Perineal protection.

Perineal tearing in childbirth is common and can have a considerable impact on women. There are various hands-on techniques that midwives use routinely to protect the perineum but not all of them are evidence based. Despite this, midwives often feel that they are the determining factor in whether a woman tears or not. Furthermore, women are rarely asked permission before hands-on techniques are used. This article explores some of the techniques used to prevent perineal tears, looks at the evidence base and invites the reader to reflect on their own practice and thinking around perineal protection.