No, I haven't used a doula before. Generally in labour I've managed fine until near the end and then I panic. I can't even remember how strong an urge to push I had - all I remember is having people yelling at me to puuuuuuuuush and feeling under pressure to get on with it. I really do think that if I was left alone and somehow able to relax then my body would just get on with things.
DH and I aren't assertive at all when having babies, although we are otherwise quite bolshy. So my hope is that if I can talk all these things through with a doula she can be assertive for me. It will also take some of the pressure off with regards to DH being there, childcare etc. We both very much hope that he'll be there, but will feel calmer if we at least know that I won't be alone if he can't be there.
I don't think I'm quite brave enough for a home birth. I'd need to hang on for blood count and GBS results before I felt safe to plan for a hb, and I know that I'd get uptight about the uncertainty. I don't think I'd get the chance to rest afterwards either - my DH is lovely but pretty hopeless like that.
I haven't thought about asking for a section, although because of my dodgy obstetric history I've got to know my consultant quite well and they are very gentle with me at the hospital. I don't think I want to go that route - my deliveries weren't anything like as difficult as yours, from the sound of it. For me too, whilst a section would save me from tearing etc, most other pelvic floor trauma is caused by the pregnancy as much as the delivery so I'm already f*ed from that point of view
From what I have read about hypnobirthing, it's very good for people who would otherwise be fearful about labour. It helps with any sort of delivery, apparently - including planned sections. I agree that complications like shoulder dystocia are going to increase the risk of tearing and I can see how you would be anxious to avoid a situation like that.
Dunno what's the best thing to do. None of the options are 100% certain and rosy, are they?