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The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second\u2010degree tears among primiparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro\u2010iliac joints, and 3) a two\u2010step head\u2010to\u2010body delivery was compared with standard care. Crude and Adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) were calculated between the intervention and the standard care group, for the various explanatory variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 597 primiparous women participated in the study, 296 in the intervention group and 301 in the standard care group. The prevalence of second\u2010degree tears was lower in the intervention group: [Adj. <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.53 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.33\u20130.84)]. A low prevalence of episiotomy was found in both groups (1.7 and 3.0%). The prevalence of epidural analgesia was 61.1 percent. Despite the high use of epidural analgesia, the midwives in the intervention group managed to use the intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is possible to reduce second\u2010degree tears among primiparous women with the use of a multifaceted midwifery intervention without increasing the prevalence of episiotomy. Furthermore, the intervention is possible to employ in larger maternity wards with midwives caring for women with both low\u2010 and high\u2010risk pregnancies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12267","type":"journal-article","created":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T09:04:56Z","timestamp":1479200696000},"page":"86-94","source":"Crossref","is-referenced-by-count":67,"title":["Midwives\u2019 Management during the Second Stage of Labor in Relation to Second\u2010Degree Tears\u2014An Experimental Study"],"prefix":"10.1111","volume":"44","author":[{"given":"Malin","family":"Edqvist","sequence":"first","affiliation":[{"name":"Institute of Health and Care Sciences The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingegerd","family":"Hildingsson","sequence":"additional","affiliation":[{"name":"Department of Nursing Mid Sweden University Sundsvall Sweden"},{"name":"Department of 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