A tear only tears as much as your body needs to, usually only skin tears. A cut usually cuts through muscle as well as skin, takes longer to heal and hurts more. A LOT MORE. AND an episiotomy increases your risk of tearing at subsequent births (I had a he** of an episiotomy last time ) There are caregivers who never do episiotomies, even if they need to do an assisted elivery (forceps/ventouse).

In short: I don't care if it looks like baby is going to rip me in half, come near my vag with a shiny sharp implement, and I'll knock your teeth out with my foot!!!!!

Tears are harder to stitch, but small tears don't need stitching and will heal better left alone.

Best thing to do is to try to allow your tissues to soften and stretch gradually and comfortably. Don't rush the 2nd stage and don't purple push (coached pushing). Do what your body tells you - get in whatever position feels best and push however feels right. Lying on your back probably won't be the position that feels best.... it tends to be more painful, harder work and increases your chances of tearing. Delivering while lying on your side or on all fours reduces your risk of tearing.

An epidural doesn't let you do either of these things (get into the right position and push as your body indicates). It numbs the pain, but it also cuts off useful info that your body is telling you, leaving you more likely to tear. A lot of places won't do an epi that close to delivery anyway.

Birthing in water helps the tissues soften, relax and stretch, but if you're not doing a pool birth, have some warm wet cloths to hold gently against your perineum to soothe it. It's gotta be REALLY gentle though, too much pressure can CAUSE tearing up inside - if you do it yourself you will very likely apply the right amount of pressure instinctively anyway, but it's harder to DIY when you're on all fours. Put your hand down there as the baby crowns; you can protect the sensitive part around your clit with your hand (that's one bit you DON'T want to tear, right?

You could try perineal massage.... not a lot of point if you've already had a baby because the tissues have already been stretched in the past, and some people reckon there's no benefit even for 1st time mums and I'm skeptical of the physiological benefits.... but I do know people who absolutely swear by it.

Linkage on episiotomy:

http://www.ima.org.il/imaj/ar03aug-11.pdf

Hehehe...thanks very much, that was very helpful. Off to read the link now

i tore with my first cuz the cord was around his neck so i had to push him straight out without panting/breathing when the head is coming out. It was quite bad and i had to have lots of stitches but it did heal within about 3 weeks and wasnt that bad. The stitches werent as bad as you would think either. x

I had an episiotomy and it healed up no problem. I was healed within a week after my daughter was born.

Not a reply to the topic as such but is anyone else terrified of the pain of tearing? Or does tearing cause the amount of pain that I imagine it would? It freaks me out, the pain of contractions seem almost tame in comparison! This is my first baby, so I have no clue but if even a vaginal exam is uncomfortable, imagine a tear?!

Mothers who have torn in delivery, is the pain unbelievably bad as I imagine it would be?

I had to have an instrumental delvery as LO was 9lb 2oz & was back to back & wouldnt move. They did an episotomy at the back but I still got a 2nd degree tear at the front. think I vaguely remember them asking for consent to perform the episotomoy but I'm not sure, everything was a bit of a blur TBH as they were also consenting me for an emergency c section if needed(luckily it wasnt) As for whether it hurts, I have no idea as I was a wimp & opted for an epidural! It was quite tender afterwards though but is getting better every day.

i had an episiotomy with my son, he was back to back and stuck and i ended up having to have a forceps delivery. I cant say whether a cut is more painfull than a tear but it did take a good 4 weeks for me to heal. im hoping not to have another episiotomy this time(i made the HUGE mistake of looking at videos of episiotomys being performed on youtube ) but having said that, if im told i need one then i will go along with it xx

You'd normally be given a local aneasthetic for an episiotomy, or if they do any stitching. So you don't feel it. You DO feel it afterwards though, and it can hurt A LOT. I was in pain for weeks, sex was impossible for the first couple of months and still very difficult after that.

The pain of crowning is also called the ring of fire. But there is a lot you can do to ease that pain. As to how bad the pain of tearing is; I would guess that depends how badly you tear... I know many women who tore just a *little bit* and didnt even know until afterwards.

I had an episiotomy and tore further still. I had to have a forceps delivery and therefore a cut was needed to assist with the delivery. As LouLou said, an episiotmy is done medically and you can't really choose whether to have one. I had a borderline 3rd degree tear.
On the plus side, I did heal after a few months and am now back to having sex and my downstairs department is fine!

Oh and the pain of tearing is NOTHING in comparison to contractions, I didn't even feel it, and thats saying a lot as I had a bad tear! I was only told about the tear as she was being placed in my arms and I couldn't care less by then! They sewed me up for 45 minutes though, thats when I knew it'd been a bit of a struggle but she was back to back and I am the tiniest person you will ever see and had a 8lbs 7oz baby.