The comment above me said it perfectly, it was necessary for me to have an epidural so that the baby would “slide out”. They said that in unmedicated births, moms push too hard and delivery too quickly to avoid tearing. They had me get an epidural at 8cm (which was a welcome relief at that point) and then she came an hour later. They had also discussed doing an emergency transverse episiotomy if there was any evidence of tearing . That being said, that wasn’t necessary as with the counter pressure and the slow delivery I didn’t tear at all. I didn’t even need pain medication in my recovery. I’m interested to know (if you are open to sharing) where you delivered. I delivered in Toronto and plan on delivering all future children there