My midwife did perineal massage for what seemed like hours while I was in labor with my son. I'd labored at home for 12 hours after SROM before heading in and she obviously saw that I needed assistance to stretch properly as I dilated. I don't know about gentle pushing... it certainly didn't feel that way but maybe it was, since I pushed on hands and knees for over 3 hours before delivering my whopping 9lb baby boy. No tearing, no damage, not even a skid mark. The positioning helped, the long second stage helped, the massage definitely helped. If I'd been hurried along with pitocin my body would definitely not have had time to stretch appropriately and I would've suffered much worse. My med-free birth was a success in every way I can describe and I look forward to doing it again!!
Oh and about a pound and a half. Baby 2 definitely is a midget compared to my first!
I wouldn't do the massage during labor. But some counter pressure with warm wet compresses definitely helped me! And I did some massage beforehand but not a ton. I pushed as gently as I could but I went natural and the pushing phase hit me like a freight train and I couldn't stop. I had a third degree tear (borderline fourth) with my first birth and this time around I had a second degree (borderline first).
The difference was warm compress, hands and knees delivery rather than a lying position, and a baby that came out the right way rather than sunny side up!