First time being pregnant... would it be better to tear naturally or just opt for the episiotomy?

Answer 1

Much better to risk a tear!

First off, there is no certainty that you will tear! Be sure to NOT push flat on your back and that will help you up your chances of keeping your perineum intact. Pushing in a squatting position opens up your pelvic outlet wider and makes you less likely to tear.

A tear is likely to be less severe than a cut. A tear may only involve skin, but a cut is certain to involve BOTH skin and muscle. If muscle is involved, that means a longer healing time.

Allowing them to cut you actually weakens your perineum and may cause you to tear on top of the cut, making it more severe! Think of it this way.....

If you have a piece of fabric and you try to rip it with your bare hands, it's hard to do. Now, take scissors and cut a little of it. Then you can tear it easily because you've weakened it. The terrible tears that go "straight through" that you hear about usually started as an episiotomy!

It takes longer for the doc to sew up a tear. BUT....here's why: he actually has to think about what he's doing. With a cut, he's got two straight lines to put back together. Nothing special to match up. With a tear, he's got two unique pieces of tissue to fit back together. Think of putting together a puzzle with straight pieces as opposed to one with uniquely shaped pieces. If you tear, it's more likely you'll get sewed up closer to how you used to be.

Tears heal better than cuts.

Talk to your doctor ahead of time and make it clear that you WILL NOT consent to an episiotomy unless there is fetal/maternal distress. If he says "all first time moms need one" then you need to RUN to a new doctor! Midwives typically have an episiotomy rate of 3% of less!

Squatting, kegels, good nutrition during pregnancy (makes the skin more elastic), perineal massage, warm compresses during pushing, having your perineum supported during pushing, following your own urges to push (instead of listening to them count) and waterbirthing are all things you can do to help protect your perineum.

Answer 2

In my experience, it all depends on the degree of the tear or cut. For my first child, I had an episiotomy because they needed to get her out fast (her heartrate was dropping). For my second, I tore. My recovery from the tear was MUCH worse than my recovery from the episiotomy.

When I was pregnant with my third child, I asked my OB to make sure to give me an episiotomy. However, when my child was born, my OB was having surgery so I ended up having the midwife deliver me. She did not give me an episiotomy and I only tore a little bit. My recovery from this tear was better than my first two recoveries.

In my opinion, I would opt for the tear, unless your child is in distress.

Best of luck to you!! :D

Answer 3

Tear!

With the episiotomy it takes doubly long to heal. And, if you tear you'll heal much faster. I tore badly in four places, but my doc said an episiotomy would have been worse...not just for healing but because incision to get the baby out would have been unbearable.

Your doc will know what to do. Don't worry about it, do keagels and worry about it if it happens. Most people don't have any problems.

Also, my tear healed fine! I didn't need any special treatment. I just used tucks. That's it. No infection no nothing. No stitches to worry about. Also, think about were they'll be cutting you. And, sitting on those stiches would kill!! The way I tore was much better than a cut. Also, I didn't feel the tearing :))

Answer 4

Neither sounds all that fun, but they say that an episiotomy is easier to repair than a tear. Besides, tears can get out of control and be quite bad. At least the episiotomy is controlled.

Answer 5

Personally I would risk the tear.

The decision is yours. Contrary to what a few others have said it is YOUR decision not the doctors. The doctor can suggest an episiotomy but needs your consent to perform it.

I suggest that you make a birth plan as to what it is you want. So that you don't have to explain yourself to different doctors or midwifes should your labour continue over a change of shift etc.

Birth plan can then be attached to your chart at the hospital and information passed on.

Answer 6

I've always figured it's better to take the chance of tearing naturally, (and hope you don't) than to decide to get the episiotomy that may not have been necessary. Even if you do tear, it may not be as bad as the actual cut that they put into you with the episiotomy! It's like cutting off your hand to get out of the handcuffs that the key that your friend across the room has may or may not open!!!! No need to cut off your hand, because it may not have been necessary if you had just tried the key!!!!

Answer 7

I would say episiotomy, but request that the doctor cut somewhat diagonally rather than straight back to avoid tearing into the rectum. I would NEVER opt to tear naturally.

Answer 8

As someone who has both, opt for the episiotomy. Tearing is horribly painful for weeks afterward. They aren't just going to do and episiotomy as routine, your Dr. will know if you need it.

Answer 9

Unfortunately, you don't have much control over either. If you tear naturally, more than likely it wasn't something foreseen. If they know your baby will be big prior to the birth, they may decide to do the episiotomy. Either way, you'd get sewed up & the recovery will be similar..

Answer 10

If you are going to tear for sure than go for the episiotomy. It won,t hurt when they do it and when they stitch you up the doctor can stitch you a little tighter. If you let it rip then it may not heal properly