Nope, you don't have to have that at all. I didn't want it but had it because I had what they term "trauma" birth where he was vac assisted and I was bleeding a bit so ob suggested it would be a good idea. So we made the decision to do it based on advice. I think it's something which is a little hard to make a FIRM decision on until you're there IYKWIM? Something you need to be open to in case it's a good idea at the time.