We did the perineal massage from about 36 weeks, and I had minor tears that didn't need stitching. My midwife didn't support the area whilst birthing but I was on my knees, which is apparently a pretty good position to birth in to be kind to your perinium!

I probably wouldn't have torn at all, but I was in a rush to get her out and I pushed her out with all my might, instead of just breathing her out as instructed. She also had a biggish head too