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Long-term sequelae of third- and fourth-degree obstetric lacerations can be severe and persistent; thus, prevention should be a major goal of delivery attendants. Because the incidence of obstetric anal sphincter tears rose through the middle of the last decade in Norway, a national preventive strategy was implemented. This approach involves bettering communication between the delivering provider and the patient, lowering rates of elective episiotomies, and improving perineal support during late second-stage labor with techniques that, before the 1980s, were relatively common. Delivering providers underwent a period of practical supervision, and the strategy included a “train-the-trainer” model to ensure sustainability of the program over t…