Good Question! Hmmm, I don't think that there was any excessive force put on my babies that wasn't needed - my last two babies needed help to get out due to mild shoulder dystocia, so my Dr and midwife did need to do a little bit of pushing etc to get them in the right position. For my first two births, it was just a gentle hand on their head so it didn't flop back when it was fully born and just pressure on my perenium to help stop tears.