I'm starting to think about writing my birthing plan and have read that it's a good idea to include your views on whether you'd like an episiotomy if it looks like you're about to tear, or if you'd prefer to just tear naturally.

First of all I was thinking [as much as the thought horrifies me!] I'd prefer an episiotomy, as at least that way you can control the direction in which it goes, and I assumed would look "neater" afterwards. But I've also heard that now people are saying tears heal better afterwards....I'm so confused!

Does anyone have any advice/helpful reading material?

Might want to do a search on it..If you tear, your skin will take the path of least resistance. If you're cut, it's just a cut...there are really big debates about this..I would also talk to your midwife/doc about stretching as the baby comes out..Most of the time, you can stretch..I had a 9lb8oz baby with only skid marks..no tears, nothing..So, it can be done.

I am debating on this myself, so I'm not a lot of help. I do however plan of doing the perineal massage, I figure it can't hurt! haha! I also found a ton of birthing plan website where you just click and go and print it off. I like this one the best. Pregnancy and Baby Birth Plan - http://PregnancyAndBaby.com... Hope this help! Good Luck!

if they advise an episiotimy i will have one but if its not an emergency and baby is ok i would rather tear. i will however do whatever i need to if baby is distressed which i am sure we are all the same on that one

the ideal for me would to just let it tear i guess lol x

Well don't go thinking any more about whether you would like an episiotomy or not because if you are delivering in the UK then you don't get to elect for an episiotomy. It is a medical interference that should only be done if there is fetal distress or you are going to have an instrumental delivery. No one can tell if you are going to tear for sure or how bad until your perineum is examined after baby is born. Even if there is the tell tale sign of 'button hole' or 'nic' to your perineum as baby is crowning a health professional can't tell how bad of a tear you will receive. Episiotomies used to be routine years ago but certainly not now with research saying to leave well alone.

Often you can get away with an intact perineum, 1st degree or 2nd degree tear which may or may not require suturing. Obviously if you have a third degree this will need stitching. Having an Episiotomy doesn't automatically prevent further tearing either, some can extend to a third degree.

Just listen to the midwife who may be telling you went to stop pushing and who may have her hand on baby's head to prevent baby shooting out quickly. She will tell you when to pant.

I've heard some mixed opinions on this aswell.. I've heard a number of things like

If you tear it may just be the skin.. If you're cut it could be the whole muscle
If you're cut it's neater.. But tear's heal quicker
I've heard LOADS.. I personally wouldn't like to be cut but if it was life or death for me or my child then go for it.. Although I would like to avoid it at all cost.. But that's just my personal feeling on it

Thanks ladies, and thanks for the link calilove77, very helpful!

An episiotomy to me is like pushing someone down the stairs so that they dont fall down them!

I was VERY sore for some time after being cut with my first and hardly noticed the tear I had with my second - my bum was more sore than my bits that time!!

Oh right! I was sure I'd read bits and bobs on this in British books but maybe I'm just getting mixed up
Makes sense though...I'm hoping for a water birth, which I know is supposed to reduce the chances of tearing, but was thinking it would surely make it more difficult for the MW to see if you were about to tear and decide whether or not to do an episiotomy. Sooo it's just a case of if you tear, then you tear...unless the baby is in trouble.

Very helpful, thanks

Haha, interesting analogy! Thanks for the input

And to add to what I have said, it isn't a practice during a delivery to observe for tearing. What would anyone think this will achieve as the head is crowning and what does anyone think can be done, there is a babies head in the way. The important tears you would want to know about happen are deep ones or in the back passage but these can't be seen occuring at any point during delivery. Small perineal tears you can see occuring whilst crowning but those are ok, they may not even need a stitch.