The jury is still out on which is better. Some say tear as it is a natural wound, others say epi. The thing with having an episiotomy is that they are guessing where and how far you will tear to try to prevent that, the other thing is they can cut angled away fromn the anus to avoid the nasty all the way through tear. The thing with this is how do you know you are even going to tear? You may be causing a wound that isn't even necessary. I didn't tear my perineum (slight graze on labia which was no big deal), if they had done an episiotomy I would have had a harder recovery time. Episiotomies do have their place, but if it's not really necessary why cut there? Just my opinion.