Well what a good topic!! I do not "guard the perineum" as I imagine a guard to be in full metal clad at the end of the bed!! I know some who warm an anal pad to place on the perineum, but personally, I am hands poised, in particular with a multip (more than one birth) as sometmes those deliveries can be so fast, and its just to stop it coming out really quick, however that said I do not and will not put pressure on the head as it descends to slow it, as I feel, and its researched that this is potentally detrimental to the fetus. I have worked with many midwives throughout my training, and have been repeatadly told to "get my hands on" or "guard that perineum" I calmly tell them that evdence does not support guarding, you know there is a mdwife in leicester who has been followed throughout her practice as in 30 years or so she has barely had a woman with a tear, she is not hands on, but very good at forming relationships with women, and getting women in tune with their bodies, and by her words of advce and support throughout. Needless to say I aspire to be like her!!

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