The reason they do electives a week or so early is because STATISTICALLY elective sections are less risky than emergency sections, but that is probably something to do with all the genuine emergencies in there - if bubs or mum is already in trouble when you operate the outcomes might be worsened by that, rather than the surgery. They also prefer to be able to schedule electives during the day for the hospital's convenience.

Talk to your ob about labouring for a bit first. In general it is MUCH better for baby to choose the birthday, as dates and scans can be out and many elective babies are premmie because of this. Even if you know the EXACT day you ovulated - sperm can live inside you for 5-7 days, so you've no way of knowing for sure what day it all happened. Some obs are very open to the idea of the baby picking the day and others are not, so asking is the only way to find out really.

As an aside, i know of a woman (friend of a friend) who had a 4th degree tear with #1 (7lbs9oz, 35cm head) (when she had an epidural and coached pushing and then ventouse) - she tore right through into her bowel for the last 4 inches of her vaginal wall and had 2 severe anal fissures too. She had #2 (9lbs1oz, 36.5cm head) at home without epidural or coached pushing, and though her pushing stage was longer (100mins) because she only pushed a tiny bit with each contraction, she didn't need a single stitch, got away with just a graze. In addition i now know 2 women who had c-sections who have now prolapsed. It can reduce the risk for some women, but please don't see it as a get out of jail free card - i would HATE for you to have the section to avoid prolapse and have one anyway.

In general women's perineal anatomy (barring actual abnormalities/birth defects) makes little difference to who will tear, as does scar tissue (which contrary to oft-told belief IS stretchy).

Things that make a difference are epidural or spinal anaesthesia (because you can't feel what you're doing), coached pushing (because you're not listening to what your body tells you), reclining pushing stage (because the weight of the baby is resting on the preineum as you push - on your hands and knees the baby's weight comes down evenly on the opening of your vagina, rather than more onto the perineum), fast pushing stage (because you don't have time to stretch), forceps or ventouse delivery (because the Ob is inclined to pull harder than you could push, which increases the stress on the whole area) and episiotomy. Your ob saying the episiotomy would be done rang alarm bells for me - episiotomies INCREASE the risk of tearing. Imagine trying to tear a towel in two, pulling on the edge. Now imagine you cut a nick in it with scissors first...! MUCH easier to tear. In addition, the kind of cut she was talking about is a particularly painful one - they cut sideways, towards the buttock, and if you tear at the epi site you can tear right into your glute, which makes sitting and walking painful for sometimes months. Emergency situations (vaginal birth of a baby with a prolapsed cord, birth of a breech whose head has become stuck and compressed the cord, forceps delivery of a baby who is in serious distress) warrant episiotomy, in general slow, gentle, delivery makes a FAR bigger difference.

If i were you (and i'm not so do feel free to ignore me!) i'd seek a second opinion before booking anything. You have time to research your options and strategies, which is a big bonus.

HTH in some way.

Bx