<prompt> The perineal injury can be prevented in normal labour bya all exceptMaintaining flexion of headTimely episotomy as a routineSlow delivery of the head in between contractionsEffective perineal guard  <response>: An episotomy will increase the risk of tear into external and spinchter or rectum or both. Conversely anterior tears involving urethra and labia are more common in women in whom an episotomy is not cut . So timely episotomy as a routine should not be done and it should be individualised 