This slideshow served as the supporting material for a one-hour breakfast session organized by Caroline Matteo and myself, Laurent Gaucher, on behalf of the National College of Midwives of France (CNSF) for the XXIV FIGO World Congress on Gynecology and Obstetrics. The primary focus of this session was to explore the "Hands-On" and "Hands-Off" approaches in the management of expulsion during childbirth. Two key meta-analyses were presented: the first, a Cochrane review, suggests that "Hands-Off" techniques may reduce episiotomy rates but have no clear impact on other significant outcomes. The second, which includes cohort studies, indicates that the "Hands-On" approach could significantly reduce the risk of Obstetric Anal Sphincter Injuries (OASIS). We also examined data from midwifery-led units in France, noting fewer instances of perineal tears compared to Australia and England. The session was designed to provoke thought and encourage dialogue on these approaches, inviting attendees to share their perspectives and experiences.