Assisted Birth

The following video (USA OBGYN) uses delivery rather than birth.  Discusses Assisted Birth – what it is, episiotomy, forceps & ventouse (vacuum).
Choices – you have plenty and should know exactly what each entails.
You can decline and episiotomy and choose to tear naturally.

To find out more about perineal techniques this overview by Dr Sara Wickham may be helpful.

https://www.sarawickham.com/research-updates/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma/

Create you own environment to encourage the positive hormones.