I haven't had either but was scared of both. When I discussed my fears of an epi with my private midwife, she told me there were 2 reasons I'd need an epi. 1) If I start tearing into the urethra/clitoris. and 2) if it looks like the perineum is about to burst from the middle out (hard to describe - imagine a marble trying to burst through some cling film). In both situations, a sideways epi would be preferred both to reduce potential damage.

I had a vaginal breech birth with a slight tear in the perineum. no stitches needed.

There are some good medical reasons for a c/s but remember it is major abdominal surgery. It's the great big needle near the spine that scares the hell out of me.

Also, I concur with Yeddi's analysis of post-VB sex. Wow!