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I have often seen a normal head delivery with no lacerations, only to find an extensive tear after the birth of the head, it is my custom to pass two fingers behind the posterior shoulder and allow it to ride out on them during the next pain, thus preventing the shoulder from ploughing through the perineum, which probably has a mucous tear already and is The frequency of tear in breech presentations is largely the result of undue haste; if time is taken and the head kept with its long axis in the proper direction, the number of tears will not greatly exceed the number of tears in head presentations.