Episiotomy and Epidurals ~ Avoid Them!

I subscribe to Midwifery Today ~ this was taken from 2/27/08 newsletter.

Avoiding an epidural is also helpful in preventing perineal damage. In one study, women with no anesthesia had the highest rate of intact perinea (34.1 percent), while women with epidurals had the highest episiotomy rate (65.2 percent). Another study shows that women who got an epidural were more than three times as likely to suffer third- or fourth-degree tears. Why would this be?
For one thing, women with epidurals often end up getting cut because they don't have enough sensation to push the baby out. The effects of epidurals are notoriously variable, and even the best anesthesiologist in the world can't predict when delivery will occur, or how different women may be affected by the same dosage of medication. Furthermore, an epidural prevents the mother from assuming optimal positions during delivery. She is also denied the natural sensations of an urge to push and has to rely on external sources to tell her when it is appropriate, instead of listening to the wisdom of her body.
Not surprisingly, oxytocin (or Pitocin) also increases a woman's chances of serious tearing: 47 percent with Pitocin vs. 29 percent of those without Pitocin tore deeply.
— Elizabeth BruceFrom the article "Everything You Need to Know to Prevent Perineal Tearing," which was excerpted from the book Get Through Childbirth in One Piece? How to Prevent Episiotomies and Tearing and published in Midwifery Today, Issue 65