But the Birth canal still isn't related to a hysterectomy. It really sounds like your friend is being given a massive bum steer by the Ob and she is going to become a product of the system All that talk about not having a VB again because she'd previously tore is just a lie and in reality it is criminal what he is doing because she is not giving informed consent when she is being treated like a mushroom by him. Fair enough, there are some instances when the tearing is bad enough that it may prevent future VB's but this is rare and there are usually other associated problems with it. I had an epi with my first birth and went on to vaginally birth 3 more babies - and there would be 1000's and 1000's of women who have done that too. I know that you said your friend has made her decision, but I just can't help but feel that she will regret making that decision once it's done.