Having an episiotomy, as opposed to NEEDING an episiotomy, is reliant on one thing, and that 's the care provider you chose to be with you at your birth. It has very very little to do with the integrity of your perineum, or whether you've had a tear or a cut before. I know midwives who have practiced in a variety of settings for many years, and have never needed to, and to have never, cut an episiotomy. I have been practicing independently for nearly 5 years, have been at close to 100 births, and have never cut one. That's a 0% episiotomy rate. That's with women having first babies, fifth babies, having vbac's, breech births, 10lb 6oz babies, the lot!
Choose a care provider with a low or negligible episiotomy rate, that alone will nearly guarantee that you won't need another one!
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