Effects of manual perineal protection and pushing techniques used in the second stage of labor on perineal outcomes: A randomized controlled trial of combinations of strategies.

Objective: To evaluate the combined impact of interventional (HOCP) and relatively more spontaneous techniques (HPUCP) employed during the second stage of labor on perineal outcomes. HOCP: Hands-on perineal protection and coached pushing HPUCP: Hands-poised perineal protection and uncoached pushing