I agree with the scalp monitoring, dd had a cut on her head that took forever to heal. Ask if they can do hourly monitoring so you can move about and have a shower if you feel like you need to.
With the tearing make sure you feel like you are ready to push, my midwife was able to move the cervix out of the way before I pushed with Ds and I didn't tear, but with dd it was so fast I probably wasn't fully dilated before I was pushing.
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