One of those had an episiotomy because the baby was starting to look compromised and needed to be born quickly, and the other was victimized by an overly aggressive supervising midwife who had a phobia about shoulder dystocia and actually reached her hand inside, alongside the shoulder. Yes, she tore. My experience leads me to believe that almost all tears can be prevented if the caregiver has the interest and skills. It bothers me that many other caregivers are cavalier about this. Ask every caregiver what their suture rate is.
Women deserve to give birth without being cut or torn.
Having your perineum cut or lacerated is not an acceptable right of passage. Once you've addressed the practical issues of preventing tears, it makes sense to address your fears. For subconscious fears, hypnotherapy can work wonders - it doesn't have to delve into the causes of the fear, it just overrides those fears to get you through the situation in good shape. For conscious fears, you might want to take a look at Henci Goer's chapter on episiotomy. Please e-mail feedback about errors of fact, spelling, grammar or semantics.