@Indianna2006 welcome and best of luck for your scan in a week! I've also had previous losses so understand the anxiety.
Re birth yes this sounds similar to me... 90 hours of labour (about 18 active labour) and ended in assisted delivery with episiotomy and third degree tear. Also due to awkward position of baby apparently! Damn them! Haha but ofc we can't always control everything.
So I'm definitely going for a natural birth again, I was lucky in that I didn't suffer bad effects from the tear beyond the usual pain and a bit of weakness early on. I did a lot of physio (loads of keggles daily for months) and scar massage every day which helped it heal nicely. I had two occasions where I had to rush to the loo early on, but haven't had incontinence issues since - I think due to all the keggles I'm actually stronger there now than I was pre pregnancy - although not when I've been spewing recently if you know what I mean 🙈.
With an assisted delivery you're much more likely to tear badly because a. We on our backs, gravity not on our side b. The forceps or ventouse pulls baby out quickly and to prevent tears it's better to let baby come out slowly / without coached pushing or being yanked out. Obviously position of baby also plays a big part - but being mobile in labour and also thinking about how we sit during pregnancy etc (spinning babies website is good for this) will help with this. Also with a second birth, things are more stretched out already so I'd hope this helps baby get into a better position as perhaps they had less room first time?
I'm also going to ask for a "hands on birth" - this is when someone supports your perenium while you're pushing with a warm compress or massage oil and their hand to help prevent tearing. Episiotomy can also make us tear worse because it weakens the skin already (think of a piece of fabric that has a small cut... Much easier to tear this further than tear the fabric without the cut).
Sorry this is a massive ramble but basically, there are ways to support having a natural birth after assisted delivery and third degree tear which can make the chances of tearing badly again quite slim. My midwife said if no ongoing incontinence issues they would not be advising a section anyway. But I think it's a v personal choice and depends a lot on how your recovery was afterwards! Happy to chat more... It's a big decision!