I have birthed over 3000 women, and I remember only one cervical tear. It is very rare in natural births without vacuum or forceps, and without agressive manipulations of the cervix with forcful dilation, which I have seen with impatient and over-zealous midwives and obstetricians. In general it is quite rare. A sign would be excessive bleeding after birth despite a well-contracted uterus. It could also happen if a women pushed very hard on a non-dilated cervix. Like if she is 8-9 centimeters open but the head is very low and she feels like she has to push very hard. This is what I was taught, but actually have never seen this happen, and lots of women pushed because they needed to before they were fully dilated. Not everything I was taught proved to be true! I tend to think that you need to do what your body tells you to in birth, and that your body wouldn't do something to harm you physically. But I'm not sure about this one. You spoke about perineal massage and scarring, but there is no connection to cervical tears and perineal massage. Only if you had a perineal tear or were cut will the massage benefit. It is of no use for cervical tears, as you don't massage the cervix. You probably won't tear again, but just to be safe, do gentle pushing . only on a fully dilated cervix. Also stay away from stripping.If you had an episiotomy or stitches from a tear, then I would highly recommend the epi-no, as it is much more effective than perineal massage.
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