Spinnerette, I read your blog and am so, so sorry that you're going through this. Your doc sounds like he's still in the nineties! Episiotomies are far, far more uncomfortable than tearing! With my first I tore so little that I didn't need stitches and barely noticed the discomfort afterwards. Also, it's not true that you can't do anything to stop tearing. It's called perineal massage, and you and your DH can both do this. I had my first with an OB/GYN in hospital and my natural birth ended up being an induction with all sorts of interventions. My best advice to you would be to think long and hard about whether you really want to deliver with this OB. Lots of first-time labours are quite long and you should have plenty of time to get to a further doc if that's what you choose. Secondly, is your OB on a rotation list or will it be definitely him who delivers you? If he's on a rotation, then you may luck out and get someone else. Thirdly, if you stay with this doc, stay home until the last possible minute!!! Then you'll be able to do what you need to keep labour moving. Does your hospital have jacuzzi tubs? They can't monitor you/check you if you're in the water ;p Is it possible to get a doula to help you and DH advocate? And, if all else fails, just refuse. They can't forcibly hold you down! When they say they want to monitor constantly, or you need to lay down cause you're ready to push, or they want to give you Pitocin to speed things up, you say "no thank you." Lastly, your nurses will be the ones taking care of you for most of your hospital stay, so don't ask the doc for a squatting bar, but when you get to the hospital, have DH ask the nurses for one. If the doc doesn't like it, too bad! When the baby's coming out someone will have to crouch down to catch him/her!!! GOOD LUCK!!! And keep believing in yourself!!!