In times of rising medico-legal and safety issues and increasing focus by women on their physical wellbeing before and after birth, it is very important to improve medical procedures, diagnosis and therapies in our view. One step is the improvement of birth attendance in order to avoid visible and non-visible birth trauma in women, such as genital tract injuries including obstetric anal sphincter tears (OASIS) and pelvic floor trauma in form the of avulsions of the levator ani muscle (LAM).