished writing my birth, for what it's worth?!!

The only bit I was unsure about was the episiotomy question...

I wrote down that I would only like an episiotomy if the MW thinks I am going to sustain a tear that will be higher than a 2nd degree level (Or if needed for an assisted delivery).

BUT what is preferable? I have a friend who was never offered an episiotomy, as she wanted a very 'natural' birth (which the MW did her best to adhere to) and then sustained a 3rd degree tear and wished afterwards she'd had the cut instead!?

Please advise!!

When I went over my birthplan with my midwife she told me that a mild tear tends to heal better than a deliberate cut/episiotomy which is why it's preferable to tear than be cut. But it's difficult to say exactly how bad a tear will be until it happens and guesswork is involved, sometimes they can predict based on previous history, rough size and position of the baby, etc.

I tore with DS, second degree. He was coming forehead first and the MW told me it would likely cause a third degree tear and an episiotomy would be favourable, the consultant then said a ventouse would be better as I'd been pushing too long and he wanted DS out before he became distressed and delivery became more difficult - either way, I was getting an episiotomy. As it happened baby came before they could even inject a local anaesthetic into my bits and DS turned his head while it was only halfway out instead of all the way out, it was this turning that caused the tear and it was second degree when checked afterwards. The MW had an idea of how severe the tear could potentially be though which was why they offered the cut.

I'm pregnant again and would still rather tear than be cut because my tear has healed wonderfully but I will still take it under advisement on the day itself and if it seems that a cut is the best options then I'd consider it.

I was under the impression a tear heals better than episiotomy but have no experience, only had v small tear with dd and only needed 2 stitches. After 10 days I felt Completley normal down there again

I had an episiotomy (no choice, prem baby, wanted to get him out fast) which healed extremely well. I had two paracetemol the following day to manage the pain and that was all. I was probably mildly sore for about 3 days.

i've had one of each (tear was 2nd degree) and i think the cut probably healed better/quicker although neither was too bad
would definitely go for cut if they thought it would be a more severe tear than that, so think its sensible what you've written

Had epi with DD1, couldn't walk properly or sit down without a cushion for about 10 days. Had 2nd degree tear with DD2 and felt absolutely no discomfort afterwards. (In interests of fairness, should point out that both times was sutured under anaesthetic in theatre so can't say anything about pain levels during actual repair work).
I would definitely go for the tear if I had DC3 unless they could tell in advance that it would to be too hideous (though how they would know this, I don't know )

What's preferable is to need neither!
I've had three episiotomys (obvously rubbish at stretching!) and they've healed fine. Episiotomy is not the end of the world nor is it a breeze. Probably best to see what happens on the day and say to the midwife you'll have one if she thinks your bits are about to explode but not as 'routine'. (they don't do them as routine now any way but it doesn't hurt to say that.)

I started to tear quite badly with DD so they cut me - at the time I would have preferred to have torn (but I later found out that it would have been 3rd/4th degree tear, so probably preferable to have a neater wound). I ended up with a ventouse delivery so would have been cut. Had 8 stitches, but it wasn't too sore and healed very quickly. I have noticed now, though, that the skin on the scar has very slightly separated.

With DS I tore, but only a 1st degree tear and needed no stitches.

Neither gave me any pain afterwards...well, no more than is usual after having a baby!

The repair job on a second degree tear isn't too bad, having the local anaesthetic is the worst bit because it's five small injections around the area and the fifth is injected into the muscle part of the bum hole - tried to think of a nice way to phrase it and couldn't! They gave me the gas and air pipe to breathe on continually while they repaired it and once the local kicks in it's a breeze. Afterwards I had some diclofenic (and smugness from the MW when I said the pill looked too big to swallow), a shower, and then walked to the post-natal ward after our alone time. I've had no lasting damage and wouldn't even know I had torn from the feel of things although the nurse who did my last gynae appointment commented on my amazing scar :) she did say it had been well stitched too though.

The good news about cuts and less severe tears (2nd and below) is that they tend to heal very well because all the tissue and muscles in that area are so elastic and have such a good blood/oxygen supply.

Hmm not sure I'll be much help. Had to have epi with ds which turned into 'extended epi' ie i tore as well.