In order to prevent from perineal rupture, if is important that the head should be born slowly and in an interval between contractions. Episiotomy,or incision of the perineal body sometimes is necessary.
The shoulders usually follow with the contraction following the birth of the head, the anterior shoulder being delivered before the posterior. The shoulders can cause damage unless they are carefully delivered. After delivery of the shoulders the rest of the body quickly follows, as soon as the child is delivered it is held with its head downwards so that any fluid or mucus in the mouth can run out.