After identifying patterns in the birth experience of women’s first labours, my next task was to compare these experiences with what happened during second labours. For the purpose of this task, I ignored women who chose to have an ELCS second time around. Here are my key findings:
When comparing second labour with first…
Induced labours dropped from 47% to 23%.
Instrumental deliveries dropped from 34% to 4%.
Episiotomies dropped from 40% to 13%.
Epidurals dropped from 38% to 10%.
Posterior positioned babies decreased slightly from 34% to 13%.
A second stage lasting more than 1 hour decreased from 64% to 15%.
Women pushing strongly during delivery of head decreased from 74% to 17%, and women panting increased slightly from 11% to 31%.
3 lucky women were treated to a soothing warm flannel on their perineum, compared with none in their first labour.
Women delivering on their back decreased slightly from 68% to 30%.
Women pushing when they felt they needed to, instead of when they were told to, increased from 20% to 42%.
I suspect that many, if not all, of the above findings will be related to the fact the woman are delivering a baby for the second time and thus their bodies and their minds are more amenable to the process. The factors that I think could be conscious decisions made in a hope to reduce damage to their perineums are the decision on when and how strongly to push, and the choice of delivery position.
Whether the difference is down to a natural or conscious decision is not important though. There are still a number of conclusions that we can draw when examining the birth experience of women who have suffered perineal tears. I will call these my tips for avoiding tears and blog about them another day as it is now my bedtime.
3rd & 4th Degree Tears 
Got directed to your website from midwifery.org. It has been extremely interesting reading. I had a 3rd degree tear with my first child (8lb13oz, with hand on his head) and have been offered an elective section for the birth of my second child, which I have turned down. I would be happy to fill in your questionnaire after my second labour (if you are still wishing to gather data). It is refreshing to see some data rather than a lot of anecdotes on the subject.
Thank you. Glad it’s useful and best of luck for your next labour. Really hope it goes well for you. I would be very grateful if you would come back and fill out the survey when you can. The more respondents I get, the better and more robust the conclusions.