Episiotomy Vs Tearing?

[Meowstro]

Does anyone have experience of both and can give me your opinions? Or if you just know of any reason to prefer one to the other? Trying to write my birth plan at the moment.

I had both. Episiotomy first and then tearing with my second.
The tearing healed much quicker and the scar is really thin. The scar from the episiotomy is still quite raised nearly four years later.
To be fair though neither hurt as much as the grazing I had.... Ouch!

I've also had both, tore with first and episiotomy with second.
First was natural delivery, tear was actually inside and yeah healed quickly and had no problems.
Second had episiotomy because of ventouse delivery and agree still a raised scar but healed easily too.
Think I would just see how it goes to be honest. Birth doesn't generally follow a plan haha!

Grazing? Or should I not ask?

As far as I understand there is now good clinical evidence to suggest that natural tearing is likely to heal better than episiotomy (they used to believe it was the other way round) and that's why episiotomy has become less common practice. I think it may only be used now when there's a really good reason. I have a feeling it's covered in the book Expecting Better which draws together research evidence around pregnancy and birth.

The analogy I've heard is imagine tearing a sheet of paper - the edges look messy but if you want to stick them back together they match / heal together easily. Whereas - if you use scissors to make a cut in a piece of paper it looks neater but needs more help to join back together.
Does that make sense? I've only ever had an epistiotomy so can't comment on tears, although I believe epistiotomy is used if the midwife thinks you're at risk of excessive / badly placed tearing.

Two babies and expecting my third. I both tore and required an episiotomy for both deliveries. Expecting the same again. It depends where you are tearing tbh. I tear at the bottom, straight backwards, so straight through my perineum. If they had allowed that tear to continue (both times) I would have needed surgery as it would go through to my anus ugh. Instead once I started tearing they had to make incisions to the lower side. So maybe just be open to both. I'd love to be one of those women who doesn't tear. Seriously I'd pay money to not tear or need an episiotomy.
The grazing is awful too though, it's basically when baby crowns and the skin stretches and splits, just very tiny splits, like loads of little cuts. Going for a wee is v sore.
Best advice I ever got was from my consultant who advised, where possible, when I needed to wee, just take off my pants, turn on the shower to v gentle and warm and wee in the shower, use the water to rinse. Stay away from nasty toilet paper and give your stitches (if you have them) a bit of a clean at the same time. Air or towel pat dry. Believe me it is worth it!

I was cut the first time a tore the second. Healed much better with the tear but fuck me it stung at the time.

I did have a ventouse delivery with the cut and natural birth with the tear which may have affected the healing.

Thanks for the info everyone. It sounds like tears are probably easier to manage because your body tears as much as it needs (which is what I'd been told) but I'll try to stay open minded.

calimommy I winced for you whilst reading your post, you are a brave woman to do it a third time! Thank you though, I'm sure your advice will prove very valuable.

OP, you will be fine! After my first I couldn't even imagine having sex ever again 😂 I was sure I would break, but it's fine, you heal. I think just going with the flow helps, and accepting that it's a bit out of your hands. I can't help how I tear but 2/2 times it's been the same so I'm guessing that's just how my body reacts. I healed much faster the second time, even though both my tear and the episiotomy were worse! But I was chilled out, I knew I would heal. And I wee'd in the shower every time 😂😂👍👍👍

I would just go with what may happen in labour. Dd1 I had an episiotomy one push later she was out her heart rate had plummeted and they wanted her out asap. Healing and pain find within a couple of weeks. Dd2 no tears or episiotomy. Dd3 came out like superman so caused a small tear on the way out. Again healed well within a couple of weeks.

I was always a bit wary of episiotomy as you are reliant on them doing it in the right place and to the right degree, if you get someone a little trigger happy they could give you an unnecessary cut. And overkeen to interfere midwives and doctors definitely exist im afraid, I've experienced it.