I delivered my son on hands and knees. My body was telling me to stay that way, I couldn't get comfortable in any other position. My midwife and the attending nurse both told me the next day that if I hadn't insisted on staying on hands and knees I absolutely would have torn or needed and episiotomy. My nine-pound baby wouldn't have been able to cross the perineum against gravity without just wrecking it. Perineal massage with oil throughout labor helped out a ton, too, but it was definitely the positioning that saved me.
I'm going to do a water birth this time. My doctor does them at our hospital.
It also helps gravity wise. Being on your back makes your body fight against you. My son was posterior and they have to keep checking that he was turning and that I was dilating.
I had gas and morphine which is part of why I tore, it zoned me out and I couldn't feel my body telling me to push.
Granted it wasn't as bad as 3rd degree tears can be but next time I have the skills and knowledge to help my body help me.
I heard being on your hands and knees gives less of a chance of tearing. And is less painful on your back
My first I ended up being forced on my back and it was very unnatural and I tore badly due to a number of other contributing factors but this time I'm gonna be on my hands and knees!