Most vaginal births are associated with some forms of trauma to the genital tract.
The morbidity associated with perineal tear is significant, especially when it comes to
third- and fourth-degree tears. Different perineal techniques and interventions are being
used to prevent perineal tear such as hands on and hands off techniques. Aim: This study
was carried out to evaluate the effect of utilizing hands on versus off method during
delivery of fetal head on occurrence of perineal tear. Design: Randomized clinical trial
study design was used. Setting: This study was carried out at Sherbeen General Hospital,
Dakahlia Governorate Egypt on 130 parturient women in the 2nd stage of labor, who were
selected by purposive sample technique and divided into two equal sample size (65). In
hands-on method group, the researcher put one hand above fetal head to maintain
downward direction toward perineum and guarding the perineum by placing the other
hand against it. In hands-off method group in which the delivery occurs without touching
the fetal head or perineum. Two tools were used to collect the necessary data namely sociodemographic
and current obstetrical data, evaluation check list to clarify perineal
condition after delivery. Results: 72.3% of hands on parturient women group had perineal
tear during labor compared with 80% of hands off group, there was statistically significant
difference between hands on and hands off groups regarding degree of perineal tear
(p=0.033). This study concluded that hands-on technique had significant effect on
decreasing rate, lowering degree of perineal tears and need to repair than hands-off
technique. This study recommended that relevant nursing curriculum must entail a detailed
portion about the correct manner of performing hands-on technique to increase the chance
of perineal integrity during the second stage of labor.