3. Primary and secondary outcome measures.

Maternal mortality and morbidity 1. Maternal death 2. Maternal morbidity Perineal or vaginal trauma 2nd, 3rd, or 4th degree perineal tears Obstetric anal sphincter injury Vaginal tears Episiotomy Perineal suturing Postpartum perineal pain Maternal morbidity Febrile morbidity Peripartum infection Wound complication Postpartum haemorrhage Serious maternal morbidity Severe obstetric haemorrhage Uterine rupture Sepsis Obstetric hysterectomy Organ failure Long‐term maternal outcomes Urinary or faecal incontinence Obstetric fistula Utero‐vaginal prolapse Neonatal mortality and morbidity 1. Neonatal death 2. Neonatal morbidity Birth trauma Fractured skull, haematoma, cerebral haemorrhage Fractured clavicle, facial paralysis, brachial plexus injury Scalp injury, facial skin lesions Retinal haemorrhage Perinatal asphyxia Low Apgar score (less than 7) at five minutes Cord blood acidosis Need for major resuscitation (respiratory support, intubation at birth) Hypoxic ischaemic encephalopathy Long‐term infant outcomes Breastfeeding Childhood disability Mother‐infant bonding or separation