My first was born via c-section (so obviously no perineum tear) and I didn't tear with my second (VBAC). I had an epidural and even though I could feel the contractions to push, I wasn't in real pain, and wonder if maybe that is why I was able to have slower/more controlled pushes (since not driver by intense pain).
My sister who had all her 3 children drug free, tore each time, and she claims that when you get to the pushing, you are so ready to be done that you tend to push harder and not really have to will/desire/energy to take it slowly.
I'm sure there is no rule to it and that women tear/not tear with and without epidurals, depending mostly on baby's size/head circumference....etc. But as I am considering going drug-free this time, I wanted to hear what you guys thought.