I have had both, episotomy in DS1 and DS2 and tearing naturally in DD.

The tearing naturally healed quicker and was less stitches, that could be down to my OB knowing what was going on down there!

I had U/S in hosp and ice treatment also and it helped heaps in both cases.

MW believe a tear will heal better...I would tend to agree unless of course you are going to tear to the point of a 3rd degree and have many stitches then I would think episotomy may be better???

As my OB explained she would see how it went, if she thought it was going to be a bad tear she would do and episi otherwise a small tear was better.

I also agree with Hollo, think the tear was better for DTD after.

See how you go....