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3% before to 3.0% after care bundle implementation (adjusted odds ratio 0.80, 95% CI 0.65-0.98, P=0.03). There was no evidence that the effect of the care bundle differed according to parity (P=0.77) or mode of birth (P=0.31). There were no significant changes in caesarean section (P=0.19) or episiotomy rates (P=0.16) during the study period. The implementation of this care bundle reduced OASI rates without affecting caesarean section rates or episiotomy use. These findings demonstrate its potential for reducing perineal trauma during c