Background & Objective: Perineal trauma usually occurs during childbirth and associates with short and long term complications for women. B lood loss, urinary, faecal and sexual incontinence are effects of after childbirth complications of perinal trauma. These can cause maternal and newborn morbidity. This study wanted to compare the effectiveness of two techniques for perineum protection " hands off" versus "hands on"(Ritgen) during childbirhtfrom view points of frequency, degree and suture of perineal trauma .

  Methods: This r andomized clinicaltrial study carried out on 70 nulliparous women thatexpecting normal birth of a singleton . They were randomly selected and divided in hands offand hands on (N = 35) groups. In the 'hands on' method, midwife put pressure on the baby's head and support ('guard') the perineum then lateral flexion is used to facilitate delivery of the shoulders, and in the 'hands off' method, midwife keep her hands poised, not touching the head or perineum, allowing spontaneous delivery of the shoulders . We analyzed data with descriptive statistical methods, t-test, chi-squer, mann whitney and non parametric tests by SPSS.

  Results: Rates of intact perineum was significantly higher in the 'hands off' group (50%, 40%, p = 0.48). The f irst and seconddegree tears were significantly lower in the 'hands off' group (40.6%, 50%, vs, 9.4%, 10%, p = 0.48). We did not observe any significant differences in the rate of lacerations in the anterior regions of the perineum and frequency of suture between the two groups

  Conclusions: The hands off technique in the second stage of labour increases the likelihood of an intact perineum.