I also read the midwife can massage the area so there's less trauma. I was actually quite scared after hearing bad experiences with labor and women on TV. For me it was painful but I've had worse headaches /stomach aches. I'm sure your midwife will teach you how to relax through the pain. I'm so happy I didn't have any meds and cherish that experience...pain and all. Thank goodness for stretchy skin lol. Naturally there are times when meds are necessary and that fine too.