A normal birth is possible without lateralization, but it presupposes that the perineum is more elastic, the fetus is not too large, the pelvis is wide, the midwife is more experienced, and the midwife does a better job of protecting the perineum. The main key to prevent perineal tear is to assist the fetal head to dip and bend with adequate protection of the perineum, so that the head can pass slowly through the vaginal opening with the smallest diameter between contractions. It is also important that the mother cooperate with the attendant and that the perineum is protected during the delivery of the fetus. In cases where the perineum is too tight or the fetus is too large and it is expected that the perineal tear will be unavoidable during delivery, or in cases where the mother and child have pathological conditions and it is urgent to end the delivery quickly, a lateral perineotomy should be performed.