Hey Daryx

it is really thoughtful of you to post for your GF...she is lucky to have you

many women who have experienced traumatic birth (and yes a vaginal birth can be just as traumatic as a c/s) do experience some degree of anxiety with subsequent pregnancies. Unfortunatley if this anxiety is not addressed in pregnancy it can set up for another disappointing birth experience....I am referring to the fear - tension - pain syndrome

a woman in labor feels anxious, releasing adrenaline (which reduces blood flow to the uterus, and reduces the levels of oxytocin and endorphins)...this leads to tension which increases adrenaline levels, decreasing further oxytocin (hormone essential for contractions) and endorphins (natural pain relief) and also reduces blood flow to the uterus (as this is not an essential organ) causing the baby to suffer from lack of oxygen and the uterus struggling to work without its power source (oxytocin and oxygen)

all in all this can lead to a painful experience, that may or may not lead to medical intervention or 'failure to progress' and a c/s

I believe it is really important to address fears of childbirth, and previous experiences. Many women find HpnoBirthing very beneficial as it works on the principles of addressing your fears, and understanding your coping mechanisms so a laboring woman is able to 'let go' in labor and birth, and allow the birth process to be an enjoyable experience

In regards to her fears concerning episiotomy or tearing as a general guide
1/3 of women tear
1/3 of women have an episiotomy
1/3 have an intact perineum

with a perineum that has previously torn it is more likely that the area will again tear, simply as the tissue is weakened. Perineal massage can be benefical to help with reducing tissue trauma, as it increases blood flow to the muscle promoting muscle elasticity. Perineal massage is also very beneficial for many women as it gets them 'down there' and sometimes identifying with our own body parts gives us more ownership and more awareness of this area.

there is also a birth breathing technique that is useful in creating perineal and pelvic floor awareness to reduce the liklihood of tearing...birth breathing
practise by sitting on the toilet (such as when you are doing a wee) and visualise the pelvic floor softening and releasing...as women we are all taught how to hold our pelvic floor, and taught to do our pelvic floors, but no one seems to say ok when you birth your baby it is important to relax your pelvic floor to facilitate the birth of your baby

I hope this helps...sometimes the best thing to do is not say anything but just hug

good luck

xx yogababy