Thanks girls, I pushed for 2 hours and then she was getting distressed, I was exhausted and had nothing else to give, a c-section was spoken of but would have been complicated as she was so far down the birth canal. I know he only cut me because he had too as we had many discussions while I was pregnant, he knew of my fears and explained various tears and epi's and reasons why he does/doesn't do them, I remember him quite clearly saying generally speaking he lets women tear if he knows it will be better healing than an epi, he cuts when the damage will be too great - ie incontinence problems. He has been my gyno for years for endo/pcos issues so I do trust him, but I'mjust not sure that the epi-no will improve things for me!