Hi OP! I have never hired a doula but I can tell you I gave birth to a 10# 4 oz baby girl at home 2 years ago and had no tearing whatsoever. I think finding the right care provider for your birth (and this may also include a doula) is your best outcome of having a quick heal after birth. Coached pushing while mom has an epidural raises the chances of the tearing.
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I tore a tiny bit with my first 3 kids. I got 1 or 2 stitches, literally, and it was really no big deal. You can get a peri bottle to keep the area clean after birth and you should heal nicely and you don't have to "mess with it" at all.
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I know moms here who've shared their tearing stories and can tell you how it was for them. I can only share my own experiences.
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And I would never consent to an episiotomy unless there was a severe emergency. Natural tears, most times, are better healing and stronger that cuts.
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And I know you're letting the fear talk to say you'd rather have a section. That is major surgery which will affect you birthing choices for the rest of your life. It's not a decision to take lightly. I think when you get your care provider and speak your fears, s/he will be able to help you and reassure you.
