Episiotomy or Tearing?

[Tiger22]

Which is better to get? Any opinions? I'm 35 weeks along with my first so I'm new to all this and seeking advice! I'm worried about incontinence...has anyone gotten this from giving birth?

 

[waiting_game]

I just had my son 2 weeks ago and got a small 2nd degree tear, it felt better after a week, i only needed 2 stitches. I think the episiotomy would be worse, because its unnatural, and have heard it can increase the risk of more severe tears. Plus they can cut you more than what you would have torn.

 

[scottiejunior]

I had an episiotomy and I ended up with a 3rd degree tear- spent an hour in surgery (no idea how many stitches).

I blame the episiotomy for how badly I tore even though my docs said its not the case!

I had forceps and that was a major part in it.

 

[HelsBels07]

I ended up having an episiotomy as LO would not come out. My skin was just not stretching and was really tight, even after about an hour of pushing. I was already starting to tear, however the MW judged the situation and thought that it would result in a 3rd or 4th degree if left. I had had no pain relief and to demonstrate how tight it was she ran her finger round LOs head and me and by far this was the most painful part of the whole labour. She did small cuts so I didn't have a bigger cut than needed.

A cut involves muscle so can take longer to heal, but a 2nd degree tear also involves muscle but can apparently heal better? I would have happliy been left to tear if it was going to be upto 2nd degree but until it happens you don't know if you will tear and to what degree. Who knows if I had have been left it may not have been as bad as expected. Where I am they will only perform an episiotomy if really needed and would normally leave you to tear.

 

[Leesy]

I had an episiotomy and tearing (not sure on degree). I beg to differ as I had more problems with the healing of the tearing. The incision from the episiotomy healed no probs.

 

[MrsHippo]

There are lots of different opinions over this. Most people would prefer to tear as apparently it heals better....but you'd assume a perfect, straight cut would heal better? I know that most midwives choose not to do it unless necessary whereas a doctor will come in and do it straight away - I think because its 'easier' for them. I personally wouldn't want to be cut unless they really needed to.

 

[staralfur]

I tore quite severely but would still do that again a hundred time before letting someone perform an episiotomy on me. The thought just makes me cringe.

I say let your body do its thing unless of course the episiotomy is absolutely necessary.

As for natural tears healing better than episiotomy cuts, it's generally completely true. My prenatal instructor gave us a really good analogy to demonstrate why that's the case but I can't for the life of me remember it right now! I'll come back if I do.

 

[Tiger22]

Thanks ladies for the advice! They may need to use forceps or vacuum on me because of my heart condition. Which worries me that I will tear more or have more issues with this :/

 

[NaturalMomma]

If you get an episiotomy you are 100% gauranteed to tear. Not all women tear in birth, I only tore with ds1 and not with my other two kids. Episiotomies where I live are only being done in medical necessity and not on request of mom.

 

[mummy2be2012]

I had a 3rd degree natural tear with my little one and was told i was at risk of being incontinent from both ends! Luckily that wasn't the case but i have been told that i have to have an episiotomy with the next baby as i will probably tear again and end up incontinent. Anyone know if there's any truth in this? xxx

 

[BunnyN]

I have decided against an episiotomy to prevent tearing. I've found most women (although not all) say tearing heals better. A high proportion of women tear during labour, however the majority of tears are very minor, many don't even need stitches and will heal quickly. Severe tears are much rarer, in some cases an episiotomy may prevent severe tearing the problem is there is no real way of knowing if tearing will be severe until it happens and it is still a relatively low percentage of the women who get cut to prevent it that would of torn badly, add to that sometimes episiotomy makes the tearing worse. If I could know before what the outcome would be I might choose the cut but seeing as there is no way of knowing I'll take my chances with tearing. You can check the episiotomy rate at your hospital too, IMO 10% is a good rate, much over 20% and they are too liberal about cutting, plenty of hospitals have a rate of over 70% which is just ridiculous if you ask me! The rates are high where I live so I don't trust them to make the decision for me. If they have a low rate you might trust their judgement more. Of course if it's needed to get the baby out quickly because it's in distress I wouldn't hesitate.

 

[kerrie24]

When I had ds1 my mum told me it was better to tear as it healed better.I didnt tear with the other 2,just got grazes and bruising.
My sister had an episiotimy for her forceps delivery and it took a long time to heal,and she says it still hurts to use tampons now(20 weeks pp)

 

[MindUtopia]

I would definitely prefer to tear naturally. With an episiotomy, you know you'll come away with a tear, even though it's 'man-made', but if you just let things go naturally, you might not tear at all or it might be fairly minor (an episiotomy is not a 'minor' tear). As for pain, I wouldn't let that be a deciding factor either. I had two minor labial tears that required stitches plus a 2nd degree perineal tear and I honestly didn't feel any of it when it happened. It was just a bit of burning like everyone describes, but it wasn't horribly painful at all and I honestly never would have guessed I even had a tear. I had my baby at home with no pain relief at all (not even gas & air), and it wasn't bad at all. The healing has been pretty straightforward. I'm only 4 week PP so I haven't exactly 'taken it for a test drive' yet if you know what I mean, but I have no discomfort now and all has healed well. I was a little bit incontinent the first couple weeks after but I don't think that had anything to do with the tear. From what my health visitor said, it's very normal and you just have to build up your pelvic floor muscle strength again, so I did regular PF exercises and now it's all normal again a few weeks later. So go with your gut, but I wouldn't worry too much about tearing. It's not a big deal and it's not nearly as scary as it sounds.

 

[Eleanor ace]

I had a 3rd degree natural tear with my little one and was told i was at risk of being incontinent from both ends! Luckily that wasn't the case but i have been told that i have to have an episiotomy with the next baby as i will probably tear again and end up incontinent. Anyone know if there's any truth in this? xxx

Was it your consultant who told you this? I'd definitely seek a 2nd opinion if they are automatically going to give you an episiotomy- you're still at risk of tearing past the cut, I would have thought they'd want you to have a c-section.
I had a 3rd/4th degree tear with DS (depending on which of my doctors you ask!) and after having the scans to check how I've healed they're happy for me to have another vaginal delivery and not too concerned about incontinence issues . However and episiotomy will be avoided unless totally necessary (A c-section would be done over an episiotomy as long as there's time) as having the episiotomy would likely make me tear into my scar x

 

[flubdub]

I have never torn, not had an episiotomy, but I would much rather tear than be cut. They say it heals easier, and it just sits more comfortably with me.

 

[minnie83]

I had an episiotomy AND still ended up with 2 tears

 

[rihanna]

I had a second degree tear which didn't hurt tearing but the stitches were very painful. That said it healed well as quickly and I can tell no difference at all now .

I'm no doctor but I would say a tear was way better than an episiotomy , tearing happens along a 'natural seam' so to speak where being cut manually just seems wrong . Where I am they only do of necessary to help you or the baby . Good luxk

 

[d_b]

I had a second degree tear on my perineum. Like rihanna I didn't feel it at the time but stitches were quite painful. They fell out right away which shouldn't have happened, so it took a while to heal. Getting cut I would imagine would be much worse, although maybe they would have done the stitches better with a clean cut and then they wouldnt have fallen out?

 

[Berri]

I had second degree tear and it took a good half hour to stitch me up but no pain (even the next day) and all healed up very well. Apparently if you can learn to do "little pushes" when the m/w tells you you may reduce risk of tearing but I just couldn't figure it out

 

[Keyval]

I had to have an epi as I needed vacuum which failed them forceps . I ended with a third degree tear right back to my back passage . I wouldn't hesitate if I needed it again though as baby was distressed