Thanks all. As usual you have given me plenty to think about.

This is not an issue about consent for me. DH and I are switched on, take no prisoners kinda people. We are also very comfortable dealing with medical staff who tell big fat fibs about risk etc. I wouldn't have an OB that I didn't trust or that I had to negotiate with.

I guess this is all hypothetical. I hadn't considered the point that sometimes they are not interchangeable ie. when the baby is in the birth canal. I also hadn't realised that the size of the cut can be different depending on the circumstance.

I hadn't even considered a VBAC and all the issues that go with them. Thanks for raising this point.

I would always prefer to tear if it came to that. That was my strong preference at my first birth, of which this thread reminded me. I had a small tear for my first labour (1 or 2 stitches I think). We were back DTD within 2 weeks and I felt no different.

I understand that everyone's experience is different. Thanks everyone for sharing your points of view.

Cheers, Fiona

P.S. Your points about making sure husband was not at that end of the bed during an episiotomy made me laugh. During our first labour he was adament he was staying up at my head and not going 'down that end'. The reality that there really were no ends to the bed and regardless of where he stood he got a good view was a bit much for him!