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thread: Natural tear vs episiotomy

  1. #1
    BellyBelly Member

    Sep 2010
    North West Victoria, Australia
    3,003

    Natural tear vs episiotomy

    I've been getting together my birth plan and what I'd like (early I know, but doing my research so I can get my VBAC)...

    Would you rather tear or have an episiotomy? My sister had an epis and took her ages to heal, so did another friend.

    Just looking for opinions and experiences.

  2. #2
    Registered User
    Add TeniBear on Facebook Follow TeniBear On Twitter

    Oct 2009
    Lalor, VIC
    5,051

    Definitely a natural tear. I haven't had an episiotomy, but I had a 2nd degree natural tear with Amelia. After maybe two or three days I could hardly feel it! Maybe they just did a really good job with the stitches, but I believe it would've healed slower if it was a deliberate cut. I've also heard that cutting an episiotomy can lead to a longer, worse tear if they're not careful with their timing.

  3. #3

    Jul 2009
    Australia
    5,102

    Everywhere i have read has said natural tearing is better as it heals faster. I had a second degree tear and it was healed after 2 weeks.

  4. #4
    BellyBelly Life Subscriber

    Jun 2008
    In snuggle land
    4,499

    I wrote I'd rather tear except for 2 scenarios:
    1) if I am tearing forward into the uretha
    2) if a balloon type tear starts in the perineum and explodes out. I hadnt heard of this, but my midwife mentioned it.

    Otherwise, I wouldn't want an epi. I'd rather be supported to borth in a way to minimise the risk of tearing (as much as that can be done).

    If you want to read more about it - try Henci Goer's the Thinking woman's guide to a better birth.

  5. #5
    BellyBelly Life Subscriber

    Jan 2006
    11,633

    I've had 2 episiotomies, first also tore so 3rd degree in end. both awful. would not choose to have one.

  6. #6
    Registered User

    Sep 2007
    Brisbane
    5,729

    I read an article on this...

    When you tear, the muscle underneath is a thin layer from the pressure of bub's head, so there is a fair bit of skin damage but little muscle damage. With an epi they often cut through more than just the stretched skin and into the underlying muscle etc.

    I would opt for a natural tear.

  7. #7

    Jan 2011
    Hunter Valley, NSW
    305

    I had a 3rd degree tear (which at the time I didn't want an epi) but it took 8mths and more surgery to fix it. I'll be opting for an epi this time.... can't be any worse for me surely!

  8. #8
    Registered User

    Mar 2007
    6,900

    I had it written in my birth plan that I would rather a natural tear. I had a second degree tear and it was only sore for about 4 days

    ETA - there's also another thread on this here: https://www.bellybelly.com.au/forums/f21/tearing-naturally-vs-episiotomy-120871/

    Last edited by Heaven; December 20th, 2011 at 02:20 PM.

  9. #9
    Registered User

    Aug 2010
    Perth
    609

    I wrote in my birth plan that I'd rather tear then have an episiotomy. I also made sure I looked into what positions are best to minimize tearing. I ended up birthing on my knees leaning against the back of the bed and only had a tiny tear that didn't require stitches. Everything I came across during my research suggested a natural tear heals much better then an episiotomy


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  10. #10
    2014 BellyBelly RAK Recipient.

    Mar 2008
    Vic
    4,806

    I had an epiositomy with a forceps delivery under a fantastic OB. I had no pain or discomfort whatsoever.

  11. #11
    2012 BellyBelly RAK Recipient.
    Add AngelPants on Facebook

    Feb 2010
    Under the rock
    1,320

    I had an episiotomy and had to go back for surgery on the scare tissue 14mth later. From everything I've heard tearing is better for healing and pain unless it's going to damage your urethra or rectum.

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  12. #12
    Registered User

    Jul 2008
    Melbourne
    3,244

    i had an epi with a forceps delivery (and ALOT of stitches) & whilst it isn't what i would have chosen (from reading, i would have preferred to tear naturally), i had one dose of panadol & that's the only pain relief i had. i healed quickly & have had no discomfort or pain since.

    not sure whether it's luck, a good ob or that i heal quickly or a combination of all 3! would still prefer to tear naturally but feel comfortable that i am able to heal from an epi if needed.

  13. #13
    Registered User

    May 2010
    victoria
    436

    I had an epi and had no pain or healing issues at all. It didn't bother me even the day I gave birth, and not even a month later I couldn't even tell I'd been cut. They done an awesome job stitching it.

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  14. #14

    Mar 2008
    Where dreams are now reality
    2,318

    Honestly, I think it depends on the circumstances at the time. I had a all but 4th degree and it took months to heal but I also wouldnt have had an episiotomy either. I was of the impression you can have an episiotomy and then still tear in another direction. Think I'd prefer just the one tear than a cut AND a tear

  15. #15
    BellyBelly Member

    Sep 2010
    North West Victoria, Australia
    3,003

    Thanks, I scar soo badly which is another reason why I'm concerned. My c/s doesn't look any different than it did a few weeks after I hate it. It's still red. My appendix scar took 5 years to start to fade so I'm not holding my breath for my c/s scar.

    I'm just worried that if they cut me down there that I won't heal and things afterwards won't be the same.

  16. #16
    BellyBelly Member

    Dec 2005
    3,130

    i had internal tears with first baby.. i found it hurt alot but it didnt last as long until it started to feel better.
    i had an episiotomy with my second baby and i found that it didnt hurt as badly but that the pain lasted for a lot longer.
    also, i had further complications from the episiotomy leading to painful intercourse and had to have it re-done when my little one was 2 1/2 years old! eeeeep!!
    so i would prefer a tear.. having said that though when you are in labour and the situation arises you do what your carers think is best and what you think is best and really what happens happens. there is no point stressing about what might happen when you may have no control over it in the first place. :-)

  17. #17
    Registered User

    Dec 2005
    In Bankworld with Barbara
    14,222

    Natural all the way! Epis cut through the muscle and take longer to heal as well as being quite painful and uncomfortable. I had an epi with my first and it was awful! I couldn't even get in the car without it hurting. But with the two tears that I had I hardly even knew they were there!

  18. #18
    Registered User

    Nov 2004
    Australia
    1,247

    I tore during my first vbac and didn't feel a thing. It was really painful after and took ages to heal. My last vbac I had an epi which was more painful than labour itself but healed so much quicker and less painful after!

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