Some midwives still take credit for ‘intact perineum’s’, Stop it. Not tearing while birthing is not a mark of any kind of success, it will happen or it won’t happen, there may be things a woman can do reduce it’s likelihood. Being upright while birthing, not doing any kind of ‘controlled pushing’, pre massage with oil etc
It raises the idea that some midwives and most doctors have, that putting pressure on the head of the baby as it crowns, and in some why ‘controlling’ a woman’s pushing can reduce the amount of perineal trauma a woman experiences.
The variables in any study are compounded, and the design of any such study has at it’s core medical presuppositions.