The Journal of Obstetrics and Gynecology of India

, Volume 64, Issue 6, pp 425–429 | Cite as

A Comparison of the “Hands-Off” and “Hands-On” Methods to Reduce Perineal Lacerations: A Randomised Clinical Trial

  • Rozita Rezaei
  • Sussan SaatsazEmail author
  • Yiong Huak Chan
  • Hamid Sharif Nia
Original Article



The objective of the current study was to compare the “Hands-off” and “Hands-on” methods to reduce perineal lacerations.


We conducted a randomized controlled trial to compare the effectiveness of two techniques for perineum protection during spontaneous delivery. Study participants included 600 nulliparous expectant mothers, who were divided equally between the “hands off” and “hands on” groups (n_300 per group).


A total of 147 (49 %) women in the “Hands-on” and 143 women (47.7 %) in the “Hand -off” groups encountered perineal trauma (p = 0.74). In the “Hands-on” group, 8 women (2.7 %) experienced a third degree trauma compared with (0.3 %) that in the “Hands-off” method (p = 0.1).

Episiotomy was performed on 38 women (12.7 %) from the “Hands-on” and 17 (5.7 %) women from the “Hands-off” (p = 0.003) groups. In addition, 28 women (9.3 %) from the “Hands-on” group and 47 women (15.7 %) from the “Hands-off” group experienced periurethral tears (p = 0.01) that did not need mending.


Application of the “Hands-off” method for vaginal delivery has a positive effect on the mother’s health because of the reduction of Episiotomy and third degree tearing. Therefore, we conclude that the “Hands-off” method offers a safer alternative for perineal control during labor.


Hands-on Hand off Perineal lacerations 



We thank all the women and midwives who took part in this study and helped us; we would also like to express our gratitude to the head of Imam Ali hospital and the authority of the delivery department. This study was funded by Mazandaran university of medical sciences, Sari, Iran

Conflict of interest

The authors have no conflicts of interest


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Copyright information

© Federation of Obstetric & Gynecological Societies of India 2014

Authors and Affiliations

  • Rozita Rezaei
    • 1
  • Sussan Saatsaz
    • 1
    Email author
  • Yiong Huak Chan
    • 2
  • Hamid Sharif Nia
    • 1
  1. 1.Faculty of Nursing and Midwifery of AmolMazandaran University of Medical SciencesSariIran
  2. 2.Biostatistics Unit, Yong Loo Lin School of MedicineNational University Health SystemSingaporeSingapore

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