The blood and mess, we can handle. The pain, we can live through.
But the thought of tearing or needing to be cut open - have an episiotomy - as the baby comes out, just makes us quiver with fear.
'Almost all women feel scared about tearing,' says midwife Gail Johnson of the Royal College of Midwives, 'but I can assure you that the thought of it is far, far worse than the reality.'
Getting the lowdown on tearing and episiotomies before it actually happens may help you cope with the fear. Read on for the facts.
Does every woman tear during labour?
'No,' says John Bidmead, consultant obstetrician and gynaecologist at London's King's College Hospital, 'but it is more likely if it's your first labour. I'd say about one-third of women tear delivering their first babies. About 10% tear delivering their second and subsequent babies.'
What makes a tear more likely?
They can happen to anyone, but tears are more likely if you have a big baby or a baby who comes out 'face up' or with her head in an awkward position.
You are also more likely to tear in a fast delivery or if you need intervention by forceps or ventouse.
How can I help prevent tearing?
Some women try massaging the perineum before the birth with vitamin-E-rich oil to make it stretchier and less likely to tear.
Says Gail, 'Once labour starts, stay as mobile and upright as possible to encourage your baby to get into the best position for the birth. When it's time to push, either lie on your side or kneel, whichever gives you more control.
'Listen to your midwife. She'll advise you when to push and when to stop and pant, and allow yourself to open up gradually. You're less likely to tear if you can take the pushing stage slowly. use your breathing exercises to help with this.'
Does it really hurt?
You're likely to feel a burning sensation as your baby's head crowns, but your perineum will be so numb and stretched that if you do tear, you probably won't feel it.
Will I need stitches?
Probably not for a small tear; experts think tears heal more quickly and better when left alone.
'With a longer or deeper tear, the midwife or consultant might numb the spot with anaesthetic and pop a couple of stitches in just to stem the bleeding and hlep close the wound,' says Mr Bidmead. 'If the tear is very serious, though - and this is unusual - it will need careful surgical repair in the operating theatre.'
Why might I need an episiotomy?
An episiotomy is a small cut (2-3cm) made in your perineum, to create more room for your baby's head to pass through.
'Episiotomies are usually only performed when it's important to get your baby out quickly, either because she is in distress, you are tired or there has been some other complication with your labour,' says Mr Bidmead.
Does it hurt?
No, because you're given a local anaesthetic and the cut is done when at the very height of a contraction when your perineum is stretched to its thinnest. In most cases, your baby is born almost immediately afterwards.
Episiotomies are always stitched. Your stitches will be the kind that dissolve in time so you won't need to have them removed.You will be given a local anaesthetic to numb the sensation while your midwife or consultant puts in the stitches.
How quickly will I heal?
You will be given painkillers after the birth, which you should take to avoid discomfort. You may find the wound stings when you have a wee. To reduce the pain, pour warm water from a small jug over your perineum as you pass urine, or have a wee while in the shower.
Many women worry their stitches will burst if they have a poo. This will not happen. Try holding a sanitary towel or a pad of toilet paper firmly over your wound while you have a poo if you are worried.
Most wounds should start to feel less tender after a few weeks. Some women find an episiotomy only starts to feel better around five weeks later.
If you have any worries about your wound or notice a smelly discharge, ask your midwife or GP to check you over.
