Permanent injury after birth vs c-section

[MrsFabuloso]

One of my best friends who is 6 months pregnant with her second bub, likely to be her last, was told last week at her midwife appointment that she has a fairly high chance of her tearing just as badly, possibly worse as she did with her first baby. The midwife told her she could end up with permanent bowel incontinence, prolapse and/or other permanent injuries, and highly recommends she has a c-section.

With her first bub, she had a severe tear, which left her unable to walk for a little while after birth, as well as having the other issues involved with bad tearing (up into he vaginal wall and anus). She had a 4.5kg baby with a very big head.

My friend is very pro-natural birth. She is quite fearful of a c-section, but also just doesn't want to have one, and doesn't believe in having one, unless it's an emergency.

She is very torn in which way to go. Unsure of whether her care providers are scare-mongering or being right in their concern. She naturally doesn't want to have serious long term/permanent issues post birth, but she also feels like she doesn't want to be scared into doing something she doesn't want to or is unnecessary. She is trying to come to terms with the information right now.

Do you have an ongoing or permanent injury similar to what I have mentioned? Does anyone have any similar stories? Any advice or suggestions for my friend?