I personally would say that if you want to be on the safe side, have a csection AND if you do...take miralax!! The pain meds they give you will make you constipated. The stool softener won't work well enough to give you that soft consistency you will want. (At least that's what happened to me). I had a csection (second one) and I only took pain meds for about 4 days. I guess I wasn't paying attention to how much water I was drinking, and even though I was taking my stool softeners, my stools were pretty hard! I'd push and strain to get them out and BAM! Anal fissure!!

(I had hemmies on and off through both pregnancies) this was my very first fissure! Hurt so bad, way more than the csection. Recovery from the csection was not bad at all! My first csection was actually a much worse recovery because I was in 26hours of labor before they had to just cut me open. So yes I'd say csection. Imagine pushing for hours and applying all that pressure down there! Ouch! I've obviously not had a vaginal birth but one can only imagine. Lol. Goodluck with which ever you decide!
