Bit OT but I was talking to a friend from mums group the other day who is expecting her second bub in 6 weeks. She sustained a third or fourth degree tear, after an episiotomy, with her first. When she had a recent appointment she was voicing her concerns over tearing again, and the midwife told her to breath the baby out rather than push. My friend questioned that and said she was told to push with her first. The midwife said they always tell first timers to push because sometimes second stage can take ages with the first baby!!!!! WTF!!!!!
No wonder so many poor women end up with episiotomies and big tears! Totally unnecessary I think!!

Claire, birthskills is another great book. The lady who wrote it reinforces that pereniums are made to stretch. Why would so many women be born with bodies that could not birth their babies without tearing. It just isn't right-modern intervention causes tearing, not natural birth!! Good Luck with your doula!