What heals better?

Stevie - posted on 03/04/2010 ( 60 moms have responded )

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I was doing up my birth plan and one of the questions was would I prefer an episiotomy or a tear? Obviously none of the above but I was wondering what would heal better? When would an episiotomy be necessary and how will I know?

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C. - posted on 03/13/2010

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Episiotomy recovery is better b/c it's a straight line instead of jagged edges. When the flesh starts to grow back it won't have to take the time to "find" the flesh on the other side like it would with a tear. Ask your doctor how big your baby is and take into consideration your body frame as well, like if you're petite, average, or have a bigger than average frame (and I mean only the frame, not how much weight you carry- if that makes sense). Ask your doctor about the episiotomy.. You'll be thanking yourself if you get one and have a good chance of tearing. I tore hole to hole and it took 3 whole months for me to heal. Hope this was helpful!

[deleted account]

From what I've read they heal about the same. I refused an episiotomy unless absolutely necessary. They should only be necessary if you need forceps or a vacuum or if the baby needs out right away. You can talk to your doctor about ways to prevent tearing. I don't know if you've had a baby before, but when you feel the "ring of fire" when baby's head is crowning you're supposed to stop pushing. You want to let the head come out very slowly. My doctor at the time told me to push through that and I tore. (Now I know better). Doctors can also do counter pressure to try to help prevent tearing. I think I would take the tear over the episiotomy because when I tore my skin was so stretched that I was numb and it didn't hurt. If you get cut before that point you're going to feel it.

Amy - posted on 03/05/2010

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tearing naturally is MUCH better! If you were to tear do not have them cut you, it will take longer to heal. I was told by several dr's that they don't personally don't cut anymore because the women heals much better after tearing naturally.

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Kendra5664 - posted on 12/22/2013

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My doctor decided to do an episiotomy when i was not going to tear naturally. She said it was needed for the baby to get out. I would have preferred to tear or better yet nothing at all! This pain is annoying and our only restroom is upstairs! Either way be prepared with ice packs, tucks, and Dermoplast spray if you end up needing stitches.

LaCi - posted on 03/15/2010

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Tears should heal faster, the difference in the wound, smooth vs rough makes a difference in the healing of the wound. Smooth cuts take long to heal than rough tears.

Joanne - posted on 03/14/2010

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i had tear with my 1st bub, including stitches, from my baby being suctioned out and i was having sex 2weeks later, thats how quick healing time was. Heard episiotomy recovery takes longer and pain last for months afterwards especially wen having sex

[deleted account]

When my daughter was born 6 months ago and the dr. said that they would only do an episiotomy if there was an emergency. They said that tearing naturally was better. I had an epideral and did not feel a thing. The hospital sent me home with meds. and witch hazel pads and other supplies to help with the healing process. I was only in any real pain for about 3 days and up and moving around fairly easily after that.

Patrica - posted on 03/14/2010

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I think it's all a matter of choice. I've given birth three times naturally/without any medication. I had two children that were 8 lbs. 7 ozs. and one that was 10 lbs. 8 ozs. My first delivery included an episiotomy, I never felt the cut, the healing process was short, and I didn't feel the doctor stitching me up, either. My second delivery was the 10 lbs. 8 ozs. baby, and even though she was that big, I didn't tear enough to even require a single stitch. I don't think the size of the baby is really much of a factor, but given the choice, I would have preferrred the episiotomy with the knowledge that it's a small controlled cut as compared to a tear that could possibly be much worse. Whatever you decide, congratulations on the baby, and I hope you have a wonderful and safe delivery!!!

Ashley - posted on 03/13/2010

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well for my first i tore bad...i had 4th degree tears and took them about an hr to stitch me up. i was bleeding so badly they couldnt see where the tear was so they had to keep putting clothes up to try and get the blood to stop a bit. honestly it was absolutely terrible. i felt it all. i felt the entire stitching and i cried the entire time. afterwards it took a good 6 wks to heal and even sometimes now (almost 2 yrs later) im still tender. im scared from it too. my 2nd the dr had to cut where my 1st tear was as i was going to tear there again. he had me stitched in 10 mins and i was healed within a wk..

ALEXIA - posted on 03/12/2010

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hi! i didnt tear with either of my kids and they were both normal sized 8lbs 11oz..i hvnt heard of them doing epis. lately..so hopefully u dont tear!!

Krista - posted on 03/12/2010

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I think it depends on the doctor who delivers you and their preference. My daughter was 9 1/2 pounds and thankfully my ob was in favor of episiotomies. I had an epidural so I did not feel it. I was sore but nothing to terrible at all and i think most of it was from pushing for four hours and having such a large baby not the incision. I was completely healed within two weeks with no pain at all. A friend i know who tore has had to have 3 surgeries to fix the damage. Good luck and it will all work out in the end.

Bridget - posted on 03/12/2010

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episiotomy is basically the doctor cutting you so you dont tear.. my sister-n-law had one but she also tore.. the stiches from the episitomy healed faster and was less painfull.. you dont want to tear but for my deliver when the time comes i just want done whats best for the baby

Anita - posted on 03/12/2010

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Episiotomy can cause irreversible nerve damage. It's best to have your DR deliver the shoulders slowly as to avoid a tear and skip the episiotomy.

Jessica - posted on 03/12/2010

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I've read tearing is better. A lot of the time only your skin will tear, whereas an episiotomy will cut through muscle. I would ask your Dr/practice what their stance is on episiotomies. The Dr who delivered me wasn't one in my practice and I'd never seen him before D day. He was just the Dr on call that night. He gave me one without asking or even telling me he was doing it. I had an epidural which, while didn't help contraction pain much, apparently numbed me enough that I didn't know he did it until afterwards, and he told me. I felt him stitching me up though which wasn't fun. It turned into a 3rd degree tear and it was sooooooo freaking painful for the first week. The two days I was in the hospital I could hardly move enough to get out of bed. It ultimately healed ok, within 3 weeks I'd say, but recovery wasn't easy. What ticks me off about it is that I'm not entirely sure I needed one! I hadn't been pushing long- 30 minutes total. I would have pushed for longer if it would have given me more time to stretch and avoid tearing. I think some Drs do tend to do them routinely, still, which is why you should ask! Next time I'm doing everything possible to avoid one. I might tear that bad anyway, but I'll take my chances!

CHERYL - posted on 03/12/2010

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EPiSiOTOMY RECOVERY iS BETTER BECAUSE iTS A CUT YOUR DOCTOR WOULD BE THE JUDGE ON iF YOU NEED ONE JUST TELL HiM/HER THAT iF NECCESSARY YOU WOULD LiKE AN EPiSiOTOMY

Jessica - posted on 03/12/2010

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Your doctor should know if you need a episiotomy while your giving birth. Personally thought, I had episiotomy. The thought of tearing instead of snipping freaked (freaks) me out!

Jennifer - posted on 03/12/2010

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I tore with my son but I had an epidural and felt nothing . I was uncomfortable for a few days but for the most part, felt great. My sister started to tear so the Dr. assisted the tear and ended up giving my sister nerve damage and now she is in extreme pain all the time and there is basically nothing that can be done about it. If I were to decided to ever have anymore children, then I would definatly not want an episiotomy.

Karen - posted on 03/12/2010

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most drs will tell you that they both heal about the same - however, with a tear the edges are not completely straight like with an episiotomy so they are sometimes more time consuming for the dr to stitch up (which is why some drs still like to do the cut). i tore with my son and did not have any pain meds and it wasn't bad at all (just felt a bit of burning and that was it) the dr gave me a needle to freeze me before stitching and to be honest, that was the worst part but seeing as i had just delivered a baby it still wasn't that bad in the grand scheme of things! i had 12 stitches and healed up completely in about 10 days.

Kristi - posted on 03/12/2010

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I have had 2 kids now, that during both labours I had no pain relief. I didn't tear at all with either Although i did have a few "grazes". Some one asked me how on earth didn't i tear, well when my midwife said to stop pushing. I stopped. It is very hard to do that when you want to just get the baby out, but I had heard about people tearing (some stories better than others) and thought it best to do what they told me.... I would hate to have to loose sensation like some people have!!!!!!!!!!!!!

Josslyn - posted on 03/11/2010

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Scary haven't event thought about it yet!! thanks for your post, they still do epis here in SA.
Suppose the healing time should be the same. Now I got some more research to do lol!!!

Elysia - posted on 03/11/2010

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i tore with my son and i didnt really have that many dramas with it, though i tore frontwards not on the perinum, i think this was because i had to have the vacumm. It was difficult to pass urine as it stung but a pump water bottle squirted durin this made all the difference. I did find that as it healed it felt like the stitches were pulling and everynow and then it aches, he will b 1 on tue. But if u have to have either i recomend sitz baths (shallow salt water baths) i found these were great and an ice pack was also a god send, even a cold washer.

DeAnna - posted on 03/11/2010

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My dr. never gave me a choice with both of mine he just let me tear....which was not bad he just stitched it up and i was never sore from it with my daughter they sent me home and i never took the pain pills that they gave me cuz i never hurt...but with my son i had to take them cuz i had a tubal and was hurting just from that...other then that just keep urself really clean and it will be fine....epi didnt work on me when i had my son so i felt everything even him putting the stitches in cuz he didnt numb me it hurt too not as bad as labor and delivery but it still hurt putting them in!

Anna - posted on 03/11/2010

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when i had my daughter, they had to use the vacuum to get her out. i tore up instead of back. luckily i had an epidural so i didnt feel anything at all. however, the healing process was not fun. it was extremely sore and not comfortable. and since i tore up, i have decreased sensation..if u know what i mean...lol.

Jessica - posted on 03/11/2010

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I had an episiotomy that was in a hook shape to go around the anus. The doctor said this is the way they do it now to prevent tears into the anal cavity too. It was a PAINFUL recovery. I couldnt even sit comfortably for like 3 weeks. My son is now 6 months and it seems to be completely healed now.

Brianna - posted on 03/11/2010

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I had the episiotomy the doctor just decided to go it didnt ask my opinion and i was in so much pain i didnt care lol. after when he was stiching me up my hubby ask him about it because in prenatal class we were told tearing was the best way cuz it heal faster but the doctors reply was " husbands prefer the episiotomy if u no what i mean and it doesnt heal any faster or slower than the tear" lol

Louise - posted on 03/11/2010

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On another note. The skill of the doctor stitching can also factor in healing! Whether you teal or are cut if its not stitched right you will have trouble. Almost 5 years later where i was cut still causes me trouble as there is scar tissue from it healing.

Louise - posted on 03/11/2010

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I had an episiotomy on my first. He had a really large head so i tore anyway and i couldn't sit down for 6 weeks without a cushion i had so many stitches. I tore on my second and had to have stitches but 2 days after i had him i was sitting cross legged on a wooden floor.



I had a failed epidural on my first and i didn't even realise that they had done the episiotomy till after. I had a different doc on my second with a different attitude. I had no pain relief on my second and i barely felt the tear. It was just a slight sting.



My personal opinion is that you may or may not tear depending on loads of things but if you have the episiotomy you may not have needed it if that makes sense

Barbora Milena - posted on 03/11/2010

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I had epistomy, they needed to take my baby quickly out, so they needed space...It hurt the first 2days, but i got cream to put on it n that made it less painful plus after every visit of toilet i just showered the stitches, then dry them well n put the cream on..after 1 week the stitches went out by themselves n the place was healed..the good thing is that epistomy is controlled, tearing can get out of control n became very big n difficult to sew, all depends on how flexible is ur skin n how big will be the baby...anyway dont worry n good luck!!!

Joy - posted on 03/11/2010

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The only reason an episiotomy would be necessary is in a situation where your baby's or your life is at risk if he/she does not come out RIGHT NOW. An example would be if your blood pressure was dangerously high or your baby's heart beat repeatedly went off the register or dropped significanly below what is safe. In that situation, your MD would inform you of the risks and most likely give you the option of an episiotomy (if your labor was already progessed to the point of getting the baby out swiftly) or an emergency C-section. So, in other words, only in a life threatening situation would you need an episiotomy.
Also, a surgical cut does technically heal better than a tear b/c it is two straight edges coming together versus two jagged edges. However, episiotomies can tear also, leading to an opening larger than may have originally occurred had you torn naturally.
The biggest thing to know is that MD's are sometimes quick to do an episiotomy when it isn't necessary b/c it kind of speeds up the process which they like b/c they are always in a hurry to get things done! So, if you want to avoid one, be sure NOT to allow one unless it is absolutely necessary to the health of you and your baby!

Theresia - posted on 03/10/2010

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my aunt was just informed the other day that her daughter which is not due for another six weeks is measuring at around 6lbs now, so they told her they will be doing a episiotomy. So, unless they expect you to have a large baby they probably wont do one. My baby was small but had a big head so I did tear a little. Congrats on the baby

Kelly - posted on 03/10/2010

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I don't know if an episiotomy recovery would be any better, but I sure hope so because tearing was HORRIBLE. My son is almost a year and I'm still healing! It seemed like I was the only new mommy that couldn't walk around in the hospital, even though I got the epidural. The pain meds helped some, but not a lot. I was back at the doctors when my son was 4 days old because my tear got infected and I still could barely walk or do anything on my own. My mom had 6 kids and says the episiotomy is much better.

Patricia - posted on 03/09/2010

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i read some of the comments just now and i do agree the tears are mostly smaller so yeah it is up to you and what your doctor decides to do

Patricia - posted on 03/09/2010

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well i was unfortunate i tore but if you have a choice i would have the episiotomy cause if they think you are going to tear they just cut it a little and it does have stitches but it heals pritty fast just keep it clean and all and it will heal good the stitches fall out on there own i ahd a problem ahd to really be sure to get the pad out of the stutches the stitches would rub the pad and it would leave little peices behind but it would be better to get cut

Jenn - posted on 03/09/2010

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I had my first child in December. I had a doula and my birth plan was set. I didn't want to get an epi if I could help it, but my baby didn't end up turning enough, and it was a pretty tight fit also. I was pushing when I shouldn't have been early on as well....if you feel like you have to poo...TELL THE DOCTORS! And don't push at that time, no matter how hard it is, I think that's where my problems started. During the pushing, the doctor sai I had started to tear quite a bit, which I didn't feel. They gave me a local anesthetic (which I didn't feel) and then gave me the epi (which I didn't feel as well) I also didn't feel him stitching me up, they had given me another needle, and also offered me the gas for afterwards, which was wonderful! So in the end, I had a 3rd drgree tear, and the epi. I didn't notive the tear afterwards, but did and still do notice the epi, it's sensitive. In the end, I guess unless your tearing is going to be very bad, you don't need an epi, or unless the vacuum or forceps are needed. Sitz baths and the peri-care bottle afterwards are wonderful too....and don't listen to the nurses telling you a hot sitz bath is what you need to do....at first if all you can handle is luke warm to cool....then go for it, and try a touch of normal salt to help heal your skin too in the sitz bath. Remember if you end upp with bruising or hemmorhoids, a diaper full of crushed ice is wonderful on your bottom too....that may be why a hot sitz bath may not sound good! Hope this helps, and good luck, you'll do great!

[deleted account]

Having torn really bad, I would have preferred an episiotomy. It took longer for it to heal, I needed more stitches, I bled alot more, and they also stitched me up too much so for awhile once I started having sex again it was painful

Elana - posted on 03/09/2010

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I had spoken with my midwife about this and expressed that I did not want an episotomy unless she could forsee that I was going to end up with a severe tear. She tried to do a lot of massage to help the tissues stretch and ultimately I did have a minor -1st degree tear that required sutures. I gave birth naturally/ without medications and even so, I did not feel the tear because the pressure of the baby coming out kinda blocked that pain, or I guess the minor tear was a minor thing compared the the rest of the birth. I needed a little anastetic to be sewn up (that was certainly more uncomfortalbe than the actual tear), but in the end it wasn't so bad. Regardless, I think its a good idea to talk to your OB/ midwife about massaging the scar from the episotomy or cut once it has healed. I found mine to be sensitive for a while and once I did some scar massage it helped a lot and became less sensitive. Now it doesn't bother me at all.

Lyndsay - posted on 03/09/2010

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I gave birth naturally because my labour was so fast (2 hours total, 10 minutes to push... 4 weeks early) and I ended up tearing. My son's shoulders got caught on the way out, and to be honest with you I did not feel a thing. Compared to the stretching and contractions, that tiny little rip is nothing. I ended up with 8 stitches afterwards, which was kind of a bother. I forgot to use the squirt bottle the first time I went pee and that was HELL, worse than the birth! Its like pouring hot acid on yourself! Just remember the squirt bottle and you will be okay. I was fully healed within the week.

Rooja - posted on 03/09/2010

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my daughter was 4 kgs, and i had an epi. It healed wonderfully. My sis had gotten a thired degree tear, and had to face a lot of problems due to that. So i chose an epi.

Jeri - posted on 03/09/2010

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episiotomy would heal better, because it is a perfect cut but a tear is jagged and harder to repair...

Nichole - posted on 03/08/2010

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A cut is better it's more controlled. I was cut, however I then tore that was almost 4 years ago where I was cut I can't tell, where I tore after that still bothers me from time to time.

Tiffany - posted on 03/08/2010

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I started to tear with my daughter and told the nurse to get the dr and cut me. I would rather be cut than to tear personally. I have friends that tore and it was bad and they had a hard time repairing it. I was sent home with stool softeners and a squirt bottle for cleaning and was better within a week or so. I am expecting my 2nd baby in a few weeks and again, if I start to tear I will have the Dr cut me. Good luck and congrats on the new baby!!

Brandy - posted on 03/08/2010

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If you look at the Evidence Based Data (which is what a Dr. or Midwife would be studying) It says tearing heals much better and faster. That being said if your perineal area becomes really white there is a loss of blood flow to the area and you are most likely to tear all the way from the front to the back OUCH OUCH. My baby had a big head and I had a loss of blood flow to the area. My midwife did a very small cut and I also tore in 2 places. I'm glad I didn't tear from the front to the back. Either way talk to your Healthcare provider and do what is right for you. You can also look up the EBD (Evidence Based Data) on this matter .....Just google it but makesur it is evidence based. These are medical studies evaluating the outcomes of both.

Melyssa - posted on 03/08/2010

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I tore and didnt have too much trouble with it besides that I ripped my stitches twice. My cousin who had her baby two months earlier had an episiotomy and it was unnesseccary. I didn't feel the tear and the worst of it was just being cautious about how I got in and out of our truck. Best of Luck!

[deleted account]

i tore and didnt feel it. i tore bad but it healed up pretty fast. they really dont do episiotomys anymore unless it's necessary for the baby to fit thru. tearing naturally is better i think. unless thats what the burn was lol. i just burned a bit as she crowned but once she was out i had no idea i tore until my mil said omg look at all that blood. so ya i was freaking out after that lol. but then i realized i just tore and really didnt care since i had my baby and it was done and over with. but the pain lasted a bit but it was bearable. as long as i took my time getting up and moving around it was good.

Jessica - posted on 03/08/2010

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i told them to let me tear... and honestly when you tear its naturally accuring so the damage usually isnt so bad. ive heard horror stories from women who had the episiotomies and theyre not fun.

Sarah - posted on 03/08/2010

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I nearly had to have an episiotomy but luckly I didn't, and I didn't tear either. I think these days it's better just to tear naturally and only have an episiotomy if nessacary.

Tina - posted on 03/08/2010

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ive had both and would def say natural tears hurt less at the time and heal better,my first labour ended in epi and took me months to heal properly,whereas my natural tear in my second labour healed within a couple of weeks. x

Amy - posted on 03/08/2010

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I had an episotomy when I had my little boy 8 months ago, It had to be done because the cord was wrapped around his neck and they were having trouble getting his head through with forceps. I hadn't had an epidural so obviously it was painful but no more painful than giving birth itself! Ultimatly you may find there is no choice in the matter if they need to get your baby out quickly but I'm glad they didn't leave me to tear and my stitches healed within 4 weeks

Erin - posted on 03/08/2010

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I was told to by my SIL to tear. She compared it to saran wrap. It is harder to rip it and if you cut it then try ripping it will rip easier. What she was saying that if you just allow yourself to tear it won't tear as mush as it would if you were cut. The episiotomy will just make it easier for you tear more. Which will take longer to heal, more stitches and hurt longer.

Dani - posted on 03/07/2010

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My mother worked labour and deliv for 15 years , as well as my grandpa was a Doc who delivered many many babies lol . Ther Swore by tearing , it heals better and faster and there is less loss of sensation and numbness after words. I never bothered asking why , I am not sure where your from but it my province the policy is to only do a episiotomy if the baby is in distress and they need to get it out right away kinda thing . Hope that helps, i really have no idea since i had an emergency c-section lol

Sarah - posted on 03/06/2010

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i had a 3rd degree tear with my first born. and when i had my second they cut me and i must say that they both healed about the same....

Ashley - posted on 03/06/2010

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Tearing is better, and statistically the wound will be much less than an episiotomy. Some moms do tear a lot, but a good midwife knows how to support the perineum and reduce if not prevent any tearing. Also, perineum massage prenatally is very helpful. The good thing is that you won't likely even know if you tore until they mention they have to stitch! it's not what people make it out to be.

It can be very sore afterward, though, and there is a product on the market the is better than any sitz bath imaginable!! (but still have sitz baths twice a day with perineum tea or epson salts).

COMPANY: Earth Mama Angel Baby
PRODUCT: Earth Mama Bottom Balm (NOT 'angel baby bottom balm')

This will heal any tear/cut and absolutely relieve the pain of a sore bottom post-delivery. It was created specifically to heal a perineum post-delivery, and is soothing and pain-relieving at the same time. I have had three kids naturally (8lb-3oz, 9lb-1oz, and 10lb-3oz!!), torn a bit, torn a lot, been bruised, etc and it was my saving grace!!!

As a doula, I give it as a gift to all of my clients.

Sarah - posted on 03/06/2010

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It was really funny, cuz my plan was to avoid an episiotomy if I could, but ultimately if it was needed get one (ie, baby needs out now etc.) When I was at the hospital, the doc said it was 50/50 chance... and then tried to convince me by scaring me ("would you rather tear???"). I felt like the stretching was going ok, so I told him not to unless ABSOLUTELY necessary.

Turns out, I had minimal tearing that didn't even need stitches! And the doc was trying to cut?? LOL. It kinda burns is all.

As to your healing question, a tear will usually heal better because the dermis layers can fit back together better (think like a zipper vs. 2 smooth surfaces).

Joanne - posted on 03/14/2010

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i had tear with my 1st bub, including stitches, from my baby being suctioned out and i was having sex 2weeks later, thats how quick healing time was. Heard episiotomy recovery takes longer and pain last for months afterwards especially wen having sex

CHERYL - posted on 03/12/2010

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EPiSiOTOMY RECOVERY iS BETTER BECAUSE iTS A CUT YOUR DOCTOR WOULD BE THE JUDGE ON iF YOU NEED ONE JUST TELL HiM/HER THAT iF NECCESSARY YOU WOULD LiKE AN EPiSiOTOMY

Kelly - posted on 03/10/2010

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I don't know if an episiotomy recovery would be any better, but I sure hope so because tearing was HORRIBLE. My son is almost a year and I'm still healing! It seemed like I was the only new mommy that couldn't walk around in the hospital, even though I got the epidural. The pain meds helped some, but not a lot. I was back at the doctors when my son was 4 days old because my tear got infected and I still could barely walk or do anything on my own. My mom had 6 kids and says the episiotomy is much better.

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