Fwiw, my skin is clearly not stretchy at all, as I got huge, deep stretch marks all over my belly when pregnant. But, I didn't tear at all, not even a graze. A huge part of it is going slow and using optimal birthing positions, breathing through some contractions and letting your body push instead of consciously doing it yourself, if you can. Letting the area stretch out a bit, letting bubs head sit there for a bit before going further. I didn't use anything, not even massage. I just went slow. I think it's rare that an episiotomy is actually ever necessary. Sometimes it totally is, but a lot of ob's are more than willing to give it a snip so it's 'quicker' and 'easier'. Good luck!