Backpack, there were similar concerns about me having a vaginal birth when I was pregnant, particularly with dd2. In the end, I was told that for me a vaginal birth would be safer than a c section, but that the pushing stage was to be limited to 10 or 20 minutes, I forget which. After that, then I would need an instrumental delivery. As it happened, I did need a ventouse delivery with dd2, but apart from her having a massive bruise on her head, she was fine, and so was I.
Dd1 came out in about 3 big pushes, because I had avoided an epidural, but with dd2 I had a bad reaction to an induction, and my womb clamped down into a contraction which couldn't release. Understandably, dd2 was not too happy about this, so I was prepped for an emergency c section, including having a spinal block. Luckily the doctors managed to stabilise my labour by throwing salbutamol down my iv line to relax my mega contraction (not so good for my heart), so I went on to have a vaginal delivery. The c section level of pain relief meant that I couldn't feel any urge to push, so needed help.
Have you decided which hospital that you are going to be booked into for delivery? Is it the one where your surgeon is based, or is that just too far away? For me, I didn't choose my nearest hospital, because it would not have been able to cope if I had had an emergency event. I didn't choose the hospital that my cardiologist is based at either, because that was just too far, but went for one inbetween which has an excellent cardiology and surgery department, plus very good obstetrics.