Your CRS mentioning the tear meeting up with a bad vaginal tear is terrifying! I wonder if she has experience with pregnant women actually delivering with an active AF. I have no doubt mine will still be unhealed by then. I've read a lot online but mostly only found speculation about delivering with an AF. I did read about a couple of people who had them and said delivery went ok, but not much else. Like you, I'm terrified delivery will make it worse and I will require the LIS. I feel like I have a chance of healing with creams once I'm no longer pregnant/breastfeeding. As long as I'm careful with diet, I can somewhat control the pain and bleeding. It's so hard to manage though and one bad bout is beyond excruciating.
It's interesting that you read about anterior tears not being caused by pressure issues. I also have an anterior tear and wonder how it will be healed? I still need to talk to my OBs about delivery with this thing. I'm afraid they will blow the issue off as nothing if they don't have experience with it, but it will be life altering if the pain gets any worse for me. Please keep in touch and let me know what you decide for your birth plan. I think I will still likely have a vaginal delivery but I need to have a discussion with my doctor still. There's another pregnant person that just posted on here too so hopefully we can all keep in touch with each others progress.