We went for our 36 week check-up today and I shared my birth plan with our midwife. I had written that I would prefer an episiotomy over tearing.
Let me explain...even though I want an all natural childbirth, I would prefer to have a local anesthetic and be cut as opposed to an unexpected tear.
Well, the midwife looked at me and said, "You really want an episiotomy? I didn't expect that from you!" She explained that evertime a woman pushes it stretches the perineum a little before the baby slides back. So, with every push, the perineum stretches a little bit more so when the full delivery comes it has stretched enough that if you do tear it should be rather small and not to a serious degree.
However, if the doctor cuts you, the area below the tear has not been stretched at all and is very likely to tear; this would cause a larger open wound from both the cut and tear. With all of this she asked me to go home and research it more.
Honestly, that was rather eye opening for me! Now that I have looked at all of the information I will ask for perineum support and if the doctor tells me that I need to be cut we will have a quick discussion as to his reasoning and go from there. If there is an issue with either Tate or myself and we need a quick delivery or the baby's position requires a little extra room then I would be okay with an episiotomy, otherwise I now prefer to have a small tear as opposed to being cut.