I wish I could help you with that one, but I didn't tear with the one I had naturally. I did have a c-section first and then a natural and then a c-section. I tried to have my last one naturally but her cord was wrapped so they had to take her. I will tell you I recovered much faster with the natual birth, but as I said I didn't tear and they didn't have to assist with anything either. He was my smallest baby too, so maybe that helped me. My first was breech so I had no choice there either.