 The World Health Organization recommends its use either alone or with amniotomy (rupture of the amniotic membrane) but advises that it must be used only after it has been correctly confirmed that labour is not proceeding properly if harm is to be avoided.The WHO does not recommend the use of antispasmodic agents for prevention of delay in labour.Perineal tears can occur during childbirth, most often at the vaginal opening as the baby's head passes through, especially if the baby descends quickly.