I did lots of perineal massage/stretching last time and had a third degree tear, so not bothering this time. I found it fairly horrible, esp as I couldn't reach towards the end and had to get my husband to help.
didn't do it and i didn't tear my perineum - best thing i did was to listen to the midwife when she said to stop pushing and only do little pushes. tore the internal vaginal wall though, but only needed two stitches which healed in a couple of weeks.
Horrible horrible horrible. stressed me out actually as it hurt. Bad enough to do this when you can reach around yourself... but couldn't reach a the end of pregnancy and DH was reluctant and had to be cajoled, so it didn't help. Just added to stress about the birth and whether we were "doing everything we could to have a more worthy vaginal (natural I think we called it) birth". BOKE when I think back.
Also ended up with crash section (as do 30% of first timers), so needn't have bothered after all.
Listen to your midwife is a much better bit of advice.
Think your best bet for intact perineum is a water birth. I used water first time (8lb 10) but got out about an hour before birth cos suddenly had a panic attack about a lip preventing baby's exit (happened to a friend), demanded midwife check, then didn't get back in. Quite bad 2nd degree tear, probably because also chose to use birthing stool so very fast. With hindsight, any sort of bum-in-air position would have been preferable and, as digitalgirl says, stop pushing! 2nd baby (8lb 6) stayed in water whole time at maternity unit (only 3 hours) and gave birth on my knees leaning over the side. Despite worrying I'd tear as before, in fact had slight scratch and nothing worse.
The research suggests it reduces rates of episiotomy/tearing in first time mums over 30.
But would agree that other things are far more important.
Practice 'horse lips' - as baby is crowning do little blows or pant through soft (shall we say 'flappy') lips!
Crowning stings, really, really stings, and you might be tempted to either push like mad to bring the stinging to an end or to clench everything to hold baby in to stop it getting any worse. Don't do either. Relax whole body, listen to midwife. Longer is better to a certain extent when it comes to crowning (within reason!). Let your perineum streeeeeeeetch as slowly as possible.