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I had a fourth degree tear with my first baby. It started with the midline episiotomy the dr used on me and continued into my rectum. I then learned that most major tearing starts with an episiotomy. I chose not to have episiotomies with my subsequent children and haven't had any tearing or injury requiring stiches. There are other ways of avoiding tearing - including perineal massage - than major abdominal surgery. I strongly suggest you look into them. Most women do not tear as much or at all with second and greater deliveries. IMO scheduling a c-section to avoid perineal tearing is foolish. There are other options.

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