Keeping perineum intact
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Rates of tearing and episiotomies are much higher in hospitals than they are at homebirth where the woman's body is left to do it's thing. Private hospitals are also worse for this than public. Being flat on your back on bed is not helpful to this yet this is what most women do for some or all of their labour, which is certain if you have an epidural. Not only does the chance increase from this, but once you have the epidural which can then lead to ineffective pushing (can't feel it properly if at all) then forceps may be used which often means an episiotomy.
Hospitals are there to control and manage the process of childbirth which doesn't run in our favour as birthing women. They have policies to protect themselves, speed things up and this often means these interventions. So you have to inform yourself about what you don't want, your rights etc.
Giving birth in water is brilliant for supporting the perineum as is birthing upright. Warm compresses can be used, and Ina May Gaskin has a manuvure she successfully uses which is discussed in one of her books.
Also when in fear, or anxious, some women don't relax their pelvic floor/perineum and the pushing fights against this - so educate yourself outside the hospital (New Active Birth by Janet Balaskas or The Thinking Woman's Guide to a Better Birth), get great support and trust your body!!! It is capable of blowing those stats out the water.
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we are talking about a piece of flesh either being able to stretch to accommodate, or alternatively unable to stretch to accommodate (and hence tearing). I don't see how psychology enters into it. That would be like saying that women get stretch marks on their belly because psychologically they are reluctant to allow their skin to stretch to accommodate the baby bump. Some women have more collagen and their skin is more pliable (lucky ducks!) whereas others are bound to stretch and tear. Of course having a forceps delivery will virtually guarantee tearing, but I don't think that's what Melody is talking about. BTW Melody you lucky duck not tearing at all with such a big bub!!
You need to try to relax the perineum - and come on, how many of us do because we don't get told, or we are so scared of tearing, the 'ring of fire' etc if you haven't had an epidural. Fear of birth and pain is an absolute epidemic and psychological blocks are a big problem - I have seen many of them first hand in births where there has been past sexual abuse, generally feeling 'unsafe' and fear of 'tools'. It is possible to be so tense and fearful that you tighten up in places you never thought possible and nor-adrenaline kicks in and the whole process stops or as observed by midwives and doulas, even goes backwards. My teacher has been studying it for years, based on books written on the topic by further experts on the psychology of birth and the way it's changing. 
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